Chapter 4 Flashcards
An acquired language disorder resulting from damage to the brain.
Aphasia
Aphasia is most often caused by ____ within the ________
Stroke; language-dominant ( usually left) hemispheres
Any etiology that damages the left hemisphere can produce ____
Aphasia
Aphasia is ____ resulting from _____
An acquired language disorder resulting from damage to the brain.
Aphasia is most often caused by stroke within the ______
Most often caused by stroke within the language-dominant (usually left) hemisphere
Aphasia is not the result of ______, _____, or ______.
Aphasia is not the result of motor, intellectual, or psychological impairment.
Aphasia is a deficit in ____, _____ or _____
Aphasia is a deficit in language production, language comprehension or both
Individuals with aphasia can display language deficits in any or all modalities of language which include
- production
- comprehension of spoken
- Reading
- written language
(i.e., reading, writing, speaking, understanding)
Difficulty formulating or producing language to indicate meaning.
Expressive language deficits
Expressive language deficits usually arise from lesions in the ______ portion of the left cerebral hemisphere.
Anterior/frontal
Expressive language deficits is when one has difficulty ____ or _____ language to indicate meaning.
Difficulty formulating or producing language to indicate meaning.
Lesions anywhere in the anterior portion of the left hemisphere are likely to produce some ______ language deficit.
Lesions anywhere in the anterior portion of the left hemisphere are likely to produce some expressive language deficit.
Difficulty deriving meaning from language.
Receptive language deficits
Receptive language deficits usually arise from lesions in the ______ portion of the left hemisphere.
Usually arise from lesions in the posterior/back portion of the left hemisphere.
Receptive language deficits is when one has difficulty ______ from language.
Difficulty deriving meaning from language.
Usually arise from lesions in the posterior/back portion of the left hemisphere.
Receptive language deficits
Signs and symptoms of aphasia include
- Anomia
- Verbal Comprehension deficits
- Paraphasias
- Perseveration
- Agrammatism
- Repetition deficits
- Alexia and Agraphia
Deficit in word finding ability & deficits in expressive language
Anomia
In anomia, one knows the ______ the person wants to ______ but ____ find the _____ to do so.
Knows the meaning the person wants to communicate but cannot find the word or words to do so.
Often can describe in detail and maybe even use hand gestures but cannot find the appropriate word to name the object.
Anomia
Anomia has deficits in ____ & _____
Word finding ability & expressive language
In Anomia, one can often describe in ____ and maybe even use _____ but cannot ____ the _____ _____ to _____ the ____.
Often can describe in detail and maybe even use hand gestures but cannot find the appropriate word to name the object.
Some level of _____ is found in all the aphasias
Some level of anomia is found in all the aphasias
Inability to comprehend the spoken language others produce.
Verbal comprehension deficits
Verbal comprehension deficits refers specifically to _____
Verbal language
Verbal comprehension deficit is the inability to _____ the ______others ____.
Inability to comprehend the spoken language others produce.
Errors in expressive language unrelated to motor deficits but linked to higher language-level deficits associated with aphasia.
Paraphasias
Syllables, words or phrases produced unintentionally by an individual is known as
Paraphasias
Different types of paraphasias:
- Phonemic paraphasias
- Neologism
- Semantic paraphasia
- Unrelated verbal paraphasia
Paraphasias is described as _____, ____, or ____ produced ____ by an individual
Syllables, words or phrases produced unintentionally by an individual
Paraphasias are ____ in expressive language unrelated to ____ but linked to _____ deficits associated with _____.
Errors in expressive language unrelated to motor deficits but linked to higher language-level deficits associated with aphasia.
when the word produced is discernable, yet there are phoneme-level mistakes.
Phonemic paraphasia/literal paraphasia
Example of phonemic Paraphasia is saying ____ instead of ____
Say “Taples” instead of “Staple”
Another word for phonemic paraphasia is
Literal paraphasia
when a person produces a word that is entirely different from the intended word and is mostly unintelligible
Neologism/neologistic paraphasia
An example of neologism is saying ____ instead of ____
Say “dowfler” instead of “pencil”
when one word is substituted for another word that is similar in meaning
Semantic paraphasia
An example of semantic paraphasia is saying ____ for ____
Say “glass” for “cup”
a substitution for a word that is unrelated in meaning to the intended word
Unrelated verbal paraphasia
An example of unrelated verbal paraphasia is saying ___ for ____
Say “lunch” for “bicycle”
Neologism/neologistic paraphasia is when a person produces a word that is ____ _____ from the ____ word and is mostly ____
Neologism/neologistic paraphasia- when a person produces a word that is entirely different from the intended word and is mostly unintelligible
Semantic paraphasia is when one word is _____ for another word that is ____ in ____
Semantic paraphasia- when one word is substituted for another word that is similar in meaning
Unrelated verbal paraphasia is a ____ for a word that is ____ in ____ to the intended word
Unrelated verbal paraphasia-a substitution for a word that is unrelated in meaning to the intended word
Phonemic paraphasia/literal paraphasia is when the word produced is ____, yet there are _____
Phonemic paraphasia/literal paraphasia- when the word produced is discernable, yet there are phoneme-level mistakes.
to do something repeatedly, redundantly, and inappropriately
Perseverate- to do something repeatedly, redundantly, and inappropriately
a word that is said repeatedly and inappropriately
Perseveration- a word that is said repeatedly and inappropriately
when a word produced earlier is repeatedly and inadvertently produced by an individual instead of the intended word
Perseverative paraphasia- when a word produced earlier is repeatedly and inadvertently produced by an individual instead of the intended word
Perseveration is a ___ that is said ___ and ____
Perseveration- a word that is said repeatedly and inappropriately
Perseverate is to do something ____, ____, and ___
Perseverate- to do something repeatedly, redundantly, and inappropriately
Perseverative paraphasia is when a word produced __ is ____ and ____ produced by an individual instead of the intended word
Perseverative paraphasia- when a word produced earlier is repeatedly and inadvertently produced by an individual instead of the intended word
A lack of grammar
Agrammiatism
An example of perseveration paraphasia is when an individual with aphasia correctly names a hammer as a “hammer” but then involuntary continues to produce “hammer” when presented with other items, despite knowing the correct names of the other items
In agrammatism, speech is often referred to as sounding ____, which indicates that ___ words are used, but the words that are used are used with some degree of ___.
Speech is often referred to as sounding telegraphic, which indicates that few words are used, but the words that are used are used with some degree of efficiency.
the words that carry the meaning of a sentence
Content word- the words that carry the meaning of a sentence
the in-between words used to frame the major content words in a sentence.
Function word: the in-between words used to frame the major content words in a sentence.
Content word are the words that ____ the __ of a sentence
Content word- the words that carry the meaning of a sentence
Function word is the ___ words used to ____ the ___ words in a sentence.
Function word- the in-between words used to frame the major content words in a sentence.
Ability to repeat words originates with the ______, the white matter pathways stretching between Broca’s area and Wernicke’s areas.
Repetition deficits arcuate fasciculus
White matter pathways enable a word to be heard and then travel from the posterior portion of the left hemisphere to the anterior portion
Repetition deficits
Lesions along the arcuate fasciculus create ____ by impairing an individuals ability to move the auditory image from the left temporal lobe to the left frontal lobe where the word is selected for expression
repetition deficits
**Just because the person cannot repeat the word, does not mean they cannot understand the meaning of the word they have been asked to repeat.
Acquired reading impairment that has many subtypes
Alexia
Acquired impairment in the ability to form letters or form words using letters
Agraphia
Lesions to the left hemisphere at the angular gyrus often result in _____ and ___
Lesions to the left hemisphere at the angular gyrus often result in alexia and agraphia
Alexia is acquired ____ ___ that has many subtypes
Acquired reading impairment that has many subtypes
Agraphia is acquired impairment in the ability to _____ or ____ ___ using _____
Acquired impairment in the ability to form letters or form words using letters
Lesions to the ____ hemisphere at the ____ ___ often result in alexia and agraphia
Lesions to the left hemisphere at the angular gyrus often result in alexia and agraphia
Related behaviors of aphasia include
Self Repairs
Speech Disfluencies
Struggle in Nonfluent Aphasias
Preserved and Automatic Language
Ability to repeat words originates with the ___ _____, the _____ pathways stretching between ___ and the _____
Ability to repeat words originates with the arcurate fasciculus, the white matter pathways stretching between Broca’s area and Wernicke’s areas.
Enable a word to be heard and then travel from the ____ portion of the ____ hemisphere to the ___ portion
Enable a word to be heard and then travel from the posterior portion of the left hemisphere to the anterior portion
Move the auditory image from the left ____ lobe to the left _____ lobe
Move the auditory image from the left temporal lobe to the left frontal lobe
Occurs when a speaker restates or revises a word or phrase in an attempt to produce it in error-free fashion or refine it to reflect the intended meaning
Self repairs
An acquired language disorder resulting from damage to the brain
Aphasia
Aphasia is known as ____ due to ___ to the brain
Language disorders due to damage to the brain
Modalities of aphasia
Difficultly reading
Difficulty writing
Difficulty speaking
Difficulty understanding
When a person’s brain is damaged, it is rare that only a single deficit ( such as aphasia) arises. True or false
True
Most individuals with aphasia also have deficits in ___ and ___ that can affect ___, __, or ___
Most individuals with aphasia also have deficits in cognition and motor skills that can affect speech, swallowing, or both
The ability to acquire and process knowledge about the world/process though
Cognition
Cognitive deficits always co-occur with aphasia. True or false
False. Cognitive deficits do not always co-occur with aphasia
Most etiologies that result in ___ usually create some collateral damage to _____ _____ as well
Aphasia; cognitive abilities
Cognitive deficits that present concomitantly with aphasia:
-arousal
-attention
-short term memory
-problem solving
-inferencing
-executive functioning skills
Often ___ arise with damage to the ___ because they are responsible for ___ and gross _____ of ___
Often motor skills deficits arise with damage to the frontal lobes because they are responsible for initiating and gross planning of movement
Motor skill deficits include:
Dysarthria
Apraxia of speech
Dysphagia
What is dysphagia
Swallowing disorder; unsafe swallowing
Two types of aphasia classification system
Non fluent aphasia and fluent aphasia
Nonfluent aphasia includes:
-Brocas aphasia
-transcortial motor aphasia
-global aphasia
Fluent aphasia includes:
-wernicke’s aphasia
-transortical sensory aphasia
-conduction aphasia
-anomic aphasia
A nonspecific form of fluent or Nonfluent aphasia that combines attributes of more distinctive forms of such acquired language
Mixed aphasia/ semi fluent aphasia
This type of aphasia patients display usually evolves during their recovery and rehabilitation, so any initial labeling is not static for long
Mixed aphasia/ semi fluent aphasia
Mixed aphasia/ semi fluent aphasia is a ___ form of fluent or Nonfluent aphasia that ____ ___attributes of more ____ forms of such acquired language
A nonspecific form of fluent or nonfluent aphasia that combines attributes of more distinctive forms of such acquired language
What is the purpose of having system of classification?
One purpose of having a system of classification, even if it is an imperfect one, is to have a reference point for professionals to communicate information about patients. Thus enables standardization of knowledge and language among speech-language pathologist and streamlining of communication regarding patients language deficits.
The practice of identifying the location of the pathology in the brain based on the profile of deficits the individual displays , especially when ____ is visible on ___ studies
Lesion localization; especially when no lesion is visible on imaging studies
What is the point of having system classification?
- Reference point for professionals to communicate information about patients
- Streamlining of communication regarding patients language deficits
Cortical aphasias arise as a result of damage to the ____
Cortex, at or near Broca’s area, wernickes area, and the accurate fasciculus
Structures of the cortex include:
Frontal lobe, parietal lobe, temporal lobe, occipital lobe
Subcortical aphasias arise as a result of damage to the ____
Subcortical structures, at or near an area within the basal ganglia known as the stratiocapsular region
___ acquired deficits in language abilities that arise as a result of damage to the cortex
Cortical aphasia
___ aphasias that arise as a result of damage to Subcortical structures
Subcortical aphasia
Cortical aphasia occurs after damage to the cortex, at or near __, ___, and the ___
Broca’s area, wernickes area, and the accurate fasciculus
Subcortical aphasia results from damage to Subcortical structures at or near an area within the ___ known as the ____
Basal ganglia; stratiocapsular region
In cortical aphasia, individuals with Nonfluent aphasia display very ____, ____, and ___ that consists of mainly content words
Very agrammatic, halting, and effortful speech that consists of mainly content words
Cortical aphasia of Nonfluent aphasia include:
-Brocas aphasia
-transocrtical motor aphasias
-global aphasia
In cortical aphasia, individuals with fluent aphasias display ___ though often ___ speech
Fluent though often nonsensical speech
Cortical aphasia of fluent aphasia include:
-Wernickes aphasia
-transcortical sensory aphasia
-conduction aphasias
____ includes agrammatic, halting and effortful speech that consists of mainly content words
Nonfluent aphasia
Nonfluent aphasia includes ____ words per ___ or ___ words per ___
10 words per minute or 50 words per minute
Nonfluent aphasia speak in ___ or ____
Speak in short phrases or single-word utterances
____ are usually very aware of language deficits and are motived to improve expressive language abilities
Nonfluent
Most Nonfluent aphasias exist alongside significant motor deficits contralateral to the site of lesion. True or false
True
Nonfluent aphasia are usually very aware of ____ and are motivated to improve ____ abilities
Language deficits; expressive language abilities
Hemiparesis is ____or the ____ to move on one side of the body, making it hard to perform everyday activities
Hemiparesis- weakness or the inability to move on one side of the body, making it hard to perform everyday activities
Hemiparalysis/hemiplegia- _____ to one side of the body
Hemiparalysis/hemiplegia- paralysis to one side of the body
Another word for Hemiparalysis
hemiplegia
paralysis to one side of the body
Hemiparalysis/hemiplegia- paralysis to one side of the body
weakness or the inability to move on one side of the body, making it hard to perform everyday activities
Hemiparesis- weakness or the inability to move on one side of the body, making it hard to perform everyday activities
Damage to the inferior posterior frontal lobe of the left hemisphere extending deep into the white matter.
Brocas aphasias
Brocas aphasias occurs when there is Damage to the ______ of the ______ hemisphere extending deep into the ____
Damage to the inferior posterior frontal lobe of the left hemisphere extending deep into the white matter.
____ is located just anterior to the fissure of Rolando
Prerolandic- located just anterior to the fissure of Rolando
___ just above the sylvian fissure
Suprasylvian- just above the sylvian fissure
Suprasylvian- just ____ the _____
Suprasylvian- just above the sylvian fissure
Prerolandic- located just ____ to the ___
Prerolandic- located just anterior to the fissure of Rolando
Broca’s area is ____, ____ and receives vascular supply from the middle cerebral artery
Prerolandic and suprasylvian
Broca’s area receives ____ from the ___
Receives vascular supply from the middle cerebral artery.
Brocas aphasia includes ___, ___, ____ and often ___ speech
Halting, effortful, agrammatic and often telegraphic speech
Those with Brocas aphasia have Extreme difficulty producing ______ correct ____ language
Extreme difficulty producing grammatically correct expressive language
____ Speech consists largely of content words
Brocas aphasia
Brocas aphasias use Unsuccessful attempts to self-repair speech errors also contribute to the disfluency
. True or false
True
Brocas aphasia includes:
-Written language mirrors their verbal output.
-Written language is usually further hindered by hemiplegia or hemiparesis contralateral to the lesion.
-Functionally/grossly intact receptive language!
-Usually respond to simple questions using limited speech or body language.
-Higher-level receptive language deficits are often present
-Deficits in reading mirror receptive language deficits.
-Cannot repeat phrases or even single words
Transcortical motor aphasia has __ primary locations of damage
2 primary locations of damage
2 primary locations of damage of transcortical motor aphasias are:
2 primary locations of damage: supplementary motor cortex and the area just anterior to Broca’s area
Transcortical motor aphasia Lesions result from occlusion of _____ to the ____ in the ___ hemisphere.
Lesions result from occlusion of branches anterior to the cerebral artery in the left hemisphere.
Transcortical motor aphasias have very ___ speech and likely ___
Very disfluent speech and likely anomia.
Transcortical motor aphasia includes:
-Writing mirrors their verbal output.
-Functionally/grossly intact receptive language!
-Hallmark characteristic: preserved repetition abilities
Despite deficits in expressive language, individuals with Brocas aphasia display functionally/grossly intact ___
Receptive language
____- receptive language deficits are often present in Brocas aphasia
Higher-level receptive language deficits are often present
Despite having mostly intact receptive language abilities, those with Brocas aphasia cannot ____ or even ___
Cannot repeat phrases or even single words.
Patient with Brocas aphasia are able to understand most of the everyday conversation around them. True or false
True
In Brocas aphasia, written language ___ their __
Written language mirrors their verbal output.
Brocas aphasia includes deficits in reading usually mirror receptive language deficits. True or false
True
Brocas aphasia usually respond to ___ using ___ or ___
Usually respond to simple questions using limited speech or body language.
In Brocas aphasia, the Written language is usually further hindered by ___ or _____ contralateral to the lesion.
Written language is usually further hindered by hemiplegia or hemiparesis contralateral to the lesion.
The hallmark characteristic of transcortical motor aphasia that differentiates it from Brocas aphasia is ____
Preserved repetition abilities
As in Brocas aphasias, written language in transcortical motor aphasia often __ ___ ___
Writing mirrors their verbal output.
Individuals with transcortical motor aphasia are very good ___ despite their expressive language deficits
Communicators
Those with transcortical motor aphasia display intact ___
Receptive language abilities
Damage to and loss of the zone of language.
Global aphasia
___ involves all of Broca’s area and Wernicke’s area, as well as the arcurate fasciculus
Zone of language
The most severe form of aphasia is ___
Global aphasia
Global aphasia involves occlusion of a ____ of the ___
Occlusion of a primary branch of the left middle cerebral artery
___ is the worst prognosis for recovery
Global aphasia
Zone of language includes all of ____ and ___, as well as the ___
Zone of language- all of Broca’s area and Wernicke’s area, as well as the arcurate fasciculus
Global aphasia involves little to no ____ or ___
Little to no receptive or expressive language ability.
Global aphasia individuals are unable to comprehend the ____
Unable to comprehend the shortest spoken utterances.
Global aphasia Might be unable to produce even a ___
Might be unable to produce even a single word verbally.
Global aphasia patients Might retain ability to produce ______ ___ and _____ them endlessly or produce them in ____ to every question.
Might retain ability to produce 1 or 2 neologisms and repeat them endlessly or produce them in response to every question.
____ Present with most if not all concomitant cognitive and motor deficits.
Global aphasia
global aphasia patients are difficult to
Difficult to arouse.
Global aphasia patients usually have ___, ___, ____-, ____, ____ and ___ problems
Usually have hemiplegia contralaterally, severe dysarthria, buccofaccial oral apraxia, apraxia of speech, swallowing and mastication problems.
___ is fluent though often nonsensical speech.
Fluent aphasia
Fluent aphasia Usually have ___ motor deficits.
Usually have no gross motor deficits.
Wernickes aphasia occurs from Damage to the ____ of the ____ of the _____ lobe of the ____ hemisphere
Damage to the posterior one-third of the superior gyrus of the temporal lobe of the left hemisphere
Lesions often result from an occlusion in the inferior/posterior branches of the middle cerebral artery
Wernickes aphasia
Lesion more posteriorly toward the angular gyrus and into the visual association cortex of the occipital lobe, the more likely reading deficits are present resulting from impaired ability to process visual information.
Wernickes aphasia
Wernickes aphasia lesions often result from an occlusion in the ___ branches of the ____
Lesions often result from an occlusion in the inferior/posterior branches of the middle cerebral artery
___ involve Significant receptive language deficits
Wernickes aphasia
Wernickes aphasia consists of impaired ___
Repetition
____Usually unable to recognize their deficits (neurological deficit).
Anosognosia- Usually unable to recognize their deficits (neurological deficit).
Wernickes aphasia are very ___
Very fluent speakers
In wernickes aphasia, the expressive language is heavily composed of ___ and ___ as to be indecipherable
Expressive language is heavily composed of neologisms and paraphasias as to be indecipherable.
Significant receptive language deficits and
Impaired repetition
Wernickes aphasia
Wernickes aphasia consists of loss of ____
Loss of verbal pragmatic skills
In wernickes aphasia, Conversational turn-taking becomes notoriously ___ for them.
Conversational turn-taking becomes notoriously difficult for them.
____ -nonstop output of speech
Logorrhea- nonstop output of speech
___ is also known as “empty speech”
Logorrhea
___ involves anosognosia and logorrhea
Wernickes aphasia
Lesions occur posteriorly to Wernicke’s area at the temporo-occipital-parietal junction.
Transcortical sensory aphasia
Transcortical sensory aphasia
Poor auditory comprehension
Relatively intact repetition
Fluent speech with semantic paraphasias
Intact repetition abilities usually distinguish Transcortical sensory aphasia from Wernicke’s aphasia.
Transcortical sensory aphasia
Visual deficits are often present due to lesion within the visual/occipital association area.
Transcortical sensory aphasia
Lesion is on the supramarginal gyrus of the parietal lobe, posterior to the primary sensory cortex and just above Wernicke’s area.
Conduction aphasia
Fluent speech
Relatively intact auditory comprehension
Significant deficits in repetition
Phonemic paraphasias
Anomia
Conduction aphasia
May not be able to repeat they can paraphrase the meaning of the language heard because of intact auditory comprehension and expression.
Conduction aphasia
Disproportionate severity relative to other deficits present or even in isolation.
Anomia aphasia
Anomia can be produced by damage _____ within the ____ of the brain.
Anomia can be produced by damage anywhere within the language areas of the brain.
Fluent speech
Intact receptive language
Significant difficulty in naming
Anomia aphasia
Aphasia as the result of damage to the thalamus and damage to parts of the basal ganglia.
Subcortical aphasia
2types of subcortical aphasias
Thalami’s aphasia
Striatocapsulsar aphasia
Ischemic stroke within the left or dominant side of the thalamus
Thalamus aphasia
Thalamus aphasia characteristics
Fluent speech
Significant anomia in spontaneous speech
Less anomia in confrontational naming tasks
Normal articulation
Thalamus aphasia characterized by
Hypophonic voice
Intact repetition
Intact grammar
Speech output if reduced and only semifluent.
Ischemic stroke within the part of the basal ganglia known as the striatum.
Striatocapsular aphasia
Striatocapscular aphasia
Loss of fluency
Rare phonemic paraphasias
Preserved repetition
Mild anomia
Infarcts that damage the striatum can at times also disrupt blood flow to the primary language cortices enough to create a profile, but not enough to demonstrate immediate cell death that shows up on neuroimaging studies used in the hospitals.
Striatocapsular aphasia
