Chapter 7 Flashcards
Describes the types of communication deficits seen in people who have sustained damage to the brain in one way or another.
Neurological Impairments
Related to linguistic programming, speech motor programming, and the production of expressive speech and language.
Broca’s Area
Primarily responsbile for the comprehension of speech and language and the formulation of language concepts.
Wernicke’s Area
Language that is formulated in Wernicke’s Area is transmitted (via the arcuate fasciculus) to…
Broca’s Area for speech to be programmed and transmitted to the muscles for speech.
The loss of the ability to comprehend or formulate language typically associated with neurological damage.
Aphasia
A disorder that results from damage to the parts of the brain that contain language
Aphasia
Causes problems with any or all of the following: speaking, listening, reading, and writing
Aphasia
What causes damage to the brain that results in Aphasia?
Typically caused by a stroke (Cerebrovascular Accident CVA)
What causes strokes?
- blockage in a blood vessel supplying blood to brain (ischemic)
- Or bleeding in or around the brain (hemorrhagic)
Says, “A disturbance of one or more aspects of language comprehension, one or more aspects of language form and expression. The disturbance is caused by newly acquired disease of the CNS.”
Damasio (1981)
Types of Strokes (CVA)
- Ischemic
2. Hemorrhagic
Blockage in the artery that supplies blood (oxygen) to the brain.
Ischemic Stroke
“Gradual blockage”
Thrombosis
“Clot gets lodged in artery causing blockage”
Embolism
A bleed in the brain caused by an aneurysm
Hemorrhagic Stroke
A bubble in the artery. Over time it gets weak and bursts
Aneurysm
Difficult with retrieving and producing words
Anomia
Sound and word substitutions that are often found in the speech of aphasic patients whose speech and language is fluent
Paraphasias
Words made up by patients with aphasia. They use them as though everyone understands them
Neologisms
Using normal intonation, prosody, and fluent speech and language while stringing together a series of meaningless words that don’t make sense to the listener.
Jargon
Deficit where articles, conjunctions, and grammatical morphemes might be left out. Effortful; short sentences tend to leave in nouns and/or verbs
Agrammatism
Leaving out most nouns and verbs, leaving in only non-content words.
Paragrammatism
Unintentional repetition of a word, sound or movement.
Perseveration
- Varies in severity
- Depends on extend and location of damage
- Damage associated with Wernicke’s Area and surrounding tissue
- Perhaps like hearing another language
Deficits of Comprehension associated with Aphasia
May be able to understand simple conversation, but not complex
Aphasia
May be able to follow simple commands, but nothing more
Aphasia
Verbal anosia- “pure word deafness”- unable to comprehend any verbal language
Aphasia
Difficulty identifying sensory information.
Agnosias
Client is able to perceive the sensation, but unable to interpret what is it
Agnosias
Can be evident in all senses: visual, tactile, auditory, taste, and smell
Agnosias
Able to read words, but can’t explain, doesn’t know what they have read.
Visual Agnosias
Patient can read fluently, but has no idea what the word means
Visual Agnosias
Deficits in Reading and Writing associated with Aphasia (2)
- Agraphia
2. Alexia
Inability to write, not due to weakness, but related to inability to connect the language areas of the brain with the areas that control the ability to write words
Agraphia
Problems associated with reading
Alexia
Both deficits exist on a continuum ranging from no ability to mildly impaired
Agraphia and Alexia
Classification of Aphasia types (3):
- Expressive/receptive
- Fluent/non-fluent
- Boston Classification System
Boston Classification System (8 but only 4 important)
- Broca’s Aphasia
- Wernicke’s Aphasia
- Global Aphasia
- Anomic Aphasia
Broca’s Aphasia: What area of the brain is damaged?
Anterior part. usually anterior to the lower portion of the motor area (Broca’s Area)
Broca’s Aphasia: Is the deficit primary expressive or receptive?
Expressive
- Difficult producing grammatical sentences; mostly nouns verbs, adjectives
- Difficult naming objects
- Difficult with oral reading and reading comprehension
characteristics of Broca’s Aphasia
Wernicke’s Area: What area of the brain is damaged?
Upper portion of the temporal lobe (Wernicke’s Area)
Wernicke’s Area: Is the deficit primary expressive or receptive?
Receptive
- Fluent sounding speech, but makes no sense (jargon)
- Lots of paraphasia and neologisms
- Significant comprehension problems
characteristics of Wernicke’s Aphasia
Global Aphasia: What area of the brain is damaged?
Both Broca’s area and Wernicke’s area and connections between the two
Global Aphasia: Is the deficit primary expressive or receptive?
Both expressive and receptive
- Stereotypical expressions in response to any question
- Jargon
- Preservations
characteristics of Global Aphasia
Anomic Aphasia: What area of the brain is damaged?
Outside of the language zone. Varies from person to person
Anomic Aphasia: Is the deficit primary expressive or receptive?
Expressive
- Word finding deficits
2. Paraphasias
characteristics of Anomic Aphasia
Left hemisphere intact= therefore intact language, but still have poor communication
Right Hemisphere Disorder
Primary deficits of Right Hemisphere Disorder (3)
- Communication
- Attention/perception
- Cognition
A sudden trauma to the head or the piercing of the skull by a foreign object results in a traumatic (sudden and severe) brain injury.
Traumatic Brain Injury
Trauma is extremely induced
Traumatic Brain Injury
Also called head injury or brain injury
Traumatic Brain Injury
Injuries range from mild to severe (meaning extent of damage to the brain)
Traumatic Brain Injury
Symptoms range from mild to severe (impact on life)
Traumatic Brain Injury
- MVA
- Falls
- Sporting accidents
- Occupational injuries
- Violent crimes
- Abuse
- Suicide attempts
- Military actions
Causes of Traumatic Brain Injury
TBI
Traumatic Brain Injury
Males have it 2-3 times more
TBI
Ages 15-24
TBI
Ages 75-older
TBI
Those in urban areas
TBI
Lower socioeconomic status
TBI
May though October
TBI
Types of injuries that produce close head injury (2)
- Acceleration/deceleration
2. Nonacceleration
Damage occurs at the site of impact
Coup
A secondary injury occurs in the opposite direction
Contracoup
a brain injury in which damage in the form of extensive lesions in white matter tracts occurs over a widespread area.
Diffuse Axonal Shearing
A concussion is a…
mild TBI
An impairment of short and long term memory with related changed in abstract thinking, judgement, and personality that causes significant and occupational impairment
Dementia
What are the chronic disorders of the brain that lead to dementia? (4)
- Alzheimer’s Disease
- Pick’s Disease
- Multiple Strokes
- Other brain disorders such as TBI
Motor Speech Disorders: (2)
- Dysarthria
2. Apraxia
Results from paralysis, weakness, or incoordination of the speech musculature that is a neurological origin
Dysarthria
Symptoms of Dysarthria:
Vary, depending on the type and location of damage to the nervous system
Damage to muscles controlling respiration, phonation, articulation. Causes weakness or paralysis
Dysarthria
Dysarthria speech can be:
- Slurred, slower rate due to weak muscles
- Frequent rapid, uncontrolled movements and stiffness of muscles
- Mixed symptoms
Difficult or inability to produce learned speech movements.
Apraxia of Speech
- Difficult initiating speech and voice
- Inconsistent sound errors
- Hesitant, interrupted, not fluent speech
- Impairment increases as word length increases
Characteristics of Apraxia of Speech
May be able to purse lips and whistle at will
Apraxia of Speech
Unable to correctly achieve lip movement for /w/ in word water
Apraxia of Speech
