Chapters 1 & 3 Flashcards
What is a neurogenic communication disorder?
A disturbance of problem with communication arising from damage to the nervous system
The nervous system consists of the ____ & the _____
Central nervous system & peripheral nervous system
The central nervous system (CNS) consists of:
The brain & spinal cord
The peripheral nervous system (PNS) consists of:
The cranial nerves, spinal nerves, and peripheral nerves
Some neurogenic communication disorders include:
Aphasias, dysarthrias, apraxia of speech, right hemisphere disorders, dementia
Four treatment environments include the following: (1)
- Skilled nursing facility
- Acute care facility
- Rehabilitation facility
- Outpatient rehabilitation facility
Four treatment environments include the following: (2)
- Home health care
- Hospice care
- Children’s hospital
- Schools
The three key areas involved in neurogenic disorders are
Cognition, language, and speech
____ is the ability to acquire and process knowledge about the world/ process thought
Cognition
Cognition is the ability to ____ and ____ about the world/ process thought
Acquire and process knowledge
Why is cognition so important?
Many cognitive processes underlie and support appropriate and effective communication
A lack of cognitive abilities undermines the _____
Ability to communicate effectively
Why is cognition so important?
If the patient can’t remember what the SLP just said, then the patient will not be able to response appropriate.
The role, as a SLP, is to—
Identify and treat deficits in cognition that contribute to disordered communication
The 13 types of cognition include:
- Arousal
- Orienting
- Attention
- Working memory
- Short-term memory
- Long-term memory
- Procedural memory
- Declarative memory
- Episodic memory
- Orientation
- Problem solving
- Inferencing
- Executive functions
Arousal is the level _____ and the ability to___ to stimuli
Wakefulness; respond
An example of arousal is—
Glasgow Coma Scale
The level of wakefulness and the ability to respond to stimuli is known as _____
Arousal
The ability to direct attention towards a stimulus
Orienting
Hierarchy order of treatment of attention:
Vigilance
Sustained attention
Selective attention
Alternating attention
Divided attention
The ability to stay alert to the occurrence of a possible stimulus
Vigilance
Sustained attention is the ability to ____ on a _____ stimulus
The ability to hold attention on a single stimulus
The ability to hold attention on a stimulus while ignoring the presence of competing stimuli
Selective attention
The ability to alternate one’s attention back and forth from one stimulus to another
Alternating attention
Divided attention is the ability to attend to _____
The ability to attend to one stimulus while simultaneously attending to another stimulus
Another word for divided attention is—
Multitasking
The ability to hold a finite amount of information for immediate processing and manipulating
Working memory
According to Baddeley (1986) model, on working memory:
- Phonological loop responsible for retention and processing of speech and language
- Visuospatial sketch pad for retaining visual information for active processing. Example: location of a parked car
An example of working memory is
Holding onto directions until you reach the destination
Short-term memory is the ability to store _______ in one’s memory in a ______ state for a period of a few seconds or minutes, a few hours or days
Information; readily accessible
Short term memory involves a ___ storage capacity
Limited storage capacity
An example of short term memory is
What you had for lunch/breakfast
Storing information in a readily accessible way
Short term memory
Ability to store information in one’s memory for months or years
Long term memory
Long term memory involves functionally ____ capacity for information
Functionally unlimited capacity for information
The memory of sequences of action used to complete task
Procedural memory
Procedural memory uses “_____” memory
“How to” memory
In procedural memory, much is ____ and deployed in ____ function
Much is overlearned and deployed in automatic function
The ability to remember facts
Declarative memory
In episodic memory, you must ___ specific ___
Recall of specific, recently experienced events (or episodes)
An example of episodic memory is remembering -
A vacation
Knowledge of oneself, and of her place and space in time
Orientation
Some questions involved in orientation are—
Who am i?
Where am i?
When am i?
Ability to find an appropriate solution to a problem
Problem solving
Problem solving involves the ability to _____ to solve a problem, ___ the strategy and ____ the results
Ability to pick a strategy to solve a problem, apply the strategy and evaluate the results
Given details, the ability to make a leap in judgement to a correct interpretation of the overall meaning of the details
Inferencing
Executive functions involves ____ cognitive systems that employ and manage other ones
High level cognitive systems that employ and manage other ones
The ability to plan a sequence of actions to achieve a goal, the ability to maintain behaviors meant to accomplish goals, ability to monitor a situation and modify behavior accordingly
Executive functions
Executive functions uses cognitive functions such as ____, ____, ____, _____, _____, ______ behaviors to meet high-level goals
Attention, memory, planning, problem solving, initiating, and organizational behaviors
Executive functions are housed in _____ area of the ____ lobes
Housed in prefrontal areas of the frontal lobes
Language is defined as a set of ____ used to _____ meaning
A set of symbols used to communicate meaning
Language is defined as a set of symbols used to communicate meaning.
Symbols include:
- Written language
- Verbal as in spoken language
- Manual as in sign language
- expressive and receptive abilities
What are the two types of language
Expressive and receptive
Words people assign to ideas to express the meaning of their thoughts
Expressive language
The ability to understand language is known as —
Receptive language
An example of expressive language is
Verbal or written
An example of receptive language is —-
Understand spoken and written language
Speech is defined as ___ made by the ____ and ____ structures of the body to create verbal language
Speech is defined as sounds made by the vocal and articulatory structures of the body to create verbal language
Verbal production of language is known as
Speech
What does etiology mean?
Underlying cause of a symptom or deficit
Neurogenic communication disorders vary greatly in their etiology. True or false
True
Results from a systemic breakdown or destruction of structures within the peripheral or central nervous system
Degenerative disorders and diseases
____ ethnologies include sudden or traumatic events
Acute ethnologies
Acute ethnologies include sudden or traumatic events, such as:
Traumatic brain injury
Seizures
Tumor
Surgical trauma
Infection
Stroke
____ diseases can also produce deficits in speech, cognition and language
Infectious diseases
How the damage to the nervous system manifests in deficits in communication, cognition and behavior is determined by:
- The site of the damage
- And the severity of the damage
Means to be of an unknown origin
Idiopathic etiology
___ is the 3rd leading cause of death in the United States, behind heart diseases and cancer
Stroke/ cerebrovascular accident
Stoke/ cerebrovascular accident is the leading cause of_____ and _____disability
Leading cause of hospital admission and long-term disability
It is estimated that every ___ someone in the US has a stroke
40 seconds
It is estimated that every ____ someone dies of a stroke
4 minutes
Studies have shown more ____ die of stroke than ____
Studies show more women die of stroke than men
A stroke is an ____ to blood flow to a part of the brain by a ____ or _____
An interruption to blood flow to a part of the brain by a clot or hemorrhage
Another word for stroke is
Cerebrovascular accident (CVA)
A stroke is when brain tissue is permanently destroyed ceases to function due to increase blood supply to the affected area. True or false
False A stroke is when brain tissue is either permanently destroyed or temporarily ceases to function due to decreased or absent blood supply to the affected area
A stoke can produce damage to only one area of the brain. True or false
False. A stroke can produce damage to any area of the brain or brain stem
Stroke is often referred to as a cerebrovascular accident or CVA. True or false
True
During a stroke, brain tissue can either be ____ or _____
Permanently destroyed or temporarily ceases to function
When brain tissue is permanently destroyed, the body:
- Reabsorbs the dead cells
- An empty space is left on the cortex or within the brain where the tissue once was
Damage to brain tissue is from the loss of ____ resulting from a lack of blood supply
Loss of oxygen supply
Partial loss of oxygen supply to the brain tissue
HYPOXIA
Complete lack of oxygen supply to the brain tissue
ANOXIA
Typically the brain can go ____ without oxygen before _____ begins to cause permanent cell death within the brain
6-8 minutes; anoxia
Hypoxia is ____ loss of oxygen supply to the brain tissue
Partial loss of oxygen to the brain tissue
Anoxia is the ____ loss of oxygen supply to the brain tissue
Complete loss of oxygen supply to the brain tissue
The two main forms of stroke
Ischemic stroke and hemorrhagic stroke
Blood clot blocks blood flow to part of the brain is known as
Ischemic stroke
Artery ruptures, causing bleeding around the brain is know as
Hemorrhagic stroke
The term ischemia means ___ or ___ in a blood vessel
Term ischemia means blockage or restriction in a blood vessel
___ occurs when a blood vessel supplying blood flow to the brain becomes occluded.
Ischemic stroke
Ischemic stoke ____ brain tissue of the blood supply necessary for ____ of the tissue
Deprives brain tissue of the blood supply necessary for survival of the tissue
The three forms of ischemic stroke are:
- Thrombotic stroke
- Embolic stroke
- Transient ischemic attack
___ is occlusion that forms slowly in an artery
Thrombus
Thrombotic stroke occurs when a ____ blood flow to the brain
Thrombotic stroke occurs when a thrombus interrupts blood flow to the brain
Thrombotic stroke is usually the result of ____
Atherosclerosis
A condition in which a person has a buildup of fatty materials such as cholesterol in the blood; it accumulates over time on the walls of the arteries, narrowing them and eventually restricting blood flow
Atherosclerosis
Thrombus is an ___ that forms slowly in an ____
Occlusion that forms slowly in an artery
Atherosclerosis is a condition in which a person has a buildup of ___ materials such as cholesterol in the blood.
Fatty
In atherosclerosis, fatty materials buildup in the blood. It accumulates over time on the ____ of the arteries, _____ them and eventually ____ blood flow
It accumulates over time on the wall of the arteries, narrowing them and eventually restricting blood flow
___ is a mass, such as a blood clot that originates in the body and travels through the vascular system
Embolus
Embolic stroke occurs when an embolus, formed ______, travels to the _____ and lodges in a blood vessel, restricting or cutting off blood circulation within the brain
Formed elsewhere in the body, travels to the brain
A piece of thrombus can become an embolus. True or false
True
When a piece of thrombus becomes an embolus, it is known as —
Thromboembolus
Thromboembolus occurs when a _____ breaks off an atrial wall and ____ in the brain to _____ an occlusion within the blood vessel
A piece of thrombus breaks off an arterial wall and travels elsewhere in the brain to lodge and create an occlusion within the blood vessel
A mini stoke or in the medical community known as a TIA
Transient Ischemic Attack
A small ischemia within the brain that resolves within ____
24 hours
Person can present with mild motor or cognitive deficits that goes away when blood clot causing the ischemia is broken down and resolves the occlusion. True or false
True
Usually TIA ___(does or doesn’t) cause permanent deficits or life-threatening health issues
Does not
Usually TIA are usually warning signs of a larger, more ____ to come
Destructive stroke
Location of the focal damage within the brain following ischemia; dead tissue; dies within 1 hour of ischemia
Ischemia core
Death of cells within the core is irreversible
Tissue necrosis
Tissue that still receives enough collateral blood supply to stay alive; can often be salvaged with prompt medical care
Ischemic prenumbra
Saving the prenumbra improves the ____ and ____ prognosis of the patient
Short term & long term
Damage within the prenumbra can typically be ___ within ______ of onset of ischemia
Reversed; 2-4 hours
When a blood vessel within the brain ruptures
Hemorrhagic stroke
____ percent of strokes are hemorrhagic
13%
Most significant factor associated with hemorrhagic stroke is ___ also known as ____
High blood pressure; hypertension
Hemorrhagic stokes usually occur with individuals with high blood pressure during periods of ____
High physical activity
Hemorrhagic stroke typically requires _____ to repair the broken blood vessel and stop the bleeding
Immediate surgery
Hemorrhagic stoke have a ____ chance of survival than those with ischemic stroke
Less chance of survival
Individuals who survive hemorrhagic stroke have fewer enduring deficits than those who experimented ischemic strokes. True or false
True
The 2 primary kinds of hemorrhagic stroke are
- Subarachnoid hemorrhage
- Intracerebral hemorrhage
Bleed that occurs between the arachnoid matter and the pia matter, which overlay and protect the cerebrum
Subarachnoid
When a blood vessel bursts within the brain itself and the blood pours out into the brain tissue where it does not belong, which damages tissue and increases intracranial pressure, which makes it increasingly difficult for the heart to pump blood to the brain and can quickly lead to death if not treated.
Intracerebral stroke
During Intracerebral stoke, the brain tissue is damaged, which causes ______, making it difficult for the heart to pump blood to the brain
Intracranial pressure to increase
Some symptoms of Intracerebral stoke include
- sudden and very severe headache and vomiting
- clap of thunder headaches
- more sudden and definite
An abnormal stretching and ballooning of the wall of a blood vessel
Aneurysm
An aneurysm results from ___ or ____ that weaken the wall of the artery
Disease or hereditary factors
Aneurysm is the abnormal ____ and ____ of the wall of a blood vessel
Stretching and ballooning
____ and ____ can also contribute to placing above normal pressure on artery walls
Hypertension and atherosclerosis
Some symptoms of cerebral aneurysm include:
- Severe headache
- Nausea
- Vomiting
- Blurred vision or sensitivity to light
- Seizures
- Loss of consciousness
There may or may not be any symptoms until aneurysm ruptures. True or false
True
Once an aneurysm ruptures, it becomes a ___ stoke
Hemorrhagic
Aneurysms of the brain often occur within the ____
Circle of Willis
Aneurysms of the brain tend to be deadly. True or false
True
Most patients who survive an aneurysm, will have some form of _____
Permanent disability
___ is when serious life-threatening damage to the brain occurs as the result of an external or forceful event
TBI- Traumatic Brain Injury
Some usual causes of Traumatic Brain Injury are:
Falls
Motor vehicle traffic accidents
Being struck by an object
Violent assaults
Impact from TBI can be from a mild concussion to coma or vegetative state or death. True or false
True
_____ individuals experience a TBI each year in the U.S.A
1.4 million
Deficits of TBI in language and cognition are:
Many, complex and varied depending on which areas a of the PNS and CNS were damaged and to what extent
SLPs treat individuals with TBI by focusing on
speech, language, cognition and swallowing disorders
SLPs work with TBI individuals right after their ____ to when they _____ (e.g., home, work, school)
Work with individuals right after their admittance to the hospital to when they begin returning to their previous life (e.g., home, work, school)
In TBI, for children, rehabilitation hopefully culminates at release from hospital. True or false
True
TBI is very common in children ages _____ and under
4 years
depressants, meaning they work by depressing or lowering the function of the CNS.
Opioids
OxyContin is considered ____
An opioid
Opioids are ____, they work by depressing or lowering the function of the ____
Depressants; CNS
Name three types of opioids
OxyContin
Heroin
Synthetic opioids
What are synthetic opioids
Mixed with heroin to increase potency:
1. Fentanyl
2. Carfenttanyl
fentanyl is ___ more potent than heroin
50-100 times
Carfenttanyl is ___ times more potent than heroin and ___ times more potent than fentanyl
10,000 times heroin and 100 times more potent than fentanyl
Overdosed and lost consciousness -> continued ___ of the CNS -> decreases ___ > respiratory center of the CNS in the brain stem is ____ > the body ____or itself
Overdosed and lost consciousness -> continued depressing of the CNS -> decreases automatic function > respiratory center of the CNS in the brain stem is inhibited > the body stops breathing for itself
Overall, overdoes and lost consciousness can lead to
The body to stop breathing for itself
_____ overdose can take hours to shut down the respiratory system
Heroin overdose can take hours to shut down the respiratory system
Fentanyl can be instantaneous with users collapsing with the needle still in their arm. True or false
True
Time spent not breathing deprives the brain of oxygen, which brain tissue needs to survive. True or false
True
Brain injury can result from ___ brain injury or ____ brain injury.
Brain injury can result from hypoxic brain injury or anoxic brain injury.
Deprive the entire brain!
Nonlocalized
In addition to hypoxic or anoxic brain injury, if an individual survives an overdose, he/she might also have ____
In addition to hypoxic or anoxic brain injury, if an individual survives an overdose, he/she might also have Toxic Brain Injury.
Damage to the brain from high levels of poisonous substances in the body
Toxic Brain Injury
Common causes of Toxic Brain Injury included
overdose & carbon monoxide poisoning
Deficits from hypoxic/anoxic and toxic brain injury include
Visuomotor (fine motor) skills
Visual attention
Executive Function
Working memory
Impulsivity
Decision making
Dassanayake and colleagues (2012) found patients who clinically recovered from drug overdose displayed ___ on all cognitive domains tested.
Cognitive impairments
Abnormal growth of cells in the brain
Brain tumor
tumor that originates in the brain and that has not spread from elsewhere
Primary tumor
is a cancerous tumor that has spread from another part of the body to the brain, will need biopsy, surgery and/or radiation
Secondary or metastic tumor
Malignant brain tumor is
Brain cancer
cannot spread to other parts of the body is known as
enign brain tumor- cannot spread to other parts of the body
when a tumor displaces or crushes areas of the brain, possibly causing symptoms
Mass effect
Deficits produced by a tumor depend on the area of the brain the tumor affects and to what degree. True or false
True
Symptoms of a tumor occur and worsen gradually over longer periods of time as the tumor grows. True or false
True
collateral damage to the delicate tissues of the brain that occurs during the process of achieving the objective of the surgery.
Surgical trauma
Surgical trauma is often performed to remove a ___ or repair a ____
Often performed to remove a tumor or repair a hemorrhagic stroke.
After surgical trauma, an SLP will focus on -
Speech, language, cognition, speech or swallowing
Manage secondary risks of brain damage:
- Seizures
- Additional cerebrovascular accidents
- Acquired infections
- Increased intracranial pressure
Infections can damage the __ and ____, or both
Infections can damage the CNS and PNS, or both
Infections include the following:
Viral, fungal, bacterial, parasitic
Encephalitis
HIV/Aids
Creutzfeldt-Jacob Disease
Syphilis
Poliomyelitis
An acute infection or inflammation of the brain or spinal cord caused by viral or bacterial infection to the brain.
Encephalitis
Symptoms of encephalitis include
headaches, fevers, confusion, and seizures, which often reflect the type and location of the infection.
fast moving characterized by T cells of the immune system attacking and causing inflammation in either the right or left hemisphere.
Rasmussen’s encephalitis
Presenting symptom of Rasmussen’s encephalitis is ____ that creates unilateral tremor in an extremity contralateral to the affected cerebral hemisphere.
Presenting symptom is seizure activity that creates unilateral tremor in an extremity contralateral to the affected cerebral hemisphere.
Rasmussen’s encephalitis is the fast moving characterized by ____ of the immune system attacking and causing ___ in either the right or left hemisphere
fast moving characterized by T cells of the immune system attacking and causing inflammation in either the right or left hemisphere.
HIV is the virus that leads to ___
HIV is the virus that leads to AIDS (acquired immune deficiency syndrome)
Most common neurocognitive changes seen in AIDS are as follows:
- Inability to learn new information
- loss of gross and fine motor abilities
- gait disturbances, reduced attention abilities
- slowness in processing information
- disfluent speech, and impaired recall
Degenerative and fatal brain disease, which has genetic and infectious etiologies
Creutzfeldt- Jacob Disease
small infectious protein with its own genetic coding
Prion
involuntary rapid twitching of a muscle or group of muscles
Myoclonus
Most cases are produced by a type of infectious pathogen known as a prion
Creutzfeldt- Jakob Disease
Creutzfeldt- Jakob Disease
Attacks the central nervous system
Has no cure
Usually fatal within a year of onset of symptoms
Sexually transmitted disease that is highly treatable with the antibiotic penicillin and is curable.
Syphilis
a variation of the syphilis that infects the nervous system.
Neurosyphalis
a virus that attacks the PNS and causes paralysis and absent reflexes AKA Polio
Poliomyelitis
Commonly known as polio is caused by a virus and is highly preventable with a vaccine.
Poliomyelitis
Polio is now rare in the US and Uk, however still an active threat in many developing countries. True or false
True
Poliomyelitis is categorized by the sections of the ___ that it affects.
PNS
Nonsymmetrical paralysis with diminished or absent reflexes
Poliomyelitis
A sudden often periodic abnormal level of electrical discharge occurring within the brain
Seizures
remain confined to a particular region of the brain.
Partial seizure- remain confined to a particular region of the brain.
affect the entire brain and are associated with a total loss of consciousness or awareness
Generalized seizure- affect the entire brain and are associated with a total loss of consciousness or awareness
Certain infectious diseases and congenital disorders such as epilepsy produce seizures. True or false
True
