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Neuro Rehab Test 2 > Communication > Flashcards

Communication Flashcards

1
Q

what portion of stroke survivors will have communication disorders?

A

1/3

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2
Q

how can we classify communication disorders?

A

speech or language problem

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3
Q

differentiate language v speech

A

language: use of symbols (print, pics, spoken words) that make up our messages
speech: mechanics of talking - vocal production including multiple components

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4
Q

what are the five components of speech

A
  1. respiration (breath support)
  2. phonation (vocal tracts to modify acoustics)
  3. articulation (use of tongue, teeth, and lips to produce sounds
  4. resonance (quality of voice)
  5. prosody (rhythm, fluency, and patterns of speech)
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5
Q

expressive and receptive language disorders consistently seen with ____ brain damage

A

left

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6
Q

Left sided (dominant) language centers confirmed by left-sided damage resulting in…. (2)

A
  1. acquired dyslexia

2. deaf aphasia

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7
Q

what is deaf aphasia

A

a consequence of left brain damage in hearing impaired individuals where the individual loses the ability to sign, akin to verbal aphasia

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8
Q

what are the right brain pragmatic aspects to language?

A
  1. context
  2. metaphors
  3. inflection
  4. jokes
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9
Q

how is language affected following R brain injury?

A

patients may lose the ability to understand context, they will consider things literally, will not be able to understand inflection, and may not understand jokes

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10
Q

give an example of how a patient with R sided brain injury might have difficulty in communication

A

“heavy heart” can be taken literally

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11
Q

Five types of communcation disorders

A
  1. dysarthria
  2. dysphagia
  3. apraxia
  4. aphasia
  5. cognitive-communcation
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12
Q

define dysarthria

A

motor SPEECH disorder caused by weakness/paresis/paralysis of muscles involved in speech

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13
Q

T/F: Dysarthria on affects the phonation (motor) component of speech

A

false: dysarthria can affect ALL components of speech

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14
Q

what causes dysarthria

A

unilateral, bilateral, or brainstem involvement (a UMN OR LMN issue)

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15
Q

what is the chief patient complaint with dysarthria

A

“people don’t understand me… they think I’m drunk”

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16
Q

what does dysarthria sound/look like (4)

A
  1. facial muscle visible weakness/asymmetry
  2. slurring
  3. complex sounds are shortened (street = reet)
  4. wet/breathy/strained
17
Q

what are four strategies to use with dysarthria patients?

A
  1. eliminate environmental variables
  2. ask patient to slow down/space out each word
  3. yes/no questions or options
  4. letter boards/writing/etc (alt communication)
18
Q

what is apraxia

A

a motor SPEECH disorder caused by motor planning problems related to muscles of speech production

19
Q

T/F: those with speech apraxia are able to respond “hi,” “how are you,” and “stop it.”

A

true! automatic speech may be intact in those with apraxia

20
Q

what is a typical patient complaint with apraxia

A

“i know what I want to say but I can’t say it”

21
Q

What does apraxia sound/look like?

A
  1. errors - inconsistent and unpredictable
  2. automatic speech > volitional speech
  3. awareness of errors, but unable to correct
  4. may be accompanied by limb apraxia
22
Q

what are three apraxia strategies to be used by the PT

A
  1. limit burden by asking yes/no or give options
  2. alt communication
  3. speak slowly and let the patient watch your mouth
23
Q

what is aphasia

A

LANGUAGE disorder due to (usu) LEFT hemisphere damage

24
Q

what does aphasia look/sound like

A
  1. impaired auditory comprehension/retention
  2. impaired accuracy of speech
  3. impaired reading comprehension
  4. impaired writing
25
Q

What is a common patient complaint of aphasia

A

“i can’t… understand you, find the word I want, make myself understood” - like being in a foreign country!!!

26
Q

T/F: aphasia is a speech disorder

A

false - it is a language disorder

27
Q

T/F: aphasia is a cognitive disorder

A

false - a patient’s cognitive ability may be masked by aphasia

28
Q

what is the APHASIA strategy to communicate with aphasic patients

A 
A - ask simple questions
P - provide choices
H - help communicate if asked
A - acknowledge frustration
S - slow... speak slowly and clearly
I - if you don't understand, say so!
A - allow extra time
29
Q

what are the two major categories of aphasia

A
  1. nonfluent (Broca’s) global transcortical motor aphasia

2. fluent (Wernicke’s) conduction anomic transcortical sensory aphasia

30
Q

what does nonfluent aphasia sound/look like

A
  1. slow, laborious, halting
  2. telegraphic (high content but absent little words)
  3. words may be wrong, but related to the right word
  4. apraxia
  5. comprehension > expression
  6. good error awareness
31
Q

what are four nonfluent aphasia strategies

A
  1. establish yes/no strategy
  2. simplify language (only give back what the patient gives you)
  3. give single written word cues/choices
  4. use gestures, objects, pictures, facial expressions
32
Q

what does fluent aphasia sound/look like

A
  1. fluent, copious, effortless expression
  2. normal intonation
  3. decreased auditory comprehension
  4. poor error awareness
33
Q

what are 2 fluent aphasia strategies

A
  1. stop them from talking when you are

2. use all previously described strategies

34
Q

what is the best position to swallow

A

“chin tuck facilitates swallow”

Neuro Rehab Test 2 (11 decks)

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