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Praxis > ECU aphasia > Flashcards

ECU aphasia Flashcards

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1
Q

which area or the brain contains Wernickes

A

area 22

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2
Q

which functions are affected by damage to the angular gyrus

A

acalculia

agraphia

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3
Q

which area of the brain is indicated in apraxia

A

insula

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4
Q

what is ischemia

A

physiological tissue change

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5
Q

what is infaction

A

tissue death

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6
Q

what is the physiologic response to an ischemic stroke

A 
edema
transneural degeneration
denervation hypersensitivity
diaschisis (distal loss of function)
collateral sprouting(neighboring neurons take over)
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7
Q

what is the penumbra

A

area around a stroke that could either die or survive

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8
Q

what are medical treatments for ischemic stroke

A
  1. carotid endarterectomy
  2. carotid stenting
  3. tPA
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9
Q

what are the 3 types of hemorrhagic strokes

A
  1. epidural
  2. subdural
  3. intracerebral
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10
Q

what are medical treatments for hemorrhagic stroke

A
  1. clipping

2. cerebral stent

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11
Q

what is hypoperfusion

A

reduction of blood flow to all parts of the body

watershed areas affected

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12
Q

what are the Brodmann’s area for speech and language

A

44 Pars Opercularis: brocas area
Broca’s aphasia and apraxia

45 Pars Triangularis: Brocas
22 Superior Temporal Gyrus: Wernickes aphasia
40 Supramarginal Gyris” Wernickes aphasia
41,42 Primary Auditory Association Cortex: Wernickes
39 Angluar Gyrus: Acalculia, agraphia, alexia

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13
Q

what are the patterns of impairment with aphasia

A
  1. speech fluency
  2. paraphasia (word, sound errors, semantic errors)
  3. repetition
  4. language comprehension
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14
Q

what are the characteristics of nonfluent aphasia

A
  1. slow halting speech
  2. great effort
  3. speech has diminished or absent intonation or emphatic stress
  4. function words omitted
  5. rely a lot on nouns
  6. 3-4 words per breath
  7. associated with agrammatism
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15
Q

what are the characteristics of fluent aphasia

A
  1. speech smooth and effortless
  2. rate and intonation similar to normal speaker
  3. function words present
  4. syntax appropriate
  5. variety of grammatical constructions
  6. 5-6 words per breath
  7. associated with paragrammatism or grammatically incorrect sentences
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16
Q

what are the types of nonfluent aphasia

A

broca’s

global

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17
Q

what are the types of fluent aphasia

A

wernickes
conduction
anomic
transcortical sensory

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18
Q

what are the characteristics of Brocas

A

poor fluency
good content
comprehend intact words and simple sentences
poor repetition
poor naming of verbs
poor reading and spelling
associated with right arm weakness and apraxia
preserved self monitoring
writing large, absent of function words(macrographia)

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19
Q

what are the characteristics of wernickes

A 
good fluency
poor content and comprehension
poor repetition
poor naming, worse for nouns
poor spelling and reading
associated with superior visual field cut
jargon
poor self monitoring
anosognosia
micrographia
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20
Q

what are the characteristics of conduction aphasia

A 
fair-good fluency
good content
comprehension of intact words and simple sentences
poor repetition
fair-good naming
spelling and reading may be spared
associated with poor working memory
lesions in upper temporal, lower parietal or insula
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21
Q

what are the characteristics of transcortical motor aphasia

A 
poor fluency
good content
comprehension of intact words and simple sentences
good repetition
fair-good naming
spelling and reading may be spared
associated with abulia
damage to watershed areas that spare brocas
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22
Q

what are the characteristics of transcortical sensory

A 
good fluency
poor content and comprehension
good repetition
poor naming, spelling, and writing
asociated with right field cut
damage to watershed areas that spare wernickes
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23
Q

which artery is responsible for thalamic aphasia

A

posterior cerebral artery

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24
Q

what is alexia without agraphia

A

pure word blindness
can write complex sentences but cant read what they wrote
difficulty copying

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25
Q

what is ideational apraxia

A

inability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects

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26
Q

what is ideomotor apraxia

A

inability to imitate hand gestures

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27
Q

what is intentional aphasia

A

intent to speak
anterior
impaired expressive language and motor speech

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28
Q

what is attentional aphasia

A

sensory
impaired attention to comprehension
posterior

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29
Q

what is the NIH stroke scal

A

clinical assessment tool to evaluate and document neurological status in acute stroke patients

30
Q

what are some functional outcome assessment measures of stroke

A
  1. functional independence measure
  2. stroke impact scale
  3. burden of stroke scale
31
Q

what are some aphasia screening tools

A
  1. language screening test (naming, repetition, automatic speech)
  2. aphasia rapid test: beside assessment to rate aphasia severity in acute stroke patients
32
Q

what are components of comprehensive aphasia test batteries

A
  1. comprehension
  2. expression(repetition)
  3. motor skills
  4. reading/writing
  5. memory
  6. voice/swallowing
33
Q

what are some tests of sentence comprehension

A
  1. token test

2. northwestern syntax screening test

34
Q

what are assessments for single word comprehension

A
  1. select from an array procedure

2. test of single word comprehension (PPVT)

35
Q

what variables influence single word comprehension

A

frequency
semantic or acoustic relationship to foil
part of speech
ambiguity

36
Q

what variables influence sentence comprehension

A

length and syntactic comprehension
reversibiity and plausability
predictability
personal reference ( using pronouns, who is “he”)

37
Q

what variables influence discourse comprehension

A 
salience
directness
redundancy
cohesion and coherence
rate and emphatic stress
38
Q

what is cohesion

A

how sentences are held together by conjunctions or pronouns

39
Q

what is coherence

A

topic maintenance

40
Q

what are some assessments of verbal expression

A
  1. simple speech production: repetitions, sentence completion, automatized sequences
  2. confrontational and responsive naming
41
Q

what variables affect naming accuracy

A

frequency of occurrence
length and phonologic omplexity
semantic categories
context

42
Q

what areas should be assessed for aphasia

A 
comprehension
expression
reading
writing
cognition
pragmatics
43
Q

what are the predictors of aphasia recovery

A 
age
handedness
education
intelligence
size, location, and number of lesions
type of aphasia
biggest predictor is initial aphasia severity
44
Q

during what part of recovery is there the most improvement

A

first 3 months

45
Q

what is the stimulation-facilitation model of treatment

A
  1. aphasia is an auditory processing deficit
  2. make the stimulus adequate
  3. bombard with stimuli
  4. elicit accurate responses
  5. use cueing and cueing hierarchies
46
Q

what is the modality model of treatment

A
  1. aphasia is a uni or multi-modality deficit
  2. remediate input and output modalities, singly or in combination
  3. pair weak with strong modalities
47
Q

what is the linguistic model of treatment

A
  1. aphasia is a selective deficit in language system or subsystems
  2. restore language performance by organizing stimuli according to linguistic system and complexity
48
Q

what is the processing model of treatment

A
  1. aphasia reflects the product of spared language in response to impaired modules
  2. an impairment in the “executor” that allocates attentional resources to modules and processes
  3. restore or compensate for language specific processing deficit
49
Q

what is the minor hemisphere mediation model of treatment

A

use minor hemisphere abiities to mediate communication through use of imagery, drawing, melody, contextually rich stimuli, novel stimuli, and humor

50
Q

what is the functional communication model of treatment

A

emphasize pragmatic function over linguistic form

  1. enhance intermodality flexibiity
  2. establish strategies for communication repair
51
Q

what is Response Elaboration Training

A
  1. increases MLU in nonfluent patient by capitalizing on preserved oral repetition
  2. designed to enhance initiation ability
  3. elaboration on patients phrase
  4. targets expressive language
52
Q

what is Promoting Aphasics Communicative Effectiveness

A
  1. use all channels of communication (verbal, gestural, writing)
  2. emphasize content over form
  3. patient and clinicians simulate conversation
  4. free choice of communication mode
  5. targets communication
53
Q

what is the Life Participation Approach

A
  1. focus is on re-engagement in life and real life goal
  2. social approach vs a medical model
  3. problems emerge from interaction between individual and environment
  4. targets communication
54
Q

what is the social approach to treatment

A
  1. enhance communication by expanding skill in coversation, compensatory-strategies, scaffolding and supported conversations and partner training
  2. increase participation in events
  3. provide support systems
  4. increae confidence and positive identity
  5. promoting advocacy
55
Q

what is language oriented treatment

A
  1. fits into linguistic model
  2. highly structured
  3. receptive targets include improving discrimination of speech sounds, improving access to word meanings, and changing the environment to support auditory comprehension
  4. expressive targets include semantic cueing, categorization, word to picture matching, phonemic cueing, cueing spoken output with written letters, repetition, and reading aloud
  5. targets all language domains
56
Q

what is constraint induced language therapy

A

individuals with aphasia use the communication channel that is accessible with the least amount of effort
strategies suppress these in favor of verbal communication
2. avoid compensation by not allowing non verbal communication
3. targets expressive language

57
Q

what is communicative speech therapy

A
  1. emphasizes interaction between patient and clinician in natural communication
  2. foals include topic maintenance, discourse management
  3. pragmatic treatment goals addressed along with linguistic therapy
58
Q

what is the Bottom up model of auditory comprehension treatment

A
  1. start with physical characteristics of message

2. work way through series of levels until the message is comprehended

59
Q

what is the Top down model of auditory comprehension treatment

A
  1. begin with general expectations about what a speaker is likely to say
  2. use general knowledge to prove or disprove their expectations
60
Q

what are treatment techniques for sentence comprehension

A
  1. answering questions (yes/no and open ended)
  2. follw spoken directions
  3. sentence verification (sentence to picture match or multiple choice responses)
61
Q

what is the heirarchy of reading comprehension tasks

A
  1. functional reading (survival skills)
  2. single word
  3. sentence reading
  4. paragraph and text
62
Q

how do you facilitate expressive language

A
  1. phrase and sentence completion
  2. word and phrase repetition
  3. confrontation naming
  4. responsive naming
63
Q

how do you facilitate word retrieval

A
  1. delay
  2. semantic association
  3. phonetic association
  4. description
  5. generalization
64
Q

what are characteristics of right hemisphere syndrome

A
  1. left visual neglect
  2. difficulty with facial recognition
  3. poor awareness of deficits
  4. poor self monitoring
  5. impulsive behavior
  6. poor initiation and motivation
  7. disorientation
    8 impaired attention/memory
  8. difficulty with organization and problem solving
  9. difficulty with social aspects of language
65
Q

what are task oriented approaches

A

improve performance on specific activities specialized to the patient. Considered functional therapy approach

66
Q

what are process oriented approaches

A
  1. addresses processes and mechanisms underlying observed disabilities
  2. includes compensation techniques and facilitation techniques
67
Q

how do you treat left neglect through compensation

A

verbal cues
visual and tactile cues
anchors
restructuring the enviornment

68
Q

how do you treat left neglect through facilitation

A

pharmocological
vestibular stimulation
behavioral treatments
left limb stimulation

69
Q

what is edgeness

A
  1. patient becomes familiar with spatial boundaries by tracing the perimeter with one finger
  2. colored cubes are placed on work space
  3. patient instructed to find and remove cubes
70
Q

what is bookness

A

patient opens a book and traces perimeter

2.patient matches stimuli on right and left side

71
Q

how do you treat sustained attention

A
  1. yes/no questions
  2. simple math
  3. sorting
  4. letter cancellation
  5. solving mazes

Praxis (20 decks)

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