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Aphasia > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is a stroke?

A

generic term for brain damage that is caused by a lack of blood or bleeding

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2
Q

What is the technical term for a stroke?

A

cerebral vascular accident

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3
Q

What are the warning signs of a stroke?

A

Sudden numbness or weakness in the face, arm or leg
sudden confusion, trouble speaking, or understanding
sudden trouble walking, dizziness, or loss of balance
sudden trouble seeing in one or both eyes
sudden severe headache with no known cause

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4
Q

What does FAST stand for?

A

Face drooping
Arm weakness
Speech difficulty
Time to call 9-11

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5
Q

What are the two types of stroke?

A

icshemic and hemorrhagic

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6
Q

What is an ischemic stroke?

A

When a blood vessel becomes blocked and a portion of the brain is deprived of oxygen

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7
Q

What is a hemorrhagic stroke?

A

When a blood vessel becomes weak and ruptures or by a TBI to a blood vessel

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8
Q

What is the stroke belt?

A

The region in the US where the highest number of strokes occur

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9
Q

What is Eastern NC, SC, and GA considered?

A

the stroke buckle

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10
Q

How many individuals have a stroke each year in the US?

A

795,000

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11
Q

What percentage of strokes are ischemic?

A

80-85%

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12
Q

1 of 4 strokes are in people who_______.

A

have had a previous stroke

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13
Q

Do males or females tend to have more strokes?

A

females (could be due to the fact that we live longer ;))

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14
Q

Strokes kill _____ people a year.

A

130,000 or 1/19

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15
Q

What are the risk factors for stroke? (13)

A 
	Atherosclerosis
	Heart disease
	Age
	High cholesterol
	Cancer
	Heredity
	Alcohol use
	Smoking
	Diabetes
	Hypertension
	Obesity
	Physical inactivity
	Amphetamines
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16
Q

Which races have a greater likelihood of having a stroke?

A

AA and hispanics by 2-3x

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17
Q

What is a transient ischemic attack?

A

a mini or brief stroke with symptoms that usually resolve within an hour- 24 hours; Temporary disruptions of ceberal circulation accompanied by rapidly developing sensory disturbance and limb weakness

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18
Q

What are the layers of the brain? (starting at the scalp and going deeper) (7)

A 
Scalp
Cranium
Dura mater
Arachnoid
Subarachnoid space
Pia mater
Cerebral cortex
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19
Q

What are the four lobes of the brain?

A

Frontal, Parietal, Temporal and Occipital

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20
Q

What does the frontal lobe control?

A

Motor control, concentration, planning, problem solving, speech, and smell

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21
Q

What does the parietal lobe control?

A

Sensation, taste, and body awareness

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22
Q

What does the temporal lobe control?

A

Hearing and facial recognition

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23
Q

What does the occipital lobe control?

A

vision

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24
Q

What does the cerebellum control?

A

coordination and muscle movements

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25
Q

What is the Slyvian fissure?

A

It is a lateral fissure that divides the brain horizontally. It marks the lower boundary between the frontal and parietal lobe and the temporal lobe

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26
Q

What is the Rolandic fissure?

A

It is a central fissure also known as the central sulcus and divides the brain into anterior and posterior regions

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27
Q

Describe the frontal cortex.

A

It governs aspects of behaviors, is a very complex area and diseases can vary drastically across patients even if the lesion is in the same area

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28
Q

What is the insula cortex?

A

The patch of cortex folded into the lateral cerebral fissure that controls expressive language and motor speech

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29
Q

What is the arcuate fasciculus?

A

The arcuate fasciculus is a neural pathway compiled of fiber bundles that extend anteriorly from the posterior portion of the temporal lobe to the posterior region of the inferior prefrontal lobe, thereby linking the expressive (i.e., Broca’s area) and receptive (i.e., Wernicke’s area) language centers of the cortex

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30
Q

What would happen if there was a stroke in the arcuate fasciculus?

A

Conduction aphasia–> no repeating but comprehension and expression should be intact

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31
Q

What is the basal ganglia?

A

receives input mostly from the frontal lobe. Controls major muscle groups in trunk and limbs for dealing with shifts in body weight.

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32
Q

What would be impaired if there was a problem with the basal ganglia?

A

Impairment may lead to deficits in movement and sensation.

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33
Q

What is the thalamus?

A

major relay center for motor information coming down from the motor cortex and for sensory information going up to the sensory cortex

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34
Q

What does the anterior thalamus control?

A

expressive language

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35
Q

What does the posterior thalamus control?

A

receptive language

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36
Q

What is the internal capsule?

A

the general white matter area that sits between the ventricles and the basal ganglia that contains both ascending and descending axons and fibers going to and coming from the cerebral cortex

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37
Q

Strokes in the internal capsule have ___ outcomes.

A

Poor ( results in significant sensory and motor deficits)

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38
Q

What is the middle cerebral artery?

A

Supplies most of the lateral surfaces of the brains hemispheres, plus the thalamus and basal ganglia. Majority of the artery located in the parietal lobe.

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39
Q

The middle cerebral artery is critical for ____.

A

language functions

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40
Q

What are the lenticulostriate arteries?

A

small arteries that branch from the middle cerebral artery and feed into the basal ganglia and internal capsule.

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41
Q

What happens if there is a stroke in the lenticulostriate arteries?

A

The internal capsule could be disrupted

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42
Q

What are watershed regions?

A

Areas where there is not a good overlap of blood supply

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43
Q

Do the watershed regions have a huge impact on speech and language areas?

A

No but it may change the profile of the client

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44
Q

What areas are considered cortical regions?

A

the 4 lobes

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45
Q

What are considered subcortical regions?

A

the areas below and surrounded by the lobes like the basal ganglia, thalamus, and ventricles

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46
Q

What is eschemia?

A

tissue damage

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47
Q

What is infarction?

A

tissue death

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48
Q

what is diaschisis?

A

is a sudden loss (or change) of function in a portion of the brain connected to a distant, but damaged, brain area.

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49
Q

What is thrombosis?

A

local coagulation or clotting of the blood in a part of the circulatory system.

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50
Q

What is an embolism?

A

the lodging of an embolus, which may be a blood clot, fat globule, gas bubble or foreign material in the bloodstream. This can cause a blockage in a blood vessel.

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51
Q

What is hypoperfusion?

A

decreased blood flow

52
Q

What is an aneurysm?

A

a break in the blood vessel in the brain

53
Q

What are the physiological responses that one may have after a stroke? (5)

A
  • Edema
  • transneural degeneration
  • denervation hypersensitivity
  • diaschisis
  • collateral sprouting
54
Q

What is edema?

A

swelling

55
Q

What is trans-neural degeneration?

A

the death of neurons caused by the disruption of input from or output to other nearby neurons

56
Q

What is degeneration hypersensitivity?

A

extreme sensitivity due to interruption of neuronal supply/ activity

57
Q

What is collateral sprouting?

A

neurons adjacent to the damaged area may take over functions performed by the damaged area

58
Q

What medical treatments could be performed for an ischemic stroke before speech therapy begins?

A

carotid endarterectomy
carotid stenting
tissue plasminogen activator(tPA)
cerebral stenting

59
Q

What is carotid endarterectomy?

A

Carotid endarterectomy is an operation during which your vascular surgeon removes the inner lining of your carotid artery if it has become thickened or damaged. This procedure eliminates a substance called plaque from your artery and can restore blood flow.

60
Q

What is carotid stenting?

A

is an endovascular surgery where a stent is deployed within the lumen of the carotidartery to prevent a stroke by treating narrowing of the carotid artery. CAS is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky

61
Q

What is tissue plasminogen activator (tPA)?

A

treatment for ischemic stroke only! Must be given within 3-4 hours of stroke. Drug, dripping drug tPA directly on the clot through a catheter, it does not have to make its way though the bloodstream.

62
Q

What is cerebral stenting?

A

Cerebral stents are used to treat the narrowing of cerebral arteries

63
Q

What is a Lacunar stroke?

A

a type of stroke that results from occlusion of one of the penetrating arteries that provides blood to the brain’s deep structures

64
Q

What is an extracerebral hemorrhage?

A

a hemorrhage that takes place in the meninges

65
Q

What is a intracerebral hemorrhage?

A

a hemorrhage that occurs inside the cortex

66
Q

What are anteriorvenous malformations (AVM)?

A

genetic malformations that occur in the blood vessels in the brain; mostly seen in young adults; outcome dictated by location of the AVM

67
Q

What are the treatment options for a hemorrhagic stroke?

A
  • Microsurgical clipping

- Cerebral Stenting

68
Q

What is microsurgical clipping?

A

A small metal clip is used to stop the flow of blood

69
Q

What is cerebral stenting for a hemorrhagic stroke?

A

putting a stent in the aneurysm. The stent clocks the aneurysm from circulation and causes the blood to clot

70
Q

What medical treatment is used for cerebral spinal fluid leakage? (CSF)

A
  • using a shunt to drain the fluid
71
Q

What is a subdural hematoma?

A

a collection of blood that forms in the sub-dural space

72
Q

What percentage of the population is left hemisphere dominant?

A

97%

73
Q

Describe cerebral dominance

A
  • Left hemisphere dominant for language in most right handed adults
  • mirror image concept for left-handed adults
74
Q

_____ handed brains may be more flexible about which hemisphere gets language responsibility.

A

Left

75
Q

Which handedness normally lends itself to better recovery from aphasia?

A

Left

76
Q

Which of Brodmann’s areas are responsible for expressive language?

A

44- Pars opercularis

45- Pars triangularis

77
Q

Which of Brodmann’s areas are responsible for receptive language?

A

22- Superior Temporal Gyrus
39- Angular Gyrus
40- Supramarginal gyrus
41 and 42- Primary Auditory Association Cortex

78
Q

What is the function of Brodmann’s area # 39 (angular gyrus)?

A

calculation and written expression

79
Q

Aphasia is NOT…. (3)

A
  • slurred speech
  • confused language
  • pragmatic problem
80
Q

What is plasticity?

A

the ability of the brain to reassign functions when an area of the brain has been damaged

81
Q

Non-fluent aphasia occurs _____ to the central sulcus.

A

anterior

82
Q

Fluent aphasia occurs ____ to the central sulcus.

A

posterior

83
Q

What are characteristics of non-fluent aphasia?

A

• Speak slowly, haltingly and with great effort, pausing between syllables and words
• Speech has machine- like quality with diminished or absent intonation and emphatic stress patterns
• Characteristics
 Slow, labored speech
 Grammatical constructions are restricted
 Intonation reduced or absent
 Function words omitted
 Rely on a lot on nouns
 3-4 words per breath group
 Associated with agrammatism

84
Q

What are the characteristics of fluent aphasia?

A 
•	Speak smoothly and  effortlessly
•	Speech rate,  intonation, and  emphatic stress similar  to normal speakers
•	Characteristics
	Normal/near normal speech  rates 
	Variety of grammatical  constructions
	Intonation patterns present and  usually appropriate
	Function words present
	Syntax appropriate
	> 5-6 words per breath group
	Can be associated with:
Paragrammatism
“word salad”
“grammatically incorrect sentences
85
Q

What types of Aphasia are considered non-fluent?

A

Broca’s and Global

86
Q

Which types of aphasia are considered fluent?

A

Wernicke’s, Conduction, Anomic, Transcortical Motor, Transcortical Sensory

87
Q

What is paraphasia?

A

word substitution errors produced by individuals with aphasia

88
Q

What are the types of paraphasia?

A

Literal and Semantic

89
Q

What are Literal paraphasia errors?

A

phonological errors in which incorrect sound replace correct sounds “trable or fable” for “table”

90
Q

What are semantic paraphasia errors?

A

Incorrect word substitution for the correct word

“chair” for “table”

91
Q

What is agrammatism?

A

grammar disturbances in labored non-fluent aphasia

92
Q

What is anomia?

A

a broad term for having difficulty finding words

93
Q

What is circumlocution?

A

Talking around words in context

94
Q

What are the two models of aphasia?

A

Localization of function and connectionist

95
Q

Describe the localization model.

A

Assignment of impaired functions to a damaged region of the brain when damage in a region of the brain produces a given pattern of impairment

96
Q

What are the limitations of the localization model?

A
  • localized damage to Broca’s and Wernicke’s areas does not produce aphasia
  • aphasia can be caused by damage to the sub-cortical structures
97
Q

What do anti-localizationalists believe?

A

the brain operates as an integrated whole

98
Q

Describe the Connectionist model.

A

Language is ordered in a diffuse way

99
Q

What are the two steps to the Connectionist model?

A
  1. activation is added to the semantic features of a word

2. phonological encoding

100
Q

What are the error patterns in naming for the connectionist model? (5)

A

For the word cat:

  1. Semantic: same category “dog”
  2. Formal: morphological error “mat or cap”
  3. Mixed: both formal and semantic “rat”
  4. Unrelated: “pen or log”
  5. Non-words: “lat or lom”
101
Q

Which types of Aphasia are considered to be from damage to the cortical structures? (3)

A
  1. Broca’s
  2. Wernicke’s
  3. Global
102
Q

Which types of aphasia are considered from damage to the fiber tracts? (4)

A
  1. Conduction
  2. Transcortical motor
  3. Transcortical sensory
  4. mixed transcortical
103
Q

Which type of aphasia is considered to be of unknown origin?

A

anomic

104
Q

Describe fluency, comprehension and repetition in Broca’s aphasia.

A

F: poor
C: intact words and simple sentences
R: poor, non-fluent

105
Q

Describe fluency, comprehension and repetition in Wernicke’s aphasia.

A

F: good
C: poor
R: poor, fluent jargon

106
Q

Describe fluency, comprehension and repetition in Conduction aphasia.

A

F: fair-good
C: intact words and simple sentences
R: poor

107
Q

Describe fluency, comprehension and repetition in Transcortical motor aphasia (TCM).

A

F: poor
C: intact words and simple sentences
R:good

108
Q

Describe fluency, comprehension and repetition in transcortical sensory aphasia (TCS)

A

F: good
C: poor
R: good

109
Q

Describe fluency, comprehension and repetition in global aphasia.

A

F: poor
C: poor
R: poor

110
Q

Describe fluency, comprehension and repetition in anomic aphasia.

A

F: good
C: good
R: good

111
Q

What are other names for Broca’s aphasia?

A

Expressive, Motor, Anterior, Non-fluent

112
Q

Describe characteristics of Broca’s aphasia.

A
  1. Non-fluent
  2. Agrammatic output
  3. comprehension relatively preserved but not “normal”
  4. poor nonfluent repetition
  5. preserved self-monitoring
  6. writing is similar to verbal output
113
Q

What causes chronic agrammatic aphasia? (in Broca’s)

A

lesions in Broca’s areas extending into anterior insula cortex and temporal and parietal regions

114
Q

What are the differences between little Broca’s and big Broca’s?

A

Little B’s are smaller lesions that resolve quickly while Big B’s are full blown and produce complex aphasia

115
Q

What are other names for Wernicke’s aphasia?

A

Sensory, receptive, posterior, fluent

116
Q

What are characteristics of Wernicke’s Aphasia?

A
  • fluent speech
  • frequent semantic paraphasia
  • paragrammatism
  • jargon
  • impaired repetition
  • poor comprehension
  • poor self monitoring
  • anosognosia (poor self-monitoring)
117
Q

What are characteristics of global aphasia?

A
  • severe impairments in all areas
  • difficulty with basic comprehension
  • limited verbal output
118
Q

What are characteristics of conduction aphasia?

A
  • fluent verbal output
  • occasional verbal paraphasia
  • impaired repetition
  • relatively preserved comprehension
  • poor oral reading
119
Q

What are characteristics of transcortical motor aphasia?

A
  • reduced speech output
  • good repetition
  • good auditory comprehension
120
Q

What are characteristics of Transcortical sensory aphasia?

A
  • poor comprehension
  • good repetition
  • fluent empty speech with paraphasia
121
Q

What are characteristics of anomic aphasia?

A
  • word retrieval in verbal output and writing
  • fluent and grammatically correct
  • unusual pausing and circumlocutions
122
Q

What is considered to be the residual state of many aphasic syndromes AFTER time of improvement?

A

anomic aphasia

123
Q

What are the characteristics of subcortical aphasia?

A

o Deficits may have impact on quality of life
o Comprehension deficits are mild-mod
o Written comprehension is more preserved than oral
o Verbal memory deficits may contribute to reduced language scores
o Phonemic and semantic paraphasias can be present
o Category specific and proper name anomia can be present

124
Q

What is Alexia with Agraphia?

A

(not a motor issue; language impaired)
• Oral reading grossly impaired
• Cannot identify words spelled out by the examiner
• Copying printed material is better than writing to dictation
• Common component of aphasia syndromes and rare in isolation

125
Q

What is Alexia without Agraphia?

A

(Not a motor issue)
• Pure Word Blindness
• Demonstrate ability to write complex sentences or narratives but cannot read what they have written
• May retain the ability to identify familiar words
• Difficulty copying material

126
Q

What is Apraxia?

A
  • motor planning
  • Don’t respond to visual cueing
    -can coexist with a stroke
    2 types
  • ideational- • Inability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects in everyday life
  • ideomotor- • Inability to correctly imitate hand gestures and voluntarily mime tool/object use
127
Q

What is the Pseudobulbar affect?

A

neurologic disorder characterized by involuntary crying or uncontrollable episodes of crying/laughing

Aphasia (1 decks)

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