Exam Study Guide Flashcards
What does it mean that ‘aphasia is a disorder of language, not cognition’?
Aphasia does not affect a person’s intelligence or thinking, only their ability to produce and comprehend language.
What is aphasia not?
Aphasia is not a sensory, motor, psychiatric, or intellectual disorder.
How does Hallowell define aphasia?
Aphasia is a speech disorder that affects access to language, not the loss of linguistic concepts.
How can speech be affected in a person with aphasia (PWA)?
If a PWA has trouble finding the language to produce, it could affect their speech, but it’s not due to the speech mechanism itself.
What does it mean that ‘Aphasia is a central disorder’?
The damage causing aphasia is in one location, indicating a single grammar underlying language for talking or writing.
What is the difference between propositional and sub-propositional language?
Propositional language is intentional and creative; sub-propositional language is automatic use of words and phrases.
What does it mean that aphasia is a problem with access rather than storage?
PWA do not lose linguistic information; they have difficulty retrieving the information that is already in their brains.
What is the benefit of understanding aphasia within a biopsychosocial framework?
It considers the medical condition, emotional impact, and social participation, providing a comprehensive view of how aphasia affects lives.
List four types of paraphasia and provide an example for each.
- Phonemic Paraphasia: kiger for tiger
- Semantic Paraphasia: Lion for tiger
- Unrelated paraphasia: Comb for tiger
- Neologistic Paraphasia: floofle for tiger
Define anomia.
Difficulty with word finding.
Define circumlocution.
Talking around the word a person wants to say.
Define agrammatism.
Difficulties with creating grammatically correct sentences and utilizing grammar.
What are errors of omission?
Omitting words from sentences.
What are errors of commission?
Errors in the use of words.
Define jargon.
Non-words or made-up words.
What is a problem with the classical model of aphasia?
It does not consider the complex ways in which brain regions work together to produce and comprehend language.
What is the difference between open and closed-class words?
Open-class words are content words; closed-class words are grammatical words.
Describe the speech of a fluent speaker.
Words come easily; may include not always the right words, jargon, and neologism.
Describe the speech of a non-fluent speaker.
Halting and effortful, often agrammatical.
What is working memory?
Where the cognitive workload is managed.
Aside from CVAs, list three other ways someone could have aphasia.
- Tumor
- Anoxia
- Hydrocephalus
Which artery blockage is most likely to lead to aphasia, and why?
MCA because it supplies blood flow to the left surface of the hemisphere where Broca’s and Wernicke’s areas are located.
Define ischemic stroke.
A blockage of the vessel.
Define hemorrhagic stroke.
A rupture of the vessel with bleeding.
What is thrombosis?
Accumulation of atherosclerotic platelets and fatty plaque on the vessel wall, causing narrowing.
What is an embolism?
Platelets and fatty plaque break off a vessel wall and travel until the cerebral artery becomes too small.
List two types of hemorrhagic stroke.
- Intracerebral Hemorrhage
- Subarachnoid Hemorrhage
Define aneurysm.
A dilated blood vessel that stretches and weakens the vessel wall.
What is a penumbra?
Area surrounding infarction where blood flow is reduced, but tissue is intact.
Define hypoperfusion.
Reduced blood flow to the area surrounding the infarction.
What is diachisis?
Suspension of functions that depend on structures remote from the infarct.
What is spontaneous reperfusion?
Flow to the uninfarcted side improves spontaneously within two to three weeks after onset.
Define AVM.
Arteriovenous malformation where arterial walls weaken and the capillary network between arteries and veins is absent.
What is a hematoma?
Accumulation of blood that floods the brain’s surface or brain tissue.
What are two language features of Broca’s aphasia?
- Non-fluent speech
- Agrammatism
What are two language features of Wernicke’s aphasia?
- Fluent speech
- Jargon
What is crossed aphasia?
Aphasia resulting from a right-side stroke.
What is subcortical aphasia?
Aphasia resulting from damage to subthalamic structures such as the thalamus.
What speech feature might you expect from a patient with an anterior lesion?
Nonfluent speech and possible hemiparesis due to proximity to the motor area.
What distinguishes patients with parasylvian vs. extrasylvian lesions?
Parasylvian lesions are near the sylvian fissure and are connected to worse repetition; extrasylvian lesions are associated with better repetition.
What is more important than deciding which ‘type’ of aphasia a patient has?
How it affects life participation and symptoms of their aphasia.
What is a lexical decision task?
It measures the speed of recognizing words and is often used to assess semantic networks.
What is the evidence for semantic networks?
Demonstrated by the semantic priming effect, where a lexical decision is faster when preceded by a semantically related prime.
List three ways to assess sentence-level comprehension.
- Follow simple commands (listening)
- Follow simple instructions (reading)
- Assess syntactic system with garden path sentences
What makes a sentence more challenging for a PWA to comprehend?
- Complexity
- Reversibility
- Canonicity
What is a semantic concept?
A representation of a word without letters, such as features of the object or idea.
Define argument structure.
A grammar component that entails who is doing what to whom in a sentence.
What is visual agnosia?
Nonaphasic misnaming.
What is the difference in naming tasks for someone with a lexical impairment versus a semantic impairment?
- Lexical: trouble recalling words from spelling
- Semantic: trouble recalling words from category
What is the order of events in the cognitive neuropsychological model of object naming?
- See object
- Picture Recognition
- Conceptual semantic system
- Phonological Output lexicon
- Articulatory Processes
- Spoken Name
Do PWAs have more or fewer word finding deficits in picture naming versus narratives?
Fewer deficits in narratives compared to picture naming.
What might indicate about semantic vs lexical access for a PWA who produces many circumlocutions?
In cases of anomia, there would be more difficulty with lexical access than semantic access.
What additional assessment is performed when meeting someone with aphasia?
Assessing swallowing ability and safety.
What is a prognosis?
How a condition is expected to manifest over time, including the prospect of recovery.
Which types of alexia have difficulties with the sublexical route?
Phonological Alexia & Deep Alexia.
Which types of alexia have trouble with the lexical semantic route?
Surface Alexia & Pure Alexia, with difficulties in irregular spelling, homophones, and homographs.
What are the four types of agraphia?
- Phonological Agraphia
- Deep Agraphia
- Surface (lexical) Agraphia: Sound-to-Letter Route Effective
- Graphemic Buffer Agraphia
What is supported conversation?
A method that acknowledges a person with aphasia’s competence and facilitates communication.
List four goals of the aphasia assessment.
- Identifying strengths and weaknesses
- Deduce the type of aphasia
- Find out the patient’s goals
- Get documentation for payers
What are three things to learn from the case history?
- Patient routines
- When the stroke occurred
- Aspects of life most affected
What are three features a good aphasia battery should have?
- A comprehensive assessment of language functions
- Covers all four language functions/modalities
- Minimizes influence of intelligence, education, or other extralinguistic content
What is special about the BDAE?
It was the first test to document syndromes in aphasia and includes a short form.
What are two problems with the BDAE?
- Outdated picture for descriptive task
- Contains an image of a noose
What is one advantage of the WAB?
Summary score can be completed in only 30-45 minutes; uses real objects for word level tasks.
Why is a screener better than an informal evaluation?
Informal evaluations lack validity and reliability.
What are two types of word fluency tasks?
- Divergent Naming Task
- Letter-Fluency Task
Why should we care about limb apraxia?
Limb use can help PWAs with gestures and gestural communication.
What is the process approach to assessment?
The clinician writes down every answer verbatim and observes the setting and behavior to understand strengths and weaknesses.
