Exam Study Mix Flashcards
Process Approach
- Clinician writes down all answers verbatim
- Observes setting and bx during and between assessment tasks for strengths and weaknesses
- Uses qualitative data to assess PWA
Why should we care about Limb Apraxia?
Limb use can be an important strategy for helping PWA communicate with gestures and gestural communication.
Two Types of Word Fluency Tasks
- Divergent Naming Task
- Letter-Fluency Task
Divergent Naming Task
Generate words from a semantic base (category)
Letter-Fluency Task
Generate words from a lexical base (starts with letter…)
Why is a screener better than an informal evaluation?
Informal evaluations lack validity and reliability
Advantage of WAB
- Summary score can be completed in 30-45 minutes
- Uses real objects for word level tasks
- Bedside version
Problems with BDAE
Outdated pictures (kitchen picture & noose), takes long time to administer
Special Aspect of BDAE
First test to document syndromes in aphasia; includes short form
3 Features of a Good Aphasia Battery
- Comprehensive assessment of language functions
- Covers all 4 langauge functions/ modalities at all levels of language (reading, writing, listening, speaking)
- Minimizes influence of intelligence, education, or other extralinguisitic content
Things to Learn from Case History
Patient Routines
When Stroke was
Aspects of life most affected
Goals of Aphasia Assessment
- Identify strengths/weaknesses to inform treatment (+severity)
- Deduce aphasia type
- Discover Pt’s goals
- Get documentation for payers
How to Acknowledge Competence?
1.Acknowledge their frustration and tell them they know they know what they want to communicate
- Speak in a natural manner
- Let them know their thoughts and opinions are important.
How to Reveal Competence?
- Use resources for the PWA to communicate (letter board, Yes/No sheet, writing tools, pain scale)
Why is Supported Conversation Important?
Because PWA have a problem with language access, not cognition, and they are in charge of their health and planning. People need to know their thoughts on this.
4 Types of Agrpahia
- Phonological Agraphia
- Deep Agraphia
- Surface (Lexical) Agraphia
- Graphemic Buffer Agraphia
Which type of Agraphia is the sound to letter route an effective strategy?
Surface (Lexical) Agraphia
4 Types of Alexia
- Pure Alexia
- Surface Alexia
- Phonological Alexia
- Deep Alexia
Pure Alexia
- Alexia w/o Agraphia
- Retain ability to spell & write
- Impairment between visual and naming system
- Will use letter by letter strategy (short words easier)
Surface Alexia
- Impairments in the lexical semantic reading route
- Difficulty with irregular spellings, homophone, homograph, low frequency words
Phonological Alexia
- Damage to sublexical route
- High frequency words > low
- High imageability words > low
- Content words > grammatical words
- ❌ non-words
Deep Alexia
- Damage to semantics and sublexical route
- High frequency > low
- High imageability > low
- Content words > grammatical
5 ❌ non-words - ❌ semantic errors
Phonological Agraphia
- Damage to sublexical route
- High frequency > low
- High imageability > low
- Content words > grammatical
- Difficulty spelling non-words
- Spelling errors typically not phonologically plausible (flewen for flower)
Deep Agraphia
- Damage to Semantics and Phonological
- High frequency > low
- High imageability > low
- Content words > grammatical
❌ non-words
❌ semantic errors
Surface Agraphia
- Lost or degraded orthographic representations
- Difficulty with irregular spellings, homophones, and low frequency words
Graphemic Buffer Agraphia
- A short-term memory issue
- Lexical-semantic and sublexical routes intact
- Long words more difficult than short words
- Types of Errors: Omissions (sweatr), Substitutions (peanul), Transpositions (painetr), additions (flowaer)
Allographic Conversion Agraphia
- Well-formed but incorrect letters or disturbed letter formation
- Preserved oral spelling
- Print vs. Cursive
- Person will have preserved copy, but impaired transcoding (e.g., ask to transcode from upper to lower case)
Treatment for Allographic Conversion Agraphia
Use self-dictation!
Types of Alexia with Trouble with lexical semantic route?
Surface & Pure Alexia & Deep
Types of Alexia with trouble with sublexical route?
Phonological and deep alexia
What is the sublexical route?
The route that skips the semantic route straight to the phonological buffer. It does not depend on the activation of words in the lexicon.
Prognosis
Prediction of the progression of a condition over time and recovery likelihood
First thing to assess besides language deficits/skills?
1.Swallowing ability and safety
2.Educating and counselling
3.Teaching communication
Semantic vs lexical access for PWA with lots of circumlocutions
Indicates poor lexical access but good semantic access
Would a PWA have more or fewer word finding deficits in picture naming vs narratives?
Word finding narratives would have fewer deficits
Order of Events for Neuropsychology model of object naming
- See object
- Picture Recognition
- Conceptual Semantic System
- Phonological Output Lexicon
- Articulatory Processes
- Spoken Name
Confrontational Naming Task: Lexical Impairment vs Semantic Impairment
- Lexical: Has trouble recalling words from the spelling and sounds, word form
- Has trouble recalling words from the category and meaning
Visual Agnosia
Nonaphasic misnaming
Argument Structure
Grammar component that entails who is doing what to whom in a sentence
Semantic concept
Representation of a word without letters, such as features of the object or idea
3 things that make a sentence more challenging
- Complexity (Active easier than passive)
- Reversibility (reversible sentences harder)
- Canonicity (deviating from easiest to understand structure (agent-action-recepient); embedded clauses)
3 ways to assess sentence level comprehension
- Follow simple commands (listening)
- Follow simple instruction (reading)
- Point to a picture after reading a sentence.
Syntactic Parsing Mechanism
Assigning structure to a string of words
Evidence for semantic networks
Demonstrated by the semantic priming effect, where a lexical decision is faster when preceded by a semantically related prime
What is more important than type of aphasia?
- How it affects life participation
- Symptoms of aphasia
- Dissociation vs. Syndrome
- Describe speech and strengths, levels and severity
Parasylvian Lesion
- Near Sylvian fissure
- Affects repetition
Extrasylvian lesion
- Far from Sylvian fissure
- Connected to better repetition
Crossed Aphasia
Aphasia from right-hemisphere stroke
Subcortical aphasia
- Aphasia from damage to subthalamic structures
- Thalamic = Word finding deficits
- Non-thalamic (incl. basal ganglia)= global, Broca’s, and Wernicke’s
Broca’s Aphasia
Non-fluent and effortful
Global Aphasia
Non-fluent, poor comprehension,
Conduction Aphasia
Fluent, good comprehension, worse repetition
Transcortical Motor Aphasia
Non-fluent, repetitions intact
Transcortical Sensory Aphasia
fluent, repetitions intact
Transcortical Mixed Aphasia
non-fluent, poor comprehension; repetition intact
Wernicke’s Aphasia
Fluent, poor comprehension, jargon
Anomic aphasia
Mild, fluent, comprehension intact
Hematoma
Accumulation of blood that floods the brain’s surface or brain tissue
Arteriovenous Malformation:
In which arterial walls weaken and the capillary network between arteries and veins is absent
Spontaneous Reperfusion
Flow to the uninfarcted side improves spontaneously and dramatically within two or three weeks after onset
Diaschisis
Suspension of functions that depend on structures remote from the infarct
Hypoperfusion
Reduced bloodflow to the area surrounding the infarction
Penumbra
Area surrounding the infarction, a grayish margin where blood flow is reduced, but tissue is intact
Aneurysm
A dilated blood vessel that stretches and weakens the vessel wall
Intracerebral hemorrhage
invades deep interior regions of the brain (thalamus, basal ganglia)
Subarachnoid Hemorrhage
occurs in the meningeal membranes protecting the brain
Thrombosis
accumulation of atherosclerotic platelets and fatty plaque on the vessel wall, causing narrowing (stenosis)
Embolism
Platelets and fatty plaque break off a vessel wall and travel until the cerebral artery becomes too small for it to travel
Ischemic Stroke
Blockage of the vessel
Hemorrhage
Rupture of the vessel with bleeding
Blockage of which artery will most likely lead to aphasia?
MCA because it supplies blood flow to the left hemisphere where language centers are located
Aphasia Causes
- CVA
- Tumor
- TBI
- Hydrocephalus
- Anoxia
- Degenerative Diseases
Open-Class Words
Content words like Nouns, Verbs, Adj.
Closed-Class words
Limited in number and mainly used for grammatical meaning
Problem with classical model
The problem with the classical model is that it does not consider the complex ways in which brain regions work together to produce and comprehend language.
Jargon
non-words or made-up words
Errors of commission
Errors in the use of words
Errors of omission
omitting words from sentences
Agrammatism
Difficulties with creating grammatically correct sentences and utilizing grammar
Circumlocution
Talking around the word a person wants to say
Anomia
Difficulty with word finding
Biopsychosocial model
A biopsychosocial framework considers the PWA’s medical condition, the affect on their emotions and mental health, as well as the impact on their social participation, which gives a fuller comprehensive look at how aphasia impacts their lives.
Propositional Language
the intentional, creative use of language.
Subpropositional Language
The automatic use of language with words and phrases
Aphasia as a Central Disorder
Damaging that causing aphasia is in ONE location; ie, one grammar is underlying language whether it’s for talking or writing
What is Aphasia Not?
Aphasia is not a sensory, motor, psychiatric, or intellectual disorder
Aphasia Definition
Aphasia is a speech disorder that affects the access to language. It is not the loss of linguistic concepts, but the ability to retrieve them.
