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Aphasia > Fluent aphasias > Flashcards

Fluent aphasias Flashcards

1
Q

Fluent Aphasias

A

may be referenced as: receptive aphasia, sensory aphasia, posterior aphasia, and semantic aphasia

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2
Q

S/S of fluent aphasias

A
  • language comprehension deficits
  • paraphasic speech with poor self-monitoring
  • effortless and melodic speech
  • good articulation
  • decreased use of real words
  • decreased amount of information spoken
  • tendency to be paragrammatic
  • self-initiated output
  • may use circumlocuations
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3
Q

Types of fluent aphasias

A
  • Wernickes
  • Anomic
  • Conduction
  • Transcortical Sensory
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4
Q

Wernicke’s Aphasia

A
  • carl wernicke in 1874
  • characterized by fluent and sometimes excessive verbal expressions that are grammatically correct
  • full of paraphasias (often rendering speech unintelligible)
  • significant auditory comprehension deficits
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5
Q

Wernickes- Neuroanatomical Bases

A
  • superior temporal gyrus in the dominant hemisphere
  • specifically the posterior portion of the superior temporal gyrus
  • common etiologies:

— embolic/thrombolic CVA’s and intracranial hemorrhage; trauma; tumor in the posterior temporal lobe

— even untreated ear infections

  • supplied by the posterior branches of the left middle cerebral artery
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6
Q

Wernicke’s General Characteristics

A
  • pt’s may appear “normal”
  • do not necessarily have paresis or paralysis

— site of the lesion is away from the motor centers of the brain

  • may sound confused: jargon filled, irrelevant speech
  • lack insight into their disability: do not seem to be aware of their disorder and its effects on the listener
  • lack frustration in failed communicative attempts
  • exhibit psychiatric symptoms: may be paranoid, homicidal, suicidal
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7
Q

Wernicke’s Language Characteristics 1

A
  • excessive word output; cocktail party speech
  • normal prosody w/good articulation and normal phrase length
  • generally intact grammatical forms; pts may exhibit paragrammatism; excess use of grammatical morphemes
  • severe word-finding issues; completely fail to name objects shown or may produce a semantic substitution or neologistic response
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8
Q

Wernicke’s Language Characteristics 2

A
  • pts may circumlocute
  • empty speech: semantic and literal paraphasias
  • may retain grammatical words and omit content words
  • very poor auditory comprehension; HALLMARK
  • impaired conversational skills; especially w/competing noise; may fail to yield to conversational partners
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9
Q

Wernicke’s Language Characteristics 3

A
  • impaired repetition skills; may correspond to the degree auditory comprehension is impaired
  • difficulty with reading comprehension and writing
  • unable to monitor speech (feedback loop is broken)
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10
Q

Wernicke’s Aphasia Chart

  1. lesion site
  2. verbal expression
  3. AC
  4. naming
A
  1. posterior portion of the superior/posterior temporal gyrus
  2. described as excessive w/paraphasias, empty speech and paragrammatism
  3. severely impaired
  4. severely impaired w/frequent word substitutions; phonemic priming is not usually helpful
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11
Q

Wernicke’s Aphasia Chart

  1. repetition
  2. oral reading
  3. reading comprehension
  4. writing
A
  1. impaired; will possibly mirror verbal expression
  2. impaired
  3. impaired
  4. impaired; paraphasic; neologistic
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12
Q

Transcortical Sensory Aphasia

A
  • first described in 1881
  • aka posterior isolation syndrome and extrasylvian sensory aphasia
  • pts will echo and imitate what is heard
  • some have even called it Wernicke’s type II
  • distinguishing hallmark b/w Wernicke’s and TSA is that pts w/TSA are good at repetition
  • fluent counterpart to TMA
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13
Q

Transcortical Sensory Aphasia-Neuroanatomical bases

A
  • lesion in the temproparietal region
  • damage to the posterior portion of the middle temporal gyrus is typical
  • cortical regions damaged are in the watershed areas of the middle cerebral artery
  • head trauma can also cause TSA
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14
Q

Transcortical Sensory Aphasia- General characteristics

A
  • onset is usually w/hemiparesis that resolves
  • pts in the initial stages of Alzheimer’s disease mirror symptoms that are similar to those of TSA but continue to worsen into irreversible dementia
  • unilateral inattention is common; left neglect is a diagnostic feature of right hemisphere dysfunction
  • sensory loss may/may not be present with some pts demonstrating signs of visual problems
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15
Q

Transcortical Sensory Aphasia- Language characteristics 1

A
  • fluent, well-articulated, paraphasic, echolalic, empty speech in the context of poor auditory comprehension
  • generally good syntactic skills; no agrammatism
  • full of semantic and neologistic paraphasias
  • do not exhibit logorrhea or press of speech that characterizes pts w/Wernicke’s aphasia
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16
Q

Transcortical Sensory Aphasia- Language characteristics 2

A
  • impaired naming
  • good repetition skills; may not comprehend what they are repeating
  • echolalia
  • normal automatic speech once initiated
  • poor reading comprehension; able to read orally
17
Q

TSC Aphasia Chart

  1. Lesion site
  2. Verbal expression
  3. AC
  4. Naming
A
  1. lesion in the temporoparietal region; posterior middle temporal gyrus
  2. good w/paraphasias; echolalic; empty speech; unaware of deficits; speech is parrot-like
  3. impaired
  4. Impaired; phonemic priming is not usually helpful
18
Q

TSC Aphasia Chart

  1. repetition
  2. oral reading
  3. reading comprehension
  4. writing
A
  1. good; echolalic
  2. good
  3. impaired
  4. impaired
19
Q

Conduction Aphasia

A
  • characterized by paraphasic fluency, good comprehension and impaired repetition
  • similar to pts w/Wernicke’s aphasia but with good auditory comprehension
20
Q

Conduction Aphasia- Neuroanatomical bases

A
  • more controversial than other types
  • lesions of the supramarginal gyrus and/or the arcuate fasciculus
  • bimodal distribution model

—- more anteriorly located lesions produce less fluent aphasia w/better auditory comprehension skills; more posterior lesions may produce more fluent aphasia w/poorer auditory comprehension

21
Q

Conduction Aphasia- general characteristics

A
  • present w/varied neurological and other symptoms
  • some will have paresis; others will not
  • some will exhibit limb dyspraxia; others will not
  • some will show signs of right sensory impairment; others will not
22
Q

Conduction Aphasia- Language characteristics 1

A
  • characterized by impaired repetition w/fluent speech and naming deficits
  • marked difficulty in repeating modeled productions even though comprehension is intact
  • may use words in speech they cannot repeat when requested to do so
23
Q

Conduction Aphasia- Language characteristics 2

A
  • varied speech fluency; hence bimodal distribution model
  • semantic and neologistic paraphasias are less frequent in this aphasia
  • marked anomia
  • appear to be aware of errors but cannot correct them
24
Q

Conduction Aphasia Chart

  1. Lesion site
  2. verbal expression
  3. AC
  4. naming
A
  1. supramarginal gyrus; left parietal lobe; arcuate fasciculus
  2. good w/pauses and paraphasias
  3. good; possible mild comprehension
  4. impaired
25
Q

Conduction Aphasia Chart

  1. repetition
  2. oral reading
  3. reading comprehension
  4. writing
  5. Additional info
A
  1. severely impaired
  2. impaired
  3. good
  4. impaired
  5. cortical stuttering/neurogenic stuttering is sometimes present
26
Q

Anomic Aphasia

A
  • lesion site is undetermined or highly variable
  • anomia: difficulty naming; a symptom present in almost all types of aphasia
  • anomic aphasia: syndrome whose overriding feature is persistent and severe naming problems in the context of relatively intact language skills
  • important to distinguish anomia as a symptom versus anomia as a syndrome
  • anomia is the most commonly found residual symptom in persons who have recovered from all types of aphasia
27
Q

Anomic Aphasia- Neuroanatomical Bases

A
  • lesion sites are controversial

- some cite issues at the angular gyrus and the second temporal gyrus

28
Q

Anomic Aphasia- language characteristics

A
  • pts with anomic aphasia tend to have greater success naming words that are:

—nouns

—more frequently used in language

—shorter in length

—personally meaningful

—used more in conversation

—part of sentence completion task

29
Q

Anomic aphasia chart

  1. Lesion site
  2. verbal expression
  3. AC
  4. naming
A
  1. angular gyrus; second temporal gyrus
  2. good but w/frequent pauses and some paraphasias
  3. good; mildly impaired
  4. severely impaired; lots of circumlocutions
30
Q

Anomic Aphasia Chart

  1. repetition
  2. oral reading
  3. reading comprehension
  4. writing
A
  1. good
  2. good
  3. good
  4. good; will mirror verbal expression

Aphasia (13 decks)

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