general Flashcards
definition
impairment due to acquired and recent impairment of the CNS, of the ability to comprehend and formulate language. Multimodality disorder represented by a variety of impairments in auditory language and reading/writing. It cannot be explained by dementia, sensory loss, or motor function (not aphasia if cognition is also impacted)- (Rosenbeck, LaPointe, & Wertz, 1967)
anomia
word retrieval deficit
paraphasia
misproduction of a word
- verbal: unrelated real word
- semantic: related to target word
- lexical: similar to semantic/verbal
- phonemic: substitute, transpose, or omit sounds
- sublexical: include phonemic and neologism errors
- neologistic: made up word
- perseverative: from previous utterance
agrammatic
lacks inflection, prepositions, verbs, copulas; stringing together of nouns and verbs, telegraphic, usually NONFLUENT
paragrammatic:
unsystematic omission or substitution of grammatical morphemes; fluent
alexia
reading deficit
agraphia
writing deficit
Broca’s
nonfluent
- damage: broca’s area, premotor area, motor strip, insula, basal ganglia
- production is effortful, restricted vocab, telegraphic, noun dominated, deletion of functor words
- repetition: impaired
- aud comp: impaired with complex sentences
- writing: similar to spoken output
- may also have oral apraxia
- usually have right upper extremity spasticity and right lower facial weakness–consistent with UUMN dysarthria)
-Severity rating scale BDAE: 1-1.5, 2 and 3 not uncommon with recovery
-articulatory agility: 1-4
-phrase length: 1-4
-grammatical form: 1-4
-melodic line: 1-4
paraphasia in RS: 5-7
-word finding r/t fluency: 4-7
-sentence rep: 30-65%
-AC: above 50
Wernicke’s
FLUENT
- damage: posterior lesion, superior temporal gyrus (wernickes, 22), may extend to angular and supramarginal gyrus, middle temp gyrus (aud comp) and primary/secondary auditory areas
- production: fluent, normal prosody, lacking content,no self-corrections, paraphasic errors including semantic, phonemic, and neologistic
- naming: impaired
- writing and reading deficits
- aud comp IMPAIRED
- unaware of deficits, usually no hemiparesis
- severe cases: may be jargon speech
-BDAE raing profile of speech characteristics
-AA: 6-7
-PL: 5.5-7
-GF: 5/5-7
-ML: 6.5-7
Paraphasia in RS: 1-4
-Word finding r/t fluency: 1-3
-SR: 0-60%
-AC: 0-50 (below 50%)
Conduction
damage: supramarginal gyrus, primary auditory cortex, insula, subcortical white matter, ARCUATE FASCICULUS
- FLUENT, literal paraphasias, phonemic paraphasias, impaired naming;vflow may be interrupted by frequent attempts at self-correction or word finding difficulties
- frequent phonemic paraphasias that client tries to correct–> conduit d’approache, conduit d’ecart: attempts move closer and closert to target or further and further
- repetition: SEVERELY IMPAIRED (hallmark)
- aud com: relatively spared
- writing impaired with difficulty planning sounds and letters
- aware of deficit, self-corrections and frustration, sometimes rt sided paresis
BDAE rating scale speech characteristics:
- AA: 5-7
- PL: 5-7
- GF: 4.5-7
- ML: 5.5-7
- Praphasia in RS: 2-4
- Word finding r/t fluency: 2-4
- SR: 0-55%
- AC: 50-100%
Global
EXTENSIVE DAMAGE, broca’s, wernicke’s, etc
- production is fluent or nonfluent, severe deficits across all language modalities
- gesture well
- profound anomia, virtually no speech output (THAT GUY FROM BMC)
- sometimes stereotyped utterances
- repetition: impaired
- aud comp good for single nouns and verbs ONLY
- impaired reading and writing
anomic
- lesion: posterior lesion in left temporal cortex, middle or inferior temporal gyri
- fluent, empty content
- naming difficulty!
- nouns worse than verbs
- many semantic paraphasias
- repetition, aud comp, reading and writing all okay (reading comp impaired with increased length)
BDAE rating scale speech characteristics
- AA: 6.5-7
- PL: 6-7
- GF: 6.5-7
- ML: 6.5-7
- Paraphasia in RS: 5-7
- WF r/t fluency: 2-4
- SR: 65-100%
- AC: 60-100%
transcortical motor
- damage: frontal areas outside broca’s, extends anterior to the premotor cortex, deep white matter
- production is nonfluent, reduced complexity, phonemic paraphasias, perseveration
- repetition: good (HALLMARK)
- aud comp: relatively unimpaired for conversation, but may be impaired when tested formally/complex
- reading, writing impaired
transcrotical sensory
- damage: outside wernicke’s, posterior mid-temporal gyrus, angular gyrus, white matter
- production is FLUENT, neologistic, circumlocutory empty speech, cant access meaning
- repetition GOOD (hallmark)
- comprehension: context dependent
- reading and writing impaired
transcortical mixed
damage: outside wernicke’s and broca’s; diffuse pathologies not exclusive to CVA
- production: sparse verbal output, nonfluent,
- naming: impaired
- repetition: GOOD (hallmark)
- IMPAIRED auditory comp (on BDAE should be below 50th percentile to consider mixed nonfluent vs. broca;s)
- reading and writing impaired
