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Cognitive Communication > Impaired Cognition > Flashcards

Impaired Cognition Flashcards

1
Q

Why do patients benefit from consultation with speech pathology?

A

The diseases & conditions (etiologies) that can cause cognitive communication disorders encompasses the entire spectrum of etiologies in medicine

communication etiologies = medicine etiologies

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2
Q

How is etiology different from pathophysiology?

A

Etiology

  • cause, set of causes, or manner of causation of a disease or condition
  • disease/injury

Pathophysiology

  • describes the functional changes associated with or resulting from disease or injury
  • what you’d expect to see considering disease/injury (etiology)

Both are important in understanding course, prognosis, and treatment of disease or injury

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3
Q

The Etiology of a disease is…

A

the cause, set of causes or manner of causation of a disease or condition

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4
Q

Pathophysiology of a disease is…

A

the functional changes associated with or resulting from disease or injury

–> what you’d exprect to see considering disease/injury

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5
Q

_________________ & ________________ are important in understanding the course, prognosis, and treatment of disease or injury

A

Etiology & Pathophysiology

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6
Q

Name Etiologic Categories

A

DINT 2I TV (Din’t 2 eye TV) Think too much TV = illness

  • Degenerative - neurons decline
  • Inflammatory -responses to bacteria
  • Neoplastic - causes cancer
  • Toxic Metabolic - deficiencies/toxicity ( too much junk food is toxic–> deficiencies)

2 I (eyes)

  • Iatrogenic - needed surgery now im damaged
  • Idiopathic - who knows why?

TV

  • Trauma - lots of gunshots, falls, and sports on TV
  • Vascular - stroke/neurologic deficits
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7
Q

What type of disease etiology causes decline in neuronal function?

A

Degenerative Diseases

(i.e. Alzheimers)

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8
Q

What etiology is caused by responses to bacteria, immunologic reactions, viruses?

A

Inflammatory Diseases

e.g. Covid-19, meningitis

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9
Q

Which etiology is caused by vitamin deficiencies, complications of kidney and liver disease, hypoxia, hyponatremia, drug toxicity?

A

Toxic- metabolic diseases

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10
Q

What etiology does cancer fall under?

A

Neoplastic diseases

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11
Q

What etiology is most common cause of neurologic deficits?

A

Vascular diseases

e.g. cerebrovascular disease (stroke)

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12
Q

Potential precipitating events (e.g. MVA, fall, gunshot wounds, blast injury, and sports-related injuries all are ________

A

Trauma

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13
Q

Disease caused by medical examinations or treatment are considered _____ in etiology

A

Iatrogenic

e.g. nerve damage from surgery

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14
Q

Diseases of unknown causes are called ______________ in etiology

A

Idiopathic

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15
Q

How are diseases/conditions categorized?

A

CAR-D-D *think cardi-b

  • C-onditions of Immunocompromise (please me song)
  • A-cute onset diseases that remain stable or improve (started from the bottom now we here)
  • R-elapsing remitting diseases (general downward trend) - (Be Careful)
  • D-iseases that worsen - (i Like it)
  • D-iseases that are episodic -(WAP)
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16
Q
  • Stroke
  • TBI
  • Abscesses
  • Encephalitis

are _______ diseases that are ______ or ______

A

acute onset diseases

stable

improve

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17
Q

what are acute onset diseases?

A

Diseases that remain stable or improve:

Stroke

TBI

Abscesses

Enchephalitis

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18
Q

What causes CVAs/Strokes?

A

lack of blood flow to any area of the brain (including brainstem)

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19
Q

a lack of blood flow to any area of the brain and brainstem would cause…

A

Cerebrovascular accident (CVA, aka stroke)

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20
Q

What deficits most often result due to the loss of blood flow in the left MCA from stroke?

A

cognitive-linguistic defecits

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21
Q

What happens as a result of blockage in brain from stroke?

A
  • blockage prevents nearby brain tissure from getting nutrients
  • Brain tissue is deprived of oxygen & nutrients, it begins to die
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22
Q

3rd leading cause of death & leading cause of disability

A

Strokes

700,000 strokes annually

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23
Q

Types of stroke are

A

Hemorrhagic

Ischemic

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24
Q

Hemorrhagic stroke caused by..

A

ruptured blood vessel that causes bleeding in the brain

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25
Q

2 subtypes of hemorrhagic stroke

A
  • intracerebral (within the brain) hemorrhage
  • subarachnoid ( within arachnoid space) hemorrhage
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26
Q

Name two types of weakened blood vessels that cause hemorrhagic stroke

A
  • Cerebral aneurysm: ballooning, weakened artery
  • Arteriovenous malformation (AVMs): tangle of blood vessels; congenital but can become a problem
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27
Q

A ballooning, weakend artery is ____

A

cerebral aneurysm

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28
Q

A tangle of blood vessels that are congenital and can become a problem are —

A

Arteriovenous Malformations (AVMs)

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29
Q

Cerebral aneurysms & Arteriovenous malformations (AVMs) usually cause

A

hemorraghic stroke

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30
Q

What type of stroke accounts for nearly 90% of all strokes?

A

Ischemic (clots)

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31
Q

2 subtypes of Ischemic clots are

A
  • Thrombotic - forms in artery within brain & blocks blood flow
  • Embolic- clot forms & travels in bloodstream then lodges & blocks blood flow
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32
Q

_____ _____ form in arteries within the brain and blocks blood flow causing an ______ stroke

A

Thrombotic clots; Ischemic

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33
Q

_____ _____ form and travel in blood stream, lodging & blocking blood flow causing ______ stroke

A

Embolic clot; Ischemic

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34
Q

_______ is the brain’s way of reorganizing neural connections to compensate for injury and disease

A

Neuroplasticity

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35
Q

Symptoms of stroke

A

First few days following stroke is the critical period. Recognize signs:

  • F-ace drooping
  • A-rm weakness
  • S-peech difficulty
  • T-ime to call 911
36
Q

Emphasis after stroke is on

A
  • restoring blood flow in order to save brain tissue (as much as possible)
  • determining cause & finding treatments
37
Q

Do the majority of strokes improve?

yes or no

A

YES!

often improvment continues often throughout the patient’s lifetime (neuroplasticity)

38
Q

What contributes to improvement after stroke?

A

Neuroplasticity!

neural connections are reorganized in brain to compensate for injury & disease

39
Q

Why is the location of stroke (site of lesion important to determine after a stroke?

A
  • Site of lesions can give insight to what deficits may occur.

Examples:

  • Left MCA blockage = results in ischemia to left posterior, inferior frontal lobe = Broca’s aphasia
  • Subarachnoid hemorrhage in temporal lobe caused by trauma = headache, visuospatial neglect.
40
Q

Severities of

Traumatic Brain Injury

(TBI)

A
  • Mild - brief loss of consciousness
    • Most recover within 3-12 months
  • Severe- prolonged loss consciousness (including coma)
    • Long-term difficulties
41
Q

Types of

Traumatic Brain Injury

(TBI)

A

2 types:

  • Closed brain injury
    • cause by a rapid forward or backward movement and shaking of the brain inside the bony skull = bruising & tearing of brain tissue and blood vessels.
      • car accidents, falls, and increasing in sports
  • Penetrating brain injury
    • caused when there is a break in the skull
      • gun shot wounds
42
Q

Shearing of the brain’s nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull

A

Diffuse axonal injury

43
Q

Diffuse axonal injuries are always evident on CT & MRI scans

True or False

A

FALSE!

Diffuse axonal injuries are often microscopic that they may not show on CT (computed tomography) scans or MRI (magnetic resonance imaging) scans.

44
Q

___________ start with a localized area of cerebritis (inflammation of the cerebrum) developing into collection of pus & well vascularized capsule

45
Q

How are abscesses similar to stroke?

A

the deficits will depend on location of abscess

46
Q

Encephalitis is …

A

________ the inflammation of the brain parenchyma or tissue itself

47
Q

Types of Encephalitis

A
  • Viral
  • Bacterial
48
Q

Area of brain where encephalitis tends to occur

A

Temporal lobes

49
Q

Deficits that occur with encephalitis

A
  • Significant dysnomia
  • impaired new learning
  • impaired memory
50
Q

Conditions of Immunocompromise examples

A
  • Progressive multifocal leukoencephalopathy
  • HIV infections/AIDS
  • COVID-19
  • May also include those on immunosuppressant medications or chemotherapy
51
Q
  • Progressive multifocal leukoencephalopathy
  • HIV/AIDS
  • COVID
  • those on immunosuppressent medications
  • those undergoing chemotherapy

are all examples of what type of etiology?

A

Conditions of Immunocompromise

52
Q

Progressive Multifocal Leukoencephalopathy (PML)

A
  • Disease of white matter of the brain
  • caused by virus infection that targets myelin making cells (which insulates neurons).
  • has been noted to occur in patients with AIDS
    • and in those taking natalizumab to treat Multiple sclerosis or rheumatoid arthritis
  • has a subacute onset of altered mental status
    • and focal symptoms related to location of PML lesions
53
Q

What is the cause of PML (progressive multifocal leukoencephalopathy)?

A
  • A virus infection targets cells that make myelin which insulates nerve cells
  • Disease of white matter of the brain
54
Q

What patients has PML been noted to occur in?

A
  • AIDS
  • those taking natalizumab for MS or RA
55
Q

Symptoms of PML

A
  • subacute onset of altered mental status
  • focal symptoms related to location of PML lesions
56
Q

How does HIV/AIDs affect the body?

A
  • by killing CD4+T cells which weaken the immune system
    • allowing opportunistic infections
57
Q

Why are T cells important?

A
  • they are essential to the immune response
  • without T cells, body cannot fight infections or kill cancerous cells
58
Q

Cognitive changes caused by HIV virus

A
  • HIV-associated Neurocognitive disorder (HAND)
    • group of neurocognitive disorders consisting of:
      • HAD - HIV associated dementia, used to be called AIDS dementia complex ; more severe form of HAND
        • considered subcortical-type dementia
        • impairments in attention, processing speed, executive function & verbal memory.
      • MND - mild neurocognitive disorder
    • some patients see improvment in cognitive testing with antiretroviral medication
59
Q

COVID-19 cognitive deficits

A

Potential link between inflammatory status & cognitive functions in COVID-19 patients

  • potential cognitive dysfunction
  • sustained attention deficit is correlated with inflammatory level
60
Q

Multiple Sclerosis (MS) and Systemic Lupus Erythematous (SLE) are examples of

__________ __________ diseases

A

relapsing remitting

61
Q

Demyelinating disease consisting of a relapsing & remiting course,

with slowd overall course (if treated)

A

Multiple Sclerosis (MS)

62
Q

Cognitive impairments resulting from MS

A
  • Memory
  • sustained attention
  • processing speed
  • executive function

**50% of patients have cognitive impairments

63
Q

Autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs; affects many different body systems

A

Systemic Lupus Erythrematosus

(SLE)

64
Q

• Alzheimer’s Disease (AD)

  • Parkinson’s Disease (PD)
  • Frontotemporal dementia (FTD)
  • Primary Progressive Aphasia (PPA)
  • Progressive Supranuclear Palsy (PSP)
  • Corticobasal Syndrome (CBS)
  • Amyotrophic lateral sclerosis (ALS)
  • Multiple System Atrophy (MSA)
  • Creutzfeldt-Jakob disease (CJD)
  • Brain tumors

are all _________ ______ _________

A

Diseases that Worsen

65
Q

Alzheimer’s Disease (AD)

-cause

A

Wide belief: Plaques (beta amyloid protein deposits) & tangles (tau protein fibers) play a role in blocking communication among nerve cells & disrupting processes that cells need to survive

  • scientists do not know exact role that plaques & tangles play in AD.
  • Those with AD tend to develop more than normal plaques & tangles in a predictable pattern
    • starts to develop in areas more important for memory
    • 2/3rds of all dementia is result of AD
66
Q

Alzheimer’s Disease (AD)

  • hallmarks
  • related communication/cognitive impairments
A
  • Hallmark* : slowly progressive memory impairment
  • Communication/Cognitive deficits:*
  • agnosia (inability to process sensory information; inability to recognize objects, persons, sounds, etc.)
  • apraxia
  • aphasia
  • executive function impairments
67
Q

Parkinson’s Disease (PD)

Cause

A
  • caused by loss of dopamine-producing nerve cells in substantia nigra
  • dopamine acts as messenger between parts of brain & nervous system
    • that help control & coordinate body movements
68
Q

Parkinsonism

A

umbrella term used to descrive symptoms of tremors, muscle rigidity & slowness of movement

69
Q

Types of Parkinson’s Disease (PD)

A
  • Parkinson’s disease: idiopathic
    • most common
  • Vascular
  • Drug-Induced
  • Other
70
Q

Parkinson’s Disease (PD)

Cognitive deficits

A
  • slower cognitive functioning and processing speeds
  • attention
  • working memory
  • executive function deficits
    • all most common as opposed to language deficits
71
Q

Frontotemporal Dementia (FTD)

cause

A
  • group of related conditions resulting form progressive degeneration of temporal and frontal lobes of brain
  • scientists believe it’s caused by large build up of one of three kinds of protein within brain cells
    • tau
    • TDP-43
    • fused-in sarcoma (FUS)
      • causing brain atrophy
72
Q

Frontotemporal Dementia (FTD)

symptoms & hallmark

A
  • Presenting symptom - behavioral difficulties
    • saying inappropriate things or lack emotion
  • Hallmark - Executive dysfunction
73
Q

Types of Frontotemporal Dementia (FTD)

A
  • Behavioral variant frontotemporal dementia (bvFTD)
  • Semantic variant primary progressive aphasia (svPPA)
  • Non-fluent/aggrammatic variant primary progressive aphasia (nfvPPA)
74
Q

Primary Progressive Aphasia (PPA)

-cause

A
  • cause = atrophy in frontal, temporal or parietal lobes
    • primarily on left side of brain
    • atrophy may be caused by abnormal proteins
75
Q

Primary Progressive Aphasia (PPA)

types

A

• Semantic variant primary progressive aphasia (svPPA)
• Non-fluent/agrammatic variant primary progressive
aphasia (nfvPPA)

  • lopopenic variant primary progressive aphasia (LvPPA)
    • at autopsy, patients with lvPPA are often found to have AD, not FTD
76
Q

Caused by atrophy in frontal, temporal or parietal lobes primarily on left side of brain

may be caused by abnormal proteins

A

Primary Progressive Aphasia

77
Q

Progressive Supranuclear Palsy (PSP)

cause

deficits

A
  • buildup of tau proteins in brain
  • deficits
    • impaired balance
    • impaired eye movements (inability to look down)
    • spastic dysarthria
    • dysphagia
    • bradykinesia
    • rigidity
    • frontal behavioral changes
    • Executive dysfunction & poor recall
78
Q

Corticobasal Syndrome (CBS)

cause

deficits

A
  • buildup of tau or amyloid proteins causing brain atrophy
  • Impairments:
    • limb apraxia
    • visuospatial impairments
    • rigidity
    • acalculia
    • frontal dysfunctions
    • alien limb phenomenon
    • language impairments later on
    • might develop memory or executive impairments later on
79
Q

Amyotrophic Lateral Sclerosis (ALS)

cause

A
  • most common motor neuron disease in adults
  • progressive muscle paresis & paralysis
    • 20% of patients also have FTD signs & symptoms
    • 50% of patients have mild executive function impairments
  • Unknown why motor neurons are dying in the disease
    • more clues pointing to inflammation
80
Q

A rare, degenerative neurological disorder affecting your body’s involuntary (autonomic) functions

including:

  • blood pressure
  • breathing
  • bladder function
  • motor control
A

Multiple System Atrophy (MSA)

81
Q

Creutzfeldt-Jakob Disease (CJD)

cause

symptoms

deficits

A

A fast, progressive, invariably fatal neurodegenerative disease

  • cause = misshapen prion proteins
  • symptoms =
    • personality changes
    • anxiety
    • depression
  • deficits =
    • memory loss
    • executive dysfunction
    • blurred vision or blindness
    • insomnia
    • dysarthria
    • dysphagia
    • dyskinesias
82
Q

Brain Tumors

types

causes

A
  • Types:
    • Primary
    • Metastasis from other cancer sites
  • Glioblastoma accounts for 50-60% of all cases
    • life expectance 12-15 months after diagnosis
83
Q

Brain tumors

symptoms

deficits

A

Symptoms: depend on type of cancer/location

  • Seizures
  • headaches
  • nausea
  • vomiting
  • changes to personality

Deficits

  • memory loss
  • changes to personality
  • attention
  • executive dysfunction
84
Q

Transient Ischemic Attacks (TIAs)

Seizures

are _______ that are ________

A

Diseases that are Episodic

85
Q

Appears exactly like a stroke but resolves within 24 hours

A

Transient Ischemic Attack

*If symptoms last longer than 24 hours, considered a stroke

86
Q

Seizures

cause

deficits

recovery

A
  • Causes = variety; Epilepsy is a seizure disorder
  • Slowly recover following seizure
    • postictal period (altered state of consciousness after an epileptic seizure) can be a few hours - 24 hours
  • Cognitive communication impairments -
    • may occur during or in postictal period, but usually resolve

Cognitive Communication (11 decks)

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