L7: Neurobehavioural, Language, Comm Profiles of Aphasia P2 Flashcards
Wernicke’s aphasia is a type of
fluent/posterior apahsia
anomia
word finding difficulties
wernicke’s aphasia presents as ____ except for periods of ______, normal to excessive ____ output, press of speech, and logorrhoea
fluent
anomia
verbal
logorrhoea = incoherent talking
wernicke’s speehc can be described as
semanticlaly empty, primarily functors, and info empty words (stuff, that, those)
morphosyntactic structures near normal, if abnormal, considered paragrammatic rather than agrammatic, may observe correct use of complex grammatical forms
paragrammatism vs agrammatism
para = the incorrect use of grammar
agram = omitting grammatical words
what are the features of paragrammatism?
errors may or may not occur in writing as well as in spoken output
generally well constructed syntax of sentences
substitution of grammatical morphemes
paragrammtic errors theorized to occur later in the sentence
in wernicke’s:
articulation and prosody are generally _____
serial spoken output is ____
_____ rate in conjunction with press of speech
_____ interuption
_______ of comm difficulties
unimpaired
strong
inc
resists
usually unaware
wernicke’s involves no verbal or oral apraxia BUT…. (2 things)
all types of paraphasias (generally not responsive to phonemic cues)
perseveration
paraphasias=
a substitution in speech
perseveration=
unintentional production of an info unit previously produced or heard or seen
substituted for correct response
gets stuck
often unaware
what are the 3 types of paraphasias and the 2 additional related types?
semantic
phonemic
neologistic (neologism)
extended jargon
circumlocution
semantic paraphasias are
disruption at the lexical level
semantically related or unrelated to the target word
ex. jelly fish for octopus (related), or chicken for octopus (unrelated), or chair for octopus (verbal)
phonemic paraphasias are
disruption at the phonological level
similar word or non word substitutions; 50% or more of the error overlaps phonologically w the target
octagon for octopus (real word) vs ocoput for octopus (non-word)
neologistic paraphasias are
not a word phonologically or semantically
often follows the phonological rules of the language
ex. ertig for octopus
extended jargon paraphasias are (not a type of paraphasic error by can be included)
running/connected utterances (phrases or sentences) in which includes senseless words or neologisms
circumlocution is
talking around the intended word - informative description
in wernicke’s reptition is
disturbed
may be related to severe auditory comp difficulties, contains paraphasias
in wernicke’s auditory comp is
severely impaired -understand v little
may comp simple words, phrases, sentences
system overloads easily
may have phoneme discrimination probs
in wernicke’s reading comp is
often reading parallels auditory comp deficit (connected!)
since reading is learned thru our auditory sys, if aud comp is impaired then…
reading comp impaired and/or angular gyrus sys involved; storage of symbols is disturbed and reading comp is disturbed
in wernicke’s reading aloud is
disturbed but not to the same extent as reading comp
filled w paraphasic errors (literal/phonemic and verbal/semantic)
in wernicke’s writing is
impaired on a linguistic level but not often at motoric level
paraphasic errors
lacks meaning - semantically empty
in Wernicke’s, they may exhibit initial paresis but…
and abulatory losses are ____, tactile losses _____….
and visual losses _____
transient and disappears shortly post onset
rare
can be present
may occur
in Wernicke’s the patients may become ____ as others focus on deficits client unable to _____
paranoid
see or appreciate (bc they are unaware)
site of lesion for Wernicke’s
wernicke’s area, posterior 1/3 of STG plus inferior parietal
BA 22
conduction aphasia is a type of
fluent/posterior aphasia
conduction aphasia is considered a fluent aphasia but…
verbal output limited to brief bursts of utterances
in conduction aphasia, conversation output is impaired due to
word finding pauses and attempts to self correct
in conduction aphasia, verbal output in # words/min approaches _____ vs wernicke’s ____ output
normal
copious
in conduction aphasia there are _____ paraphasic errors, _____ of phonemes is impaired
literal/phonemic
selection
in conduction aphasia, ____ are used in the setting of impaired word retrieval
circumlocutions
in conduction aphasia, verbal output is facilitated by
singing and rhythmic patterning
serial talk is robust if you give a starting phonemic cue
in conduction aphasia they have _____ intonation, _____ syntax, and _____ of errors
normal
near normal
aware
the most classic sign of conduction aphasia is… why?
repetition problems
they understand what they hear but cannot transfer to Broca’s area for rep purposes
in conduction aphasia aud comp and reading comp is ____
good (contrast aud comp w wernicke’s)
reading aloud in conduction aphasia is …
impaired bc info cannot be transmitted to Broca’s area for verbal output
describe how writing is effected in conduction aphasia
impaired on a linguistic level but not often at motoric level
spelling errors bc of storage disturbances to angular gyrus
words omitted and interchanged in sentences
in conduction aphasia, there are often ___ neurological deficits, but…
no
other can exhibit some
in conduction aphasia, motor hemiparesis and sensory disturbances are ____, and involves…
variable
depends on location of lesion
usually only arm or R side of face
sensory loss may only involve distal portions of upper limb (fingers)
in conduction aphasia, the visual field is …
involved - usually apparent either R-homonymous hemianopia or inferior or superior quadrantanopia
in conduction aphasia, ideomotor apraxia is inconsistent for ___ but consistent for ______ structures…. sometimes diff to separate comp probs from ___ component
limb
face/oral/resp structures
apraxic
site of lesion of conduction aphasia
interruption along the arcuate fasciculus; white matter pathways under supramarginal gyrus
anomic aphasia is a type of
fluent/posterior aphasia
wernicke’s and conduction may evolve into an
anomic aphasia
in anomic aphasia, there is ______ naming relative to other difficulties
disproportionately greater difficulty
in anomic aphasia, there is ______ hesitations, grammatically ______ spoken output
intermittent
well-formed
in anomic aphasia, ____ of substantive words, _____ of content aka “____”
absence
vagueness emptiness
semantically empty
in anomic aphasia, _____ can be vague and bizarre
circumlocutions
in anomic aphasia, they may say ______ phrases, ex. little things
non-specific
in anomic aphasia, _____ are infrequent, but semantic when present
paraphasias
in anomic aphasia, repetition skills are ______
good
in anomic aphasia, auditory comp is
relatively or entirely intact
in anomic aphasia, writing/reading skills..
vary along a broad spectrum
spelling also varies considerably
in anomic aphasia, you do not usually see hard or soft…
neurological signs
site of lesion for anomic aphasia
least reliably localized of all aphasia syndromes; usually in L temporo parietal area and may extend into angular gyrus resulting in severe alexia and agraphia
alexia =
impairment in reading
agraphia=
impairment in ability to write
transcortical sensory aphasia is a type of
fluent/posterior aphasia
transcortical sensory aphasia is quite
rare, but w a similar profile to Wernicke’s
in transcortical sensory aphasia, you’ll see:
_______ speech
_____ neologisms, paraphasias, circumlocutions
_____ severly impaired
will not initiate _____, but evoked are ________
well articulated
frequent
naming
utterances, fluent and empty
in transcortical sensory aphasia, repetition is (!!!!!!!)
excellent! (words>sentences)
may be considered echolalia (involuntary rep of everything heard)
in transcortical sensory aphasia, auditory comp is
impaired w moderate to severe levels
in transcortical sensory aphasia, reading comp is
poor
in transcortical sensory aphasia, reading aloud has
a wide range of performance from preserved to defective
in transcortical sensory aphasia, writing is
poor (similar to W)
in transcortical sensory aphasia, there are sensory
impairments
transcortical sensory aphasia may involve gerstman’s syndrome which requires the following 4 characs (in dispute)
R/L disorientation
finger agnosia
agraphia
severe acalculia
finger agnosia =
close eyes, examiner touches fingers, client cannot tell which finger touched
acalculia =
acquired arithmetic deficits
in transcortical sensory aphasia, there is ____ awareness of the extent of impairment
poor
site of transcortical sensory aphasia
posterior parieto-temporal, sparing wernicke’s area; parietal and temporal border zones
disruption in blood supply from the PCA affecting the inferior temporal lobe and anterior occipital lobe
subcortical lesions may cause aphasia in 3 ways:
thalamus and BG
subcortical vascular lesions (striate arteries)
combination of 1 and 2
why would thalamus/BG damage cause aphasia?
play direct regulatory or indirect gating roles in cortical language functions via projection fibres/tracts (ex. internal capsule and cornona radiata)
subcortical vascular lesions (striate arteries) could cause aphasia bc
they may have widespread effect, creating hypofusion in LH perisylvian cortical regions
anterior capsular/putamen lesions cause a combination of
TCM and Broca’s aphasia characs
for all subcortical variants of aphasia we will see…
borderline fluent vs non fluent
anterior capsule/putamen lesions cause the following spontaneous language symps
borderline fluent (6-8 words)
hypophonia w poor articulatory agility
variable syntax
phonemic and semantic paraphasias
repetition in anterior capsule/putamen lesions is
relatively good
auditory comp in anterior capsule/putamen lesions is
relatively good
posterior casular/putamen lesions show a combination of
Broca’s and Wernicke’s aphasias
posterior casular/putamen lesions show the following spontaneous language symps
borderline fluent (6-8 words)
hypophonia w good artic agility
variable syntax
phonemic, semantic, neologistic paraphasias
posterior casular/putamen lesions show ___ repetition
poor
posterior casular/putamen lesions show ___ auditory comp
poor
thalamic lesions = thalamic aphasia, effects thalamic projections to
both frontal and posterior cortical language zones and to motor cortex
thalamic lesions = thalamic aphasia may result in ____ and _____ aphasia like linguistic characteristics
TCM and TCS
thalamic lesions = thalamic aphasia have the following spontaneous language symps
borderline fluent (6-8 words)
somewhat perseverative
anomia w semantic (verbal) paraphasias
intact syntax
thalamic lesions = thalamic aphasia show ______ repetition
relatively spared (like transcortical)
thalamic lesions = thalamic aphasia show ___ auditory comp
variable
during the acute stage, there is variability in aphasic syndromes bc
diaschisis is more extended and complex
unusual aphasia manifestations due to 1) focal brain pathology and 2) extended brain dysfunction secondary to diaschisis
there is also variability in aphasic syndroms because the brain is a dynamic system…
with areas of interconnectivity
simple brain functions localized into single brain areas
diverse and simultaneous activation of complex brain functions
there is also variability in aphasic syndromes bc of individuality…
indv diffs in brain organization and connectivity
indv life and linguistic experiences influence the organization of cog and language
3 reasons for variability in aphasic syndromes:
acute stage
dynamic and interconnected
individuality
