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Aphasia > Lecture 3: Sequelae of TBI 2 > Flashcards

Lecture 3: Sequelae of TBI 2 Flashcards

1
Q

Neurodiagnostic purpose

A

Means often used to diagnose neural pathology & associated deficits; some methods are post-hoc, some are invasive, & some are inferential; may be static or dynamic

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2
Q

Neurodiagnostic Methods used most often in diagnosis of stroke:

A

MRI, CT, SPECT scans

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3
Q

Prevalence

A

total number of disease cases at a given period of time

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4
Q

Incidence

A

Number of new cases during some time period

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5
Q

Prevalence of Strokes

A

3rd leading cause of death in US; mortality rates differ across types; leading cause of disability

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6
Q

Which type of strokes more common?

A

ischemic more than hemorrhagic

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7
Q

Which type of aphasia more common in younger pts?

A

Broca’s aphasia

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8
Q

Which type of aphasia more common in older pts?

A

Wernicke’s

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9
Q

Pts with aphasia grouped according to…

A

fluency of speech; some pts have relatively preserved fluency of speech while others have marked difficulty in producing & sustaining fluent speech: so either fluent or nonfluent; classification based on both deficiencies of language & anatomical considerations

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10
Q

Receptive & Expressive Aphasias

A

References deficits in language comprehension &/or production; can also be mixed type; generally correlated w/ differing sites of lesion

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11
Q

More anterior cerebral lesions tend to be associated with

A

Language production problems

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12
Q

Lesions more posteriorly located in the cerebrum tend to produce

A

more comprehension related issues

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13
Q

Nonfluent aphasias are considered_____

A

expressive aphasias

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14
Q

Fluent aphasias are considered _______

A

receptive aphasias

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15
Q

Aphasia Symptomatology

A

Most pts will demonstrate a set of common sx
Various paraphasias; D/o’s of fluency; Auditory comprehension; Repetition; Paragrammatism vs. agrammatism; Anomia; Writing problems; Reading problems; Visual (gestures); Apraxia vs. dysarthria or both

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16
Q

Paraphasias

A

Errors in speech consisting of unintended words or sound substitutions; often considered a central sign of aphasia; most are present in all types of aphasia & can’t be considered significant factor in diagnosis of specific types

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17
Q

3 Primary Types of Paraphasias

A

Verbal (global) paraphasia
Neologistic paraphasia
Phonemic (literal) paraphasia

18
Q

Verbal paraphasia

A

AKA global paraphasia
Entire word is substituted
2 Types: semantic paraphasia & random paraphasia

19
Q

Semantic Paraphasia

A

Type of verbal paraphasia

Substituted word is semantically related to the 1 intended (says son for daughter)

20
Q

Random Paraphasia

A

Type of verbal paraphasia

Substituted & intended words are not semantically related (window for banana)

21
Q

Neologistic paraphasias

A

References use of meaningless, invented words

Pts may refer to an object by their invented, nonsensical term

22
Q

Phonemic Paraphasias

A

AKA Literal paraphasias
Substitution of 1 phoneme for another (loman for woman) or the addition of a phoneme (wolman for woman)
Different diagnosis than apraxia of speech or speech sound disorder

23
Q

Fluency

A

Speech that approximates normal rate, typical word output, length of sentences, & melodic contour

24
Q

Disorders of Fluency

A

Aspects of language production; Fluent speech flows & is produced with less effort & is smooth & devoid of too many interruptions

25
Q

What is fluent speech considered?

A

produce 5+ connected words

26
Q

Fluency is considered significantly impaired when…

A

Word output is less than 50 words a minute in conversation

27
Q

Pts who are nonfluent

A

Tend to speak with a degree of muscular effort not seen in normally fluent speakers
Speech may be slow, deliberate, or limited
Utterances may contain fewer words than normal
Speech is usually hesitant

28
Q

Auditory Comprehension

A

Most pts with aphasia have some degree of difficulty with it
Not dependent necessarily upon fluent or nonfluent status; it’s degree of severity that varies
Assessed from simple tasks to more complex multi-steps

29
Q

Repetition

A

pt’s imitation of single words, phrases, & sentences
Usually more frequently present in cases of impaired auditory comprehension; not always the case
Must rule out true deficit vs. inability to repeat secondary to apraxia, etc.

30
Q

Paragrammatism

A

Seen in fluent aphasias
Substitution/addition of inappropriate sequences (verb tense confusions, gender case issues, incorrect choice of prepositions, misuse of inflections, juxtaposition issues)
Cocktail party speech

31
Q

Agrammatism

A

Seen in nonfluent aphasias
Simplification/reduction of grammatical construction
Omission of articles, connected words, auxiliary verbs, inflectional morphemes
Pt’s will only use content words
Telegraphic speech

32
Q

Anomia

A

Word finding difficulty usually persists for those that recover
Present in confrontational naming
Word frequency & semantic categories: words that are less frequent in everyday language
Not particularly useful when differentiating types of aphasia (more of a general problem)
Persistent & severe word-finding & naming difficulties are dominant; pt may have anomic aphasia

33
Q

Divergent Confrontational Naming

A

Name 3 fruits

34
Q

Convergent Confrontational Naming

A

apple, pear, and orange are all _____

35
Q

Agraphia

A

writing problems associated with cerebral lesions

36
Q

Grapheme Expression

A

Most all pts will demonstrate some difficulty with writing
Problems will generally reflect problems seen in verbal expression: agrammatic, effortful sparse speech seen in pts w/ Broca’s aphasia will demonstrate agrammatic, effortful, sparse writing
May exhibit poor letter &/or word formation
May reverse, confuse, or substitute letters
Self-correction may be poor; nonsensical words & poor orthographic skills
May be totally unreadable

37
Q

Reading Problems

A

Again, variety is noted in pts with aphasia
Some have difficulty reading secondary to verbal expressive problems
Others may demonstrate poor comprehension of what is read silently or orally

38
Q

Alexia

A

Loss of or inability to comprehend written language

39
Q

Aphasia is not:

A

schizophrenia or dementia

40
Q

Dementia

A

Progressive neurological disease in which communicative & cognitive skills, along with social & personal behaviors continue to deteriorate
Alzheimer’s; Pick’s & Parkinson’s can also cause it

41
Q

Schizophrenia

A

Psychiatric disorder characterized by disordered thought, affect, & behavior
Pts exhibit irrelevant speech & disturbed thinking
Disassociation from reality with hallucinogenic qualities
Typically diagnosed earlier in life than aphasia
Onset is usually more gradual

42
Q

8 Must-Knows

A 
Site of lesion
Oral expression
Repetition
Naming
Auditory comprehension
Oral reading
Reading Comprehension
Grapheme expression

Aphasia (8 decks)

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