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Aphasia > Lecture 5: Fluent Aphasias > Flashcards

Lecture 5: Fluent Aphasias Flashcards

1
Q

Fluent Aphasias may also be Referenced as:

A

receptive aphasia, sensory aphasia, posterior aphasia, semantic aphasia

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2
Q

General s/s of fluent aphasia

A

Language comprehension deficits, paraphasic speech w/ poor self-monitoring, effortless & melodic speech, good artic, decreased use of real words, decreased amt of info spoken, tendency to be paragrammatic, self-initiated output, may use circumlocutions

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3
Q

Types of fluent aphasias

A

Wernicke’s, transcortical sensory, conduction, anomic

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4
Q

Wernicke’s Aphasia Background

A

Carl Wernicke in 1874
Characterized by fluent & sometimes excessive verbal expressions
Full of paraphasias (often rendering speech unintelligible)
Significant auditory comprehension deficits
Hallmarks: fluent but jargon-filled speech & defective auditory comprehension

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5
Q

Neuroanatomical Bases of Wernicke’s Aphasia

A

Superior temporal gyrus in dominant hemisphere, specifically posterior portion
Common etiologies: embolic/thrombolic CVAs & intracranial hemorrhage, trauma, tumor in posterior temporal lobe; untreated ear infections
Supplied by posterior branches of left MCA

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6
Q

General Characteristics of Wernicke’s Aphasia

A

Pts may appear normal
Don’t necessarily have paresis or paralysis; site of lesion is away from motor centers of brain
May sound confused; jargon-filled, irrelevant speech
Lack insight into their disability: don’t seem to be aware of their disorder & its effects on the listener
Lacks frustration in failed communicative attempts
Exhibit psychiatric symptoms: may be paranoid, homicidal, suicidal

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7
Q

Language Characteristics of Wernicke’s Aphasia

A

Excessive word output; cocktail party speech
Normal prosody w/ good artic & normal phrase length
Generally intact grammatical forms; may exhibit paragrammatism; excess use of grammatical morphemes
Severe word-finding issues; completely fail to name objects shown/ may produce a semantic substitution or neologistic response
May circumlocute
Empty speech: semantic & literal paraphasias
May retain grammatical words & omit content words
Hallmark: very poor auditory comprehension
Impaired convo skills, espcially w/ competing noise; may fail to yield to convo partners
Impaired repetition skills; may correspond to degree auditory comprehension is impaired
Difficulty w/ reading comprehension & writing
Unable to monitor speech: feedback loop broken

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8
Q

Wernicke’s aphasia site of lesion

A

Posterior portion of the superior/posterior temporal gyrus

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9
Q

Verbal expression in Wernicke’s aphasia

A

Described as excessive w/ paraphasias, empty speech, & paragrammatism

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10
Q

Auditory comprehension Wernicke’s aphasia

A

Severely impaired

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11
Q

Naming in Wernicke’s aphasia

A

Severely impaired w/ frequent word substitutions; phonemic priming is not usually helpful

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12
Q

Repetition in Wernicke’s aphasia

A

Impaired; will possibly mirror verbal expression

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13
Q

Oral reading in Wernicke’s aphasia

A

Impaired

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14
Q

Reading comprehension in Wernicke’s aphasia

A

Impaired

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15
Q

Writing in Wernicke’s aphasia

A

Impaired; paraphasic; neologistic

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16
Q

Transcortical Sensory Aphasia Background

A

1st described in 1881; aka posterior isolation syndrome & extrasylvian sensory aphasia
Pts will echo & imitate what is heard (echolalic behavior)
Some have even called it Wernicke’s Type II aphasia
Distinguishing hallmark between Wernicke’s & TSA is that pts w/ TSA are good at repetition
Fluent counterpart to TMA

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17
Q

Neuroanatomical Bases to TSA

A

Lesion in the temporoparietal region
Damage to the posterior portion of the middle temporal gyrus is typical
Cortical regions damaged are in watershed areas in the MCA
Head trauma can also cause TSA

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18
Q

General Characteristics of TSA

A

Onset is usually w/ hemiparesis that resolves
Pts in the initial stages of Alzheimer’s mirror sx’s 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 w/ some pts demonstrating signs of visual problems

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19
Q

Language Characteristics of TSA

A

Fluent, well-artic, paraphasic, echolalic, empty speech in context of poor AC
Generally good syntactic skills; no agrammatism; full of semantic & neologistic paraphasias
Don’t exhibit logorrhea or press of speech characterizing Wernicke’s aphasia
Impaired naming; echolalia
Good repetition skills; may not comprehend what they’re repeating
Normal automatic speech once initiated
Poor reading comprehension; able to read orally

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20
Q

Lesion site of TSA

A

Lesion in the temporoparietal region; posterior middle temporal gyrus

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21
Q

Verbal expression of TSA

A

Good w/ paraphasias; echolalic; empty speech; unaware of deficits; speech is parrot-like

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22
Q

AC in TSA

A

Impaired

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23
Q

Naming in TSA

A

Impaired; phonemic priming not usually helpful

24
Q

Repetition in TSA

A

Good; echolalic

25
Q

Oral reading in TSA

A

Good

26
Q

Reading comprehension in TSA

A

Impaired

27
Q

Writing in TSA

A

Impaired

28
Q

Conduction Aphasia Background

A

Characterized by paraphasic fluency, good comprehension, impaired repetition
Similar to pts with Wernicke’s aphasia but with good ( to normal) AC

29
Q

Neuroanatomical Bases of Conduction Aphasia

A

More controversial than other types
Lesions of the supramarginal gyrus &/or arcuate fasciculus
Bimodal distribution model

30
Q

Bimodal distribution model

A

More anteriorly located lesions produce less fluent aphasia w/ better AC skills; more posterior lesions may produce more fluent aphasia w/ poorer AC

31
Q

General Characteristics of Conduction Aphasia

A

Present w/ varied neuro & other sx’s
Some will have paresis & others won’t
Some will exhibit limb dyspraxia; others won’t
Some will show signs of right sensory impairment; others won’t

32
Q

Language Characteristics of Conduction Aphasia

A

Impaired repetition w/ fluent speech & naming deficits
Marked difficulty in repeating modeled productions even though comprehension is intact
May use words in speech they can’t repeat when requested to do so
Varied speech fluency; hence bimodal distribution model
Semantic & neologistic paraphasias less frequent
Marked anomia
Appear to be aware of errors but can’t correct them

33
Q

Lesion site of Conduction Aphasia

A

Supramarginal gyrus; left parietal lobe; arcuate fasciculus

34
Q

Verbal expression of conduction aphasia

A

Good with pauses & paraphasias

35
Q

AC in conduction aphasia

A

Good; possible mild comprehension

36
Q

Naming in conduction aphasia

A

Impaired

37
Q

Repetition in conduction aphasia

A

Severely impaired

38
Q

Oral reading in conduction aphasia

A

Impaired

39
Q

Reading comprehension in conduction aphasia

A

good

40
Q

Writing in conduction aphasia

A

Impaired

41
Q

Additional info of conduction aphasia

A

Cortical stuttering/neurogenic stuttering is sometimes present

42
Q

Anomic Aphasia Background

A

Lesion site undetermined or highly variable
Impt. to distinguish anomia as a sx vs anomia as a syndrome
Anomia is most commonly found residual symptom in persons who have recovered from all types of aphasia

43
Q

Anomia

A

Difficulty naming; a sx present in almost all types of aphasia

44
Q

Anomic Aphasia

A

Syndrome whose overriding feature is persistent & severe naming problems in the context of relatively intact language skills

45
Q

Neuroanatomical Bases of Anomic Aphasia

A

Lesion sites are controversial

Some cite issues at the angular gyrus & the second temporal gyrus

46
Q

Language Components of Anomic Aphasia

A

Marked sign is persistent naming difficulties
Fluent, empty speech may be another sign
Unimpaired pointing
Frequent circumlocution; substitutions (this, that, thing)
Normal syntax, good AC, intact repetition, good artic & normal-to-near-normal oral reading & writing
Verbal paraphasias present

47
Q

Additional Info related to Anomic Aphasia

A

Pts who have this have greater success naming words that are: nouns, words more frequently used in language, words shorter in length, personally meaningful, used more in conversation, part of sentence completion task

48
Q

Lesion Site Anomic Aphasia

A

Angular gyrus; second temporal gyrus

49
Q

Verbal expression Anomic Aphasia

A

Good but with frequent pauses & some paraphasias

50
Q

AC in Anomic Aphasia

A

Good; mildly impaired

51
Q

Naming in Anomic Aphasia

A

Severely impaired; lots of circumlocutions

52
Q

Repetition in Anomic Aphasia

A

Good

53
Q

Oral Reading in Anomic Aphasia

A

Good

54
Q

Reading Comprehension in Anomic Aphasia

A

Good

55
Q

Writing in Anomic Aphasia

A

Good; Will mirror verbal expression

56
Q

Hallmark for Conduction Aphasia

A

Good auditory comprehension (AC)
(Disproportionate impairment in repetition, fluent speech that’s not as fluent as Wernicke’s aphasia, phonemic paraphasias, & good comprehension are distinguishing features (p. 171)

Aphasia (8 decks)

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