MWF 10 Flashcards
Cognition is the ability to…
Acquire and Process knowledge
What is Vigilance?
one’s awareness of their five senses, but no need to process them
lowest level of cognitive functioning
What is Sustained Attention?
ability to focus for long periods of time with no distracting stimulus around
What is Selective Attention?
focusing on a specific task for some time while simultaneously ignoring distractions and irrelevant information
What is Alternating Attention?
the ability to switch between tasks; to stop one task, do another, and return to initial task
What is Divided Attention?
focusing on multiple tasks at once; tasks have to be easy
most FRAGILE type of attention
Doing two different language tasks simultaneously is what kind of attention?
Alternating Attention
What is Working Memory?
the ability to hold a finite amount of info for immediate processing and manipulating that would be lost within a few seconds if not somehow reinforced
What is Declarative Memory?
the ability to remember facts, right or wrong answers
ex: remembering colors, names of objects
What is Episodic Memory?
the ability to recall specific, recent events; such as a vacation, child being born, etc
What is Procedural Memory?
the memory of sequences of actions used to complete tasks;
ex: how to… brush teeth, drive, dress
What is Prospective Memory?
the memory that involves remembering to perform/recall a planned action/intention at a future time
Which domain of memory needs to be assessed extra carefully?
Prospective Memory
What is Orientation?
a person’s knowledge of themself and of their place in space and time; who, where, and when they are
What is Executive Function?
high-level cognitive systems that employ and manage other lower-level cognitive functions
What are the functions in Executive Functioning?
attention, memory, planning, problem solving, initiating, and organizational behaviors
Where is the Executive Functioning located?
housed within prefrontal areas of the frontal lobes
What is the definition of Speech?
the set of sounds produced by the vocal tract for the purpose of spoken language
What is the definition of Language?
the use of a set of symbols used to communicate meaning; can be used visually, verbally, or manually
What is Semantics?
the study of meaning and abilities related to word meanings
What is Morphosyntax?
abilities related to extending and combining words
What are Pragmatics?
abilities related to language use in social contexts
What are Paralinguistic Cues?
non-linguistic info that augments a speaker’s message; may include tone, speech rate, facial expression
What are Metalinguistic/Metacognitive Skills?
the ability to reflect on one’s language and cognitive skills
What is the definition of Motor Speech Disorder?
a motor impairment that adversely affects speech production and intelligibility
can involve motor planning or execution
What is Dysarthria?
the brain sends message and cannot produce sound due to motor execution problem
What is Dysphagia?
difficulty in swallowing
What is the definition of Normal Cognitive Decline?
age-related cognitive changes affecting domains such as memory, word recall, and processing speed
What is Dementia?
chronic, persistent impairment of mental faculties, most conspicuously (but not exclusively) memory
True or False: It is difficult to identify the difference between Normal Cognitive Decline and Dementia?
True; both have similar effects
What is Primary Progressive Aphasia?
Progressive loss of language faculties in the absence of a dementia diagnosis
True or False: In those with Primary Progressive Aphasia, the cognition factor in Executive Functioning is damaged
False; Executive Functioning maintains intact in terms of cognition though they are UNABLE TO VERBALIZE it
True or False: In those with Primary Progressive Aphasia, language ability is suddenly affected
False, language ability is affected over time
Directional Terms: Rostral vs. Caudal
Rostral is towards the beak
Caudal is towards the tail
Directional Terms; Ventral vs. Dorsal
Ventral is towards the belly
Dorsal is towards the back
Directional Terms: Dextrad vs. Sinistrad
Dextrad is to the right
Sinistrad is to the left
Sagittal Plane
Separates the body into left and right halves
Coronal Plane
“Crown”; separates body into front and back halves
Transverse Plane
separates the body into top and bottom halves
The Cranium - Coup
when the brain hits the inner front of skull due to accident
The Cranium - Contrecoup
when coup occurs, brain rebounds to back and causes more injury
True or False: Damage can occur to rising intracranial pressure causing swelling of the brain and its structures
True
Which cranial bones are unpaired?
Frontal Bone, Occipital Bone, Sphenoid Bone, and Ethmoid Bone
Which cranial bones are paired?
Parietal Bone and Temporal Bone
Damage to which cranial bone will damage the olfactory nerve?
Ethmoid Bone
What are the three meninges?
Dura Mater
Arachnoid Membrane
Pia Mater
What is the function of Cerebrospinal Fluid?
Cushion and support the brain; support metabolic functions
What is the definition of a Fissure?
a deep divide between sections of brain tissue
What is the definition of the Cortex?
the top layer of brain tissue; unusual configuration and is gray and rind-like
What is the function of the Primary Visual Cortex?
it receives visual information from the contralateral visual field
What is the function of the Visual Association Area?
it contributes to complex visual analysis
What are the three prominent gyri in the Temporal Lobe?
The superior, middle, and inferior gyri
What is the function of the Primary Auditory Cortex?
detects information from both ears
What is the function of the Auditory Association Cortex?
processes auditory information
What is the function of Wernicke’s Area?
important in comprehension of spoken word and verbal memory
Where is Wernicke’s Area located?
located in posterior superior portion of the superior temporal gyrus
True or False: Wernicke’s Area is functional in both hemispheres
Functional in dominant hemisphere only
What is the function of the Postcentral Gyrus?
receives sensory information from contralateral body and face
What is the primary sensory cortex called?
Postcentral Gyrus
What is the Angular Gyrus associated with functionally?
associated with reading, writing, and calculation ( with Supermarginal Gyrus); word recall
What three Gyrus are in the Parietal Lobe?
- Postcentral Gyrus
- Angular Gyrus
- Supermarginal Gyrus
What is the function of the Supramarginal Gyrus?
works with Wernicke’s area in processing syntax, semantics, and phonological components of speech
What is the name of the primary motor cortex?
The Precentral Gyrus
True or False: The Precentral Gyrus is organized topographically for contralateral movement
True
Which cortical motor areas does the Precentral Gyrus receive input from?
the Thalamus, Basal Ganglia, Cerebellum, and other cortical motor areas
What is the function of Precentral Gyrus?
it is involved in the initiation of motor movement
What are the four Frontal Association Areas?
- Premotor Cortex
- Supplementary Motor Area
- Broca’s Area
- Prefrontal Cortex
What is the function of the Premotor Cortex?
planned skilled motor movements for the hands, fingers, and speech
What is the function of the Supplementary Motor Area?
plays a role in preparing and executing sequential voluntary movements, as well as speech
What is the function of Broca’s Area?
planned motor speech movement
Where is Broca’s Area located?
unilateral, found in dominant hemisphere only
lies in lower portion of premotor cortex
What is the function of the Prefrontal Cortex?
contributes to cognitive function and personality
What is the name of the big pocket of gray matter that is tucked into the brain?
the Insula
Where is the Insula located?
lies in the perisylvian part of brain
What is the function of the Insula?
important in language processing and function
Where is the Opercula?
the zones superficial to the Insula consisting of gray matter
What is the function of the Opercula?
language function
What happens if the Corpus Callosum is damaged?
a person will be unable to do common tasks, like walking and ability to touch an object and understand what it is
What is the function of the Corpus Callosum?
Important in Interhemisphere Communciation
What is the function of the Cerebellum?
important for smooth and efficient movement and speech motor functioning and learning
What is the function of the Basal Ganglia?
motor function, cognition, and emotion
What is the role of the Amygdala?
the formation of emotional memories
What is the function of the Limbic System?
handling emotional aspects of behavior and motivation
What happens if the Limbic System is damaged?
the person will function using more emotional drive
What is the function of the Hippocampus?
important for forming memories
What system is the Hippocampus a part of?
the Limbic System
What three structures are present in the Brainstem?
The midbrain, pons, and medulla
What is the site of pyramidal decussation?
the Medulla
What is the definition of Decussation?
where fibers cross for sensory information
What is the Synaptic Cleft?
the space between dendritic spine and the axon button
What are the Association Fibers?
carries information within a hemisphere from one lobe to another
What kind of fiber is the Arculate Fasciculus?
an Association Fiber
What are the Commisural Fibers?
any place in the body where two paired structures meet; carries information between the hemispheres
What kind of fiber is the Corpus Callosum?
a Commisural Fiber
What are the Projection Fibers?
fibers that carry sensory and motor information to and from cortex
What does SAME stand for?
Sensory - Afferent
Motor - Efferent
What is Cranial Nerve One and its function?
Olfactory Nerve
smell and taste
What is Cranial Nerve Five and its function?
Trigeminal Nerve
Jaw strength and control
articulation
What is Cranial Nerve Seven and its function?
Facial Nerve
Facial muscles and taste and salivation
What is Cranial Nerve Eight and its function?
Vestibulocochlear Nerve
Balance and hearing
What is Cranial Nerve Nine and its function?
Glossopharyngeal Nerve
resonance and pharyngeal stage of swallowing
What is Cranial Nerve Ten and its function?
Vagus Nerve
Velum and larynx
Reason for hyponasality in voice
What is Cranial Nerve Eleven and its function?
Accessory Nerve
Effects on posture and swallowing
Secondary effects on communication
What is Cranial Nerve Twelve and its function?
Hypoglossal Nerve
Tongue movement for speech and swallowing
What happens if blood flow to the brain ceases for 4-6 min?
Irreversible brain damage
What happens if blood flow to the brain ceases for 5-8 seconds?
Loss of consciousness
Where do the right and left cerebral artery come together and what is this structure called?
at the base of the skull; called the Basilar Artery
What is the structure where blood flows through the neck and is a pathway for much of the bloodflow to the body
the Common Carotid Artery
What is the function of the Anterior Cerebral Artery?
pathway of bloodflow from front of brain to Parietal-Occipital junction
What is the pathway for blood to travel to the right supplementary motor area?
Heart - Aorta - Branciosyphallic - Right common carotid - right internal carotid - right middle cerebral artery
What two arteries are present in the Vertebrobasilar system?
- Vertebral Artery
- Basilar Artery
How does blood get to the occipital lobe?
Heart - Aorta - Branchiosyphallic (if right) - Subclavian Artery (back of brain) - Vertebral Artery - Basilar Artery - Posterior Cerebral Artery
What structure can help blood navigate to the brain if there is a blockage in the chosen pathway?
the Circle of Willis
Which artery supplies the MEDIAL surface of the frontal lobe and parietal lobe of the brain?
the Anterior Cerebral Artery
Which artery supplies the LATERAL surface of the frontal lobe, parietal lobe, and the temporal lobe?
Middle Cerebral Artery
Which artery supplies the Occipital Lobe?
the Posterior Cerebral Artery
What is a Thrombus Blockage?
refers to a blockage on a wall of a blood vessel
What is an Embolus Blockage?
a traveling blood clot going through arteries with the potential to cause a blockage of blood flow
What is an Atheroma Blockage?
degeneration of the walls of the arteries caused by accumulated fatty deposits and scar tissue, and leading to restriction of the circulation and a risk of thrombosis.
What are the two types of bleeds/hemorrages?
- Aneurysm
- Arteriovenous Malformation (AVM)
What is an Aneurysm?
a weak spot in the wall of an artery; progressive growth that ruptures and spills blood
Dr’s often caution those with high blood pressure of this possibility
What is an Arteriovenous Malformation (AVM)?
an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation, causing blood to leak and cause a stroke
What is Ischemia?
tissue damage as a result of oxygen deprivation
What is a Transient Ischemic Attack (TIA)?
a “mini-stroke”; short term effects of a stroke that don’t cause irreparable damage
What is an Infarct?
an area where tissue has been deprived of oxygen long enough to become dead tissue
What is a Cerebrovascular Accident?
a stroke, vascular tissues oxygen supply has been disrupted therefore causing lasting effects
What are the types of Strokes?
- Ischemic/Occlusive
- Hemorragic
What are Ischemic/Occlusive strokes?
where there is prevention of normal blood flow therefore blocking the artery
What are the two types of Ischemic/Occlusive stroke?
- Thrombolic
- Embolic
What is a Thrombolic Stroke?
a stroke caused by a blockage on a wall of a blood vessel
What is an Embolic Stroke?
a stroke caused by a traveling blood clot that caused a blockage of blood flow
What are the two types of Aneurysm-caused Strokes?
- Intracerebral - within the brain
- Subarachnoid - within the meninges
What is Atrial Fibrillation?
irregular heart rhythm, blood sitting in atria ends up clotting
What does the acronym FAST describe?
Stroke Symptoms:
Face - asymmetrical drooping
Arms - cant lift both arms above shoulders
Speech - slurred
Time - how long from onset of symptoms
In order for the best outcome for the stroke patient, within how long of onset does the patient have to be administered drugs for best results?
Needs to be administered drugs within three hours of onset of stroke symptoms
What are the two types of TBI?
- Epidural Hematoma
- Subdural Hematoma
What is a Epidural Hematoma?
bleeding that occurs between the dura mater and cranium; especially dangerous in early stages
What is a Subdural Hematoma?
bleeding that occurs between the skull and the brain; more progressive
Describe the nature of Infection-causing brain injuries
the damage is more focal, in one particular spot of the brain
What is Encephalitis?
inflammation/infection in the head
if blood-brain barrier is breached, this is hard to fix
What is Creutz Feldt-Jakob Disease?
a rapidly progressive, invariably fatal neurodegenerative disorder believed to be caused by an abnormal isoform of a cellular glycoprotein known as the prion protein
What are the three main causes of an Acquired Brain Injury?
- Infections
- Neoplasms
- Seizure Disorders
True or False: Poorly managed HIV, Syphillus, and Herpes can cause Acquired BI
True
What are some risk factors for Stroke?
Over 65 years old
Previous TIA or CVA
High Blood Pressure
Diabetes
High Cholesterol
Heart Disease
Carotid Artery Disease
CABBAGE (surgery)
Atrial Fibrillation
What does Ictus mean?
a period of primary symptoms
True or False: Seizures alone can damage the brain
True
True or False: SLP’s do NOT play a big role in Discharge Planning of Acute Care patients
False! They assess cognition and play big role
What are the two types of structural neuroimaging?
CT and MRI
What is a CT scan?
“Computed Tymography”; images of slices of the brain, uses radiation
What is an MRI scan?
“Magnetic Resonance Imaging”; no use of radiation, measures spin properties of hydrogen molecules in brain tissue, allows for higher resolution in imaging
What are the two types of functional neuroimaging?
PET scan and fMRI’s
Which type of neuroimaging is used more often in research environments?
Functional Neuroimaging
What is a PET scan?
“Positron Emission Therapy”; inject radioactive glucose-like substance into blood stream to follow path as it decays
What is an fMRI?
“Functional MRI”; can see blood flow to brain
What is the most common Aphasia diagnosis and the most optimistic?
Broca’s Aphasia
True or False: Broca’s Aphasia has the greatest degree of progress is generally seen in 1st year post-stroke
True
What is Perseveration?
When a patient is stuck on a subject or sound intrusively
What is Paraphasia?
What are Literal Paraphasias?
most common; at least half of the word being said is correct; also Phonemic/Phonological
What are Neologistic Paraphasias?
where 2/3 of the word being said is incorrect; words with no meaning such as “berkaboo”; HALLMARK FEATURE OF WERNICKES aphasia
What are Verbal Paraphasias?
where patient says the right genre of the word, but wrong kind;
ex: Give me a plum! No, I meant peach!
What are Anomias?
refers to word retrieval deficits and is common across Aphasia types
How can Anomia be assessed?
can be assessed through confrontation or repetition tasks
What is Agnosia?
a neurological disorder that results in an inability to recognize objects (such as an apple or a key), persons, smells, or sounds despite normally functioning senses (such as visual or auditory). These deficits are not due to memory loss.
What is Apraxia?
person has trouble with motor planning of speech, knowing where to place the sound
What are the characteristics of Apraxia?
Impaired initiation, Effortful speech, Inconsistent error patterns, and Visible groping
What is Hemiplegia?
where one side has paralysis
What is Hemiparesis?
where one side has weakness
What is Logorrhea?
Flow of words; word dumping
What are some characteristics of Agrammatism?
Limited prosody
Possible dysarthria, usually mild
Facial hemiparesis
Limb hemiparesis/hemiplegia
Limb apraxia
Hyposthesia
What are some limits of comprehension in Broca’s Aphasia?
-Comprehension is relatively intact, as compared to Wernickes Aphasia
-Comprehension is impaired for complex tasks, especially involving grammatically complex utterances
-Patients are generally aware of their production errors
Reading/Writing deficits in Broca’s Aphasia
Since reading/writing is built off spoken language, reading intact though varies case by case
Other symbol system deficits in Broca’s Aphasia
issues with reading symbols like traffic signs, numbers, music notes
What is Lability?
emotional regulation; considered a fragile skill; hard for patient’s with sudden onset Aphasia
What is Expressive Aphasia?
Aphasia with deficits mainly concerning expressive aphasia, more common form of aphasia
What are more names for Broca’s Aphasia (4) ?
- Expressive Aphasia
- Agrammatical Aphasia
- Motor Aphasia
- Efferent Motor Aphasia
What are the main characteristics of Broca’s Aphasia?
- Empty space
- Effortful
- Limited prosody
- Content-dense
- Keen awareness
What are the main characteristics of Wernicke’s Aphasia?
- Abundance of Words
- Easy
- Normal Melodic Line
- Largely empty
- Low awareness
What is Paragrammatism?
pseudogrammar; sounds like correct grammar but is not
What are the most common type of paraphasias in Wernicke’s Aphasia?
Neologistic errors
What is Anosognosia?
the patient is unaware of their own deficits; does not know there is a problem with their communication
True or False: In Broca’s Aphasia and Wernicke’s Aphasia, both have issues with symbolic representation?
True
What are some other names for Wernicke’s Aphasia?
- Receptive Aphasia
- Sensory Aphasia
- Semantic Aphasia
- Jargon Aphasia
True or False: In both Broca’s Aphasia and Wernicke’s Aphasia, both have impaired repetition?
True
What are some characteristics of Conduction Aphasia?
a Fluent aphasia where the person has:
+ intact auditory comprehension
+ intact fluent spontaneous speech
- frequent literal and verbal paraphasias
- Conduite d’approche
- Disproportionately impaired repetition
- Reading/Writing Impairment
- Anomia
What is the distinct characteristic of Conduction Aphasia?
Disproportionately impaired repetition where person cannot repeat back what clinician says in sequence
What is Circumlocution?
when a person with aphasia talks around a subject to get to a certain word
What are some characteristics of Transcortical Sensory Aphasia?
a fluent aphasia where the person has:
+ intact prosody
+ preserved repetition
- impaired comprehension
- frequent paraphasias
- circumlocution
- anosognosia
- writing impairment
-reading impairment**
- anomia**
-echolalia
What is specific about the reading impairment in Transcortical Sensory Aphasia?
the reading impairment is not an impairment of literacy but literacy comprehension
What is specific about the Anomia in Transcortical Sensory Aphasia?
the person typically says answers off the top of their head and will not identify if they have even said the right one; GUESSING
What are some characteristics of Transcortical Motor Aphasia?
a nonfluent aphasia where the person has:
+ intact auditory comprehension
+ preserved repetition
+ reading comprehension
- reduced utterance length
- reduced syntactic complexity
- imprecise productions
- possible deficits for grammatically complexity
- writing comprehension
- often preceded by mutism
Why is Transcortical Motor Aphasia often preceded by mutism?
A cause of this is often a lesion present affecting the supplementary motor area
What are some characteristics of Mixed Transcortical Aphasia?
a nonfluent aphasia where the person has:
~ multifocal or diffuse damage
+ preserved repetition
- pronounced anomia
- poor comprehension
- sparse output
- frequent echolalia
- possible association with hypoxia
What type of aphasia has some possible association with hypoxia?
Mixed Transcortical Aphasia
What are some characteristics of Global Aphasia?
a nonfluent aphasia where the person has:
All aspects of language severely impaired and persistent across all modalities therefore being very difficult to treat
More specifically:
- Comprehension is only intact for questions with immediate relevance
- Limited verbal expression
- Nonverbal problem solving impaired
What are some characteristics of Anomic Aphasia?
A nonfluent aphasia where the site of lesion is variable, most likely near temporoparietal junction
Characteristics include:
+ Fluent speech
+ Intact prosody
+ Intact articulation
+ Intact syntax
+ Intact repetition
- Word finding
- Circumlocutions
- Verbal paraphasias
~ Possible reading/writing issues
What are some characteristics of Subcortical Aphasia?
A type of Aphasia that is controversial and associated with lesions of the thalamus or basal ganglia where presentation is variable and symptoms may be transient
