Neurogenic Communication Disorders Flashcards
Dementia is due to degenerative diseases of the ___
CNS
Three types of dementia based on their location
Cortical dementia = cerebral cortex
Subcortical dementia = basal ganglia, thalamus, brainstem
Mixed dementia = cortical + subcortical structures
Cortical dementia examples
Alzheimer’s disease
Pick’s disease
Primary progressive aphasia
Most common subcortical dementia
Parkinson’s Disease
PD is due to deterioration of _____ in the basal ganglia + brainstem which inhibit neuronal activity and prevent unintended movements
Dopamine producing neurons
Early stage signs of PD
Micrographia
Tremor in hands
Immobility
Typical onset age of PD
50-56
Definition of mild cognitive impairment
Goes beyond normal aging but not significant enough to affect activity participation/functional independence (e.g. episodic memory loss, language impairments, neuropsychiatric symptoms)
T/F: PD affects cognition
True - memory, abstract reasoning, and other tasks that require sustained mental function progressively become compromised
T/F: Impaired vocabulary and syntax are some of the first signs of PD
False - vocab, syntax and grammar are preserved in PD until the late stages
Typical life expectancy post-onset of HD
a) 5-10 years
b) 10-15 years
c) 15-20 years
d) 20+ years
c) 15-20 years
Personality changes in HD
Irritability and emotional outbursts
T/F: In both PD and HD, intellectual functions begin to slow
False – in HD yes but PD, usually in tact, able to remain in familiar environments with supervision
What type of memory do Montessori activities acces?
Procedural memory
First symptoms of Alzheimer’s
MR. JDM (Jeffrey Dean Morgan)
- Lapse in Memory
- Faulty reasoning
- Poor judgement
- Disorientation in non-familiar enviros
- Alterations in mood (depressed, irritable, suspicious)
T/F: Intellect and cognition are mostly spared in AD
False - become increasingly impaired
Two main features of non-fluent PPA
- Agrammatism
- Hesitant speech with AOS
At least 2 of the following for non-fluent/agrammatic PPA
- Difficulty understanding complex phrases
- Preserved word comprehension
- Preserved object knowledge
2 features that must be present for semantic PPA
- Anomia (impaired word retrieval/confrontation naming)
- Impaired single-word comprehension
At least 3 of the following for semantic PPA
- Impaired object knowledge (especially low-freq)
- Surface dyslexia/dysgraphia
- Spared repetition
- Spared speech production (grammar + motor)
2 features that MUST be present for logopenic PPA
- Impaired word retrieval in spontaneous speech/naming
- Impaired repetition of sentences
At least three of the following for logopenic PPA
- Phonological errors (e.g. cluster reduction)
- Spared single-word comp/object knowledge
- Spared motor speech
- Absence of agrammatism
Three main categories of RHBD impairments
- Attentional / Perceptual Deficits
- Affective Deficits
- Communicative Deficits
What are the attentional deficits of RHBD?
- Left-side neglect
- Denial of illness
- Facial recognition deficits
- Reproducing shapes
- Disorientation
- Visuoperceptual deficits
What are the affective deficits of RHBD?
- Difficulty understanding emotions on faces
- Difficulty understanding emotion expressed in a single word/tone of voice
- Difficulty expressing emotions
What are the communicative deficits of RHBD?
- Difficulty with prosody (expressive and receptive)
- Impaired/disorganized narrative + discourse skills
- Difficulty understanding implied/abstract messages
- Pragmatics (e.g. turn taking, eye contact, excessive speech, topic maintenance)
What is a general way to distinguish between aphasia and dementia in evaluation?
Aphasia – tend to perform better on nonverbal tests of intelligence/problem solving than verbal tasks
Dementia – poor on both
What type of memory is affected at the beginning of Alzheimer’s?
Declarative
- Semantic (facts, words, names - meaning of a word/expresssion)
- Historical events
- Episodic (related to emotion)
What type of memory is more affected toward the end of Alzheimer’s?
Procedural
- Associations
- Motor skills
-
What is prospective memory?
Ability for intentions from the past to inform actions in the present (made a plan to do something later in the day)
In most cases, a dementia diagnosis requires progressive deterioration in at least 3 of the following functions:
Intellectual functions
Judgement
Thinking (cognition?)
Visuospatial skills
Constructional abilities
Language
Memory
Emotion
Behaviour
What is Mild Cognitive Impairment?
Only ONE of the potential functions is impaired and the severity is MILD
Causes of reversible dementias
About 20% of cases:
Metabolic disturbances
Chronic renal failure
Persistent anemia
Drug toxicity
Lung & heart disease
Nutritional deficiencies
T/F: Pre-existing learning disability makes a person more vulnerable to effects of TBI
True
Risks post-TBI
- Seizures
- Depression + PTSD (self-medication)
- 2nd TBI
- Criminality
- Homelessness
Post-injury factors that influence recovery
- Early medical intervention (time is brain)
- Early rehab
- Long-term support network
- Individual resilience/effort/adjustment
What is a diffuse brain injury?
Crosses multiple brain regions –> affects entire brain
Examples of diffuse brain injury
Global Ischemic (loss of oxygen)
Edema (brain swelling)
What is a focal brain injury?
Injury to a specific part
Examples of focal brain injury
Scalp lacerations
Skull fractures
Contusions (brain bruise)
Intracranial hemorrgage
Acceleration vs. Non-acceleration trauma
Acceleration – moving head hits moving object/stationary object/or whiplash
Non-acceleration – non-moving head hit by object –> consequences come from the deformation of the skull
Which is more dangerous, an epidural hematoma or a subdural hematoma?
Subdural –> spreads more slowly, so no initial symptoms; epidural can be resolved with a hole to relieve pressure and remove blood
Common consequence (secondary) of diffuse injuries
Cerebral edema
Environmental compensations for TBI
- Stick to a routine
- Keep belongings in a designated place
- Educate the family on what’s going on and how to interact
- Set time limits for working on difficult tasks (avoid errors + fatigue)
