neurogenic disorders Flashcards
what is ischemic penumbra
when the surround tissue function is compromised
what is a characteristic of hemorrhagic strokes
thunderclap headache with sudden onset
what is a semantic paraphasia
substitution of one word for another which may be related in meaning marker for pencil
what is a phonemic or literal paraphasia
error at sound level tup for cup
what is a neologism
nonword
what is logorrhea
excessive inappropriate productio of speech which is tangential
what is empty speech
using general words such as this, that, stuff etc to replace specific words
what are characteristics of Broca’s
- impaired naming
- nonfluent speech
- limited word output
- distored speech sounds
- telegraphic speech
- impaired repetition
- poor oral reading and comprehension
- difficulty writing
- monotonous
what are characteristics of transcortical motor aphasia
caused by lesions in the supplementary motor area supplied by the anterior cerebral artery and anterior MCA 1. no spontaneous speech 2. nonfluent 3. intact repetition 4. echolalia and perseveration 5. awareness of grammar 6. refusal to repeat nonsense words 7. unfinished sentences 8. attempts to initiate speech with the help of motor activities such as clapping, head noding and had waving 9. good comprehension 10 difficulty with oral reading 11. seriously impaired writing 12. lack of interest in communication
what is mixed transcortical aphasia
rare
cause by lesions in border zone of brain between middle, anterior and posterior arteries
results in limited spontaneous speech, automatic and unintentionl communication, s
mostly unimpaired automatic speech
severe echolalia
impaired auditory comprehension
impaired fluency
naming difficulty
bilaterl upper motor neuron paralysis (spastic), weakness of limbs, and visual field defects
what are characteristics of global aphasia
caused by extensive lesions in perisylvian region
usually due to occlusion of left MCA
wide spread destruction of the frontotemporoparietal region
what are characteristics of Wernickes aphasia
- fluent speech with normal phrase lenth
- rapid rate of speech with normal prosody
- intact grammar
- severe anomia
- semantic and literal paraphasias, extra syllables in words, neologisms
- circumlocution
- empty speech
- poor auditory comprehension for sentences and names of common objects
- worse comprehension in background noise
- o,[aored re[etotopm
- difficulty reading and writing
- anosognosia
- paranoia, depression
what are characteristics of transcortical sensory aphasia
lesions in temporoparietal region
arcuate fascicuus may be unaffected
parts of occipital lobe may be affected
posterior branch of the left MCA
1. fluent speech
2. paraphasias and empty speech
3. good repetition but poor comprehension of repetitions
4. echolalia of grammaticall incorrect forms, nonsense syllables and foreign languages
5. impaired auditory comprehension
6. difficulty pointing, obeying comands, or answering yes-no questions
7. normal automatic speech (counting)
8. tendency to complete sentences started by cliinician
9. good reading with poor comprehension
10. may have one sided neglect
what are characteristics of conduction aphasia
lesions in supramarginal gyrus and arcuate fasciculus
1. impaired repetition
2. speech fluency
3. phonemic paraphasias
4. word finding difficulties
5. empty speech
6. near normal comprehension
7. variable reading problems with better comprehension of silent reading
8. buccofacial apraxia: difficult performing buccofacial movement
9. no neurological symptoms i some, paresis of right face and limb in others
10 oral apraxia
11. right sensory impairment may be present
what can lesions to the basal ganglia produce
anomic global brocas wernickes transcortical motor aphasia
what can lesions to the thalamus cause
fluent aphasia with paraphasias and poor comprehension
word finding and naming problems
limited verbal output
neologisms
what can lesions to the cerebellum cause
limited fluency
mild anomia
mild speech comprehension problems may be the dominant symptom
what is included in a bedside evaluation for aphasia
- ask personal questions such as name
- ask for nonverbal responses (point to window)
- ask questions related to orientation ( is California a state in Canada)
- get a brief reading and writing smaple
what are possible screening tests for aphasia
- bedside western aphasia bettery
- BDAE-3 short form
- Mississippi aphasia screening test
what are functional communication assessments
target daily living skills
may be assessed by observing how a client communicates their needs
what skills are necessary to assess in aphasia
- repetition: single words, objects names, verbs, function words; repetition of sentences
- assessment of naming skills: responsive naming (what color is snow) and confrontational naming
- word fluency (name all the animals you can think of)
- production of sentence when a word is supplied
- production of multiple sentences (tell me about…)
- narrative skills: retell a story
- discourse
- assess fluency
- assess functional communication
- assess auditory comprehension
- assess comprehension of single words
- assess comprehension of sentences, paragraphs, discourse
- assess reading
- assess writing
- gestures
- automated speech
how do you assess auditory comprehension of spoken language
- hearing eval
- visual eval
- appropriate response to verbal commands
- comprehension of multistep commands
what is restorative aphasia treatment
help patient regain skills lost by reducing the severity of the deficits
what is compensatory aphasia treatment
help individuals to function despite deficits by teaching compensatory behaviors