Quiz 1 Flashcards
Incidence
of newly diagnosed Cases per specified unit of time
likelynumber ofnewly diagnosed cases per specified unit of time
Prevalence
Proportion of people that had/have the disorder at a particular time
Acquired neurogenic cognitive-linguistic disorders
Wide array of disorders of language caused by problems in the brain of a person who had previously acquired language
Aphasia is…
- Acquired
- Problem of circuitry more than etiology
- Lesion matters: site, size, location
Are congenital disorders, AoS, language of generalized intellectual impairment, and dysarthria neurogenic cognitive linguistic disorders?
No
What 4 elements should be in a complete aphasia definition?
Acquired, language, neurological, multimodal
Modifiable risk factors
Poor diet
Lack of exercise
High stress
Smoking
Non-modifiable risk factors
Structural abnormalities in the blood supply
Hematological pathologies
Type 1 diabetes
Gender
3 layers of the meninges
Dura matter
Arachnoid matter
Pia matter
Toxemia
Poisoning, irritation, or inflammation of nervous system tissue through exposure to harmful substances
Neoplasm (tumor)
2 major types:
Malignant and benign
Etiologies: primary tumors result from uncontrolled growth of 2 types of cells
- glial and meningeal cells
What is a transient ischemic attack?
Temporary blockage of the blood supply to any area of the brain.
Usually lasts less than 30 minutes
Usually occurs before full blown stroke
Warning signs and causes of TIA?
Warning signs are the same as for stroke
Causes are a thrombus or an embolus, change in BP
What % of strokes are ischemic?
80%
What factors affect prognosis for recovery from stroke or TBI?
Etiology
Pre-onset characteristics
Present (post-onset) status
General positive and negative influences
For people w/ aphasia: Aphasia severity and type
What is anoxia?
Lack of oxygen can cause generalized cortical loss
Receptive/Fluent/Posterior aphasias
More difficulty with comprehension as opposed to production
Expressive/Non-fluent/Anterior aphasias
More difficultly with production as opposed to comprehension
which term best conveys patient centered care?
Patient
Aphasic
Their name
Their name
What are the components of health and functioning according to the WHO ICF?
Body structures & functions
activities and participation
environmental
personal
Etiologies of stroke
cerebral thrombosis, embolism, or hemorrhage
subarachnoid hemorrhage
transient ischemic attack
arterio-venous malformation (congenital)
the primary cause of stoke is atherosclerosis (buildup of matter within arteries)
How is the WHO ICF relevant to clinicians?
How is the WHO ICF relevant to clinicians?
Unidimensional framework of aphasia
All levels of language included as one cohesive set of abilities
Multidimensional framework of aphasia
Recognizes varied forms/ syndromes of aphasia
Ties form of aphasia to site of lesion
Medical framework of aphasia
Considers aphasia at the IMPAIRMENT level
Assessment identifies deficits – Treatment design to reduce deficits
Cognitive neuropsychological framework of aphasia
Based on models of mental representation and types and stages of information processing
Aphasia seen as a disruption in the processing required and that processing passes unidirectionally in stages.
Biopsychosocial framework of aphasia
Attention to the complex interaction of multiple factors that constitute “disability” and affect health.
Social framework of aphasia
Aphasia viewed as a social condition, not an individual’s impairment
Severity of aphasia, NOT a function of the level of cognitive-linguistic deficit, but influenced by the person’s communicative environment
CAT scan
Quick results but poor resolution and unable to detect acute infarcts in the cerebrum or brain stem
Magnetic Resonance Imaging
sensitive to acute injury (4-6 hours). Cannot be used with ferrous metal implants. Can induce claustrophobia
Diffusion Weighted Imaging
can detect an infarct in 15-20 minutes but cannot be used with metal implants.
functional MRI
indexing dynamic changes in blood flow related to O2 levels in the cerebral tissue. Useful for studying patterns of brain processing
Cerebral angiography
uses a contrast medium and can visual the extent of cerebral blood flow problems.
EEG
low-cost, non-invasive procedure for measuring brain waves
electrocorticography
very invasive procedure that can delineate (map out) areas of function and non-function during surgical planning for tumors or epilepsy.
What does BE FAST stand for ?
Balance loss
Eyesight changes
Face drooping
Arm Weakness
Speech difficulty
Time to call 911
Which is most important between cultural competence, cultural responsiveness, and cultural humility? Why did you make that choice?
Cultural humility is recognizing that you will have a different set of beliefs, background, racial, gender, sexuality, etc. from your patient but knowing that when it comes to speaking with and treating your patient it is important to always take their culture into account
Cultural responsiveness is ensuring that your statements/responses to your patient are culturally sensitive to their beliefs, background, language, etc. This is also ensuring that your therapy with them is culturally sensitive as well.
Cultural competence is having a significant understanding of your patient’s (or anyone else’s) cultural background but does not necessarily include respecting it. It is purely a measurement of knowledge of the subject matter.
Transcortical Motor aphasia
damage to the anterior watershed area of L frontal lobe
similar to Broca’s but repetition is intact
Transcortical sensory aphasia
damage to angular gyrus (BA 39) posterior middle temporal gyrus (BA 37)
similar to Wernicke’s but repetition is intact
Mixed transcortical aphasia
multi-focal lesions in the frontal /temporal watershed regions
similar to global aphasia but intact repetition
Conduction aphasia
damage to arcuate fasciculus
impaired repetition; literal paraphasia
Anomic aphasia
Global aphasia
damage to planum temporale
combination of expressive and receptive language deficits in all modalities
Broca’s aphasia
Damage to frontal operculum (BAs 44 and 45)
agrammatism; telegraphic speech; dysnomia; circumlocutions; literal paraphasia; effortful speech; catastrophic reaction; emotional lability
Wernicke’s aphasia
damage to superior temporal lobe; BA 22
neologisms; paraphasias (literal, semantic); logorrhea; press of speech; anosognosia; verbal perseveration
Places aphasiologists work?
Hospitals
Rehabilitation centers
Skilled nursing facilities
Long-term care facilities
Continuing care retirement communities
Home health agencies
Private practice clinics
Not-for-profit communication disorders clinics
Home health agencies
Aphasia centers
primary progressive aphasia
The ongoing loss of language abilities in the face of relatively preserved cognitive abilities
Subtypes: semantic, logopenic, agrammatic (non-fluent)
anomic aphasia
Word-finding difficulty; spared comprehension/syntactic production; circumlocutions; the use of generic terms; fillers
crossed aphasia
Any form of aphasia that is due to damage to the right hemisphere instead of the left in a person who is right-handed
subcortical aphasia
Any form of aphasia that is associated with a lesion below the cortex
Lesion sites: thalamus; basal ganglia; cerebellum; internal capsule
What do SLPs specializing in neurogenic communication disorders do?
teaching and mentoring
clinical intervention
interprofessional collaboration
advocacy
business-related responsibilities
leadership and management
research
multidisciplinary team
Each team member represents his/her own expertise and confers with other team members regularly about discipline-specific and general rehab goals
interdisciplinary team
Greater communication across team members, high degree of collaborative decision making about strategies for working together to achieve optimal outcomes for overall health and wellbeing
transdisciplinary team
Further cross-training of team members; lines clearly demarcating expertise of one discipline’s scope of practice may be blurred
how do SLPs get paid?
salary
hourly rate for all services
hourly for billable services
pre diem (daily)
specified amount per unit of time
privately
What makes services reimbursable?
Effective documentation
A physician’s order
Pre-authorization for services by the third-party payer
Evidence services are covered by the plan
Evidence of need for skilled services
Confirmation the methods used are evidence-based
Documentation of the life-impacting nature of services
Evidence of treatment progress
Good relationships with decision makers at third-party payer agencies
law
Law consists of locally, regionally, or nationally adopted rules and principles about rights, equality, fairness, and involves the balancing of varied interest
morality
Morality consists of subjective judgment of what conduct and consequences are good and bad
Moral principles include:
Respect for people, Beneficence, Nonmaleficence, Justice
ethics
Ethics is subjective decision-making about what is right or wrong, what our obligations to other are, and what is appropriate
What global trends are affecting the incidence and prevalence of neurogenic communication disorders?
Rapidly expanding aging population
Demographic shifts
Increasing incidence and prevalence of conditions that cause neurogenic communication disorders
Health-care and prevention infrastructure challenges
Global health priorities
what are the purposes of assessment?
Supporting initial and ongoing intervention
Contributing to the diagnostic process
Indexing and describing declining abilities
Indexing and describing the various impacts of language and related cognitive impairments
Helping inform prognosis
Planning intervention with substantial patient and family input
Measuring, describing, and documenting baselines and progress during treatment
Justifying treatment to payors
Determining when a person has met goals
Collecting data to document clinical outcomes
