Role of Speech Pathology - Brancamp Flashcards
1
Q
What capacity of the brain diminishes with age?
A
cerebral plasticity
2
Q
Aphasia is (neurogenic/psychological)
A
neurogenic
3
Q
Aphasia is (predisposed/acquired)
A
acquired
4
Q
T/F: Aphasia is a problem of sensation, motor function, or intellect
A
false
5
Q
T/F: aphasia may include all aspects of language
A
true
6
Q
which components, specifically, of language does aphasia involve/
A
auditory comprehension
visual and reading comprehension
oral-expressive language
writing
7
Q
Aphasia is not a disturbance of…
A
articulation
8
Q
Are patients with mutism aphasic?
A
not necessarily
9
Q
Does aphonia imply aphasia?
A
no
10
Q
Can you have aphasia during an acute confusional state?
A
no
11
Q
What is the name for speech issues caused problems with the muscular control over the speech mechanism due to CNS or PNS damage?
A
dysarthria
12
Q
What is apraxia?
A
A neurogenic speech disorder resulting from impairment of the capacity to program sensorimotor commands for positioning and movement of muscles for the volitional production of speech.
13
Q
Can apraxia occur without issues of conscious thought or language?
A
yes
14
Q
What are some accompanying disorders of aphasia?
A
Agnosia Acalculia (dyscalculia) Alexia/dyslexia (deep and surface) Agraphia (dysgraphia) Constructional disturbance
15
Q
80% of aphasia syndromes conform to (blank) schemes while 20% are due to individual differences
A
anatomical
16
Q
Where are lesions located for Broca’s aphasia?
A
lateral frontal
surpasylvian
pre-Rolandic extending into adjacent subcortical periventricular white matter
17
Q
Where are the lesions in Wernicke’s?
A
posterior third of temporal gyrus
18
Q
Where are the lesions in Conduction aphasia?
A
Supramarginal gyrus and underlying white matter
Wernicke’s area
left insula
auditory cortex
19
Q
Where are the lesions for anomic aphasia?
A
angular gyrus
second temporal gyrus
20
Q
transcortical motor aphasia has lesions where?
A
anterior frontal paramedian
anterior and supeior area to broca’s
21
Q
Transcortical sensory aphasia has lesions where?
A
posterior parieto-temporal
SPARING Wernicke’s area
22
Q
Where are the lesions for global aphasia?
A
large perisylvian extending deep into the subjacent white matter
23
Q
Where are the lesions for subcortical aphasia?
A
- thalamus
1. head of caudate nucleus, putamen, or internal capsule
24
Q
What side of the brain does listening come in on?
A
left
25
Where is listeing processed?
on the right in Wernicke's
26
How is listening and speech transferred from Wernicke's to Broca's centers?
arcuate fasciculus
27
What does the prefrontal association area do?
formulation of speech sounds
28
what type of aphasia is due to issues in the arcuate fasciculus?
conduction aphasia
29
What is the function of Broca's aphasia?
motor programming for articulation
30
what is the function of the precentral gyrus?
activation of muscles for articulation
31
What is the function of the arcuate fasciculus?
transmission of linguistic info to anterior areas from posterior areas
32
what is the function of Wernicke's area?
comprehension of oral language (posterior language zone)
33
what is the function of the angular gyrus?
integrates visual, auditory, and tactile info and carries out symbolic integration for reading
34
Left parietal though to be one of two areas associated with what? L. occipital also asscd with it
alexia
35
What is the function of the supramarginal gyrus?
symbolic integration for writing
36
What is the function of the corpus callosum?
transmission of info between hemispheres
37
what type of aphasia is receptive?
Wernicke's
38
Expressive aphasias are due to lesions in which part of the brain?
anterior; motor lesions; aka broca's aphasia
39
What are the cortical aphasias?
```
Cortical aphasia syndromes
Broca’s aphasia
Wernicke’s aphasia
Conduction aphasia
Anomic aphasia
Transcortical motor aphasia
Transcortical sensory aphasia
Global aphasia
Mixed nonfluent aphasia
```
40
what re the subcortical aphasias?
```
Subcortical aphasia syndromes
Anterior capsular-putaminal aphasia
Posterior capsular-putaminal aphasia
Global capsular-putaminal aphasia
Thalamic aphasia
```
41
Despite not being able to communicate with spoken language, how will aphasia pts try to communicate in the first few hours?
gestures or facial expression
42
are hemorrhagic or ischemic strokes worse?
hemorrhagic
43
What are the difficulties of pts with aphasia?
understanding purely verbal commands
is aware of self and environment
intent on communicating thoughts
44
what is fluent aphasia?
9+ words per utterance
| approximates normal speech in rate of word production, length of sentences, melodic intonation
45
what is nonfluent aphasia?
```
rate is slow
sentence length short
melodic intonation lost
production is effortful
more pauses than actual words
(0-5) words per utterance
```
46
what is the hallmark of aphasia?
failure to repeats words or sentences
47
What region of the brain is responsible for impaired repetition?
perisylvian region of dominant hemisphere
48
Is auditory comprehension commonly preserved in aphasia?
no, rarely
49
What is the issue with auditory comprehension in aphasia?
ability to decode the input
50
what is agrammatism?
difficulty ordering words and putting them together in a sentence.
51
is word content spared in agrammatism?
yes
52
What type of aphasia is agrammatism?
anterior aka broca's aphasia
53
What are some examples of agrammatism?
may use wrong pronouns, won't use infinitive verbs or conjugate verbs, can't use BOUND MORPHEMES aka past tense and present progressive
54
If auditory comprehension is an issue, then (blank) comprehension is also an issue
reading
55
T/F: reading comprehension deficit can occur without auditory or writing impairment
true
56
T/F: in most cases of aphasia, reading, writing, and auditory comprehension are impaired to the same degree
false; all impaired to different degrees
57
```
what type of aphasia is this?
Dysfluent
Increased effort in speaking
Speech is agrammatic, telegraphic, groping
Often accompanied dysarthria and/or apraxia of speech
Comprehension better than expressive
Repetition abnormal
Naming is poor
Writing reflects spoken output
```
broca's aphasia
58
are pts with broca's aphasia aware of their impairments?
yes
59
```
What type of aphasia is this?
Pt. usually appears normal with no dysarthria or limb weakness/paralysis.
Speech is fluent but often presents with paraphasias and jargon
Syntax is normal
Comprehension is poor
Reading is poor
Repetition is poor.
Word-salad
```
Wernicke's aphasia
60
Describe the mild form of Wernicke's
aware of errors and generally follow conversational turn taking
61
describe moderate wernicke's
rarely notice errors or attempt repairs; attentive & cooperative but get off topic easily (verbal tangents)
62
describe severe wernicke's
attentive, but severe comprehension deficits interfere with all communication tasks; unaware of errors and communication failure
63
what type of wernicke's lacks the social pragmatic understanding?
severe
64
Global aphasia is a severe impairment in both (blank and blank)
comprehension and expression
65
T/F: pts with global aphasia have concrete understanding of symbols
true
66
T/F: pts with global aphasia have difficulty with abstract or inferential info
true
67
With respect to their understanding, describe how a pt with global aphasia understands a picture with words and symbols
understands the symbol but not the word; danger sign--understand skull and crossbones but not the word danger
68
Pts with global aphasia perform better with activities that are automatic or have lots of (blank) content
emotional
69
Speech in global aphasia is limited and replaced by.....
stereotypical sayings, overlearned phrases, or expletives
70
T/F: pts with global aphasia are not socially appropriate
false, they are; helps to distinguish them from the demented patient
71
What types of questions do pts with global aphasia tend to understand the best?
personal questions
72
where is the lesion in conduction aphasia?
arcuate fasciculus
| temporal lobe in the audiotory association area
73
Conduction aphasia has (fluent/non-fluent) speech
fluent
74
What type of deficits are the worst in conduction aphasia?
moderate to mild
75
What is the hallmark of conduction aphasia?
inability to repeat long sentences; grossly repaired repetition and relatively preserved language comprehension
76
How does the prosody change in conduction aphasia?
pauses and hesitations
77
Do people with conduction aphasia attempt to make repairs to their errors?
yes
78
isolation syndrome is due to what type of aphasia?
transcortical aphasia
79
What is the hallmark of transcortical aphasia?
preserved repetition
80
What types of aphasias spare repetition?
Wernicke's
Broca's
Arcuate fasciculus
Transcortical
81
Lesions in transcortical aphasia are (inside/outside) the perisylvian zone
outside
82
What are the three types of transcortical aphasia?
motor
sensory
mixed
83
what is anomia?
difficulty finding words
84
What is anomic aphasia?
Spontaneous speech is fluent and grammatically correct, but marred with frequent word-retrieval failures. Average phrase length WNL
85
how is repetition in anomic aphasia?
intact
86
how is auditory comprehension in anomic aphasia?
intact
87
what is the leading cause of right hemisphere disorders?
CVA
88
T/F: all pts with an RHD have communicative defects
false
89
What percent of pts with RHD have a comm/cog deficit?
50%
90
prosopagnosia is an LHD or RHD?
RHD
91
How are RHD pts with syntax, morphology, grammar, and phonology
few if any problems
92
Do pts with RHD have classical aphasia?
no
93
The ability to come up with words that they want to say in pts with RHD is (equal/less than) age matched peers
equal
94
Why do pts with RHD have a hard time naming pictures or objects?
visual perceptual or visuospatial difficulties
95
What side of the visual field is neglected in RHD?
the left side
96
Where is the lesion located in neglect?
1. inferior parietal lobe or parieto-temporal junction
| 2. inferior frontal lobe, underlying white matter, thalamus, basal ganglia
97
What are the four types of neglect?
visual
motor
tactile
auditory
98
what is the difference between a sensory deficit and tactile neglect?
tactile neglect is greater than a sensory deficit
99
what is the result of auditory neglect?
poor localization of sounds
100
What are the three zones of space that neglect can be grouped into?
personal space
peri-personal space
extra-personal space
101
What are examples of personal space neglect?
Neglect to shave, comb, dress on L side
102
What are the examples of peri-personal space neglect?
Neglect of items scanning/drawing/copying; L placed item on food tray
103
what are examples of extra-personal space neglect?
Neglect of people on left side of room, items on L of room
104
T/F: neglect is a constant issue
false; varies hour to hour and day to day
105
How long does it take for neglect to resolve?
within the first few weeks
106
What is neglect often accompanied by?
anosognosia (refusal to recognize the presence of a disorder)
107
What is the relationship between neglect and cog/comm defs?
presence of neglect means more likely to have cog/comm defs
108
what are the neglect related reading and writing issues?
neglect dyslexia and dysgraphia
109
What is aprosodia?
Production: flat, monotone speech, rate sounds fast
Comprehension: problems interpreting prosody
110
RHD possibly effects (blank) prosody more than linguistic prosody
emotional
111
in what RHD can we often miss a co-Dx of depression?
aprosody because of the lack of emotion
112
What are the biggest issues of comm in aprosodia?
emotion and nonverbal comm
113
describe the production in aprosodia?
Use fewer emotionally-charged words
Reduced facial expressions
Reduced animation
Flat affect – reduced animation, reduced prosody/intonation
114
what is the only issue with comprehension in aprosodia?
misinterpret social and emotional cues
115
what are some of the themes in RHD comm disorders?
problems with multiple meanings, distantly related meanings, and using context, and pragmatics
