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NeuroPT2 > Speech-Lang Patho > Flashcards

Speech-Lang Patho Flashcards

1
Q

SLPs

What are they?

A

dx and tx disorders:

speech

language

swallowing

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2
Q

Anatomy wise… SLPs work a lot w/

A

soft palate

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3
Q

Resp provides energy and foundation for______

A

phonation→ making sounds w/ mouth

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4
Q

Mm’s of Respiration

A

Thoracic→ Inspiration

Abdominal→ Expiration

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5
Q

Phonation:

A

air for speech comes from lungs, thru trachea, and to the larynx (voice box)

*sets vocal cords in motion for voicing

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6
Q

Phonation:

2 sets of Laryngeal muscles

A
  1. Intrinsic
  2. Extrinsic
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7
Q

Phonation:

Myoelastic Aerodynamic Theory

A
  • States that vocal cords vibrate bc of the forces and pressure of air and the elasticity of the vocal cords
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8
Q

Phonation:

KEY neuroanatomical structures involved in vocalization:

A
  • Cortical areas
  • Cerebellum
  • CN’s
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9
Q

Articulation:

A

Movement of speech structures to produce sounds (phonemes)

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10
Q

Resonation and Articulation depends on the integrity of these structures:

A
  • Pharynx
  • Soft palate
  • Hard palate
  • Mandible
  • Teeth
  • Tongue
  • Lips
  • Cheeks
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11
Q

Resonation

A

Tones gen’d by larynx travel UPWARD and are resonated by the pharynx, oral cavity, nasal cavity

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12
Q

Nervous System

PNS vs. CNS

REVIEW

A
  • PNS
    • CN’s
    • Spinal Nerves
    • ANS
      • Sympa vs. Parasympa
  • CNS
    • Brain
    • SC
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13
Q

Cranial Nerves Mnemonics

A
  • Oh Oh Oh To Touch And Feel Virgin Girls Vaginas And Hymens
  • Some Say Marry Money, But My Brother Says Big Boobs Matter More!
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14
Q

MOST important part of PNS in relation to communication-→

A

Cranial nerves!

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15
Q

Cranial Nerves directly involved w/:

speech

language

hearing

What are they?

A
  • V: Trigeminal→ Mixed
  • VII: Facial→ Mixed
  • VIII: Acoustic (Vestibulocochlear)→ Sensory
  • IX: Glossopharyngeal→ Mixed
  • XI: Spinal Accessory→ Motor
  • XII: Hypoglossal→ Motor
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16
Q

CNS and SLP Focus

A
  • More on Brain→ more related to speech/lang.
    • Brain stem
    • Reticular Activating Formation
      • attn, consciousness
    • Diencephalon
      • Thalamus
        • conscious/alert
      • Hypothalamus
        • emotion
    • Basal Ganglia
      • Body posture/dysarthria/dyskinesia
    • Cerebellum
      • equilibrium/coordination: Ataxia
      • Speech prod: ataxic dysarthria
    • Cerebrum
      • cerebral cortex
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17
Q

Cerebrum:

Cerebral Cortex

A

BIGGEST and MOST IMPORTANT structure for lang, speech, hearing

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18
Q

Frontal Lobe

The jist…

A
  • plans/intentions dictate conscious behavior
  • Primary Motor Cortex→ includes Broca’s
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19
Q

Parietal Lobe

The jist…

A
  • Somatic Sensory area
    • pain, press, temp, touch
  • Angular gyrus, Supramarginal gyrus
    • → critical to speech (Aphasia)
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20
Q

Occipital Lobe

The jist…

A

VISION

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21
Q

Temporal Lobe

The jist…

A
  • Primary Auditory Cortex
  • Auditory Assoc. Area→ Wernicke’s
    • Wernicke’s think COMPREHENSION
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22
Q

Neurologically Based Communication Disorders***

IMPORTANT!

A
  • Aphasia
  • Apraxia of Speech
    • P for Planning
  • Dysarthria
  • Dementia
  • Rt. Hemi Syndrome
  • TBI
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23
Q

Aphasia

A
  • Neuro based language disorder from neuro pathos→ Think CVA! (most common)
  • Impaired:
    • verbal expression (talking)
    • auditory comprehension (understanding)
    • read/writing
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24
Q

Ischemic CVA:

A

Blocked or interrupted blood supply to brain

  • Thrombosis→ collection of blood mat that blocks flow
  • Embolus→ traveling mass of arterial debris or clump of tissue from a tumor that gets lodged in a smaller artery and blocks flow
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25
Hemorrhagic CVA:
caused by bleeding in brain due to **ruptured blood vessels** * Intracranial (w/in brain) * Extracranial (w/in meninges) * **subarachnoid, subdural, epidural varieties**
26
OTHER causes of **A**phasia
* brain tumor * Intracranial tumors→ primary or metastatic * Infections (viral or bacterial)
27
_Classifications_ of **A**phasias: 3:
1. Nonfluent 2. Fluent 3. Subcortical
28
Non-Fluent Aphasias ## Footnote **Main ones are \*'d**
* **Broca's\*** * Transcortical Motor * Mixed Transcortical * **Global\***
29
Fluent **A**phasias ## Footnote **Main ones are \*'d**
* **Wernicke's\*** * **think _comprehension problems_** * Transcortical sensory * **Conduction\*** * Anomic
30
Freq used terms w/ **aphasia:** ## Footnote **Echolalia**
auto repetition of vocalizations made by another person
31
Freq used terms w/ **aphasia:** ## Footnote **Perseveration**
repetition of response/word/phrase/gesture even when it is no longer relevant or approp.
32
Freq used terms w/ **aphasia:** ## Footnote **Agrammatism**
inability to speak in grammatically correct way, **form of _expressive aphasia_**
33
Freq used terms w/ **aphasia:** ## Footnote **Content Words**
Have **MEANING!** Nouns, verbs, adjectives, adverbs (-ly) have MEANING
34
Freq used terms w/ **aphasia:** ## Footnote **Function Words**
words of **little lexical meaning**/glue that holds sentence together i.e.→ and, the, or, me, you, and but
35
Freq used terms w/ **aphasia:** ## Footnote **Telegraphic Speech**
simplified formation, many or all **function words** omitted
36
Freq used terms w/ **paraphasias:** ## Footnote **Phonological/literal**
replacement/transposition ex. **papple for apple**
37
Freq used terms w/ **Paraphasias:** **Neologistic**
non-English, gibberish
38
Freq used terms w/ **Paraphasias:** ## Footnote **Verbal**
tiger for lion foot for shoe
39
Broca's Aphasia is a _______ Aphasia
NON-FLUENT
40
Broca's Aphasia \***Non-fluent**
* Damage to **post-inf. front gyrus of _left-hemisphere_** (this is lang. side in most people) * **Characteristics:** * NON-fluent, effortful, slow, halting speech * Lmtd word OUTPUT, short phrases and sentences * Misarticulated/distorted sounds * often lmtd to **nouns/verbs** * impaired naming and repetition * Poor reading comp * Writing probs→ slow/laborious→ using non-dom left hand * **Better auditory comprehension\* of spoken language** than **production** * may see apraxia and dysarthria
41
Global Aphasia is the _________ form
MOST SEVERE
42
Global Aphasia
* MOST SEVERE * Ext. lesions affecting **all lang** **areas→ Perisylvian Area** * WIDESPREAD damage in fronto-temporo-parietal region * **Characteristics:** * Profoundly impaired lang skills * Impaired repetition/naming * Expressive lmtd to a few words, exclamations * Auditory comp limtd to single word * Impaired reading/writing skills * Perseverations
43
4 Domains w/ Aphasias:
1. Speaking 2. Listening 3. Reading 4. Writing
44
**Wernicke's Aphasia** is a _______ aphasia
FLUENT
45
Wernicke's Aphasia
**COMMON,** caused by lesions in **post portion of _sup. temporal gyrus in L. hemi_** * **_Characteristics:_** * incessant, effortlessly produced flowing speech w/ norm fluency * rapid rate of speech * intact grammatical structures * severe word finding * paraphasic errors, neologisms * circumlocution, empty speech * talking around in circles * **Poor auditory _comprehension\*\*_** * no commands, cnt answer Y/N * Impaired repetition * writing probs→ meaningless, freq errors * poor communication in spite of fluent speech
46
Distinguishing factor in **Conduction Aphasia**
\*region b/w Broca's and Wernicke's damaged * Disproportionate impairment in repetition
47
Subcortical Aphasias
\*Lesions in areas **surrounding Basal Ganglia and Thalamus**
48
Aphasia Assessment:
* Repetition skills * Naming skills * **Auditory comprehension of _spoken lang_** * **Auditory comprehension of _single words, sentences, paragraphs_** * reading * writing * gestures/pantomine * automatic speech/singing * visuospatial skils
49
Positive Prognostic Indicators
see pics
50
Aphasia may be accompanied by: **A**lexia
Loss of **previously acquired reading** skills due to damage vs. **Dyslexia→** diff learning to read
51
Aphasia may be accompanied by: **A**graphia
Loss or impairment of **writing skills** due to lesion in **second frontal gyrus**
52
Aphasia may be accompanied by: **A**gnosias
impaired understanding of the **meaning of certain stimuli** even though there is no peripheral sensory impairment \*damage to occ/parietal regions * auditory agnosia * phone rings-dont understand its phone * auditory verbal agnosia * impaired understanding of spoken words (Wernicke's) * visual agnosia * impaired visual recognition * tactile agnosia * fork in box, pt cant tell you its a fork
53
Apraxia of Speech AOS **\*Speech→ motor programming diff's**
damage to **Broca's** ## Footnote **neurogenic speech disorder involves sensorimotor probs in _positioning and sequentially moving mm's for volitional speech prod._**
54
AOS diff. lies where?
Diff lies in **executing** the voluntary mvmts involved in speech \*often co-exists w/ aphasia
55
Communication Deficits in AOS \*Apraxia of Speech
* gen awareness of problem * probs w/ volitional or spont. sequencing of mvmts reqd for speech * high variability of speech errors, changing patterns of errors * subs, distortions and omissions of speech sounds * incd freq of errors on longer words * slowed or delayed initiation of speech\*\* * groping or struggling * attempts at self-correct * prosodic probs
56
Interventions for Apraxia of Speech \*important to PT
* emphasize total comm. (combine use of verbal express, gestures, writing, AAC * articulatory accuracy, slower rate * cueing, singing * SEVERE→ speak slowly, shorter sentences, reduce background noise, talk only when pt focused, use total comms
57
Dysarthrias Think\_\_\_\_\_\_\_
Slurred speech!!!
58
Dysarthria
group of motor-speech disorders * impaired mm control of speech mech, PNS or CNS patho * manifest probs in **respiration, phonation, articulation, prosody and resonance**
59
Communication Disorders Assocd w/ **Dysarthria (motor-speech probs)**
* resp probs * phonatory probs: pitch, loudness, etc.. * articulation probs * prosodic disorders * resonance disorders * hyper/hypo nasality
60
Tx of Dysarthria In terms of PT\*
* compensatory strats * mirrors, tape recording/phone ex's
61
Dysphagia
Impairment **swallowing**
62
Dysphagia think \_\_\_\_\_\_\_
ASPIRATION!!! \*preventing it
63
Dysphagia is impaired execution of **3 phases of swallow** ## Footnote **3:**
1. Oral 2. Pharyngeal 3. Esophageal \*chewing food, preparing for swallow, initiating swallow, propelling bolus thru pharynx and passing to esophagus
64
Dysphagia Causes
* CVA→ brainstem and Ant. Cortical * neuro dis's * sx or radiation therapy head, neck, brain * TBI/C/S disease * polio, COPD, CP * genetics * SE's drugs
65
Dysphagia and stroke pts
75% affected
66
LEAD CAUSE of dysphagia
Brainstem strokes
67
Assessment of Dysphagia main ones she mentioned
* Barium Swallow Study (MBSS) * Swallow eval (bedside)
68
S/S Aspiration Dysphagia think Aspiration
* cough/choke/throat clearing * watery eyes * runny nose * wet vocal quality * breathing diff * fever * PNA
69
Compensatory strats for Dysphagia
* chin tuck * head turn/tilt * alt solids/liqs * cough/throat clear * hard swallows * small bites/sips
70
VitalStim
\*for **dysphagia** Like NMES for swallow mm's After MBSS test
71
Dementia
Acquired neuro. syndrome assoc'd w/ persistent or progressive deterioration in intellectual functioning * decline in cognition, visuospatial, lang, memory, emotion, personality * progressive but reversable **when due to metabolic disturb (UTI)**
72
3 types of Dementia
1. Cortical 2. Subcortical 3. Mixed
73
Cortical Dementia
* intellectual and lang deterioration **precede motor defs** * **alzheimers type**
74
subcortical dementia
motor sxs Parkinson's Huntington's Reduced dopamine due to loss of cells in **substantia nigra**
75
Clinical mgmt Dementia **Early stages**
communication, memory and behavioral mgmt
76
Clinical mgmt Dementia ## Footnote **Later stages**
* family ed. * approach slowly * eye contact * speak slow/clear * keep convo concrete * ask Y/N? * restate important info * structure surroundings * establish routine\*\*\*
77
Rt. Hemisphere Syndrome
* Rt. Hemi→ processing holistic-gestalt stimuli, visual/spatial info, face recognition, drawing/copying * **Attentional and perceptual deficits are _dominant_**
78
RHD (Rt. Hemi Syndrome) Attn and Perceptual defs:
* Left neglect * denial of illness * confab regarding disability * face recognition defs * constructional impairs * attn. deficits * disorientation * visuoperceptual defs
79
Communication defs w/ **RHD**
* prosodic defs * impaired narrative skills * confabulation (made up truths), excessive speech * diff w/ abstract ideas * pragmatic defs * body lang/context cues/approp. * naming probs, diff comprehending complex verbal mats
80
Cognitive therapy for TBI:
* lang * memory * orientation * prob solving/abstract reasoning * attn/concentration * initation diffs/slowed responses * organization * executive functions→ plan/initiate/regulate * perseverations/inflexibility
81
TBI: Important Factors to Consider
see pics
82
TBI: More Important Factors to Consider
see pics

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