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Organic & Neurogenic Comm Disorders > Stroke > Flashcards

Stroke Flashcards

1
Q

Cerebrovascular accident (CVA)

A

– loss of blood supply to a focal area of the brain

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2
Q

Ischemic

A

arterial blockage
-complete or partial

Atherosclerosis can cause arteries to thicken blocking blood flow

Thrombosis- blockage or occlusion of an artery

Embolism- a thrombosis or blood clot that has traveled
-Embolic stroke

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3
Q

Hemorrhagic

A

– arterial bleed

Brain damage everywhere blood touches
Brian swells when blood touces it

2 types of hemorrhages: intracerebral & extracerebral (in meninges)

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4
Q

Transient ischemic attack (TIA)

A

– “mini stroke” causes temporarily loss of blood to the brain (CDC, 2014)

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5
Q

Adult Risk Factors

A 
TIA
High blood pressure
High cholesterol
Heart disease
Atherosclerosis
Diabetes
Sickle cell disease
Smoking
Obesity
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6
Q

Child Risk Factors

A

Heart disease
Hemorrhage
Sickle cell disease
Vascular malformations

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7
Q

Vascular System

A

Carries blood to and from the heart

Arteries- carry blood away from the heart

Veins- carry blood to the heart

Capillaries- connect arteries and veins

Blood- supplies the brain with oxygen and glucose
BUT- blood and brain DO NOT mix

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8
Q

Cerebrovascular system

A
  • network of arteries, veins, and capillaries that supply blood to the brain
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9
Q

Arteries

A

2 common carotid arteries- supplies the front of the brain

  • Branches into the internal carotid arteries at the base of the skull
  • Internal carotid arteries divide into smaller arteries that supply specific portions of the brain

Anterior cerebral arteries

Middle cerebral arteries

2 vertebral arteries- supplies the back of the brain
-Fuse to form the basilar artery

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10
Q

Circle of Willis

A

Carotid and vertebral arteries- come together to form a circle of arteries at the base of the brain.

Circle- redundant system that has some back-up if there is a blockage

Blockage or damage to an artery above the Circle of Willis may cause focal brain damage

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11
Q

aneurism

A

weakness in artery wall

causes a bulge that is susceptible to bursting

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12
Q

Ischemic stroke improvement:

A

Often occurs within a few weeks

Within first 3 months see significant recovery as blood reduces and brain swelling decreases

After 3-6 months recovery slows

If brain tissue dies - infarct

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13
Q

Hemorrhagic stroke improvement:

A

Rapid recovery over first few months

Better long-term outcomes

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14
Q

CNS

A
  • brain and spinal cord

Spinal cord- carries neural messages from the brain to structures outside of the brain (peripheral structures)

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15
Q

Brainstem

A

Cranial nerves extend from the brainstem and then travel to other parts of the body (head, neck, face, ear, etc.)

Medulla, pons, and midbrain

Medulla has cranial nerves for tongue, laryngeal and diaphragmatic movement
Pons has cranial nerves for eye, facial, and hearing

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16
Q

Cerebrum

A
  • Two brain hemispheres
    Contain white and grey matter
    White matter directly below the cerebral cortex
    Contains fiber tracts that send information through pathways to different parts of the brain
    Grey matter structures (e.g. thalamus & basal ganglia) are connected by the white matter pathways
17
Q

Lateralization

A
  • “one hemisphere is dominant for a particular function”(Bloom, 1997, p.146)
    Language lateralized to left hemisphere
    Nonverbal, visuo-spatial perceptual information
18
Q

Brain Damage

A

Damage to a brain results in a specific pattern of deficits
Damage to language areas results in aphasia
Brain may not be as compartmentalized as we thought
Brain is a network of connections

19
Q

Lateralization

A
  • “one hemisphere is dominant for a particular function”(Bloom, 1997, p.146)

Language lateralized to left hemisphere

Nonverbal, visuo-spatial perceptual information

20
Q

Localization

A
  • one area of brain is responsible for a certain function

Broca’s area responsible for speech execution

21
Q

Brain Damage

A

Damage to a brain results in a specific pattern of deficits

Damage to language areas results in aphasia

Brain may not be as compartmentalized as we thought

Brain is a network of connections

22
Q

Aphasia

A

An acquired language disorder

Can be caused by stroke, TBI, tumor, or disease (damage to the brain)

categorized as fluent or nonfluent

Diagnosis is made based on standardized and nonstandardized test results
Discourse has to be analyzed

23
Q

Fluent aphasias

A
  • caused by damage to the posterior temporal lobe

Speak a lot but it doesn’t make sense, have normal articulation and syntax

24
Q

Nonfluent aphasias

A
  • caused by damage to the frontal lobe

Speaking short phrases or single words with reduced prosody, have syntax errors, misarticulate, and may repeat words or phrases (perseverate)

Often have weakness or paralysis on the right side of their body

25
Q

Broca’s aphasia:

A

Non-Fluent

Damage- cortical and subcortical areas in the lower left frontal lobe
Including the precentral gyrus

Characteristics-

  • Apraxia
  • Agrammatic- short utterances that contain only content words
  • Mildly impaired naming abilities
  • Repetitions of sentences are agrammatic
  • Oral reading and writing deficits
26
Q

Transcortical motor aphasia:

A

Non-Fluent

Damage- frontal lobe in the area that connects Broca’s and the supplementary motor cortex

Broca’s area is NOT damaged

Characteristics-

  • Articulation is intact
  • Sentences contain syntactic errors
  • Can repeat sentences
  • Auditory comprehension is relatively good
  • Reading and writing deficits are similar to Broca’s aphasia
27
Q

Global aphasia:

A

Non-Fluent

Damage- large lesion affecting Broca’s and Wernicke’s areas
Including white matter deep to these structures

Characteristics-
-Limited verbal speech- meaningless or repetitions
Severe naming and sentence repetition -deficits
-May have some automatic speech
-Severely impaired auditory comprehension
-May be able to answer some yes/no questions and respond to basic commands
-Reading and writing severely impaired
-May have no functional reading

28
Q

Wernicke’s

A

Fluent

Damage- posterior 1/3 of the superior temporal gyrus

Characteristics-
-Talks a lot and fast- without articulation errors
-Language can be empty or vague
-Neologistic jargon
-Paragrammatic-small grammar mistakes
-Auditory comprehension is severely impaired (hallmark)
-Naming and repetition are severely impaired
Reading and writing skills are variable, but impaired

29
Q

Anomic

A

Fluent

Damage- Angular gyrus or the second temporal gyrus

Characteristics-

  • Mild-moderate auditory comprehension deficits
  • Severe word finding deficits- makes conversational speech appear empty (hallmark)
  • Reading and writing
  • Angular gyrus damage-severe impairments
  • Second temporal gyrus- mild deficits similar to those heard in their speech
30
Q

Conduction:

A

Fluent

Damage-Arcuate fasciculus

Characteristics-

  • Mild word finding deficits
  • Mild auditory comprehension deficits
  • Severe repetition impairment (hallmark)
  • Writing may have syntactic and spelling errors
31
Q

Transcortical sensory

A

Fluent

Damage- Posterior parietal-temporal area (Wernicke’s NOT damaged)

Characteristics-

  • Severe auditory comprehension deficits
  • Severe naming deficits
  • CAN repeat
  • Good oral reading, poor comprehension
  • Writing is severely impaired
32
Q

Primary progressive aphasia

A

-slow progression of aphasia symptoms

Associated with disease processes- NOT stroke

33
Q

Right Brain Stroke Damage

A

Characteristics-

  • May have mild naming and auditory comprehension deficits
  • Selective attention deficits
  • Unilateral neglect on left side
  • May not eat food on left side of plate
  • Severe cases can ignore left side of body
  • Literal interpretation of language
  • Difficulty interpreting humor and figurative language
  • Discourse deficits
  • Disorganized
  • Difficulty integrating narrative information
  • Discourse deficits impair functioning in everyday activities
34
Q

Emotional Processing

A

Significant deficits in emotional processing and expression

  • Monotone
  • Flat affect
  • Indifferent or unaware of deficits
  • Difficulty interpreting other’s emotions
  • Prosody
  • Facial expression
35
Q

Aphasia Assessment

A

Focused on differential diagnosis btwn
Aphasia & Other communication disorders

Collect a detailed case history-
Talk with the patient and family
Review medical history
Standardized and nonstandardized language assessments

Assessment is on-going to determine treatment goals

Reading, writing, and speaking must be assessed

36
Q

Bilingual Aphasia

A

Determine preferred language

Three recovery patterns:

  • The first language acquired is less impaired and shows better recovery
  • Most familiar or most recently used language recovers first
  • The language with the most emotional attachment recovers first
37
Q

Right Hemisphere Assessment

A

Language deficits may not be apparent on standardized language assessments

Need to administer right hemisphere specific assessments:
-RIC Evaluation of Communication -Problems in Right Hemisphere Dysfunction (RICE)

Need to assess:

  • Discourse
  • Visuo-spatial
  • Reading and writing
  • Complex language- metaphors & idioms
38
Q

Stroke Treatment

A

Interdisciplinary approach

General SLP treatment goals:

  • Educate and provide support to the family
  • Develop compensatory strategies that improve the individual’s ability to communicate and understand communication
  • Promote cognitive and linguistic recovery
  • Promote independence

Organic & Neurogenic Comm Disorders (10 decks)

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