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Acquired Language Disorders GRAD > TEST 1 > Flashcards

TEST 1 Flashcards

1
Q

Neurologic causes of communication disorders

A
  • Stroke
  • Intracranial tumors
  • Hydrocephalus
  • Infections/toxins
  • Nutritional/metabolic disorders
  • Traumatic/Acquired brain injury
  • Dementia
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2
Q

Stroke/CVA

A

-Sudden death of brain cells due to lack of oxygen when blood flow to brain is impaired by blockage or rupture of an artery to brain

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3
Q

Symptoms of a CVA

A
  • Most common symptom is weakness or paralysis of one side of body w. partial or complete loss of voluntary movement or sensation in a leg &/or arm
  • speech problems and weakness of facial muscles (facial droop), causing drooling
  • Numbness or tingling is very common
  • Vertigo/dizziness
  • Swallowing problems-dysphagia
  • Problems w. consciousness
  • Sudden headache
  • visual-perceptual deficits
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4
Q

Embolic Stroke/Cerebral Embolism

A
  • Occurs when a fragment of material travels from other parts of body (heart) to neck or brain and blocks a blood vessel
  • Fragments may be a blood clot, a piece of atherosclerotic plaque, tissue from a tumor or tissue from a tumor
  • Symptoms are rapid in onset
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5
Q

Effects of Stroke-Right Hemisphere

A
  • Left hemiparesis (weakness) or hemiplegia (complete loss of strength)
  • Analytical, spatial and perceptual deficits-judging distances, sizes, speed, position or relating parts to whole
  • Left-neglect-ignore objects in the left visual field
  • Impulsivity
  • Anosognosia-lack of awareness of deficits, which leads to poor safety awareness and poor decision making (may try to drive a car)
  • Short-term memory deficits
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6
Q

Anosognosia

A

lack of awareness of deficits, which leads to poor safety awareness and poor decision making (may try to drive a car)

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7
Q

Neurologic Examination (4)

A
  • Cranial nerves
  • Motor System
  • Consciousness/Cognitive Status
  • Radiologic Studies
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8
Q

Ischemic CVA

A

”deprived of blood”

  • blockage of artery causes lack of blood supply to parts of CNS which that artery “feeds”
  • 80% of stokes are ischemic
  • Can be thrombotic or embolic
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9
Q

Thrombotic stroke/cerebral thrombosis

A
  • an artery to brain is blocked by a clot
  • Occur mostly in large arteries-internal carotids, vertebrals and the basilar arteries
  • Occlusion for more than a few minutes (3-5) causes death/necrosis of CNS tissue
  • ischemic CVA
  • blood flows through arteries it changes directions at bends and bifurcations where arteries narrow
  • change in direction and size cause turbulence and increased velocity which roughens inner lining of artery and causes a plaque to form-atherosclerotic plaque
  • plaque reduces size of space (lumen) w. in artery and causes stenosis
  • As lumen size decreases so does vol of blood flowing through it
  • clot eventually occludes artery causing a thrombotic CVA
  • Symptoms slower in onset
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10
Q

Large Vessel Thrombosis

A
  • Thrombotic stroke occurs most often in large arteries, so large vessel thrombosis is most common and best understood type of thrombotic stroke.
  • Most are caused by a combo of long-term atherosclerosis followed by rapid blood clot formation
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11
Q

Small Vessel Disease/Lacunar Infarction

A

-Small vessel disease, or lacunar infarction, occurs when blood flow is blocked to a very small arterial vessel

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12
Q

TIA

A
  • transient stroke that lasts only a few minutes.
  • occurs when blood supply to part of brain is briefly interrupted.
  • symptoms are sudden and are similar to those of stroke but do not last as long and disappear w. in an hr, although they may persist for up to 24 hrs.
  • Most due to small emboli which occlude artery and break-up or dissolve
  • occur when an artery is almost fully occluded causing significant changes in blood pressure and flow
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13
Q

Symptoms of TIA

A
  • numbness or weakness in the face, arm, or leg, especially on one side of body
  • confusion or difficulty in talking or understanding speech
  • trouble seeing in one or both eyes
  • difficulty walking, dizziness, or loss of balance and coordination
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14
Q

Hemorrhagic Stroke-Cerebral Hemorrhage

A
  • blood vessel bursts inside brain
  • Damage can occur very rapidly bc of presence of blood itself, or bc fluid increases pressure on brain and harms it by pressing it against skull
  • Usually associated w high blood pressure, which “stresses artery walls until they break”
  • Another cause is an aneurysm.-”a weak spot in an artery wall, which balloons out bc of pressure of blood circulating inside affected artery”
  • larger aneurysm is, more likely it is to burst.
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15
Q

Hemorrhagic Stroke Extracerebral

A

-effects blood vessels of meninges-3 connective tissue layers of the CNS (the pia mater-closest to the CNS structures, the arachnoid and the dura mater-farthest from the CNS)

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16
Q

Subarachnoid hemorrhage

A
  • blood btwn arachnoid and pia matter

- usually due to aneurysm

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17
Q

Subdural hemorrhage

A
  • blood beneath dura matter

- usually due to head injury

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18
Q

Extradural hemorrhage

A
  • blood btwn dura matter and skull

- usually due to head injury

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19
Q

intracerebral hemorrhage

A
  • Internal bleeding in any part of brain
  • bleeding may be isolated to part of one hemi (lobar intracerebral hemorrhage) or it may occur in other brain structures, such as thalamus, basal ganglia, pons, or cerebellum (deep intracerebral hemorrhage).”
  • Can be caused by tbi, aneurysm or hypertension (high blood pressure)
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20
Q

Effects of Stroke Left Hemisphere

A

Right hemiparesis (weakness) or hemiplegia (complete loss of strength)
Aphasia
Slow and cautious-need frequent encouragement, prompting, & feedback
Attention deficits
Immediate, short term &/or long term memory deficits
Difficulty w generalization

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21
Q

Effects of Stroke Cerebellar

A

Poor coordination
Balance problems
Dizziness/Vertigo-can cause nausea and vomiting
Abnormal reflexes-head tick movements, torso jerks

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22
Q

Effects of Stroke Brainstem

A 
Paralysis or paresis of one or both sides of body
Problems w regulating breathing
Problems w heartbeat and blood pressure
Vertigo
Disrupts eye movements
Pharyngeal phase dysphagia
Short-term memory deficits
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23
Q

Motor Assessment

A
  • Muscle tone-tension in muscle when voluntarily relaxed
  • Range of motion
  • Hypertonia-resistence to passive movement
  • Spacticity-muscles are tense and hard resist stretching
  • Rigidity-relaxed muscles resist movement
  • Hypotonia/flaccidity-”floppy” muscles
  • Muscle strength
  • Monoplegia-paralysis of one limb
  • Hemeplegia-paralysis of both limbs on same side of body
  • Quadriplegia-paralysis of all four limbs
  • Reflexes- gag, swallow, corneal
  • Plantar/babinski reflex-toes bend down (normal)
  • Palmar reflex-involuntary grasping of objects
  • Dyskinesia-frequent involuntary movements
  • Tremor-cyclic, small amplitude movements
  • Resting-when muscles are relaxed
  • Postural-during certain postures
  • Intention-only during volitional movements
  • Athetosis-slow, writhing movements
  • Dystonia-involuntary contracions lasting long durations
  • Fasciculations-fine, rapid, twitching movements
  • Tics-repetitive movements (blinking, cough)
  • Ataxia-difficulty initiating and terminating muscle movements
  • Gait-walking/running
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24
Q

White Matter

A

Communicating fibers
Afferent and efferent tracts
Upper motor neuron lesions lower motor neuron lesions
Differential diagnosis

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25
Q

Gray Matter

A

Neuron bodies

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26
Q

Disorder causing demyelination of axon fibers:

A

MS is result of damage to myelin; affecting messages transfers btwn brain and other parts of body

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27
Q

Fibers (myelinated)

A

Projection fibers
Association fibers
Comissural fibers

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28
Q

Projection Fibers

A

Make up tracts (=pathways) connecting cortex w distant structures: brainstem and spinal cord (to and from)

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29
Q

Association Fibers

A

Communication btwn regions of same hemisphere
One example : arcuate fasciculus
Communication btwn frontal lobe and temporal, and parietal lobes
Damage: Conduction Aphasia - comprehension/expression are intact, but - inability to repeat info presented auditorily

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30
Q

Comissural Fibers

A

Communication btwn two hemispheres
Corpus Callosum – major group communication fibers
1940 – surgery as epilepsy treatment: cutting corpus callosum. Seizures stopped, but each hemisphere started to operate independently.

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31
Q

Ascending tracts

A

afferent

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32
Q

Descending Tracts

A

efferent

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33
Q

Major Descending Tracts

A

Originate in cortex, travel down brainstem
Pyramidal tracts (the corticospinal and corticobulbar tracts)
Tectospinal
Rubrospinal
Vestibulospinal all extra
Pontine reticulospinal
Medullary reticulospinal tracts

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34
Q

Pyramidal Tracts

A

carry impulses that convey info about voluntary fine motor movements. Fine motor movement of fingers when typing

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35
Q

Extrapyramidal Tracts

A

transmit impulses that control more of postural support needed to perform fine motor movements.
Keeping posture to type.
Indirect activation system basically start from brainstem to spinal nerves.

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36
Q

Tracts for Speech

A

Rubrospinal and Pontine and Medullary reticulospinal

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37
Q

Tectospinal tract

A

eyes

38
Q

vestibulospinal tract

A

hearing and balance

39
Q

Reticulospinal tract

A

reticular formation down to spinal nerves.

Tracts as a whole is important for upright posture and body’s ability to attend to external environment

40
Q

Corticospinal Tract

A

Responsible for
1.activation of skeletal muscles for voluntary movements
2. Inhibition of reflexes
Composed of axons descending from cortex and terminate in brainstem and synapse w cranial nerves in medulla.

41
Q

Corticobulbar tract

A

The corticobulbar regulation of some CNs is bilateral:
Trigeminal, facial (part), vagus, and glossopharyngeal nerves
Unilateral or bilateral innervation and what structures or regions or functions do those cranial nerves help assist.

42
Q

LMN sometimes called

A

final common pathway, cranial nerves, or spinal nerves

43
Q

UMN Lesions

A

-Corticospinal tract
-Immediately after damage: Muscle weakness, loss of fine motor skills, reduced muscle tone, but later muscle tone returns + muscles become spastic
-Hyperactive reflexes
-Positive Babinski reflex
-Damage before decussation in medulla → symptoms contralateral to area of damage
No muscle degeneration

44
Q

Axons

A
  • Contain terminal buttons/synaptic buttons

- Covered in thin layer of white, fatty substance myelin sheath

45
Q

How do neurons work and transmit information?

A
  • axons send electrical signals from the neuron’s cell body to the synaptic buttons. Electrical signal causes buttons to release a chemical (neurotransmitter) which is then received at dendrite of next neuron.
  • chemical transfer of neurotransmitter that is picked up by the dendrite and sent to the cell body which tells cell body what electrical signal to send to next neuron.
46
Q

Dendrites

A

-short, hair-like fibers that extend from cell body to receive information from axons of other cells

47
Q

Neurons

A
  • Neurons receive info through dendrites and transmit info through axons
  • Nerve cells have 2 parts: soma or cell body and nerve fibers
48
Q

Synapse

A

-point at which axon of one neuron meets dendrite of another neuron

49
Q

Synaptic Cleft

A
  • tiny space btwn an axon and a dendrite

- where synaptic buttons release neurotransmitters

50
Q

Nerve fiber tracts

A
  • bundles of axons in nervous system

- form white matter of CNS

51
Q

Neurotransmitter

A
  • chemicals contained within terminal buttons which aid in contact between two nerves
  • may excite or inhibit next neuron
52
Q

Projection Fibers

A
  • carry info from brain to brain stem and spinal cord or from peripheral sensory nerves
  • efferent and afferent
53
Q

Efferent projection fibers

A

motor nerves-carry signals from the motor and pre-motor cortex through the brain to the muscles and glands

54
Q

Afferent projection fibers

A

sensory nerves-carry sensory info from sensory receptor cells via peripheral sensory nerves throughout PNS through spinal cord to brain

55
Q

Somatic nervous system

A

Sensory perception & volitional motor activity

Major components-cranial nerves & spinal nerves

56
Q

Autonomic nervous system

A

Controls involuntary functions such as breathing and heartbeat
Divided into sympathetic (panics) and parasympathetic (calms) branches

57
Q

Cranial vault

A

space inside skull

58
Q

Ventricles

A
  • 2 lateral ventricles which are both connected to third ventricle which is connected to fourth ventricle
  • ventricles contain choroid plexus which are soft masses of tissue which produce cerebrospinal fluid
59
Q

Frontal Lobe

A

-Posterior boundary is central fissure and lower boundary is lateral fissure
-Contains motor speech area or “Broca’s Area”
Planning
Problem solving
Inhibition
Short-term or working memory
Motor behavior
Regulates social behavior

60
Q

Parietal Lobe

A

-Behind central fissure and above lateral fissure
-Supramarginal gyrus-problems w writing (agraphia)
-Angular gyrus-naming and reading problems
-“Wernicke’s Area” is only partially in parietal lobe
Attention
Combines information from different senses
Processes skin pressure
Processes touch
Processes skin temperature
Processes pain

61
Q

Temporal Lobe

A

-Bottom third of each hemisphere-lateral fissure forms top boundary
-Sensory speech area/Wernicke’s Area (left hemisphere only)-comprehension of written and spoken language
Process verbal meaning
Speech production
Process emotion in speech
Process auditory pitch
Memory for faces
Object recognition
Long-term memory
Some visual processing
Emotion and personality
Comprehending speech/Auditory reception-Primary auditory cortex & Auditory Association Area

62
Q

Primary Motor Cortex

A

In both hemispheres but larger in left hemisphere
Known as Herschel’s gyri
Primary function is hearing

63
Q

Occipital Lobe

A 
Located behind parietal lobe
Smallest lobe
Primary Visual Cortex
Processing visual stimuli
Processing color
Processing motion
Processing form
Imagery
64
Q

Motor Cortex

A
  • Control of skilled movements
  • Located just in front of central fissure
  • A homunculus or map is used to depict cortical area responsible for muscle groups
  • larger representation the more diverse, intricate and precise movements required
65
Q

Primary Sensory Functions of Left Hemisphere

A

Sensation of right body
Perception of right visual field
Appreciation of sound from right ear

66
Q

Look up picture of lobes of brain

A

don’t forget lateral sulcus

67
Q

Primary Sensory Functions of Right Hemisphere

A

Sensation of left body
Perception of left visual field
Appreciation of sound from left ear

68
Q

Left Hemisphere Language Skills

A

-comprehension and expression of oral and written lang including storage and recall of symbols and nominals
-storage of common nouns and action verbs rules of grammar and structure of language
verbal word recognition

69
Q

Right Hemisphere Cognitive Functions

A 
Spatial orientation 
Spatial relations
Sequencing of symbols, objects, and events
Timing and time perception
Music appreciation
Recognition of objects and faces
Geometric communication
Non-verbal communication
Fundamental movement of left body
Left voluntary gaze 
Motor persistence
Order 
Planning
Volition
Diligence
Executive control-problem solving, reasoning
Abiding by rules and regulations
70
Q

Left Hemisphere Emotional Functions

A 
Denial, oppositional behavior, non-compliance, and hostile anger (mania)
Obsessions and compulsions
"Learned" pessimism and negativity
Pedantic/wrote, rigid responses
Rationalization
71
Q

Left Frontal Lobes Functions

A

Fundamental movement of right body
Right voluntary gaze
Clarity of verbal thought (freedom from auditory-verbal hallucinations and delusions)

72
Q

Right Hemisphere Emotional Functions

A 
Prosody
Primary emotionality
Empathy and comprehension of emotionality
Affective behavior (depression)
Wit and humor
73
Q

Primary Visual Imagery of Right Hemisphere

A

Picture-to-picture storage and representation
Symbolization (symbolic representation)
Picture-to-word storage and representation

74
Q

Diencephalon

A

Located deep in cerebrum at top of brain stem btwn cerebral hemispheres
Contains thalamus and basal ganglia

75
Q

thalamus

A

integrates sensory experiences and relays them to cortical areas
-plays an important role in consciousness, alertness and attention

76
Q

basal ganglia

A

r-regulation and adjustment of major muscle groups in trunk and limbs

  • receives input from frontal lobe
  • damage causes problems w movement and sensation and results in appearance of involuntary movements called dyskinesia
77
Q

Brainstem

A

communicative and structural link between the brain and spinal cord

  • midbrain
  • pons
  • medulla oblongata
78
Q

olfactory

A

sensory

79
Q

ocular

A

sensory

80
Q

oculomotor

A

motor

81
Q

trochlear

A

motor

82
Q

trigeminal

A

both

83
Q

abducens

A

motor

84
Q

facial

A

both

85
Q

vestibulocochlear

A

sensory

86
Q

glossopharyngeal

A

both

87
Q

vagus

A

both

88
Q

accessory

A

motor

89
Q

hypoglossal

A

motor

90
Q

cerebellum

A
  • Looks like a miniature brain w 2 hemispheres and an outer layer of grey matter called cerebellar cortex
  • Coordinates and modulates movements
  • Regulates rate, range, direction, and force of movement
  • Coordinates smooth and rhythmic movements-including speech
  • Does not initiate movement!
  • damage causes clumsy movement (ataxia)
  • Located at base of brain behind pons and medulla
91
Q

Blood Supply 5 steps

A
  • Aorta-oxygenated
  • Subclavian Arteries: Branch off into common carotid arteries and into vertebral arteries
  • Vertebral arteries join together at base of pons and form basilar artery
  • Common Carotid Arteries
  • Internal and External Carotid Arteries
  • External carotids lead off to face
  • Internal carotids proceed up toward brain on each side of neck (near skin surface- what we feel to get a pulse)
  • Circle of Willis located at base of brain where 2 carotids and basilar artery meet

Acquired Language Disorders GRAD (1 decks)

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