Untitled Deck Flashcards
(136 cards)
1
Q
Computed axial tomography (CAT or CT)
A
Fast neuroimaging using X-rays, with less soft tissue detail
2
Q
Magnetic resonance imaging (MRI)
A
Slow imaging using magnetic fields/radio waves without radiation for high-resolution soft tissue images
3
Q
Functional magnetic resonance imaging (fMRI)
A
Measures brain activity by detecting changes in blood flow
4
Q
Positron emission (computed) tomography (PECT, or PET)
A
Imaging that uses radioactive tracers for metabolic activity
5
Q
Single photon emission computed tomography (SPECT)
A
Similar to PET, but uses gamma rays and is cheaper
6
Q
Cerebral angiography (Arteriography)
A
X-ray imaging of blood vessels, invasive with contrast dye
7
Q
Magnetic resonance angiography (MRA)
A
Non-invasive blood vessel imaging using magnetic fields
8
Q
Electroencephalography (EEG)
A
Recording of electrical activity in the brain using electrodes on the scalp
9
Q
Electrocorticography (ECoG)
A
Recording of electrical activity in the brain using electrodes placed directly on the surface of brain
10
Q
What are the ways of defining age?
A
- chronological
- biological
- cognitive
- psychological
- social
11
Q
Chronological age
A
how long a person has lived since birth
12
Q
Biological age
A
how one’s bodily organs function over time
13
Q
Cognitive age
A
how one’s cognitive abilities change over time
14
Q
Psychological age
A
how one’s personality changes over time
15
Q
Social age
A
How social roles and the environment evolve with age
16
Q
Aging is a ___________ process
A
ongoing
17
Q
What are key theories about aging that are especially relevant to cognition and communication?
A
• Biopsychosocial models of aging
• The life-span model of postformal cognitive development
• Motivational theory of life-span development
18
Q
Biopsychosocial models of aging
A
Biological, psychological, sociological factors that influence aging
19
Q
Life-span model of postformal cognitive development
A
7 stages helping clinicians consider changes in communication abilities and needs with age due to changes in body structure/function and evolving life priorities
20
Q
Motivational theory of life-span development
A
Focuses on highly individualized abilities
21
Q
Aging well is influenced by:
A
culture, physical body structure, life participation, and environmental influences
22
Q
What are normal changes in the brain as people age?
A
- Neuron shrinkage/reduced dendritic branching
- Atrophy (loss of tissue)
- Reduction in neurotransmitters
- Decreased white matter (especially on the frontal lobes)
- Accumulation of amyloid beta or amyloid plaques (abnormal proteins) without neurofibrillary tangles
23
Q
Atrophy during aging occurs typically in what regions of the brain?
A
primarily in the frontal lobes and hippocampus
24
Q
Positive aspects of the aging brain
A
richness of life experiences, wisdom, and less stressed/more adaptable
25
What theories have been proposed to account for cognitive-linguistic changes with aging?
- Resource capacity theories
- Speed of processing theories
- Inhibition theories
26
Resource capacity theories
reduction in cognitive capacity, not the ability to accomplish individual simple tasks. (working memory, context processing deficiency, signal degradation, transmission deficit)
27
Speed of processing theories
Cognitive processing slows as we age
28
Inhibition theories
inhibiting irrelevant info and focusing on particular tasks in the face of multiple stimuli
29
What can be done to ensure the best preservation of language abilities as people age?
Maintenance of overall physical, mental, and emotional health throughout the lifespan
30
Two major factors related to delayed onset of cognitive deficits:
- higher education levels
- average or above average SES
31
Primary auditory cortex (path of language in the brain)
perceives/translates phrase into neural code Wernicke's understands, Wernicke's extracts meaning, codes phrase in a form Broca's can work with and send to arcuate fasciculus
32
Broca (path of language in the brain)
recodes phrase to artic plan, sends to primary motor cortex, down pyramidal fibers to cranial nerves, moves speech muscles
33
Wernicke's area monitors ___________ and attempts _____________ if needed
output; correction
34
Angular gyrus
at the junction of temporal, parietal, and occipital. Important for reading and writing
35
Neologism
Non word substitutions for a target words
36
Circumlocution
Indirect, round-about language to describe word or concept
37
Conduit d'approche
Successive attempts at a target word, attempts approximate the target phonetically; final production may or may not be successful
38
Jargon
Fluent, prosodically correct output, resembling correct grammar but containing meaningless speech
39
Perseveration
Repetition of a previously used word or phrase that is no longer appropriate to the context
40
Phonemic paraphasia
Substitution, insertion, deletion, or transposition of phonemes ("able" for "apple")
41
Semantic paraphasia
Substitutions of a real word for a target word, error may be related or unrelated to the target, error may not be self-corrected ("banana" for "apple")
42
Stereotypy
Repetition of a syllable, word, or phrase frequently throughout the sample (same as perseveration)
43
Agrammatism
speech reduced in length and complexity; function words may be missing
44
Logorrhea
excessive and often incoherent wordiness
45
Anosognosia
lack of awareness of deficits
46
Emotional lability
tendency to fluctuate quickly and abruptly between distinct emotional states
47
Telegraphic speech
verbal utterances in which words are left out, but the meaning is usually clear (go car)
48
Literal paraphasia
a sound substitution or rearrangement of sounds is made, but the stated word still resembles the intended word ("hosicle" for "hospital")
49
Press of speech
Rapid, frenzied speech without pauses
50
Dynosmia
difficulty retrieving the correct word from memory when needed
51
Figure ground
The visual field is organized into objects (the figures) that stand out from their surroundings (the ground).
52
Confabulation
the act of filling in memory gaps
53
Models of language processing
1) Wernicke-Geschwind Model
2) Dual Language pathways Model
54
Wernicke's aphasia characteristics
neologisms; paraphasias (literal, semantic); logorrhea; press of speech; anosognosia; verb perseveration
55
Wernicke's aphasia brain area
temporal lobe
56
Broca's aphasia characteristics
Agrammatism; telegraphic speech; dysnomia; circumlocutions; literal paraphasia; effortful speech; catastrophic reaction; emotional lability
57
Broca's aphasia brain area
frontal operculum
58
Global aphasia characteristics
Stereotypy; a combination of expressive and receptive language deficits in all modalities.
59
Global aphasia brain area
planum temporale
60
Conduction aphasia characteristics
impaired repetition; conduit d'approche; literal paraphasia
61
Conduction aphasia brain area
arcuate fasciculus
62
Transcortical Sensory Aphasia Characteristics
Similar to Wernicke's (exception: intact repetition); echoing others' words
63
Transcortical sensory brain area
angular gyrus; posterior middle temporal gyrus
64
Transcortical motor aphasia characteristics
Similar to Broca's (exception: intact repetition)
65
Transcortical motor brain area
anterior watershed area of left frontal lobe
66
Mixed transcortical aphasia characteristics
Similar to Global aphasia (exception: intact repetition)
67
Mixed transcortical brain area
multi-focal lesions in the frontal/temporal watershed regions
68
The classic dichotomies of aphasia
receptive/fluent/posterior & expressive/non-fluent/anterior
69
Why is PPA considered an aphasia?
because loss of previously acquired language abilities due to neurological cause
70
What type of syndrome is PPA and does it display gradual or rapid onset of symptoms?
PPA is a neurodegenerative Dementia syndrome; gradual onset of symptoms
71
Anomic aphasia
Word-finding difficulty; spared comprehension/syntactic production; circumlocutions; the use of generic terms; fillers
72
Primary progressive aphasia (PPA)
The ongoing loss of language abilities in the face of relatively preserved cognitive abilities
73
What are the primary subtypes of PPA?
Non-fluent agrammatic, semantic variant, logopenic variant PPA
74
Crossed aphasia
any form of aphasia that is due to damage to the right hemisphere instead of the left in a right-handed person
75
Subcortical aphasia
any form of aphasia that is associated with a lesion below the cortex (insular lobe)
76
The severity of challenges faced by TBI survivors ranges from what?
- Barely noticeable symptoms
- Complete loss of functional abilities in all activities of daily living
- Coma
- Vegetative state
77
War related TBI's
blast injuries
78
SLPs working with TBI patients
Scope: knowledge/skills related to cognitive aspects of communication;
Interdisciplinary collaboration;
Assessment challenges: overlapping symptoms, differential diagnosis
79
What is right hemisphere syndrome?
any combination of a constellation of symptoms associated with RH damage or RH TBI
80
Where is the damage for RHS?
damage can be anywhere in the right hemisphere
81
What neurological etiology may RHS be associated with?
- Stroke
- TBI
- Tumors
- Infectious processes
82
How does RHS affect communication and life participation?
Categories of deficits that affect cognition and communication in some way, either direct or indirect
83
What are RHS cognitive-linguistic impairments?
code-switching deficits, inattentiveness, interpreting facial expressions, tangential comments, dysprosody, confabulation
84
What are special challenges that SLP's face in serving people with RHS?
- Underdiagnosis/lack of awareness
- Diversity of symptoms
- Understanding neuro structure-function relationships
- Less research on RH compared to LH communicative functions
- Characterizing what is "normal"
85
What neurodegenerative conditions most commonly affect cognitive-linguistic abilities?
- Mild cognitive impairment (MCI)
- Dementia
- Primary progressive aphasia (PPA)
86
Language problems in people with MCI and dementia are characterized as
cognitive-communicative impairments
87
Language of generalized intellectual impairment
involves a loss of language abilities in individuals with MCI or dementia
88
Dementia
language loss is secondary to the decline in cognitive abilities (slow progressive decline)
89
Early signs of dementia
word finding problems, semantic confusions in word usage, errors or gaps in spoken recall of events
90
Alzheimer's disease
gradual onset impacting memory, attention, and executive functions
91
Vascular dementia
caused by the lack of blood flow to the brain
92
Dementia with Lewy bodies
confusion, variable states of awareness, memory loss, visual hallucinations, and neuromuscular problems
93
Parkinson's associated dementia
Co-occurs with Parkinson's disease
94
Frontotemporal dementia (FTD)
expressive and receptive language deficits, discourse challenges, movement disorders, and personality and behavioral changes
95
Huntington's disease
poor language organization, confabulation, memory problems, dysnomia, irritability, and emotional lability
96
Korsakoff's syndrome
short and long-term memory deficits and confabulation typically caused by excessive alcohol use
97
Creutzfeldt-Jacob disease
rapid loss of cognitive and linguistic abilities, cortical and cerebellar coordination, and mood changes
98
AIDS dementia complex
challenges with executive functions, pragmatic abilities, attention, and memory
99
What are symptoms of nonfluent agrammatic PPA?
- Difficulty understanding/producing syntax
- Speech sound errors, omission of articles and function words
- Often concomitant apraxia of speech
100
What are symptoms of semantic variant PPA?
- Word-finding and comprehension difficulties
- Dysnomia
- Loss of semantic knowledge
101
What are symptoms of logopenic variant PPA?
- Word finding difficulties (conversation)
- Challenge of access, not semantic knowledge
- Frequent speech sound and spelling errors
102
Is there such a thing as "reversible" dementia?
By definition, dementia is progressive and gets worse over time
103
Dementia-like symptoms may be noted despite the absence of true dementia because of things such as...
depression, dietary imbalances, vitamin deficiencies, drug effects, drug interactions, post-surgical states
104
What is the role of an SLP in working with people who have PPA and dementia?
- assessment of communication strengths and weaknesses
- training and counseling
- documentation and research
- advocacy
- intervention
105
Triggers of a stroke
excessive alcohol, infection, excessive eating, pos/neg emotions, sudden changes in posture, special events, drug use, physical excretion
106
Tangential speech
communication disorder in which the train of thought of the speaker wanders and shows lack of focus, never returning to the initial topic of the conversation
107
Idioms
An expression that has a meaning apart from the meanings of its individual words (raining cats and dogs)
108
Hyper affectivity
exaggerated or heightened emotional response or expression, where an individual may experience emotions more intensely than considered typical for a situation
109
Aprosodia
flat emotionless speech
110
Prosopagnosia
inability to recognize faces
111
Amusia
loss or impairment of musical abilities (pitch, rhythm, melody; "tone deafness")
112
Anterograde amnesia
an inability to form new memories
113
Retrograde amnesia
Inability to recall old memories
114
What does differential diagnosis involve?
systematically comparing potential diagnoses based on patient's presentation, medical history, physical exam, and diagnostic tests
115
50% of cognitive therapy is _______2 words_______ and 50% is _________3 words________
compensatory strategies; changing the brain
116
Rancho Los Amigos Scale
commonly used tool for assessing cognitive and behavioral functioning as a person recovers from brain injury (10 levels; lower more severe)
117
Name 3 different cognitive linguistic impairments experienced by people with TBI
word finding, abstract language, verbal reasoning
118
What are 2 types of behavior dysfunction experienced by people with TBI?
hyperactivity and impulsivity/disinhibited
119
Other than TBI, what are 2 other acquired brain injuries that can cause cognitive linguistic impairments?
post concussion syndrome and anoxia
120
What is cognitive organization?
attention, discrimination, organization, memory (A diligent owl masters)
121
What is executive functioning?
mental processes that help apply cognitive skills to a variety of tasks (planning, organization, attention, discrimination)
122
CTE and diagnosis
chronic traumatic encephalopathy can only be confirmed through autopsy
123
Primary focus of treatment for RHS
improving awareness, attention, abstract reasoning, left attention, and pragmatics
124
MCI vs dementia
MCI: can be a sign of disease that can eventually cause dementia; Dementia: umbrella term
125
Anoxia
lack of oxygen
126
Briefly describe 3 communication deficits one might have with RHS
flat affect, poor prosody, and word finding deficits
127
A deficit in formulating and expressing correct syntax in a patient who with aphasia is termed:
agrammatism
128
Explain what specific communication characteristics occur with normal aging vs dementia and give examples
slowed processing, occasional word finding deficits, and some short term memory issues
129
Your client has a medical diagnosis of left CVA due to damage to the main branch of the MCA. Explain the importance of the left MCA to language function and state what type of aphasia you would expect from major damage to the left MCA.
The left middle cerebral artery innervates the major language zones. Damage could result in Global Aphasia.
130
Describe at least one type of aphasia that results from damage to one of the main association fiber bundles, the arcuate fasciculus.
Conduction aphasia
131
Explain neurologically why a person with Broca's aphasia may experience concomitant motor speech deficits in comparison to a person with Wernicke's aphasia
Damage to Broca's area is close to the motor strip
132
What type of aphasia results from major damage to the left MCA?
Global Aphasia
133
What type of aphasia results from damage to the arcuate fasciculus?
Conduction aphasia
134
Why may a person with Broca's aphasia experience motor speech deficits?
Damage to Broca's area is close to the motor strip and can also impact motor speech neurons
135
What does PPA begin with a decline in?
Language
136
Why are communication deficits of TBI and Dementia not typically referred to as Aphasia?
In TBI and Dementia, cognition disruptions can lead to communication disruptions (cog-communication disorders). In Aphasia, disruptions in communication come first to any possible disruptions in cognition.
