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S4- Neuro 1 > Week 4- Aphasia > Flashcards

Week 4- Aphasia Flashcards

1
Q

PART 1: SLP TERMINOLOGY

A

PART 1: SLP TERMINOLOGY

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2
Q

What is the difference between communication and language?

A
  • Communication is the active process of exchanging information and ideas (doesn’t have to be verbal).
  • Language is a complex and dynamic (rule based) system of conventional symbols that is used in various modes for thought and communication.
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3
Q

What are (2) forms of language and their definitions?

A
  • Expressive- Ability to communicate one’s thoughts, ideas, and feelings.
  • Receptive- Ability to understand what another person is communicating.
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4
Q

Which type of language is the first language skills to be developed and is relatively easier to develop?

A

Receptive Language

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5
Q

SLP Terminology:

  • _______ is how we say sounds and words.
  • _________ is how we make speech sounds by manipulating our articulators. (Boat vs Tote)
  • _______ is how we use our vocal folds and breath to make sounds. (Bad vs Pad (Bad uses vocal folds, Pad doesn’t))
  • ________ is the rhythm of our speech.
  • ________ is a fluency deficiency.
A
  • Speech
  • Articulation
  • Voice
  • Fluency
  • Dysfluency
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6
Q

How might someone with dysfluency present?

A

Stutter, my name is S-S-S-Sarah.

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7
Q

What are some forms of non-verbal communication?

A
  • facial expressions
  • tone and pitch (“I love you.” vs I love you?”)
  • Kinesics
  • Proxemics
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8
Q

What is kinesics?

A

Gestures displayed through body language.

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9
Q

What is proxemics?

A

Physical distance between the communicators.

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10
Q

_________ are the social rules we follow when we talk. List some examples.

A

Pragmatics

  • taking turns in conversation
  • how to talk to different people (mom vs girlfriend)
  • how close to stand when talking
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11
Q

______ are the aspects that shape a communicative exchange.

A

Context

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12
Q

_______ is our vocabulary of a language. (my _________ likely varies from my grandmothers).

A

Lexicon

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13
Q

_________ is the language system that refers to the meaning of words. (Ex. tree bark vs dog bark)

A

Semantics

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14
Q
  • _______ is the grammar of a language determines the sequencing of words that are acceptable in the formation of sentences.
  • What is an example?
A

-Syntax

  • English = fabulous actor
  • Spanish = actor fabuloso
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15
Q

________ is the stress and intonation used in language to help make distinctions between questions, statements, expressions of emotions, shock, exclamations, etc…

A

Prosody

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16
Q

PART 2: SPEECH CRANIAL NERVES

A

PART 2: SPEECH CRANIAL NERVES

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17
Q

What cranial nerves are involved in speech?

A
  • 5 (trigeminal)
  • 7 (facial)
  • 9 (glossopharyngeal)
  • 10 (vagus)
  • 12 (hypoglossal)

-8 in relation to understanding speech (not directly speech)

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18
Q
  • What is CN5?

- What is the function of CN5 in relation to speech?

A
  • Trigeminal

- Chewing and sensation to face, soft and hard palate, nasopharynx, teeth, and anterior 2/3 of tongue.

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19
Q
  • What is CN7?

- What is the function of CN7 in relation to speech?

A
  • Facial

- Movement of facial muscles, taste, and salivary glands.

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20
Q
  • What is CN9?

- What is the function of CN9 in relation to speech?

A
  • Glossopharyngeal
  • Taste, swallowing, elevation of pharynx and larynx, parotid salivary glands, sensation to posterior tongue and upper pharynx.
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21
Q

What is CN10?

-What is the function of CN10 in relation to speech?

A
  • Vagus

- Taste, swallowing, elevation of palate, phonation, parasympathetic outflow to visceral organs.

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22
Q
  • What is CN12?

- What is the function of CN12 in relation to speech?

A
  • Hypoglossal

- Movement of the tongue.

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23
Q

PART 3: CENTRAL LANGUAGE MECHANISM/ ANATOMY OF THE BRAIN

A

PART 3: CENTRAL LANGUAGE MECHANISM/ ANATOMY OF THE BRAIN

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24
Q

“In most people the _____ hemisphere of the brain is dominant for language. “

A

left

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25
Q
  • Broca’s Area = _______ speech

- Wernicke’s Area = _______ speech

A
  • expressive (motor)

- receptive (understanding)

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26
Q
  • What is the Perisylvian Zone?

- Does it include Broca’s and Wernicke’s Area?

A
  • Area of the dominant hemisphere where major neurological components of language are located.
  • Yes
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27
Q

Major Components of Central Language Mechanism:

  • _________ is motor programming responsible for articulation (expression of language).
  • _____________ is responsible for activation of muscles for articulation.
  • ____________ is involved in transmission of linguistic information from posterior to anterior areas. (connects Broca’s Area and Wernicke’s Area)
A
  • Broca’s Area
  • Primary Motor Cortex
  • Arcuate Fasciculus
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28
Q

Major Components of Central Language Mechanism:

  • ____________ is located behind Wernicke’s Area and integrates visual, auditory, and tactile information and carries out symbolic integration for reading.
  • ____________ is involved in comprehension of oral language.
A
  • Angular Gyrus

- Wernicke’s Area

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29
Q

Major Components of Central Language Mechanism:

  • ____________ is involved in symbolic integration for writing.
  • _________________ is a c-shaped nerve fiber bundle that transmits information between hemispheres.
A
  • Supramarginal Gyrus

- Corpus Callosum

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30
Q

Major Components of Central Language Mechanism (Subcortical):

  • ____________ is involved in naming and memory mechanisms.
  • __________, _________, and ___________ play a general role in speech and language and are part of the basal ganglia.
  • ___________ are tracts underlying the perisylvian cortical regions known to be associated with language function.
A
  • Thalamus
  • Internal Capsule, Striatum, and Globus Pallidus
  • White Matter
31
Q

Are subcortical language mechanisms fully understood?

A

No

32
Q

PART 4: APHASIA

A

PART 4: APHASIA

33
Q
  • What is aphasia?

- What side of the brain does it typically affect?

A
  • Neurogenic language disorder resulting from an injury to the brain.
  • Typically left hemisphere (or dominant hemisphere)
34
Q

What is Not Aphasia:

  • Not a ____________ _______- You had to have language in the first place to lose it.
  • Not _________ and it is not _______ of speech.
  • Communication loss can not be attributed to dementia, confusion, sensory loss (hearing loss), or motor dysfunction.
A
  • Developmental disorder

- dysarthria, apraxia

35
Q

Where Does Aphasia Come From:

  • The most common cause of aphasia is _________.
  • Aphasia can happen in all 4 language modalities. What are these?
  • _________ aphasia is generally associated with anterior lesions while ________ aphasia is posterior lesions.
  • ______ lesions are anatomical abnormalities of the brain due to trauma/disease that causes inflammation, malfunction, or destruction of brain cells/tissue. They can be localized to one part of the brain or may be widespread.
A
  • stroke/CVA
  • expressive language, receptive language, reading, writing
  • Expressive (Broca’s), Receptive (Wernicke’s)
  • Brain lesions
36
Q

The signs/symptoms of aphasia can be largely accounted for using what eight-dimension organization?

A
  1. ) Fluent vs nonfluent
  2. ) Grammatical integrity
  3. ) Volitional repetition
  4. ) Auditory comprehension
  5. ) Writing disorder
  6. ) Reading disorder
  7. ) Expression of names
  8. ) Response dynamism
37
Q

Aphasia Tests/Screeners generally include what (6) things?

A
  • Naming tasks
  • Speech sample
  • Repitition
  • Comprehension of spoken language
  • Reading
  • Writing
38
Q

Fluent Speech Pattern- Observed:

  • Defined by _____ of speech, length of utterance, ease of production, prosody.
  • What classifies as fluent speech?
  • What is logorrhea?
  • What is “pressed for speech”?
A
  • rate of speech
  • > 200wpm, long utterances (9 or more words), utterances easily produced, normal prosody.
  • Logorrhea- Lots and lots of speech that may not be meaningful.
  • Pressed for speech- The person seems compelled to keep going, getting out lots of ideas through fast and continuing ideas.
39
Q

Non-Fluent Speech Pattern- Observed:

-What classifies as non-fluent speech?

A
  • 10-50wpm with pauses, utterances are short (1-3 words), speaking seems effortful, prosody often lost
40
Q

Auditory Comprehension Tasks:

  • Can the person select appropriate items, answer ___/____ questions, and/or follow __________.
  • ______________ (auditory verbal agnosia) is where the person hears the word but cannot tell you the meaning of the word; inability to comprehend speech.
A
  • yes/no questions, commands

- pure word deafness

41
Q

Writing Task:

  • __________ is the loss of the ability to write.
  • What is pure agraphia?
  • What is paragraphias?
A
  • Agraphia
  • Pure agraphia- agraphia is the only communication deficit resulting from focal lesion (very rare).
  • Paragraphias- incorrect spelling errors caused by brain damage.
42
Q

Response Dynamism:

  • __________ is a short utterance used exclusively in all speaking attempts, it can be a word or a phrase (“son of a bitch” or “shit”. ________ is when a patient only has one word available.
  • _____________ is when a word or phrase temporarily becomes the response to all stimuli.
  • _________ is the uninhibited repetition of one’s own utterances.
  • _________ is the uninhibited repetition of another’s utterances.
A
  • Stereotypy, Monophasia
  • Verbal preservation
  • Pallilalia
  • Echolalia
43
Q

Give an example of verbal preservation.

A

What’s your name? John Smith. Where do you live? John Smith.

44
Q

Is verbal preservation or stereotypy more temporary?

A

verbal preservation

45
Q

T/F

Patients usually present solely as one kind of aphasia.

A

False

46
Q

Broca’s Aphasia:

  • _________ type of aphasia.
  • Usually, an occlusion of the _____________ artery (superior division).
  • Broca’s aphasiais often a lesion in the _________ ________ frontal gyru.
  • Characterized with awkward articulation, restricted vocabulary, restriction to simple grammatical forms in the presence of a relative preservation of auditory ____________.
  • _______ typically mirrors speech.
  • ________ may be less impaired than speech and writing.
A
  • nonfluent
  • left MCA
  • posterior inferior frontal gyru
  • comprehension
  • Writing
  • Reading
47
Q

Wernicke’s Aphasia:

  • A ________ type of aphasia.
  • Usually, an occlusion of the ______________ artery (inferior division).
  • Wernicke’s aphasiais commonly caused by alesionin the _______ _________ temporal gyrus (Wernicke’sarea).
  • Impaired auditory ___________ and fluently articulated speech marked by word substitutions.
  • Reading and writing usually ______ impaired.
  • Speech is often produced at a ________ rate than normal.
  • Production of speech is often precise—but patients may reverse phonemes and or ________. (Hospipal = hospital)
A
  • fluent
  • left MCA
  • posterior superior temporal gyrus
  • comprehension
  • severely
  • greater rate
  • syllables
48
Q

Jargon Aphasia:

  • ________aphasiain which an individual’sspeechis incomprehensible but appears to make sense to the individual.
  • Persons experiencing this condition will either replace a desired word with another that sounds or looks like the original one, or has some other connection to it, or they will replace it with randomsounds.
  • Associated with _________ aphasia, it is usually caused by damage to the temporal lobe, and more specifically, Wernicke’s area.
A
  • fluent

- Wernicke’s

49
Q

Anomic Aphasia:

  • ______ finding difficulty within fluent, grammatically well-formed speech.
  • Lesion site is usually variable but is common in left angular gyrus (near __________).
  • Speech output is somewhat vague, and patient may use _____________ as a compensatory strategy to skirt the lack of specificity of language use.
  • What is circumlocution?
A
  • Word
  • Wernicke’s
  • circumlocution
  • Using wordy and indirect language to express an idea when unable to retrieve the desired word/s.
50
Q

What is an easy way to remember Anomic Aphasia?

A

Graduate Student Aphasia (cant find the words)

51
Q

Conduction Aphasia:

  • The main impairment is in the inability to ________ words or phrases. Other areas of language are less impaired (or not at all).
  • Also known as_________ aphasia.
  • Conduction aphasia is considered a ______ form of aphasia and is relatively rare.
  • Caused by a lesion in the_________________, a bundle of nerve fibers connects Wernicke’s and Broca’s areas.
A
  • repeat
  • associative aphasia
  • mild
  • arcuate fasciculus
52
Q

Global Aphasia:

  • Severe aphasia with complete dysfunction across _______ language modalities.
  • Generally extensive damage, anywhere in the left hemisphere and sometimes bilateral – affecting _________ and __________ area.
A
  • ALL

- Wernicke’s and Broca’s

53
Q

Transcortical Aphasia:

  • Wernicke’s term for any aphasic syndrome whose lesion falls outside of the _____________ area.
  • Ability to ________ with good accuracy is retained.
  • Generally, 3 transcortical aphasias recognized. What are they?
A
  • Perisylvian Area
  • repeat
  • Transcortical Motor Aphasia, Transcortical Sensory Aphasia, Transcortical Mixed Aphasia
54
Q

Is this describing Transcortical Motor Aphasia, Transcortical Sensory Aphasia, or Transcortical Mixed Aphasia?

  • Fluent speech marked with paraphasias with semantic and neologistic substitutions, poor comprehension, good repetition.
  • Typically caused by a lesion to areas of the brain which surround Wernicke’s language area.
A

Transcortical Sensory Aphasia

55
Q

Is this describing Transcortical Motor Aphasia, Transcortical Sensory Aphasia, or Transcortical Mixed Aphasia?

  • A rare type of aphasia, Broca’s and Wernicke’s areas are typically not damaged, but the surrounding areas are injured. Damage to these association areas is thought to leave Broca’s and Wernicke’s areas isolated from the rest of the language system.
  • A common cause is awatershed strokeof the language association areas as a result of severeinternal carotid stenosis.
A

Transcortical Mixed Aphasia

56
Q

Is this describing Transcortical Motor Aphasia, Transcortical Sensory Aphasia, or Transcortical Mixed Aphasia?

  • Nonfluent speech with greater effort required than Broca’s; repetition and comprehension intact,
  • Typically caused by a lesion located nearby Broca’s area or just in front of it.
A

Transcortical Motor Aphasia

57
Q

Subcortical Aphasia:

  • Subcortical aphasias are generally characterized with preserved _________.
  • _______ aphasia is characterized by relatively consistent fluent expressive speech and impaired comprehension marked by verbal paraphasia and neologisms. Auditory and reading comprehension usually remains intact.
  • _______-_________ aphasia and aphasia associated with white matter paraventricular lesions are characterized with lack of speech fluency, occurrence of literary paraphasias, mainly preserved comprehension and naming.
A
  • repetition
  • Thalamic
  • Striato-capsular
58
Q

Progressive Aphasia:

  • Despite the name of this condition, it is a type of ___________. Generally characterized by gradual loss of language function in the context of relatively well-preserved memory, visual processing, and personality until the advanced stages
  • ___________ is often an early sign.
  • Not due to stroke, trauma, tumor, or infection
  • Spontaneous recovery ________ occur.
A
  • dementia
  • Anomia
  • doesn’t
59
Q

PART 5: APHASIA IN A CLINICAL SETTING

A

PART 5: APHASIA IN A CLINICAL SETTING

60
Q

If complete recovery from aphasia is to occur, when will it happen?

A

Within hours or days following the onset.

61
Q

____________ recovery is the gradual recovery over time with or without therapeutic intervention. Most patients experience some degree of natural recovery.

A

Spontaneous

62
Q

What is the most predictive indicator of recovery with aphasia?

A

Severity, along with size of the lesion and location.

63
Q

Do posttraumatic aphasias or aphasias due to vascular lesion generally have a better prognosis?

A

posttraumatic aphasias

64
Q

What are the top 10 word-finding strategies for aphasia?

A
  1. ) Delay
  2. ) Describe
  3. ) Association
  4. ) Synonyms
  5. ) First Letter
  6. ) Gesture
  7. ) Draw
  8. ) Look It Up
  9. ) Narrow It Down
  10. ) Come Back Later
65
Q

How do we talk to patients with aphasia?

A
  • Simple, short phrases
  • Give additional time
  • Do not talk over them, like they are kids, speak too loud
  • Simple yes/no versus elaborate questions
  • Gestures to facilitate understanding
  • Consult speech therapy
  • Never tell a patient they WILL get better! Prognosis is often unknown. Instead, focus on their hard work
66
Q

Cognitive Communication Disorders:

  • Caused by TBI, strokes-especially _______ hemisphere, dementia, brain tumors, degenerative neurological disease, alcohol abuse, medications.
  • Limit environmental factors for _______ and ________ distraction.
  • Create routine - Visual aids clock calendar.
  • Carry over skill from treatment to real life – safety problem solving versus math problem solving.
  • Pragmatics – expressing feelings, initiating conversation, taking turns in discourse.
A
  • right

- visual and auditory

67
Q

Cognitive communication disorders involves dysfunction of _________ functions such as memory, attention, organize information, interpret visual info, abstract reason/problem solving, decreased orientation.

A

executive

68
Q

__________ is an impairment of speech production resulting from damage to the central or peripheral nervous system, causing weakness, paralysis or incoordination of motor-speech system.

A

Dysarthria

69
Q

What is anarthria?

A

Speech is completely unintelligible.

70
Q

What are (3) rules for treating dysarthria?

A
  • speak loud
  • over-articulate
  • speak slow
71
Q

___________ is a neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech.

A

Apraxia

72
Q

Does apraxia involve muscle weakness, paralysis, spasticity, or involuntary movements typically associated with dysarthria, or language comprehension or production deficits that characterize aphasia?

A

No

73
Q
  • Patients with apraxia often present with _______ speech.

- It is difficult to diagnose with _________.

A
  • labored

- aphasia

74
Q

__________ is a swallowing disorder occurring as a result of various medical conditions in the oral cavity, pharynx, or esophagus.
-These patients have ________ risks.

A
  • Dysphagia

- aspiration

S4- Neuro 1 (12 decks)

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