Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
90 Cards in this Set
- Front
- Back
|
Hollists
|
assume that all aspects of cognition and language are closely intertwined.
|
|
|
Associonists
|
assume that cognitive domains and language domains are relatively independent from each other.
|
|
|
Aphasia
|
disorder that affects all language modalities.
due to brain injury |
|
|
3 basic domains of the WHO IFC framework
|
Environmental - Attitude, Technology, Etc.
Activities and Participation - Working, Driving, Hobbies, etc. Body of structure- Brain CNS, mental function, memory, communication |
|
|
PET SCAN
|
injection of radio isotope into bloodstream see which areas of brain are metabolizing more blood.
|
|
|
occipital lobe
|
damage to this lobe, would probably not result in aphasia. visual processing center.
|
|
|
frontal lobe
|
controls voluntary movements, and executive functioning.
|
|
|
parietal lobe
|
spatial sense and navigation.
|
|
|
temporal lobe
|
involved in speech, hearing, and memory
|
|
|
central sulcus
|
sperates the frontal and parietal lobes
|
|
|
Associanists
|
Broca
-Wernicke -Boston Diagnostic Aphasia Exam -One language domain = one brain structure -language mostly separate from other cognitive functions |
|
|
Hollists
|
Freud
Schuell one lang. domain- many brain struc. lang. and cog. func interrelated minnesota |
|
|
problem in Left hemisphere
|
language probably in left hemisphere .. possible aphasia -
|
|
|
problem in right hemisphere
|
all cognitive domains probably affected- possible cognitive communication impairment.
|
|
|
cognitive communication impairment
|
includes spoken and
written expression and understanding, verbal and non-verbal aspects of communication such as tone of voice and facial expression. |
|
|
how we use cognitive communication
|
1. Naming
There may be problems quickly retrieving more unusual words, or thinking of alternatives for words. Relationships between words such as opposites or categories may be disrupted. 2 Explaining (Verbal & Written) This is commonly an area of difficulty, as it requires different skills to put a message together coherently and express it clearly. It may result in an inability to explain simple COGNITIVE – COMMUNICATION Communication is a highly complex skill that we use in many different ways in our lives every day. It is probably the most complex skill that humans ever learn, so it stands to reason that it can be easily disrupted when the brain is damaged by a head injury, stroke or other trauma. procedures such as how to make coffee or more complex ideas like expressing a reasoned opinion. 3. Auditory/Reading Comprehension There may be difficulty understanding complex or abstract material, with misinterpretation of information being the result. Increasing the speed and length of material can also make it more difficult to understand. 4 Verbosity Talking too much about the same topic and not identifying when the listener is bored. 5 Inappropriate Style or Content Being over familiar or overly formal in language usage and non verbal skills. Saying things that others may find rude or embarrassing. 6. Social Skills Difficulty with knowing how to start, continue or finish a conversation. Poor use of body language and facial expression to assist with getting your message across. 7 Topic Maintenance Difficulty staying on the topic when talking. Introducing new , irrelevant topics or ideas into the conversation. 8. Planning Difficulty planning and organising a message into a coherent sequence. 9. Attention/Concentration/memory Difficulty listening and concentrating on a task, forgetting what has been said or what you are about to say. Being unable to concentrate on what someone is saying usually means it is difficult to remember it. 10. Lack of insight Difficulty identifying and acknowledging deficits, even if reminded continuously, may result in added problems for the individual or relatives and friends. Poor insight may make therapy more difficult. |
|
|
Name the three basic components of the WHO ICF framework
|
body structure, activities and participation, and environmental.
|
|
|
Differential Diagnosis
|
Determining whether a communication disorder is present, and if so, what is the communication diagnosis
|
|
|
Neurogenic communication disorders
|
-Aphasia
-Language of confusion: - Language of generalized intellectual impairment -Cognitive-Linguistic Disorder -Apriaxia -Dysarthria |
|
|
Language of generalized intellectual impairment:
|
Reduced language performance on tasks requiring better retention, closer attention, and powers of abstraction; degree of language impairment roughly proportionate to deterioration of other mental functions.
|
|
|
Language of confusion
|
Impairment of language characterized by reduced understanding of the environment; faulty memory; unclear thinking; and disorientation. Open-ended language situations elicit irrelevance, confabulation.
|
|
|
Cognitive-Linguistic Disorder:
|
Naming disturbances (nonaphasic misnaming), pragmatic disorders, language difficulties reflect underlying cognitive impairment.
|
|
|
Apraxia of speech
|
Impairment of motor programming
|
|
|
Dysarthria:
|
Disturbances in speech muscular control (weakness, slowness, incoordination)
|
|
|
Short Term Memory
|
Digit span, recall of three related/unrelated items after delay
|
|
|
Long Term Memory
|
Current events, General Information Questions
|
|
|
Loci producing aphasia
|
Left hemisphere (with exceptions)
Broca’s area +/- deep white matter Supramarginal gyrus and area surround arcuate fasciculus Wernicke’s area |
|
|
Global aphasia
|
All language modalities severely affected
Most severe form of aphasia |
|
|
Broca’s aphasia
|
Agrammatic, telegraphic speech
Proportionately more content words Often associated with apraxia of speech Semantic paraphasias prevalent |
|
|
Transcortical motor aphasia
|
Repetition abilities better than spontaneous speech output
Comprehension relatively preserved (like Broca’s) |
|
|
Wernicke’s
|
Poor auditory comprehension
Fluent speech output; paragrammatism Semantic, literal, neologistic paraphasias |
|
|
Conduction aphasia
|
Hallmark is the inability to repeat
Literal paraphasias |
|
|
Transcortical sensory aphasia
|
Poor comprehension
Good repetition ability Echolalia |
|
|
Subcortical (or thalamic) aphasias
|
Can resemble any of the other syndromes
May have unusual constellation of symptoms, including articulation and voice signs |
|
|
Fluent Apahsia
|
Wernicke's
Conduction Transcortical sensory aphasia Subcortical (thalamic) aphasia |
|
|
Nonfluent Aphasia
|
Global aphasia
Broca's Transcortical motor aphasia |
|
|
Parietal lobe
|
Disruption of visuospatial skills
Hemi-inattention (hemi-neglect, left neglect) Ignore, fail to process, incoming stimuli from left side of space (visual, auditory, tactile) Will start in middle of sentence when reading Will leave off left side of drawing May also have homonymous hemianopsia Anosognosia Denial of deficits Why are you keeping me here? May get up to walk and not use wheelchair Topographical disability Difficulty reading maps Get lost Often with bilateral damage Geographic disorientation I’m in a hospital in Cambodia Relate to immediate environment but not geographic location Constructional impairment (apraxia) Difficulty organizing actions in space Problems assembling components to form whole |
|
|
Temporal lobe
|
Music processing
Discriminating time, timbre, loudness, pitch Nonverbal memory Voice recognition Interpretation of facial expression and other extralinguistic cues Anomaly identification |
|
|
Occipital lobe
|
Visual deficits
Prosopagnosia (occipito-temporal) Failure to recognize familiar faces Can see separate parts but not integrate into whole face |
|
|
Frontal lobe
|
Executive function
Poor temporal memory Distractibility Social disinhibition Problems with attention-switching Difficulty producing or interpreting prosody Melody, rate, stress, duration Orientation Capgras Syndrome Discourse—sentence level behavior Conversation Telling a story Giving directions |
|
|
Difficulty with comprehension
|
May appear to understand more than they do
Interpreting metaphors “it’s raining cats and dogs” Difficulty with abstract language and global information Interpreting humor/jokes Inferencing Revision of initial interpretation |
|
|
Problems with production
|
Poor organization
More words with fewer details Tangential/verbose/excessive detail Loss of coherence—referent Inferencing—assume you know what they are saying See the trees but not the forest |
|
|
Extralinguistic behavior/pragmatics
|
Difficulty interpreting facial expressions, intonation, emotion
Abrupt topic-switching Control conversation Turn-taking Theory of mind/presupposition |
|
|
Boston Diagnostic Exam
|
Associationist
|
|
|
One language Domain = one brain structure
|
Associationist
|
|
|
Freud
|
Hollist
|
|
|
Language mostly separate from other cognitive functions
|
associationist
|
|
|
wernicke
|
associationist
|
|
|
freud
|
holist
|
|
|
schuell
|
holist
|
|
|
many brain structures
|
holist
|
|
|
language and cognitive functions interrelated
|
holist
|
|
|
minnesota
|
holist
|
|
|
cognitive communicative impairment
|
referring to the types of communicative symptoms observed following right hemisphere disorder. Includes impairments f perception, attention, memory, executive functioning, and certain aspects of language, that may directly or indirectly influence these patients' communication abilities.
|
|
|
Right Hemisphere Disorder
|
deficits in perceiving either visual or auditory information frequently occur following rhd.
|
|
|
Symptoms of RHD
|
visual integration deficits
topographical disorientation impaired figure/ground perception impaired depth perception geographic disorientation prosopagnosia/ facial recognition defecits visual agnosia achromatopsoa/color perception deficits impaired visual closure/perception of incomplete visual stimuli simultangagnosia/poor integration of details environmental agnosia pallinopsia/abnormal persistence of visual images sound localization deficits amusia.music perception problems auditory agnosia impaired pitch sidctimination impaired categorical processing of voice impaired loudness discrimination |
|
|
what is the most commonly impaired cognitive funchtion of RHD
|
attention
|
|
|
neglect syndrome
|
attention problems in which patients are slow or inaccurate at reporting, reacting to, orienting to, or seeking out stimuli that presented contralateral to the side of their brain damage
|
|
|
TBI
|
communication problems following tbi are typically referred to as cognitive communication disorders to capture that for most tobi patients there is a stronger cognitive rather than linguistic basis to there communicative limitations.
|
|
|
stages of recovery for TBI
|
1. coma or a period of unconsciousness 2. post-traumatic amnesia or a phase of severe confusion and disorientation 3. a rapid recovery phase of about three to six months in which they experience significant progress and 4. a long term plateau recovery phase in which they experience more gradual progress
|
|
|
ischemic stroke
|
there is a deficiency in blood flow to the brain due to blockage of an artery.
|
|
|
hemorrhagic stroke
|
occurs when an artery bursts and causes blood to escape and flood surrounding the tissue
|
|
|
hematoma
|
build up of blood
|
|
|
thrombosis
|
in a thromonotic stroke there is a buildup of artherosclerotic or fatty plaque on an artery that provides blood flow to the brain.
|
|
|
embolus
|
in an embolic stroke a clot forms or a piece of fatty plaque breaks off from elsewhere in the circulatory system and then travels to block off a smaller artery that supplies blood to the brain.
|
|
|
It’s almost impossible to predict a particular behavior (psychological reaction) from a brain profile
Why?? |
Because each person’s history influences the brain’s reaction to particular experiences
|
|
|
Consensus Definition of Self-Regulatory (Executive) Functions
|
-Initiate and Shift: self regulation, appropriate sequencing of behavior
- Inhibit and Sustain: flexibility, response inhibition -Plan Organize and Strategize: Planning of Behavior, Organiztion of behavior |
|
|
Modified Barium Swallow CPT code
|
92611
|
|
|
Define Modified Barium Swallow
|
recorded dynamic radiography that uses xrays to assess swallowing function.
|
|
|
what is the purpose of the videofluoroscopic procedure
|
to determine the abnormalities in antomy and physiology causing the symptoms of dysphagia:
1. normal /abnormal anatomy 2. discrete structural movements 3. temporal coordination of anatomic movements relative to bolus transit 4. trihectory of bolus |
|
|
identify and evaluate treatment strategies that enable the patient to immediately eat safely and /or efficeiently
|
1. adjstmtns to bolus -> volume, consistency, and rate of delivery
2. adjustments in position 3. changes in delivery method (cup, spoon, straw, etc) 4. implementations of maneuvers |
|
|
if zenker's diverticulum is suspected what is best method
|
MBS becuase you need to see the oral stage
|
|
|
indications of MBS
|
- oral stage of dysphagia
- upper esophageal/esophageal dysphagia -vague complaints -clinically inexplicable weight loss -inital exam for long standing history of dysphagia -food stuck at thryoid above or below throid notch -biofeedback -re-test |
|
|
Type and Amount of Food Presentaton
|
@ least 3 consistencies
a. thin liquid -viscosity may be increased i.e. nectar thick -> honey thick -> pudding thick b. barium paste - doesnt block airway c. material requiring chewing d. sometimes also a barium tablet to check for pill dysphagia |
|
|
How many swallows do you need for each material
|
2
|
|
|
what should you begin with
|
small amounts
-think liquid 1 ml, 3ml, 5ml, 10ml, and cup drinking -1/3tsp of pudding -1/4 cookie |
|
|
what should you note
|
amount of time it takes for patient
|
|
|
name some compensatory strategies
|
1. postural changes (head rotation, chin tuck)
2. heightening sensory (temp, bolus, volume/viscosity) 3. change in delivery (spoon/straw) |
|
|
which way is the vocal tract initally viewed
|
laterally
|
|
|
what is administered first
|
liquid barium
|
|
|
if aspiration occurs on liquid
|
try intervention strategies ..attempt to eliminate asp on several swallows then increase volume
|
|
|
if patient cant take thicker food from spoon
|
use a tongue blade
|
|
|
of aspiration occurs with thick food
|
use strategies to try and eliminate it if possible
|
|
|
if patient cant follow instructions
|
place piece of cookie in mouth to observe sponatenous chewing and swallowing
|
|
|
what is the oral transit time
|
time taken from initation of tongue movement until the bolus crosses tongue base
takes 1 to 1.5 sec |
|
|
what is phrayngeal transit time
|
time elapsed from the triggering of the phrangeal swallow until olus tail passes thru the cricppharyngeal region max of 1 sec
|
|
|
what is phrayngeal delay time
|
time interval from the end of oral transit time until the phraryngeal swallow triggers
|
|
|
etiology of aspiration
|
before during after parhyngeal swallow
|
|
|
name some postural techniques
|
head back - used for in eff. oral transit -uses gravity to clear oral cavity
head down- delay in triggering swallow - reduces tongue base - residue in vallec. head rotated to damaged side- unilateral laryngeal dysfunction |
|
|
improving oral sensory awareness is approprate for pts with
|
swallow apraxia, delayed onset of oral swallow, delayed trigger of phrayngeal swallow
|
