Aphasia Slide Cards

Front 1

Def: The faculty of knowing
Recognition and Perception: objects, faces, spatial representations
Attention and Consciousness
Language: lexical, semantic, syntactic systems
Memory
Judgment and reasoning (problem solving)
Executive functioning

Back 1

Cognition

Front 2

“ability to maintain a coherent line of thought or action.”

Back 2

Attention

Front 3

degree of wakefulness or level of consciousness

Back 3

Arousal

Front 4

Unresponsiveness/Arousal

Back 4

Damage to the ascending reticular activating system (ARAS) within the brain stem terminating in the thalamus
From the thalamus, have projections to cerebral cortex via the white matter fibers.

Front 5

3 mental operations involved in moving attention from one location to another

Back 5

Disengagement of attention from its current focus (parietal lobe engagement)
Moving attention to another location (midbrain engagement)
Engaging attention at that location (frontal-diencephalon system

Front 6

: a localized behavioral response to internal sensations (pain, temperature, thirst, hunger, discomfort) and/or external sensations (visual, auditory, kinesthetic, gustatory, olfactory)

Back 6

Focused Attention

Front 7

The ability to maintain a consistent behavioral response during a continuous activity that is specifically related to that activity. Events occur slowly and vigilance is required.

Back 7

Sustained Attention

Front 8

The ability to respond simultaneously to multiple tasks or single tasks with multiple task demands.
Associated with frontal lobes

Back 8

Divided Attention

Front 9

The ability to maintain a behavioral response to an activity in the face of distracting internal (irrelevant thoughts) or external stimuli. One has to selectively attend to relevant information and inhibit irrelevant information. Right frontal lobe particularly involved

Back 9

Selective Attention

Front 10

The ability to shift one’s attention back and forth between tasks or from one task to the next.
Associated with dorsolateral prefrontal cortex (bilaterally)

Ridley Stroop in 1935 published a paper in Journal of Experimental Psychology
When you have two dimensions of stimuli and you are paying attention to one, you can’t ignore the other.

Back 10

Alternating Attention

Front 11

Fatiguing elements (extended vigilance)
Increasing memory demands
Task complexity
Time pressure
Not personally relevant

Back 11

Areas of attention decline in > 80

Front 12

Stored knowledge and the processes of manipulating and retrieving knowledge.
A relatively enduring change in behavior as a result of experience

Back 12

Memory

Front 13

Reconceptualization of short-term memory
Active role in concurrent information processing and storage activities
Involves large bilateral portions of the dorsolateral frontal cortex

Back 13

Working memory

Front 14

responsible for the selection & execution of strategies for maintaining & shifting attention, coordinating & manipulating information.

Back 14

Central executive system

Front 15

1. phonological loop that acts as a brief acoustic store with an articulatory rehearsal mechanism.
2. stores and manipulates nonverbal spatial representations

Back 15

Verbal system

Spatial sketchpad

Front 16

There is only a limited amount of processing capability available (number of ‘slots’ in the system) not time per se.
Decays rapidly
Needs frequent updating

Back 16

Prob. w/ working memory

Front 17

Ability to consciously recollect facts, names or events when needed
Includes episodic memory, concepts (semantic) memory and word (lexical) memory

Back 17

Declarative memory

Front 18

Factual knowledge of events or episodes
Recollection of conscious experiences from personal past
Involves both recall and recognition
Hippocampus and projections to temporal and frontal lobes

Back 18

Episodic memory

Front 19

Sum total of our knowledge. Facts about the world, meanings of words and concepts
Structures surrounding the hippocampus are critical for new semantic memory
Storage appears to involve the lateral temporal lobes in the form of a distributed network. Strength of connections

Back 19

Concepts memory

Front 20

Memory that is contained within learned skills or modifiable cognitive operations. (Squire 1987)
Knowledge of “how to” with an implied understanding of “when”, but no readily available explanation of “what”
Series of condition-action relationships

Back 20

Procdural memory

Front 21

There is only a limited amount of processing capability available (number of ‘slots’ in the system) not time per se.
Decays rapidly
Needs frequent updating

Back 21

Prob. w/ working memory

Front 22

Ability to consciously recollect facts, names or events when needed
Includes episodic memory, concepts (semantic) memory and word (lexical) memory

Back 22

Declarative memory

Front 23

Factual knowledge of events or episodes
Recollection of conscious experiences from personal past
Involves both recall and recognition
Hippocampus and projections to temporal and frontal lobes

Back 23

Episodic memory

Front 24

Sum total of our knowledge. Facts about the world, meanings of words and concepts
Structures surrounding the hippocampus are critical for new semantic memory
Storage appears to involve the lateral temporal lobes in the form of a distributed network. Strength of connections

Back 24

Concepts memory

Front 25

Memory that is contained within learned skills or modifiable cognitive operations. (Squire 1987)
Knowledge of “how to” with an implied understanding of “when”, but no readily available explanation of “what”
Series of condition-action relationships

Back 25

Procdural memory

Front 26

Ability to process and perform, without the perceiver’s conscious recollection of the stimulus.
Also includes priming (prior exposure improves recall)
Includes associative learning (classical and operant conditioning-pairing of a neutral stimulus to a learned response)
Builds with repetitions
Involves the basal ganglia

Back 26

Implicit memory

Front 27

Memory of our distant past
Reminiscence bump:memories of our teen years and early adult years seem to be most resilient to decay

Back 27

Remote memory

Front 28

1. memory trace fades with passage of time; details lost
Interference_original learning is disrupted by subsequent learning
2.-what you learned before interferes with what you're trying to remember now
3.-information you’ve just learned interferes with ability to remember previous information

Back 28

Passive decay

proactive interferance

Retroactive interferance

Front 29

short-term (tested with span tasks) appears to remain relatively intact as one ages.

Back 29

Primary memory

Front 30

Ability to recognize and monitor one’s own memory capabilities and effectiveness.
Frequently impaired with frontal lobe injury
May be affected with age.
May help explain the poor generalization of procedures form training tasks to other tasks and ability to maintain them over time.

Retrospective memory refers to the ability to remember past events
Prospective memory refers to the ability to remember for upcoming events.
Persons with prospective memory impairment commonly rely on prosthetic systems like appointment books, reminders from others, or electronic reminder systems.

Back 30

Metamemory

Front 31

1. refers to the ability to remember past events
2. refers to the ability to remember for upcoming events

Back 31

Retrospective memory

Prospective memory

Front 32

which is the active organization or manipulation of incoming information

Back 32

Encoding

Front 33

Allows one to operate in a regulated fashion beyond that of instinct, habit or impulse.
The ability to project action into internal or external environments

Back 33

Executive functioning

Front 34

The ability to plan and follow through with the steps necessary to achieve a desired goal.
Motivation
Anticipation
Organization
Sequencing
Modifications of plan

Back 34

Selection and execution

Front 35

The ability to utilize internal and external feedback to control accuracy and appropriateness of ones behavior when executing a plan.
Awareness
Insight
Judgment

Back 35

Self regulation

Front 36

Ability to know self strengths & limitations
Ability to set realistic goals
Ability to plan and organize behavior designed to achieve the goals
Ability to initiate behavior toward achieving goals and inhibit behavior incompatible with achieving goals.
Ability to monitor and evaluate performance
Ability to flexibly revise plans and strategically solve problems in the event of difficulty or failure

Back 36

Effects of thoughtful behavior

Front 37

Cancellation tasks, repeating graphomotor patterns, trail making
Vigilance: sustained attention
Selection:disengaging and engaging in tasks

Back 37

Attention and concentration skills

Front 38

Visual matching, “odd-man-out” with abstract designs, clock drawing, geographic locations
Visual perception: scanning, discriminating, analyzing, interpreting visual information
Visual construction: ability to create visual stimuli using perceptual skills and motor responses

Back 38

Visuospatial skills

Front 39

Slow or rapid force applied to stationary head so it is crushed.
Impression trauma-meninges and cortex at site of impact are damaged

Back 39

Static loading

Front 40

Results from head motion generated by either impact or impulsive forces. Results in
Translational (Linear) acceleration: all parts of the body are similarly accelerated & there is no resultant relative movement among parts of the brain but there is differential movement between the brain and the skull. This results in contusions which occur directly opposite the the point of impact. This is called contrecoup contusions

Back 40

Inertial or accelerated loading

Front 41

consists of the area of brain tissue characterized by multifocal capillary hemorrhages, vascular engorgement and edema

Back 41

Contusion or bruise

Front 42

when the head receives a force that does not pass through its center of gravity resulting in a twisting motion between the brain and the skull and causes shear-strain or distortion of the brain tissue. This causes permanent stretching or rupturing of neuronal fibers that interconnect different brain regions. Referred to as diffuse axonal injury (DAI). Most lesions occur in the deep white matter.

Back 42

Rotational (angular)acceleration

Front 43

Brain is 15% of body weight; brain is 3% of adult’s body weight
More pliable because of unfused sutures and open fontanelles
Greater elasticity and may absorb energy of physical impact better
However, > pliability may result in > risk of hemorrhages.
In child, floors of the the middle cranial fossa and orbital roofs are smooth and offer little resistance

Back 43

Infant vs. adult head

Front 44

Cerebral Edema
Intracranial Pressure
Hypoxic-Ischemic Damage- decrease in O2
Hemorrhages
Seizures

Back 44

Secondary damage after TBI

Front 45

Cerebral edema is an increase in brain volume due to an accumulation of excess water in the brain tissue. Most common secondary effect of brain injury

Back 45

Cerebral Edema

Front 46

Hypoxic-Ischemic Injury
Blood that does reach the brain may be poorly oxygenated because
Respiratory distress,
Slowed heart rate resulting in poor supply of blood to brain,
Constricted cerebral blood vessels
Cerebral vasoplasm (constriction of muscular layer surrounding blood vessels)

Along with ICP, most severe CHI have hypoxic injury
Areas which are most susceptible are hippocampi (80%) which will cause damage to memory capabilities

Back 46

Hypoxic-ischemic attack

Front 47

Result from laceration of the middle meningeal artery by fx bone. Involves bleeding between the skull bones and the dura mater. Typical pt recovers from unconsciousness & then 1-2 hrs later develops paralysis as a result of compression of the ipsilateral cerebral hemisphere’s expanding hematoma.

Back 47

Extradural (epidural) hematoma:

Front 48

Rupture of the small blood vessels within the subdural space leading to bleeding between the dura mater and arachnoid.
Develops slowly: some cases days or weeks after TBI
High mortality rate
Automobile accidents are frequent cause

Back 48

subdural hemmorhage

Front 49

Rupture of the blood vessels that cross the subarachnoid space between the arachnoid and pia mater.
Common after TBI
Detected in blood in the cerebrospinal fluid (CSF)
Spontaneous recovery

Back 49

subarachnoid hemmorhage

Front 50

Consists of progressive gait disturbance
Urinary incontinence
Frontal lobe dysfunction
May occur years, months or weeks after a subarachnoid hemorrhage

Back 50

Normal pressure hydrocephalus

Front 51

Sudden, transient alteration of neurologic function often with modification of consciousness due to an abnormal discharge of neurons
Epilepsy: a neurologic disorder manifested by recurrent seizures.

Back 51

seizures

Front 52

Occurs during childhood and can persist into teens
An abrupt loss of awareness which may last only a few seconds
Patient has a bewildered look but no abnormal movements
Abnormal EEG waves
If adult onset, usually related to lesion in temporal lobe

Back 52

Petit Mal epilepsy

Front 53

Also known as tonic-clonic seizures or primary generalized seizures
Episodes of sudden loss of consciousness with associated motor activity such as collapsing to the ground and shaking
Abnormal EEG
As many as 25% or persons with CVA may develop seizure disorder usually from 6-9 months post CVA

Back 53

Grand Mal epilepsy

Front 54

Caused by highly localized focal lesions.
May start in a distal limb and spread over the course of time to involve the rest of a limb or one side of the body.
Usually from lesions in the temporal lobe
Tempo-limbic epilepsy (TLE): recurrent episodes of involuntary, apparently purposeful, complex motor activity carried out in a repetitive manner. Estabrooks p. 38

Back 54

Focal epilepsy

Front 55

tumors of the nervous system that arise from within the brain

Back 55

Gliomas

Front 56

most malignant tumor of the brain

Back 56

Glioblastoma

Front 57

New memory complaint
Objective evidence of impairment of STM for age (short-term memory)
Normal general cognitive functions
No substantial interference with work, social activities or ADLs
No dementia according to criteria

Back 57

Mild Cognitive impariment

Front 58

One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information

Back 58

Alzheimers Disease

Front 59

Also known as Dementia and Cerebrovascular Disease (DCVD)
One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information

Back 59

Vascular dementia

Front 60

Also known as Dementia and Cerebrovascular Disease (DCVD)
One of the following: impaired handling of complex tasks, impaired reasoning ability, impaired spatial ability and orientation, impaired language
On basis of patient’s history and mental status examination, patient has difficulty learning and retaining new information

Back 60

Subcortical dementias

Front 61

do need to know- initial diagnosis is Aphasia but it gets worse and worse

Back 61

Primary Progressive Aphasia

Front 62

Testing for Aphasia

Back 62

Language Processes
Cognitive Processes
Repetition
Oromotor Functioning
Intelligibility of Speech
Their perceived handicap