Neural Exam 3 Cogn-Comm Disorders/aphasia

Front 1

What is aphasia?

Back 1

Language impairment due to damage to language-dominant (usually left) cerebral hemisphere

Front 2

What will aphasia affect?

Back 2

- May affect form (phonology, morphology, syntax) and content (semantics)
- May be expressive, receptive, or both
- Pragmatics stay largely intact

Front 3

What is susceptible to stroke?

Back 3

MCA - in the left hemisphere, it results in aphasia

Front 4

What are the four steps of spontaneous spoken language?

Back 4

1. Wernicke's area retrieves words, sentence structure
2. Sends it to Broca's area via the arcuate fasciculus
3. Broca's area formulates an action plan & send plan to primary motor cortex
4. Primary motor cortex refines the plan and sends instructions to the cranial and spinal nerves for speech muscles via the corticobulbar and corticospinal tracts

Front 5

Aphasias - expressive modalities of language?

Back 5

verbal (spoken) & graphic (written) expression

Front 6

Aphasias - receptive modalities of language?

Back 6

auditory & reading comprehension

Front 7

Severity across modalities of aphasia is influenced by the ____ and _____ of the _______

Back 7

size & site of the lesion

Front 8

Aphasia impairs the brain's ability to __________ and _________?

Back 8

comprehend and formulate language

Front 9

Characteristics of Nonfluent Aphasia

Back 9

- Decreased melodic line
- Decreased utterance length
- Text message speech
- Effortful articulation
- Word retrieval difficulties
- Better comprehension than expression

Front 10

Characteristics of Fluent Aphasia

Back 10

- Adequate melodic line
- Normal or extended utterance length
- Adequate grammar (may have errors)
- Effortless articulation
- Word retrieval difficulties
- Better expression than comprehension

Front 11

Nonfluent aphasia is caused by lesions to?

Back 11

the inferior frontal lobe involving Broca's area, the anterior insula, & surrounding areas

Front 12

Non-fluent aphasia may result in?

Back 12

Hemiparesis of the limbs, typically right-side hemiparesis

Front 13

unilateral UMN involvement can result in?

Back 13

a contralateral lower facial droop and tongue weakness is expected

Front 14

Non-fluent speech will result in:

Back 14

- more content than function words in speech
- "agrammatism"
- speech is effortful with many hesitations, revisions, and interrupted melody
- increased frustration or decreased willingness to attempt to speak
- may have verbal stereotypty /bai bai bai/

Front 15

Fluent aphasia is caused by lesions involving the:

Back 15

superior temporal lobe often extending to the inferior parietal lobe

Front 16

Fluent aphasia will result in:

Back 16

- no motor impairment but may have visual field deficits consistent with a lesion involving the optic radiations of the primary visual pathway
- Speech is produced without effort and has appropriate melodic contours.
- Grammatical markings are present although they may be used in errors.
- Decreased comprehension
- Decreased ability to monitor their own speech and make self-corrections

Front 17

Categorizing aphasia is a(n) easy/difficult process.

Back 17

Difficult

Based on their skill or location of damage in the brain

Boston classification system

Front 18

Receptive Aphasia:

Back 18

problem understanding language

Front 19

Expressive Aphasia:

Back 19

problem having a hard time communicating

Front 20

Broca's Aphasia is characterized by:

Back 20

- Decreased verbal output
- Difficult time speaking
- Often lengthy pauses in their speech
- Telegraphic utteraces
- Agrammatical utterances
- "non-fluent" aphasia
- Comprehension always better than production but comprehension of syntax & complex sentences may be low

Front 21

Wernicke's Aphasia is characterized by:

Back 21

- Steady verbal output, normal phrase length, prosody
- "Fluent speech"
- Paraphasic errors (such as omission of words, incorrect words, use of neologisms (made up words), substitution of incorrect sounds in words
- Logorrhea: excessive talking
- Jargon, "empty utterances" common

Front 22

Global Aphasia is characterized by:

Back 22

- Severe impairment in both receptive and expressive language
- Can't repeat (no working memory)
- Expressive language very limited
- May have better understanding of non-verbal and gestural communication

Front 23

Anomic Aphasia is characterized by:

Back 23

- word-finding difficulty
- most aphasics resolve to this type of aphasia
- continued impairment in expressive and receptive language
- use of circumlocution
- comprehension fairly good
- repetition more intact
- reading and writing can be affected to varying degrees
- damage typically in any part of left hemisphere

Front 24

Conduction Aphasia is characterized by:

Back 24

- comprehension and speech production fairly good, through paraphasic errors are present
- NO ability to repeat
- site of lesion is the arcuate fasciculus

Front 25

SLP's role in aiding patients with aphasia:

Back 25

- Language intervention can greatly help patients with aphasia
- If person has a fluent aphasia, 1st intervention goal is to improve comprehension
- Non-fluent person - 1st intervention goal is to improve expression for basic needs and wants

Front 26

Purpose of Assessment

Back 26

1. To identify specific problems
2. To describe language behaviors
3. To determine intervention goals
4. To identify factors that facilitate the retrieval of language

Front 27

What is the inability to comprehend the written or print word as a result of a cerebral lesion?

Back 27

Alexia

Front 28

A childhood developmental version of alexia?

Back 28

Dyslexia

Front 29

The inability to recognize letters?

Back 29

Literal alexia

Front 30

the brain recognizes the letters as letters, but doesn't recognize the words?

Back 30

Verbal Alexia

Front 31

What is an uncommon syndrome that causes the loss of the ability to read printed materials but retain ability to write both to dictation and spontaneously?

Back 31

Alexia without agraphia

Front 32

Are other functions damaged with alexia without agraphia?

Back 32

No

Front 33

Alexia without agraphia characteristics?

Back 33

- Patients are able to write meaningfully but cannot read their own writing
- Right homonymous hemionopsia are present
- Can write dictation and has comprehension of spoken language
- NOT a lesion in the frontal lobe

Front 34

With alexia without agraphia, patients may have problems with?

Back 34

- Short-term memory
- Mild anomia
- Visual agnosia

Front 35

Alexia with agraphia characteristics?

Back 35

- Many different symptoms
- Sometimes right homonymous visual field deficit
- Deficits in reading letters, words, and musical notes
- Disorders number reading
- Difficulty with calculating number
- Some writing disturbances
- Cannot comprehend words spelled out loud
- Damage usually in the dominant parietal lobe in the angular gyrus area

Front 36

What is the inability and the loss of the ability to write and spell (when writing)?

Back 36

Agraphia

- Can be caused by lesions in the pathways that process language

Front 37

Writing is a complex ________ ______ _____ that involves a conversion of ____ ________ symbols into ________ symbols.

Back 37

learned motor act
oral language
written

Front 38

___________ __________ __________ encompass difficulty with any aspect of communication that is affected by disruption of cognition.

Back 38

Cognitive Communication Disorders

Front 39

Disrupted cognitive processes that impact communication include:

Back 39

attention, memory, reasoning, and executive function

Front 40

Right Hemisphere Syndrome presents with:

Back 40

- left visual neglect
- caused by a lesion on the right parietal cortex so info not processed well

Front 41

TBI results in Cognitive Impairments characterized by:

Back 41

- problems with memory, attention, learning, perception, organizing, reasoning, problem solving and judgment, and language
- Every person will have an unique configuration of skills and deficits

Front 42

What is an acquired persistent impairment of intellectual function with compromise in at least three of the following spheres of mental activity - language, memory, visuospatial skills, emotion or personality, and cognition?

Back 42

Dementia

Front 43

What are characteristics of stage I Dementia?

Back 43

- Memory for new learning is defective and remote recall is mildly impaired
- Word retrieval problems
- Difficulty understanding complex language
- Non-specific word use
- Patient may be anxious, irritable, apathetic

Front 44

What are characteristics of stage II dementia?

Back 44

- Memory for recent and remote events is more severely affected
- Lowered vocabulary output
- Repetitious speech
- often forgetful
- difficulty generating vocabulary
- Reduced comprehension
- becomes increasingly indifferent, irritable, and restless

Front 45

What are characteristics of stage III Dementia?

Back 45

- Severely impaired memory
- All intellectual functions impaired
- Language is usually not meaningful
- Some patients demonstrate mutism, echolalia
- Motor function is impaired

Front 46

Aphasia characteristics:

Back 46

- caused by a stroke
- change in person's abilities is immediately impacted
- Recovery is possible as brain heals from impact of the stroke

Front 47

Dementia characteristics:

Back 47

- Caused by diseases, other processes
- Change in a person's abilities is gradually changed
- Brain will not heal