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47 Cards in this Set
- Front
- Back
What is aphasia?
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Language impairment due to damage to language-dominant (usually left) cerebral hemisphere
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What will aphasia affect?
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- May affect form (phonology, morphology, syntax) and content (semantics)
- May be expressive, receptive, or both - Pragmatics stay largely intact |
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What is susceptible to stroke?
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MCA - in the left hemisphere, it results in aphasia
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What are the four steps of spontaneous spoken language?
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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 |
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Aphasias - expressive modalities of language?
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verbal (spoken) & graphic (written) expression
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Aphasias - receptive modalities of language?
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auditory & reading comprehension
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Severity across modalities of aphasia is influenced by the ____ and _____ of the _______
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size & site of the lesion
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Aphasia impairs the brain's ability to __________ and _________?
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comprehend and formulate language
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Characteristics of Nonfluent Aphasia
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- Decreased melodic line
- Decreased utterance length - Text message speech - Effortful articulation - Word retrieval difficulties - Better comprehension than expression |
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Characteristics of Fluent Aphasia
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- Adequate melodic line
- Normal or extended utterance length - Adequate grammar (may have errors) - Effortless articulation - Word retrieval difficulties - Better expression than comprehension |
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Nonfluent aphasia is caused by lesions to?
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the inferior frontal lobe involving Broca's area, the anterior insula, & surrounding areas
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Non-fluent aphasia may result in?
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Hemiparesis of the limbs, typically right-side hemiparesis
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unilateral UMN involvement can result in?
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a contralateral lower facial droop and tongue weakness is expected
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Non-fluent speech will result in:
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- 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/ |
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Fluent aphasia is caused by lesions involving the:
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superior temporal lobe often extending to the inferior parietal lobe
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Fluent aphasia will result in:
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- 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 |
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Categorizing aphasia is a(n) easy/difficult process.
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Difficult
Based on their skill or location of damage in the brain Boston classification system |
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Receptive Aphasia:
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problem understanding language
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Expressive Aphasia:
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problem having a hard time communicating
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Broca's Aphasia is characterized by:
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- 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 |
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Wernicke's Aphasia is characterized by:
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- 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 |
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Global Aphasia is characterized by:
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- 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 |
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Anomic Aphasia is characterized by:
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- 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 |
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Conduction Aphasia is characterized by:
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- comprehension and speech production fairly good, through paraphasic errors are present
- NO ability to repeat - site of lesion is the arcuate fasciculus |
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SLP's role in aiding patients with aphasia:
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- 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 |
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Purpose of Assessment
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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 |
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What is the inability to comprehend the written or print word as a result of a cerebral lesion?
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Alexia
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A childhood developmental version of alexia?
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Dyslexia
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The inability to recognize letters?
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Literal alexia
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the brain recognizes the letters as letters, but doesn't recognize the words?
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Verbal Alexia
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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?
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Alexia without agraphia
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Are other functions damaged with alexia without agraphia?
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No
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Alexia without agraphia characteristics?
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- 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 |
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With alexia without agraphia, patients may have problems with?
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- Short-term memory
- Mild anomia - Visual agnosia |
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Alexia with agraphia characteristics?
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- 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 |
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What is the inability and the loss of the ability to write and spell (when writing)?
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Agraphia
- Can be caused by lesions in the pathways that process language |
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Writing is a complex ________ ______ _____ that involves a conversion of ____ ________ symbols into ________ symbols.
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learned motor act
oral language written |
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___________ __________ __________ encompass difficulty with any aspect of communication that is affected by disruption of cognition.
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Cognitive Communication Disorders
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Disrupted cognitive processes that impact communication include:
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attention, memory, reasoning, and executive function
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Right Hemisphere Syndrome presents with:
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- left visual neglect
- caused by a lesion on the right parietal cortex so info not processed well |
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TBI results in Cognitive Impairments characterized by:
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- 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 |
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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?
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Dementia
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What are characteristics of stage I Dementia?
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- 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 |
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What are characteristics of stage II dementia?
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- 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 |
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What are characteristics of stage III Dementia?
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- Severely impaired memory
- All intellectual functions impaired - Language is usually not meaningful - Some patients demonstrate mutism, echolalia - Motor function is impaired |
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Aphasia characteristics:
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- caused by a stroke
- change in person's abilities is immediately impacted - Recovery is possible as brain heals from impact of the stroke |
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Dementia characteristics:
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- Caused by diseases, other processes
- Change in a person's abilities is gradually changed - Brain will not heal |