After the Stroke - Brancamp Flashcards

Question

Does a person with PWA have awareness of their environment?

Answer 1

A PWA is aware of self and environment (they are not confused, demented or psychotic), has an appropriate level of awareness. He/she is intent on communicating thoughts regarding his/her condition and environment. Exceptions are possible during the first few hours after acute infarcts and late in the chronic stages for a few.

Answer 2

FLUENT – approximates normal speech in terms of the rate of word production, length of sentences, melodic intonation, and ease in speaking [9+ words/utterance] NONFLUENT-rate is slow, sentence length is short, melodic contour is lost, production is effortful, may be more pauses than actual words. [0-5 words/utterance].

Answer 3

A group of words that is said on one breath.

Answer 4

Failure to repeat words or sentences is a hallmark of aphasia; ability may be completely lost or characterized by phonemic paraphasias or omissions of sounds/words. Presence of impaired repetition has localization value – perisylvian region of the dominant hemisphere

Answer 5

A phenome is a sound disruption. For example saying boy when you wanted to say toy.

Answer 6

In the perisylvian region.

Answer 7

Ability to decode auditory input Auditory comprehension rarely preserved in aphasia Deficits can range from inability to understand: single words sentences multiple-step commands narrative discourse

Answer 8

AGRAMMATISM refers to difficulty ordering words and putting them together in a sentence. Content words are relatively spared Agrammatic patients have difficulty producing function words and bound morphemes (problems with tense).

Answer 9

Patients with auditory comprehension deficits usually have some reading impairment Reading impairment can appear in a pure form without auditory comprehension or writing impairment. In most cases of aphasia, reading, writing, and auditory comprehension are impaired together, but not to the same degree.

Answer 10

``` Dysfluent Increased effort in speaking Speech is agrammatic, telegraphic, groping Often accompanied by dysarthria and/or apraxia of speech Comprehension better than expressive Repetition abnormal Naming is poor Writing reflects spoken output ```

Answer 11

Yes, they are: very aware of their communication and physical impairments easily upset by failed communication attempts cooperative and task oriented

Answer 12

Pt. usually appears normal with no dysarthria or limb weakness/paralysis. Speech is fluent but often presents with paraphasias and jargon Syntax is normal Comprehension is poor Reading is poor Repetition is poor. Word-salad

Answer 13

Most patients are alert, attentive and task-oriented Mild Wernicke’s: aware of errors and generally follow conversational turn taking Moderate: rarely notice errors or attempt repairs; attentive & cooperative but get off topic easily (verbal tangents) Severe: attentive, but severe comprehension deficits interfere with all communication tasks; unaware of errors and communication failure

Answer 14

Severe impairment in both comprehension and expression Concrete understanding of symbols; may not fully comprehend abstract or inferential information May not understand simple words, may only understand icons or pictures Performance usually enhanced by materials or activities that are automatic or emotionally laden

Answer 15

Speech is severely limited and often characterized by stereotypical utterances (whatawhy), overlearned phrases (how-de-do), or expletives. Most are attentive, task-oriented and socially appropriate (which helps to differentiate from the confused or demented patient). Occasionally comprehend personally relevant questions fairly well Some reliably answer yes/no questions

Answer 16

SOL is thought to be arcuate fasciculus or temporal lobe in the auditory association area Fluent speech; auditory comprehension deficits range from moderate to mild Hallmark: inability to repeat long sentences - grossly impaired repetition & relatively preserved language comprehension. Prosody may be affected because of pauses and hesitations Alert, attentive and task-oriented; aware of errors in speech and writing; attempts repairs (‘Why can’t I say that?’)

Answer 17

The ability to have vocal inflection and affect in speech.

Answer 18

Preserved repetition is defining characteristic of the transcortical aphasias (Wernicke’s, Broca’s and arcuate fasciculus are spared) Lesions are outside of the perisylvian zone Transcortical Motor Aphasia Transcortical Sensory Aphasia Mixed Transcortical Aphasia

Answer 19

Anomia – word finding difficulties; is common in aphasia and other neurologic disorders (dementia, encephalopathy). Often the residual impairment of a more severe aphasia Spontaneous speech is fluent and grammatically correct, but marred with frequent word-retrieval failures. Average phrase length WNL Auditory comprehension & repetition are relatively intact

Answer 20

Right hemisphere disorders.

Answer 21

No. 50% of all patients with RHD 80-90% of patients in rehab Diagnosis depends on who does the evaluation

Answer 22

1. deficits in facial recognition -prosopagnosia 2. deficits in comprehending facial expressions and expressing using facial expressions 3. prosodic deficits 4. inferencing deficits 5. discourse deficits

Answer 23

1. anosognosia - lack of self awareness 2. depression 3. capgras delusion - patient believes a loved one or pet has been replaced by an identical imposter 4. visual hallucinations 5. paranoid hallucinations

Answer 24

1. Visuoperceptual deficits include simultagnosia (cannot perceive more than one object at a time) and cerebral achromatopsia (color-blindness due to brain damage) 2. Attentional deficits include neglect and sustained and selective attention deficits

Answer 25

Few if any problems in comprehending or expressing language syntax (grammar), morphology (eg, word endings), and/or phonology (speech sounds) Do not have classical aphasia lexical retrieval (coming up with words they want to say) is like that of age-matched healthy individuals Trouble with naming pictures/objects may be due to visual-perceptual or visuospatial difficulties not comprehension

Answer 26

1. May be called -Hemispatial, left or visuospatial neglect, hemineglect 2. Inattention to the left side 3. Occurs in 13-80% of patients with RHD 4. Lesion localization: Inferior parietal lobe; parieto-temporal juction Inferior frontal, underlying white matter, thalamus, basal ganglia

Answer 27

1. Motor Neglect Reduced use of left side of body (less than capable) 2. Tactile Neglect Reduced response/recognition of tactile stimulation (greater than sensory deficit) 3. Auditory Neglect Reduced processing of auditory stimuli from left – poorer localization of sounds

Answer 28

Variable performance – hour to hour, day to day; within and across neglect types Often resolves within first few weeks Usually accompanied by anosognosia Presence of neglect - more likely to have other cognitive/communicative deficits

Answer 29

When the person omits letters/words, substitutes letters, parts of words or words on a line.

Answer 30

When the person writes only on the lefts side to the page but has preserved letters/words.

Answer 31

1. Production: flat, monotone speech, rate sounds fast 2. Comprehension: problems interpreting prosody 3. RHD possibly effects emotional prosody more than linguistic prosody

Answer 32

1. Impaired emotion & nonverbal communication 2. Production: Use fewer emotionally-charged words Reduced facial expressions Reduced animation Flat affect – reduced animation, reduced prosody/intonation 3. Comprehension: Misinterpretation of emotional cues (e.g., facial expression, body language, intonation)

After the Stroke - Brancamp Flashcards

(56 cards)