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Adult Language Disorders > Anomia > Flashcards

Flashcards in Anomia Deck (49):
1

Anomia - General Info

Variable lesion sites - typically on the temporo-parietal junction

Primary difficulties :
accessing and retrieving lexical forms
preserved object recognition & object use

2

Semantic Network - Aphasia

A progressive loss of the ability to remember the meaning of words, faces, and objects with temporo-parietal lobe shrinkage of that area of the brain.

3

Semantic Network - Dementia

2 Types:

Subordinate: knife to kitchen tool

Visually Related: knife to flat stick

4

Word Retrieval - Step One

Word node selection from the lexical network

2 Points of breakdown:

-Impaired activation between semantic and lexical networks
-Impaired interaction between lexical and phonological levels

5

Word Retrieval - Step One - Semantic/Lexical networks

Breakdown:

Impaired activation between semantic and lexical networks

- Weak semantic activation to activate target lexical entry
- No loss of semantic knowledge as in semantic dementia

Examples:
- semantic paraphasia - dog for cat
- No response - errors of omission due to inactivation of word nodes

6

Word Retrieval - Step One - Lexical/Phonological networks

Breakdown:

Impaired interaction between lexical and phonological levels

-Form (PH) related word errors
-- Formal paraphasia
-- Phonological feedback to further activate phonologically related words

Example:
- cat to rat to bat

7

Word Retrieval - Step Two

Errors of phonological coding of lexicon with phonological representations

Likely of phonemic substitution errors
- Sublexical errors - cat to dat

Knows what to say - speaks fluently but no names

8

Syndrome of Anomia - General Info

Near normal comprehension

Good repetition

Deficits across reading and writing

9

Syndrome of Anomia - Lexical Features

- Fluent
- Empty with circumlocutions
- Naming gaps/pauses
- Substitution : specific or non-specific words
- Generalized words for specific words
- Proper names/objects are most affected

10

Neologism - Definition

Nonsense word or words without recognition

Example:
"tilto" for "table"

11

Neologism - General Info

No conceptual deficit
- good comprehension for written words/pictures
- ability to sort written words into semantic categories
- unable to read correctly

Deficit in speech output lexicon

Involvement of content words

Word finding deficit

12

Examples of Anomia - Phonosemantic Blends

Erroneous words that share both sound and meaning with the target word

Example:
"broom" for "brush"

13

Examples of Anomia - Circumlocution

Functional description of the word/object

Example:
It calls people, has numbers = phone

14

Examples of Anomia - Wernicke

Substitution of vague pronouns

Circumlocutions

Neologism

Examples:
- Mandarin for Seahorse
- Atlas for Globe

15

Examples of Anomia - Broca

Paraphasias in Object Naming

Examples:
- Telescope for Stethoscope
- Carrot for Asparagus

16

Primary Progressive Aphasia - General Info

Progressive neurodegenerative condition

Language deficit in absence of any generalized cognitive impairments for at least 2 years
- Gradual onset
- Progressive nature
- No dementia
- Evolves into cognitive and/or behavioral problems consistent with DAT - typically within 5 years

17

PPA

Multi-modality language deficits - indistinguishable from a single event brain condition

Full awareness with no denial or deficit

Avg. age of onset = 50-55

Family history of dementia

Brain Abnormalities
- 60%
-- nonspecific neurodegenerative changes
- 40%
-- Alzheimer - NF Tangles
-- Pick disease - Tau and Pick bodies
-- Creutzfeld-Jacob disease (mad cow disease)

18

Primary Progressive Aphasia - Types - Expressive

More common type

A disorder of speaking progressing to nearly total inability to speak in most severe stage

Preserved comprehension

19

Primary Progressive Aphasia - Types - Anomia

Less common type

Begins with impaired word finding

Progressive disorder to comprehension

Preserved articiulation

20

Common Diseases associated with Anomia - Alzheimer's Disease

Degeneration to association cortices of frontal, temporal, and parietal lobes, and the hippocampus

Cholinergic deficits in hippocampus and temporal lobe

Caused/Causes:

Neurofibrillary Tangles
Neuritic Plaque

21

Neurofibrillary Tangles

Twisted and contorted fibers inside brain's cells

Presence of Tau protein

Collapsed microtubule structure

22

Neuritic Plaque

Intracellular abnormalities involving the accumulation of amyloid in neuropils

23

Common Diseases associated with Anomia - Pick Disease

Occurs earlier than Alzheimer's

Progressive degenerative condition
- frontal/temporal lobes neuronal atrophy = Pick bodies

Inappropriate social behavior, lack of empathy, distractibility, poor hygiene

Receptive and expressive communicative difficulties

24

Common Diseases associated with Anomia - Creutzfeldt-Jakob Disease

Similar to Mad Cow disease

Neurodegenerative disorder
- Brain becomes spongey/hole-y

Lifespan after diagnosis = 1 year on avg.

Causes:
- Ataxia
- Gait abnormality and dysarthria
- Mood changes
- Cognitive impairments
- Seizures
- Myoclonus

Infectious spongiform encephalopathy of animals

25

Average Age per Aphasia Type

Broca -
Youngest at Avg. age of 52.6

Wernicke -
Oldest at Avg. age of 62.8

26

Subcortical Aphasia - General Info

Debate over existence

CT - PET evidence
- implicating cortical symptoms from subcortical lesions

Below level of neocortex - inter cranial pressure causes the aphasia

27

Subcortical Aphasia - Theories & Evidence

Theories of Thalamic Functions
- Internal activating system
- Regulator for semantic accuracy - Crossen

Lesion Evidence
- Hemorrhage
- Thalamotomy
- Stimulation

28

Thalamic Syndrome

Present with anomia and aphonia

Sensorimotor Symptoms:
- Hemiplegia
- Hemianesthesia
- Hemianopsia
- Altered consciousness
- Coma
- Lowered/Increased pain threshold

29

Thalamic Aphasia

Symptoms not similar to cortical aphasias

Impaired spoken language
- Aphonia
- Dysarthria
- Anomia
-- paraphasias leading into jargon
-- semantic aphasias

Preserved comprehension

Good repetition

Reading & writing disorders are variable

Complete recovery within 4-5 weeks

30

Hemorrhage vs. Embolic stroke

Hemorrhagic stroke has a higher rate of fatality, however if you survive the stroke the recovery is much easier

31

Reading & Writing

Symbolic skills

Neural dependence on auditory-verbal modality

Two different components:
Reading
- visual system
Writing
- visual and motor-kinesthetic systems

Deficits in these areas cause:
Alexia and Agraphia

32

Alexia - Phonemic Rules

English Phonemic rules:

Acceptable words
- boy and toy
Acceptable psedo-words
- felp or blix
Unacceptable strings
- bdaxyn
Irregular words
- knife, judge

33

Alexia - Strategies for Reading

Two Types:

Phonological reading
- grapheme-phoneme mapping
- single unit conversion
- used for universal reading

Lexical reading
- accessing meaning through an orthographic representation
- used for irregular words

34

Phonological Reading

Grapheme-phoneme conversion for:
- familiar words
- pronounceable (pseudo) words
- conversion of written to spoken words
- phonological representations : basis for the abstraction of reading

Limitations:
- Foreign words
- Irregular words

35

Lexical Reading

In this type of reading one pays attention to the entire orthographic representation (word)

Lexical/Semantic based system of orthographic representation for:
- unfamiliar words
- foreign words
- irregular words
- familiar words

A written word association with a visual word (orthographic representation in lexical memory

36

Common Aphasic Alexias

Alexia with Agraphia
Alexia without Agraphia

Deep Dyslexia

Phonological Alexia
Suface Alexia
Oriental Alexia

37

Alexia with Agraphia

Inability to read or write
- involves letters, words, musical signs, and numbers
- some processing of signs and Roman/Arabic numerals
- Preserved word copying ability

Largely part of Wernicke's

Cues are of little to no help because it is a central disorder

Right hemiplegia and visual field deficit

38

Alexia without Agraphia

Inability to read, but can still write

No alexia for grapheme (can't read the whole word, but can read individual graphemes)

Recognition for spelled words

Letter by letter reader

Right visual field difficulty

39

Deep Dyslexia

Involves both routes:
- relative loss of grapheme/phoneme conversion system
- relative loss of lexical route

Reading deficit marked by
- preserved derivation of meaning from whole word
-- ex. Can't read the word, but they can get the meaning

- Semantic paralexia
-- ex. When reading they will replace the word

- Omission or misreading of grammatical/functional words
-- ex. Better reading of nouns than verbs/adjectives

- Poor ability to select a word from semantically related category of words
-- ex. rose from list of flowers

- Poor matching of homophonic words
-- ex. flour/flower

- No reading of non-words

Examples of Errors:
Nouns - night for sleep
Verbs - shining for sun
Articles - the for is
Visual - bush for brush

40

Phonological Alexia

Loss of the grapheme to phoneme route

Reliance on lexical-phonological route (reading of known words)

No paralexic errors

No reading of non-words

41

Suface Alexia

Loss of the lexical to semantic route

Reliance on the grapheme-phoneme route

No recognition of whole words

No access to meaning on a whole word basis

Access to words by sounding through grapheme/phoneme mapping

Superior reading of regular words and legitimate non-words

No reading of irregular words

42

Oriental Alexia

Only applies if you've live in China/Japan

Japanese : Two types of Graphic Systems
- Kanji - ideographic symbols
-- parietal-occipital area
- Kana - phonemic system
-- parietal-temporal area

43

Agraphia - General Info

Impaired ability to write

Mental association between letter names and graphic movements

Oral spelling via phoneme-grapheme associations and associations between concepts and letter strings:
- Generally writing and verbal skills are parallel, but not always
- Same aspects of spoken language affect writing (Broca's and Wernicke's types of aphasics)

44

Agraphia - Effects

Disturbed motor-kiesthetic function
- quality of writing
- size

Linguistic aspects
- Graphic-phonemic association
- Orthographic spelling
- Selection of graphic representations of words
- Writing of irregular words
- Semantic and syntactic organization

Visual-Spatial functions
- Disordered size relationship

45

Apraxic Agraphia

Inability to use a writing tool to form graphic symbol even when a model is presented - have a problem with the tool more than the substance

Isolated component of ideational apraxia
- All purposeful movements or as a result of constructional apraxia
-- failure to form letters even in copying
-- better ability to spell with anagram letters

46

Deep Dysgraphia

A broken link between word meaning and written word forms

Spelling errors:
- semantically related with no phonological resemblance
-- ex. smile/laugh

Better writing of concrete nouns

Impaired ability to write grammatical words

47

Phonological Agraphia

Impaired conversion of phonemes into graphemes

Can write read words

Can't write non-words

Visual errors contain resemblance to the target word

48

Surface Agraphia

Correlated with surface alexia

Makes phonemic/phonetic spelling errors
- ex. Sirkal for circle

Preserved writing of non words

49

Angular Gyrus

Crossroad between written and oral language

No spelling, recognition of oral spelling, or retrieval of graphic form from a string of letters.