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aphasia Flashcards

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0
Q

Name non fluent/ anterior aphasia syndromes

A

Broca’s
Trans cortical motor
Global

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1
Q

Name fluent/posterior aphasia syndromes

A 
Wernicke's
Conduction
Anomic
Transcortical sensory
Transcortical mixed
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2
Q

key symptom of Broca’s aphasia

A

Agrammatic production
Used to be associated with “expressive aphasia”… Word finding is more preserved than sentence formulation. Patient is often a good communicator bc the few words produced represent some of the message accurately.

Usually accompanied by right hemiplegia and mild facial weakness

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3
Q

Lesion site of Broca’s aphasia

A

Around and including Broca’s area….area 44

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4
Q

Key symptoms of transcortical motor aphasia

A

*like Broca’s aphasia but with preserved repetition

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5
Q

Lesion site for transcortical motor aphasia

A

Varied frontal lobe locations

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6
Q

Key symptoms of global aphasia

A

Poor comprehension, minimal production

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7
Q

Lesion site for global aphasia

A

Posterior & frontal peri sylvan Lang region

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8
Q

Key symptom in Wernicke’s aphasia

A

Poor comprehension, jargon, press for speech

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9
Q

Key symptoms of Conduction aphasia

A

Surprisingly impaired repetition

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10
Q

Lesion sight for Wernicke’s aphasia

A

Wernicke’s area ( posterior portion of superior temporal gyrus)

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11
Q

Key symptoms for anomic aphasia

A

Word finding deficit, empty speech

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12
Q

Lesion sight for conduction aphasia

A

Tempo-parietal boundary (supra marginal gyrus)

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13
Q

Lesion site for anomic aphasia

A

Posterior temporal-parietal boundary (angular gyrus)

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14
Q

Key symptoms in transcortical sensory aphasia

A

Like Wernicke’s aphasia, but with preserved repetition

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15
Q

Lesion site for transcortical sensory aphasia

A

Inferior temporo-occipital border area ( perhaps PCA occlusion)

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16
Q

Key symptom of transcortical mixed aphasia

A

Like global aphasia but with preserved repetition

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17
Q

Lesion site of transcortical mixed aphasia

A

Diffuse or multifocal damage in frontal and parietal lobes

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18
Q

What is the most severe form of fluent aphasia?

A

Wernicke’s aka. Sensory, jargon, receptive

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19
Q

Conversation with someone with Aphasia can go smoothly, but formal testing may show that verbal expression deteriorates precipitously when repeating phrases of increasing length and complexity.

A

Conduction

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20
Q

What is often the mildest form of aphasia?

A

Anomic

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21
Q

What association tract is thought to be damaged in conduction aphasia?

A

arcuate fasciculus

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22
Q

What is a prominent feature in transcortical sensory aphasia?

A

Echolalia

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23
Q

Paraphasia

A

Word substitution errors, produced unintentionally

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24
Agrammatism
Certain types of linguistic units drop out of | Utterances
25
Brain circulation arises from 2 pairs of arteries
The internal carotid arteries ICA | The vertebral arteries VA
26
The ICA enters the cranium and supplies much of the
Forebrain
27
The ICA bifurcates into the_______and_______
Anterior carotid artery ACA | Middle cerebral artery MCA
28
ACA and MCA supply the cerebral hemispheres over the ______and_______surfaces if the cerebral hemisphere
Anterior and lateral surfaces
29
The VAs join to form the ________which continues along the ______________and splits into the _________________.
Basilar artery Brain stem Posterior cerebral arteries
30
The PCAs supply_________parts of the brain
Posterior-inferior
31
Branches of the VA supply the_______
Brain stem
32
At the base of the brain the __________and the __________meet and make up the ___________.
Vertebral artery ICAs Circle of Willis
33
________and________ are connected by the Circle of Willis
Internal carotid | Vertebrals
34
Blood flow at the level of capillaries is called
Cerebral perfusion
35
During cerebral perfusion nutrients ________&_________are passed from___________ to _________.
Oxygen Glucose Capillaries Neural tissue
37
Perfusion is measured in
ml/100g min -1
38
Gray matter perfusion =
60ml/100g min -1
39
White matter perfusion=
30-40 ml/100g min -1
39
Ischemic stroke occurs with complete or partial______ of arteries
Occlusion
40
Perfusion below ___ results in necrosis
20 ml/100 g min -1
41
Ischemic stroke is either _______ or ________
Thrombotic | Embolus
42
Dead tissue is referred to as a
Lesion
43
Area around the lesion that may not be getting enough perfusion for neural firing but is not (yet) dead is called
Ischemic penumbra
44
Brain swelling around the lesion is usually referred to as
Edema
45
Edema usually reaches peak around ____days post-stroke but clears up in the following days
3
46
Atherosclerosis is associated with what type of ischemic stroke
Thrombotic
47
Greater than ______% occlusion results in thrombotic stroke
70
48
The site of occlusion of the artery is referred to as
Thrombus
49
Emboli stroke is
A traveling mass (embolus) that occluded an artery
50
An embolus may have been formed elsewhere...
In ventricles of the heart | Large blood vessels (breaks off from thrombus, breaks from arterial plaque)
51
Hemorrhagic stroke
Ruptured blood vessels cause bleeding
52
Causes of rupture
Weakened arterial walls (aneurysm or arterial venous malformation) High and fluctuating blood pressure Trauma to the blood vessel
53
Types of hemorrhagic stoke
Intracerebral | Extra cerebral
54
Sudden onset of stroke symptoms
``` Headache Vomiting Coma Paralysis Sensory loss Confusion Memory loss Speech lang problems ```
55
Insidious processes (slow and gradual onset)
Tumors Obstructive hydrocephalus Toxic damage Infections
56
Primary brain tumors
Originate in the brain Most common 25-50yr olds Heredity and former sites of injury invoked
57
Brain tumors
Benign or cancerous | Primary or metastatic
58
Meningiomas
Tumors within the meninges More localized Focal symptoms Most effectively removed
59
Obstructive hydrocephalus
Swollen tissue may obstruct flow of cerebrospinal fluid Intracranial pressure increases Affects brain function
60
Toxic damage
Drug overdose | Drug interactions
61
Ischemic brain damage
Ischemic damage is due to lack of oxygen tissue
62
What can cause ischemic brain damage
Breathing difficulties Slowed heart rate Constricted cerebral blood vessels
63
Dementia
Acquired neurological syndrome associated with persistent and progressive deterioration in intellectual functions *few cases dementia may be static... 10-20% may be reversible in varying degrees
64
Brain damage associated with dementia is ______ as compared with focal damage in aphasia
Diffuse
65
Causes of reversible dementia
Infections Metabolic disorders Drugs Toxic factors
66
Alzheimer's disease causes roughly ______% of all reported dementia
50
67
Other causes of dementia other than Alzheimer's
``` Vascular dementia Pick disease Parkinson's disease Progressive supra nuclear palsy Creutzfeldt-jacob disease Huntingtons disease ```
68
Dominant findings in Alzheimer's disease (AD)
Neurofibrillary tangles Senile plaques Granulovacuolar degeneration
69
Other findings in AD patients
``` Apolipoprotein E (ApoE)--- gene Acetylcholine (deficient neurotransmitter) ```
70
Senile plaque
Minute areas of cortical and sub cortical tissue degeneration, disturb neuronal transmissions
71
Granulovacuolar degeneration
Degeneration of nerve cells bc of formation of small fluid filled cavities containing granular debris Often found in hippocampus
72
Neurofibrillary tangles
Neurofibrils are filamentous structures in nerve cell body dendrites, and axons Become twisted and tangles
73
Explain word processing model
Sensation- detection of sound Perception- detection of speech Recognition- word recognition Comprehension- word meaning
74
Wernicke-lichtheim Model
Broca's area lesions cause impairment in speech production Wernicke's area lesions cause impaired auditory comprehension Disconnect between frontal and posterior lang areas causes conduction aphasia A- auditory M- motor B- ideation
75
Dual stream model
Ventral stream processes speech signals for comprehension Dorsal stream maps acoustic speech signals to frontal lobe articulatory networks Model assumes ventral system is largely bilaterally organized Dorsal stream is strongly left-hemisphere dominant
76
Brain mass is % of total body mass, yet it gets % of blood and uses up % of total oxygen and glucose in the blood stream.
2 20 20
77
Main Arguments Against Classifying Aphasia into Types
The brain functions as an integrated unit in controlling language (Damasio) Different sites of lesion affect most, if not all, language functions or modalities Variations in fluency are due to variations in severity Comprehension of spoken language is impaired in all patients, but only to varying degrees Dominant symptoms do not create syndromes because they are present in other patients (presumably belonging to other syndromes) The appearance of distinct syndromes is created by limited and biased observations that emphasize some symptoms while ignoring others Longitudinal studies show that aphasic patients are similar in later stages
78
Paraphasia
Unintended word or sound substitutions Many consider it a central sign of aphasia Generally absent in automatic speech Different types of paraphasias
79
Types of Paraphasia
Verbal paraphasia Neologistic paraphasia Phonemic (Literal) paraphasia
80
Verbal paraphasia
Entire word is substituted. Two types Semantic: substituted word is similar in meaning to the one intended i.e. son for daughter. Random: substituted and intended words are not semantically similar.
81
Neologistic paraphasia
Use of a meaningless, invented word.
82
Phonemic (Literal) paraphasia
Substitution of one sound for another i.e. ling for sing or an addition of a sound i.e. sring for sing; some part of the intended word is intact

Adult Language Disorders (7 decks)

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