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Nature of Disorders of Language and Communication > Aphasia > Flashcards

Aphasia Flashcards

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1
Q

causes of aphasia

A
  • stroke
  • TBI
  • infections (meningitis)
  • tumors
  • neurotoxicity (drugs, chemicals)
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2
Q

most common cause of aphasia

A

stroke

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3
Q

stroke cause

A

insufficient blood flow to the brain

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4
Q

brain receives ?% of cardiac output and ?% of O2

A

15% cardiac output
20& O2

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5
Q

lack of blood flow after ? seconds leads to dysfunction

A

8-10 seconds

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6
Q

lack of blood flow after ? minutes leads to irreversable damage

A

5 minutes

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7
Q

types of stroke

A
  • ischemic
  • hemorrhagic
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8
Q

ischemic stroke

A

blockage (clot, thrombus, or embolism)

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9
Q

hemorrhagic stroke

A

rupture (aneurysm)

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10
Q

transient ischemic attack (TIA)

A
  • mini stroke
  • brief, lasts only a few minutes
  • no permanent damage
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11
Q

FAST

A
  • face
  • arms
  • speech
  • time
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12
Q

TBI cause

A
  • falls
  • accidents
  • attacks
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13
Q

TBIs can cause what injury types

A
  • focal injury
  • diffuse injury
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14
Q

focal injury (TBI)

A
  • caused by a hit
  • brain bruise or bleed
  • injury to one, specific area
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15
Q

diffuse injury (TBI)

A
  • caused by a car accident
  • brain moves and rotates inside the skull
  • tearing of axons in the brain
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16
Q

infections (TBI)

A
  • encephalitis (inflammation caused by an infection or autoimmune response)
  • injury is typically more diffuse
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17
Q

tumors (TBI)

A
  • typically more focal (area of difficulty is in line with the area of the tumor)
  • with metastasis (spread) there can be more area affected
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18
Q

what types of damage can occur in a TBI

A
  • primary injuries
  • secondary injuries
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19
Q

primary injuries (TBI)

A
  • localized
  • tissue necrosis and apoptosis (cell death) occur in response to a clot, hemorrhage, or hit
  • in stroke there is a core area where cell death has occurred and the ischemic penumbra
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20
Q

ischemic penumbra meaning

A

region around the damaged area that is at risk of dying but can be salvaged with timely treatment and restoring blood-flow

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21
Q

secondary injuries (TBI)

A
  • diffuse, can be acute and chronic
  • linked to neurodegenerative disease
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22
Q

ABI associated communication disorders

A
  • aphasia
  • apraxia of speech
  • dysarthria
  • dysphonia
  • cognitive communication disorders
  • pragmatic/social communication disorders
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23
Q

what is A-FROM

A
  • Living with Aphasia - A Framework for Outcome Measurement
  • adaptation of the WHO’s ICF
  • provides a framework for thinking about aphasia
  • assess and treat all parts of aphasia
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24
Q

what is recovery in aphasia

A
  • many understandings
  • guided by A-FROM, recovery should include a focus on impairment, participation, and quality of life
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25
language includes
- concepts/semantic knowledge (red, juicy) - phonology (apple v. grapple) - vocabulary (apple) - morphology (apple-s) - syntax (I ate the apple.) - pragmatics (He's a bad apple)
26
characteristics of aphasia
- ranges from mild to severe - affect any language modality (speaking, writing, reading) - heterogeneous - can have fully intact cognition (insight, attention, memory, problem solving) - can co-occur with other communication disorders (dysarthria, apraxia) - can co-occur with motor, emotional, sensory difficulties that can impact communication and therapy
27
motor changes in aphasia
- weakness (hemiparesis, paralysis) - postural stability and head control
28
sensory changes in aphasia
- deafness - visual changes - hypothesia (reduced feeling) - pain - agnosia
29
cognitive changes in aphasia
- reduced insight - fatigue - memory - attention - executive function - orientation - arousal levels - awareness
30
emotional changes in aphasia
- depression - agitation - anxiety - lability (emotional switching)
31
semantic paraphasia definition
- a word that is conceptually/meaningfully related to the target - fork and knife
32
phonemic paraphasia definition
- a word that is phonologically similar to the target - fork and cork
33
anomia definition
difficulty naming
34
word finding definition
- difficulty finding the particular word - pauses, filler words/phrases, circumlocution
35
neologism definition
- making new words (no phonemic or semantic connection) - mation
36
circumlocution definition
- talking about a word - mango = the sweet yellow fruit
37
jargon definition
- output which is not comprehensible to a listener (can be semantic) - the dinner platomin pice
38
agrammatism definition
- difficulty with grammatical morphemes (free or bound), word order - tomorrow, I walked shop to
39
telegrammatic definition
- a term to describe halting output with omission of free or bound morphemes - walk shop
40
perseveration definition
- an unintentional production of a unit of information that has been previously produced or head - can be continuous, stuck-in-set, or recurrent - can operate at different levels (word, syntactic, etc.( - wa wa walk walk walk
41
aphasia classifications
- dichotomous - anatomical - symptom-based
42
dichotomous aphasia classification
- receptive (understanding) versus expressive (output) - fluent versus non-fluent
43
anatomical aphasia classification
- Broca's - Wernicke's - conduction
44
symptom-based aphasia classification
- anomic - global
45
receptive language and aphasia classifications associated with it
- affecting understanding or input (listening, reading) - global, wernicke's, transcortical sensory
46
expressive language and aphasia classifications associated with it
- affecting output (talking, writing) - conduction, transcortical motor, anomic, broca's, global
47
pros and cons of associating receptive and expressive language with specific aphasia classifications
pros: - provides brief description of primary nature of difficulty cons: - doesn't tell us anything about what is actually affected (semantics, syntax) - doesn't tell us about level of ability (word level) - heterogeneous
48
fluent aphasia and aphasia classifications associated with it
- able to produce fluent speech, grammar relatively intact - conduction, anomic, transcortical sensory, wernicke's
49
non-fluent aphasia and aphasia classifications associated with it
- output halting and effortful, grammar impacted, content words might be preserved - broca's, transcortical motor, global
50
pros and cons of associating fluent and non-fluent aphasia with specific aphasia classifications
pros: - non-specific description of primary nature of difficulty cons: - doesn't tell us what is affected or level of ability - doesn't tell us about language modality affected - heterogeneous
51
boston classification system
use language profiles and localization to classify into classic syndromes
52
pros and cons of boston classification system
- pros: more specific, slightly more homogeneous - cons: doesn't inform therapy
53
aphasia syndromes
- Broca's aphasia - Wernicke's aphasia - Conduction aphasia - Global aphasia - transcortical sensory aphasia - transcortical motor aphasia
54
Broca's aphasia
- left inferior frontal lobe (Broca's area) - non-fluent - lack of grammatical structure and content - comprehension stronger than expression - words produced contextually correct - ex: "want coffee"
55
Wernicke's aphasia
- posterior superior temporal gyrus (Wernicke's area) - impaired understanding with fluent speech - syntax (grammat) preserved but full of paraphasias (word errors) - ex: "I walked the dog in the poll under the saw."
56
Conduction aphasia
- arcuate fasciculus damage - fluent - cannot repeat, better spontaneous speech - generally good comprehension - phonological issues - ex: "Where is my hat", correct What's this? (hat) "bat, bat, mat, hat", wrong (cannot perceive difference)
57
Global aphasia
- large lesion in frontal/parietal/temporal lobe - severe aphasia - involves expression and comprehension in all modalities - little output except automatic phrases - severe comprehension difficulties
58
Transcortical sensory aphasia
- associated with infarcts of posterior cerebral artery - fluent with normal repetition - speech filled with paraphasias and sometimes echolalia - impaired auditory comprehension - ex: can repeat a long sentence, cannot understand it
59
Transcortical motor aphasia
- lesions of left supplementary motor cortex (initiation) - Broca's aphasia can evolve to transcortical during recovery - non-fluent - similar to Broca's however able to repeat (repeat > spontaneous speech) - good comprehension - word finding difficulties and tip of tongue phenomenom characteristic
60
full ability profile is built on:
- theory based on area of infarct - discrete impairment-based assessment results (psychometric testing) - information on functional ability in context
61
how are models useful
- conceptualize abstract, complex, and confusing processes - inform specific targets
62
Cognitive Neuropsychological Model of Language Processing
- cognitive neuropsychology aims to understand how the brain's structure and function relates to psychological processes (language, memory) - describes word level only (not sentences) - helps identify highly specific therapy targets
63
Garrett's Model of Speech Production
- can hear a word and then say it (repeat) without knowing the meaning - can read and then write a word without knowing the meaning
64
Garrett's Model of Sentence Production
- conceptual level: message - formulation level: functional, positional - formulation and articulation level: phonetic and articulatory
65
conceptual level: message (Garrett's Model of Sentence Production)
- objective and subjective - ideas about people, places, and things
66
formulation level: functional (Garrett's Model of Sentence Production)
- content words: lexical-semantic concepts (word meanings) are selected to represent the message - verb, noun, adjective: lexical-semantic concepts are assigned syntactic functions - predicate argument structure (PAS) is created, meaning only words not arranged yet
67
formulation level: positional (Garrett's Model of Sentence Production)
- word selected at the functional level are slotted into order (syntactic form) - retrieval of lexical phonological representations (i.e. k - a - t = cat)
68
formulation and articulation level: phonetic and articulatory (Garrett's Model of Sentence Production)
phonetic - motor planning and programming - plan: structure specific (tongue) - program: muscle specific (genioglossus) articulation - execution and adaptation - completing movement and changing it to suit the environment - involves pyramidal system, cranial nerves, basal ganglia, and cerebellum
69
how might difficulties with sentence production present in aphasia? (Garrett's Model of Sentence Production)
70
sentence comprehension model
- psycholinguistics steps in reverse to decode messages - complex networks
71
discourse definition
- connected language, beyond the sentence level used for a specific function - does not have a strict set of rules - has a communicative function (commenting, directing, attention, requesting, showing) - involves complex interplay between cognitive and linguistic elements
72
primary progressive aphasia (PPA)
- neurodegenerative disorder (Parkinsons, MS, dementia) - gradual emergence of language difficulties - complete diagnosis requires language difficulties for >2 years - cognitive decline emerges as the disease progresses - onset of symptoms between 50 and 70
73
PPA causes
- degeneration of the frontotemporal brain region (usually left) - often have a build up of protein tau and TDP-43
74
PPA types
- logopenic - non-fluent agrammatic - semantic
75
logopenic PPA
- impaired word finding, naming, repetition - left temporoparietal region affected - ex: telling story about their dog, cannot retrieve the word "ball"
76
non-fluent agrammatic PPA
- non-fluent, effortful speech - lacking in grammatical structures - inferior frontal gyrus and premotor regions affected - ex: "Restaurant...dinner...pasta...good"
77
semantic PPA
- impaired object knowledge - anomia - comprehension difficulties with single words (lacking context to take clues from) - atrophy in anterior parts of temporal lobe - ex: show them an apple, doesn't recognize it and can't name it. person wants an apple - asks "can I have an apple?"
78
childhood aphasia considerations
- must be considered in a developmental context - more varied presentation - more plasticity
79
what does observation include
- extended factual notes (after observation, note what is seen, heard, smelled in detail and factually) - interpretative notes (interpret notes as an SLT) - personal notes (record your thoughts and feelings)

Nature of Disorders of Language and Communication (9 decks)

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