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Adult Language Assessment > Exam 1 - CN (subcortical & unusual aphasias) > Flashcards

Exam 1 - CN (subcortical & unusual aphasias) Flashcards

1
Q

general layers of the brain

A
  1. cortex (grey matter)
  2. white matter
  3. basal ganglia & thalamus
  4. brainstem
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2
Q

extrathalamic

A

basal ganglia

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3
Q

thalamic

A

thalamus

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4
Q

relay center

A

thalamus

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5
Q

specific basal ganglia structures

A
  1. caudate nucleus
  2. internal capsule
  3. globus pallidus
  4. putamen
  5. corpus striatum
  6. substantia nigra
  7. lentiform nucleus
  8. red nucleus claustrum
  9. amygdala
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6
Q

general location of basal ganglia

A

between cortex & brainstem

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7
Q

function of basal ganglia

A

regulating motor function & muscle tone

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8
Q

general location of thalamus:

A

sits on top of brainstem

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9
Q

function of thalamus

A

integrates info from all of the senses, except smell & sends info to the cortex

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10
Q

subcortical regions

A
  1. basal ganglia
  2. thalamus
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11
Q

extrathalamic damage

A

(basal ganglia)
1. Parkinson’s disease
2. Huntington’s disease

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12
Q

thalamic damage

A

thalamic syndrome

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13
Q

mortality rate is high with damage to this region

A

thalamic

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14
Q

thalamic syndrome

A

increased or decreased threshold for sensation, somatosensory issues (touch temp pain)

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15
Q

left side subcortical lesions: white matter only

A

usually not an aphasia

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16
Q

left side subcortical lesions: basal ganglia only

A

damage must be extensive to produce an aphasia

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17
Q

left side subcortical lesions: basal ganglia + white matter

A

when aphasia like symptoms are typically observed

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18
Q

most common left side subcortical lesions

A

basal ganglia + white matter

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19
Q

basal ganglia + white matter damage

A
  1. anterior syndrome
  2. posterior syndrome
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20
Q

anterior syndrome

A

basal ganglia + white matter
1. can be confused with broca’s/TCM

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21
Q
  • hemiplegia
  • slow, dysarthric speech w/ good phrase length & prosody
  • good comprehension
  • good repetition
  • poor oral reading
  • poor writing
  • poor naming
A

anterior syndrome

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22
Q
  • hemiplegia
  • fluent speech w/out dysarthria
  • poor comprehension
  • good single word but poor sentence repetition
  • poor naming
  • poor reading & writing
A

posterior syndrome

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23
Q

posterior syndrome

A

basal ganglia + white matter
can be confused with wernicke’s/TCS

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24
Q

left side subcortical lesion: thalamic

A

sometimes confused with TCS aphasia

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25
Q
  • hemiplegia
  • hemisensory loss
  • alteration in level of consciousness
  • right visual field defect
  • initial mutism, but improve to be verbose
  • paraphasias, usually semantic
  • hypophonic jargon output
  • severe anomia
  • good comprehension
  • logorrhea
  • reduced spontaneous meaningful, verbal output
  • preserved repetition
A

thalamic lesion

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26
Q

hypophonic

A

talking quietly

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27
Q

hemiplegia is more severe with

A

subcortical aphasia bc of the role w/ the basal ganglia

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28
Q

motor neuron pathways run next to the

A

thalamus

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29
Q

dysarthria is more frequent with

A

subcortical lesions

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30
Q

mutism occurs more frequently with

A

subcortical lesions (most frequently seen with thalamic lesions)

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31
Q

voice & prosody problems occurs more frequently with

A

subcortical lesions

32
Q

paraphasias occur in ___________ but not in _____________ for ___________ aphasias

A

speech; repetition: subcortical

33
Q

____________ paraphasias occur most frequently w/ subcortical aphasias

A

semantic

34
Q

arguments FOR subcortical damage being an aphasia type

A
  1. abrupt onset
  2. acquired impairment of language
  3. symptoms can be associated with lesion site
35
Q

arguments AGAINST subcortical damage being an aphasia type

A
  1. language deficits are mild compared to motor speech deficits
  2. language problems are more transient than in cortical aphasias, especially w/ thalamic damage
36
Q

transient

A

temporary

37
Q

auditory agnosia

A

difficulty recognizing auditory stimuli, although the same stimuli may be recognized in other modalities, even though hearing sensitivity is adequate

38
Q

possible types of auditory agnosia

A
  1. amusia
  2. auditory sound
  3. pure word deafness
39
Q

amusia

A

without music

40
Q

auditory sound agnosia

A

cannot attach meaning to auditory stimuli (non-speech sounds)

41
Q

pure word deafness

A

cannot recognize speech sounds

42
Q

visual agnosia

A

impairment in the recognition of visual stimuli despite adequate visual sensitivity

43
Q

possible types of visual agnosia

A
  1. prosopagnosia
  2. autopagnosia
  3. visual object agnosia
44
Q

prosopagnosia

A

difficulty recognizing familiar faces

45
Q

autopagnosia

A

difficulty recognizing body parts

46
Q

visual object agnosia

A

difficulty recognizing actual or pictured objects

47
Q

alexia

A

acquired reading deficit (input)

48
Q

agraphia

A

acquired writing deficit (output)

49
Q

difficulties decoding written text

A

alexia

50
Q

PPA

A

primary progressive aphasia

51
Q

PPA: primary

A

impairment is prominent in a single domain (language) with relative sparing of other domains early on (e.g., motor)

52
Q

PPA: progressive

A

the impairment will get worse over time since it is caused by a neurodegenerative disease

53
Q

PPA: aphasia

A

a language impairment

54
Q

diagnostic criteria of PPA:

A
  1. min of 2 yrs of language decline
  2. prominent language deficits
  3. preservation of other mental functions
  4. independence in ADLs
  5. absence of apathy, disinhibition, forgetfulness of recent events, or visuospatial impairment
  6. exclusion of other causes of aphasia
  7. SLP & neuropsychological assessments concur w/ neurological exam
55
Q

umbrella of neurodegenerative syndromes

A

dementia

56
Q

condition, not diagnosis

A

dementia

57
Q

clinical neurodegenerative dementia syndromes

A
  1. alzheimer’s dementia
  2. posterior cortical atrophy syndrome
  3. PPA
  4. behavioral variant frontotemporal dementia
58
Q

Alzheimer’s dementia

A

amnestic dementia

59
Q

posterior cortical atrophy syndrome

A

visuospatial dementia
occipital lobe

60
Q

PPA type of dementia

A

aphasic dementia

61
Q

behavioral variant frontotemporal dementia

A

(FTD)
aphasic dementia
right side

62
Q

diagnosis of PPA:

A
  1. Hx from pt. & family + current meds
  2. neurological exam
  3. neuropsychological testing
  4. lab measures (blood tests, neuroimaging MRI, PET, LP)
63
Q

PPA: pt typically reports that onset is

A

insidious (gradual)

64
Q

PPA: pt. often presents many months/yrs after

A

onset of language difficulty

65
Q

PPA: pt. usually notices problem before

A

SO

66
Q

PPA: complaints are similar to

A

stroke-induced aphasia

67
Q

PPA: pt. rarely denies deficit; is usually the one to

A

seek Dx & Tx

68
Q

PPA: common feelings

A

frustration
reactive depression

69
Q

PPA: clinical syndrome

A

progressive aphasia w/ relative sparing of other cognitive domains

70
Q

PPA: neuroanatomic features

A

relatively focal atrophy w/in the left hemisphere language network

71
Q

PPA: neuropathologic features

A

features associated w/ PPA are variable

72
Q

3 types of PPA

A
  1. semantic variant
  2. logopenic variant
  3. nonfluent/ agrammatic variant
73
Q

semantic variant PPA

A

PPA-S
similar to wernicke’s
preserved grammar
impaired word comprehension

74
Q

logopenic variant PPA

A

PPA-L
similar to conduction or anomic aphasia
preserved grammar & word comprehension
impaired word finding/ retrieval & repetition

75
Q

nonfluent/agrammatic PPA

A

PPA-G
similar to broca’s
impaired grammar
preserved word comprehension

76
Q

PPA is a moving target:

A
  1. heterogeneity in progression rates and emergence of symptoms
  2. subtyping may not be feasible in the severe stages
77
Q

PPA long-term prognosis

A
  1. after a time of 5-20 yrs after onset, other areas of the brain become affected
  2. along w/ language deficits, individual may demonstrate difficulty w/: memory, spatial abilities, attention, personality
  3. frustration & behavioral changes are common
  4. may compromise life-sustaining functions (e.g., swallowing)

Adult Language Assessment (22 decks)

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