Neurogenic Communication Disorders Flashcards
includes terms and definitions, damaged regions, aphasia types, and dysarthria types (97 cards)
1
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working memory
A
ability to hold a given amount of information for immediate processing
2
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short-term memory
A
retention of information for longer than 30 seconds lasting hours
3
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long-term memory
A
retention of information for months and/or years
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declarative memory
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recall of facts
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episodic memory
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recall of specific and recent events
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procedural memory
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recall of sequences necessary for given tasks
7
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focused attention
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the ability to “focus” on and respond to stimuli and information
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sustained attention
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the ability to “sustain” or hold and manipulate information
9
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selective attention
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the ability to attend and “select” information within a larger set
10
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alternating attention
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the ability to switch or “alternate” attention between tasks
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divided attention
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the ability to attend and “divided” focus on multiple things at once
12
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types of neurogenic communication disorders
A
- non-fluent aphasia
- fluent aphasia
- dementia
- right hemisphere disorder (RHD)
- apraxia
- dysarthria
- TBI
13
Q
non-fluent aphasia
A
- also known as Broca’s or Expressive aphasia
- posterior inferior frontal gyrus in left hemisphere (Broca’s area)
- effortful, telegraphic speech and impaired grammar
- auditory comprehension > expression
14
Q
fluent aphasia
A
- also known as Wernicke’s or Receptive aphasia
- posterior, superior left temporal lobe (Wernicke’s area)
- fluent, copious verbal output
- poor auditory comprehension
15
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dementia
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- persistent or progressive deterioration of cognitive functions
- memory deficits are most characteristic
- may also impact language, emotional, personality, etc.
16
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right hemisphere damage/disorder (RHD)
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- acquired following a brain injury
- visuospatial deficits, visual (left) neglect
- anosognosia
- prosodic, inferencing, and discourse deficits
- sustained and selective attention deficits
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anosognosia
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denial and poor awareness of impairment
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apraxia
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- inferior posterior left hemisphere damage
- deficit to motor planning with normal speech musculature
- articulation characterized by groping, inconsistency, and errors of sound/syllable sequencing
19
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treatment of apraxia may focus on…
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- auditory visual stimulation
- oral motor repetition
- phonetic placement
- slowing down rate of speech
20
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dysarthria
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- type of dysarthria will depend on site of damage
- slowness, weakness, and incoordination of speech musculature
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types of dysarthria
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- flaccid
- spastic
- ataxic
- hypokinetic
- hyperkinetic
- unilateral upper motor neuron
22
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TBI: penetrating
A
scalp/skull broken, fractured, open TBI
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TBI: non-penetrating
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skull is not broken or fractured, closed TBI
24
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possible deficits following TBI
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- word retrieval and naming deficits
- pragmatic deficits (e.g., impaired prosody, topic maintenance, etc.)
- irritability and unreasonable behaviors
- dysarthria
- preseverations, poor attention
- reading and writing deficits
25
neurogenic communication: signs and symptoms
- anomia
- paraphasia
- perseveration
- agrammatism
- alexia
- agraphia
- neologism
- circumlocution
- jargon
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anomia
- problem with word finding
- anomia is a symptom of aphasia
- anomic aphasia
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anomic aphasia
only deficit is word retrieval
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paraphasia
error in which an incorrect word, part of word, or sound is substituted for an intended target word
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phonemic paraphasia
- few phoneme mistakes, mostly correct word
- ex: lork --> fork
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semantic paraphasia
- word substituted for word with similar meaning
- ex: fork --> spoon
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neologistic paraphasia
- word substituted for a made up word
- ex: fork --> fannak
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agrammatism
- grammar deficits, inadequate sentence production
- typically individual uses content words and omits function words
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agraphia
- acquired writing impairment following brain damage
- motor dysfunction or spelling impairment deficits
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neologism
- error type in which a new word is created
- the word has no meaning to the speaker and is entirely different from intended word
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circumlocution
- talking around the intended word or idea
- used as a strategy in speech therapy to improve word finding
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jargon
continuous fluent utterances that make little sense but appear to make sense to the speaker, typically seen in fluent aphasia
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neurogenic communication disorders
communication problems that arise following damage to the brain/nervous system
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frontal lobe
- executive function deficits (problem solving, reasoning)
- memory loss, consciousness, impulse control
- motor planning candor programming (apraxia, dysarthria)
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parietal lobe
- sensory deficits
- difficulty reading/writing, spatial relationships
- mathematical deficits
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temporal lobe
- deficits in auditory perception/sensation/integration
- categorization difficulties, memory and recognition deficits
- left temporal = verbal information, right temporal = nonverbal information
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occipital lobe
- visual deficits
- alexia = word blindness, reading impairment
- agraphia = writing impairment
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basal ganglia
- hypokinetic dysarthria = slow limited movements
- hyperkinetic dysarthria = quick, involuntary movements
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hippocampus
- memory impairments
- fears and anxieties may increase
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anterior cerebral artery stroke (ACA CVA)
- may have deficits in memory, emotion, sensory, motor speech
- cortical = apraxia
- subcortical = dysarthria
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brainstem
- attention deficits, consciousness, non-voluntary function damage
- CN damage = can present as dysarthria and/or dysphagia
- midbrain (dopamine producer): Parkinson's (hypokinetic dysarthria)
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cerebellum
- motor coordination and balance deficits
- ataxia = slurred speech, stumbling, incoordination (appears drunk)
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left hemisphere damage
- expressive deficits
- receptive deficits
- global deficits
- cognitive impairment
- right visual field impairment
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right hemisphere damage
- spatial + perceptual deficits
- discourse + pragmatic deficits
- impulse behavior + attention difficulty
- judgement + reasoning problems
- poor awareness of deficits
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ischemic CVA
- occurs due to blockage of a blood vessel
- most common cause of stroke: thrombotic, embolic
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ischemic CVA: thrombotic
blood clot develops in blood vessels inside brain, interrupted blood flow
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ischemic CVA: embolic
blood clot develops elsewhere in body + travels to brain through brainstem
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hemorrhagic CVA
- occurs due to bleeding, blood vessel rupture
- high blood pressure is most common cause
- intracerebral
- subarachnoid
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hemorrhagic CVA: intracerebral
- most common, artery bursts
- flooding tissues with blood
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hemorrhagic CVA: subarachnoid
bleeding in the area between arachnoid matter + pia mater
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transient ischemic attack
- TIA, often called "mini stroke"
- temporary clot
- may be warning sign for future stroke
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posterior cerebral artery (PCA)
- temporal + occipital lobes
- writing deficits
- memory + cognitive communication deficits
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middle cerebral artery (MCA)
- hemiplegia
- dysphagia
- Broca's/Wernicke's aphasia
- impaired vision
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anterior cerebral artery (ACA)
- hemiplegia
- flat affect
- impulsivity
- auditory comprehension deficits
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anoxia
- lack of oxygen to brain
- symptoms/treatment will vary based on cause + length of time without oxygen
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types of anoxia
- anoxic
- anemic
- toxic
- stagnant
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ataxia
- degenerative disease of nervous system
- symptoms will mimic being drunk: lack of coordination, slurred speech, falling, fine motor deficits, eye movement abnormalities
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aneurysm
abnormal ballooning, forms in blood vessel
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encephalitis
inflammation of the brain and/or spinal cord
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types of aphasia: Broca's area
- site of damage: posterior inferior frontal lobe of left hemisphere
- insight: generally aware
- expressive language: halting, effortful, nonfluent, agrammatic, telegraphic
- receptive language: intact
- repetition: impaired
- writing: impaired
- reading: varies
65
types of aphasia: Wernicke's area
- site of damage: left posterior superior temporal gyrus
- insight: impaired
- expressive language: neologisms, paraphasia, ok grammar, intact prosody
- receptive language: impaired
- repetition: impaired
- writing: impaired
- reading: impaired
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types of aphasia: transcortical motor
- site of damage: supplementary motor cortex, area just anterior to Broca's
- insight: generally impaired
- expressive language: dysfluent speech, anomia
- receptive language: intact
- repetition: intact (hallmark differential from Broca's)
- writing: impaired
- reading: n/a
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types of aphasia: transcortical sensory
- site of damage: posterior to Wernicke's area at the temporo-occipital-parietal junction
- insight: generally impaired
- expressive language: fluent speech, semantic paraphasia
- receptive language: impaired
- repetition: intact
- writing: varies (may have visual deficits)
- reading: varies (may have visual deficits)
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types of aphasia: conduction aphasia
- site of damage: supramarginal gyrus of parietal lobe (posterior to primary sensory cortex, just above Wernicke's area)
- insight: aware
- expressive language: fluent speech, phonemic paraphasia, anomia
- receptive language: intact (relatively)
- repetition: impaired
- writing: n/a
- reading: n/a
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types of aphasia: transcortical mixed
- site of damage: damage anywhere within language areas
- insight: generally aware
- expressive language: fluent speech, isolation anomia
- receptive language: intact
- repetition: intact
- writing: intact
- reading: intact
70
types of aphasia: global aphasia
- site of damage: site of lesion will vary, damage to multiple areas
- insight: varies
- expressive language: word finding, anomia
- receptive language: impaired (variable), unable to comprehend word meaning
- repetition: varies
- writing: varies
- reading: varies
71
types of dysarthria: flaccid
location- lower motor neuron
main etiologies:
- surgical trauma
- neuropathies (e.g., Bell's palsy)
- muscle disease
- myasthenia gravis
- degenerative disease
- brainstem stroke (CVA)
72
flaccid dysarthria: speech characteristics
- *hypernasality nasal emissions*
- imprecise consonants
- breathy, wet, hoarse voice
- mono pitch/loudness
- *slow and slurred DDKs*
- *tongue fasciculations*
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types of dysarthria: spastic
location- bilateral upper motor neuron
main etiologies:
- cerebrovascular (CVA)
- degenerative disease
- TBI
- infection (e.g., meningitis)
- cerebral palsy (CP)
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spastic dysarthria: speech characteristics
- *hypernasality*
- harsh, breathy voice
- *strained and strangled voice*
- mono loudness
- low pitch, mono pitch
- imprecise consonants
- excess and equal stress
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types of dysarthria: ataxic
location- cerebellum
main etiologies:
- cerebellar stroke or injury
- cerebellum atrophy
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ataxic dysarthria: speech characteristics
- *slow, slurred speech*
- excess and equal stress
- *irregular, incoordination*
- imprecise consonants
- *distorted vowels*
- mono pitch, mono loudness
- *prolonged phonemes*
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types of dysarthria: hypokinetic
location- basal ganglia (dopamine depletion)
main etiologies:
- Parkinson's disease
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hypokinetic dysarthria: speech characteristics
- mono pitch, mono loudness
- *short rushes of speech*
- low, flat pitch
- variable rate of speech
- breathy, harsh voice
- reduced stress
- inappropriate silences
- *DDKs, fast and imprecise*
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types of dysarthria: hyperkinetic
location- basal ganglia (excess dopamine)
main etiologies:
- Huntington's disease (HD)
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hyperkinetic dysarthria: speech characteristics
- *involuntary movements* at rest and during speech
- articulatory breakdowns
- *voice stoppages*
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types of dysarthria: unilateral UMN
location- unilateral upper motor neuron
main etiologies:
- unilateral stroke (CVA)
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unilateral UMN dysarthria: speech characteristics
- *unilateral facial weakness*
- harsh voice
- articulatory imprecision
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dysarthria: formal assessments
- Assessment of Intelligibility of Dysarthric Speech (AIDS)
- French Dysarthria Assessment (differential diagnosis between types)
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dysarthria assessment: structure and function
- Oral Facial Sensory Motor Examination (OFSME): facial symmetry, labial movement, mandible, dentition, tongue, palate, speech
- assess 6 cranial nerves for lower motor/upper motor neuron damage: muscle appearance and/or function (strength, range of motion, speed)
- diadochokinetic rates (DDKs): evaluate speech like movements (e.g., pa, patuh, patuhkuh)
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dysarthria: phonatory assessment
- pitch and quality
- pitch variability and loudness variability
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dysarthria: restorative treatment
goal is to improve and restore lost function
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dysarthria: compensatory treatment
goal is to compensate for deficits and reduce overall impact
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dysarthria treatment
- improve respiratory support for speech
- management and treatment of resonance
- phonation and speech intelligibility
- treatment should not include non-speech oral motor exercises (no research)
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dysarthria treatment: phonation and speech intelligibility
- maximum vowel prolongation
- diaphragmatic breathing
- postural adjustments
- bearing down, pulling, and pushing
- pacing and phrasing
- vocal function exercises
- over-articulation
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dysarthria treatment: maximum vowel prolongation
- sustained vowel: target duration and loudness
- feedback: SLP cues, recording, volume meter
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dysarthria treatment: diaphragmatic breathing
proper breathing for speech
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dysarthria treatment: postural adjustments
optimize physiological support for speech
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dysarthria treatment: bearing down, pulling, and pushing
achieve vocal fold medialization
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dysarthria treatment: pacing and phrasing
planning breaths for speech to avoid running out of air
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dysarthria treatment: vocal function exercises
- to improve phonation, loudness
- inappropriate for spastic dysarthria
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dysarthria treatment: over-articulation
over emphasizing articulatory movements to improve speech intelligibility
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