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NeuroPT2 > Speech-Lang Patho > Flashcards

Speech-Lang Patho Flashcards

1
Q

SLPs

What are they?

A

dx and tx disorders:

speech

language

swallowing

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2
Q

Anatomy wise… SLPs work a lot w/

A

soft palate

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3
Q

Resp provides energy and foundation for______

A

phonation→ making sounds w/ mouth

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4
Q

Mm’s of Respiration

A

Thoracic→ Inspiration

Abdominal→ Expiration

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5
Q

Phonation:

A

air for speech comes from lungs, thru trachea, and to the larynx (voice box)

*sets vocal cords in motion for voicing

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6
Q

Phonation:

2 sets of Laryngeal muscles

A
  1. Intrinsic
  2. Extrinsic
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7
Q

Phonation:

Myoelastic Aerodynamic Theory

A
  • States that vocal cords vibrate bc of the forces and pressure of air and the elasticity of the vocal cords
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8
Q

Phonation:

KEY neuroanatomical structures involved in vocalization:

A
  • Cortical areas
  • Cerebellum
  • CN’s
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9
Q

Articulation:

A

Movement of speech structures to produce sounds (phonemes)

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10
Q

Resonation and Articulation depends on the integrity of these structures:

A
  • Pharynx
  • Soft palate
  • Hard palate
  • Mandible
  • Teeth
  • Tongue
  • Lips
  • Cheeks
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11
Q

Resonation

A

Tones gen’d by larynx travel UPWARD and are resonated by the pharynx, oral cavity, nasal cavity

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12
Q

Nervous System

PNS vs. CNS

REVIEW

A
  • PNS
    • CN’s
    • Spinal Nerves
    • ANS
      • Sympa vs. Parasympa
  • CNS
    • Brain
    • SC
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13
Q

Cranial Nerves Mnemonics

A
  • Oh Oh Oh To Touch And Feel Virgin Girls Vaginas And Hymens
  • Some Say Marry Money, But My Brother Says Big Boobs Matter More!
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14
Q

MOST important part of PNS in relation to communication-→

A

Cranial nerves!

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15
Q

Cranial Nerves directly involved w/:

speech

language

hearing

What are they?

A
  • V: Trigeminal→ Mixed
  • VII: Facial→ Mixed
  • VIII: Acoustic (Vestibulocochlear)→ Sensory
  • IX: Glossopharyngeal→ Mixed
  • XI: Spinal Accessory→ Motor
  • XII: Hypoglossal→ Motor
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16
Q

CNS and SLP Focus

A
  • More on Brain→ more related to speech/lang.
    • Brain stem
    • Reticular Activating Formation
      • attn, consciousness
    • Diencephalon
      • Thalamus
        • conscious/alert
      • Hypothalamus
        • emotion
    • Basal Ganglia
      • Body posture/dysarthria/dyskinesia
    • Cerebellum
      • equilibrium/coordination: Ataxia
      • Speech prod: ataxic dysarthria
    • Cerebrum
      • cerebral cortex
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17
Q

Cerebrum:

Cerebral Cortex

A

BIGGEST and MOST IMPORTANT structure for lang, speech, hearing

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18
Q

Frontal Lobe

The jist…

A
  • plans/intentions dictate conscious behavior
  • Primary Motor Cortex→ includes Broca’s
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19
Q

Parietal Lobe

The jist…

A
  • Somatic Sensory area
    • pain, press, temp, touch
  • Angular gyrus, Supramarginal gyrus
    • → critical to speech (Aphasia)
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20
Q

Occipital Lobe

The jist…

A

VISION

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21
Q

Temporal Lobe

The jist…

A
  • Primary Auditory Cortex
  • Auditory Assoc. Area→ Wernicke’s
    • Wernicke’s think COMPREHENSION
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22
Q

Neurologically Based Communication Disorders***

IMPORTANT!

A
  • Aphasia
  • Apraxia of Speech
    • P for Planning
  • Dysarthria
  • Dementia
  • Rt. Hemi Syndrome
  • TBI
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23
Q

Aphasia

A
  • Neuro based language disorder from neuro pathos→ Think CVA! (most common)
  • Impaired:
    • verbal expression (talking)
    • auditory comprehension (understanding)
    • read/writing
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24
Q

Ischemic CVA:

A

Blocked or interrupted blood supply to brain

  • Thrombosis→ collection of blood mat that blocks flow
  • Embolus→ traveling mass of arterial debris or clump of tissue from a tumor that gets lodged in a smaller artery and blocks flow
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25
Q

Hemorrhagic CVA:

A

caused by bleeding in brain due to ruptured blood vessels

  • Intracranial (w/in brain)
  • Extracranial (w/in meninges)
    • subarachnoid, subdural, epidural varieties
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26
Q

OTHER causes of Aphasia

A
  • brain tumor
  • Intracranial tumors→ primary or metastatic
  • Infections (viral or bacterial)
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27
Q

Classifications of Aphasias:

3:

A
  1. Nonfluent
  2. Fluent
  3. Subcortical
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28
Q

Non-Fluent Aphasias

Main ones are *‘d

A
  • Broca’s*
  • Transcortical Motor
  • Mixed Transcortical
  • Global*
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29
Q

Fluent Aphasias

Main ones are *‘d

A
  • Wernicke’s*
    • think comprehension problems
  • Transcortical sensory
  • Conduction*
  • Anomic
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30
Q

Freq used terms w/ aphasia:

Echolalia

A

auto repetition of vocalizations made by another person

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31
Q

Freq used terms w/ aphasia:

Perseveration

A

repetition of response/word/phrase/gesture even when it is no longer relevant or approp.

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32
Q

Freq used terms w/ aphasia:

Agrammatism

A

inability to speak in grammatically correct way, form of expressive aphasia

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33
Q

Freq used terms w/ aphasia:

Content Words

A

Have MEANING!

Nouns, verbs, adjectives, adverbs (-ly)

have MEANING

34
Q

Freq used terms w/ aphasia:

Function Words

A

words of little lexical meaning/glue that holds sentence together

i.e.→ and, the, or, me, you, and but

35
Q

Freq used terms w/ aphasia:

Telegraphic Speech

A

simplified formation, many or all function words omitted

36
Q

Freq used terms w/ paraphasias:

Phonological/literal

A

replacement/transposition

ex. papple for apple

37
Q

Freq used terms w/ Paraphasias:

Neologistic

A

non-English, gibberish

38
Q

Freq used terms w/ Paraphasias:

Verbal

A

tiger for lion

foot for shoe

39
Q

Broca’s Aphasia is a _______ Aphasia

A

NON-FLUENT

40
Q

Broca’s Aphasia

*Non-fluent

A
  • Damage to post-inf. front gyrus of left-hemisphere (this is lang. side in most people)
  • Characteristics:
    • NON-fluent, effortful, slow, halting speech
    • Lmtd word OUTPUT, short phrases and sentences
    • Misarticulated/distorted sounds
    • often lmtd to nouns/verbs
    • impaired naming and repetition
    • Poor reading comp
    • Writing probs→ slow/laborious→ using non-dom left hand
    • Better auditory comprehension* of spoken language than production
    • may see apraxia and dysarthria
41
Q

Global Aphasia is the _________ form

A

MOST SEVERE

42
Q

Global Aphasia

A
  • MOST SEVERE
  • Ext. lesions affecting all lang areas→ Perisylvian Area
  • WIDESPREAD damage in fronto-temporo-parietal region
  • Characteristics:
    • Profoundly impaired lang skills
    • Impaired repetition/naming
    • Expressive lmtd to a few words, exclamations
    • Auditory comp limtd to single word
    • Impaired reading/writing skills
    • Perseverations
43
Q

4 Domains w/ Aphasias:

A
  1. Speaking
  2. Listening
  3. Reading
  4. Writing
44
Q

Wernicke’s Aphasia is a _______ aphasia

A

FLUENT

45
Q

Wernicke’s Aphasia

A

COMMON, caused by lesions in post portion of sup. temporal gyrus in L. hemi

  • Characteristics:
    • incessant, effortlessly produced flowing speech w/ norm fluency
    • rapid rate of speech
    • intact grammatical structures
    • severe word finding
    • paraphasic errors, neologisms
    • circumlocution, empty speech
      • talking around in circles
    • Poor auditory comprehension**
      • no commands, cnt answer Y/N
    • Impaired repetition
    • writing probs→ meaningless, freq errors
    • poor communication in spite of fluent speech
46
Q

Distinguishing factor in Conduction Aphasia

A

*region b/w Broca’s and Wernicke’s damaged

  • Disproportionate impairment in repetition
47
Q

Subcortical Aphasias

A

*Lesions in areas surrounding Basal Ganglia and Thalamus

48
Q

Aphasia Assessment:

A
  • Repetition skills
  • Naming skills
  • Auditory comprehension of spoken lang
  • Auditory comprehension of single words, sentences, paragraphs
  • reading
  • writing
  • gestures/pantomine
  • automatic speech/singing
  • visuospatial skils
49
Q

Positive Prognostic Indicators

A

see pics

50
Q

Aphasia may be accompanied by:

Alexia

A

Loss of previously acquired reading skills due to damage

vs.

Dyslexia→ diff learning to read

51
Q

Aphasia may be accompanied by:

Agraphia

A

Loss or impairment of writing skills due to lesion in second frontal gyrus

52
Q

Aphasia may be accompanied by:

Agnosias

A

impaired understanding of the meaning of certain stimuli even though there is no peripheral sensory impairment

*damage to occ/parietal regions

  • auditory agnosia
    • phone rings-dont understand its phone
  • auditory verbal agnosia
    • impaired understanding of spoken words (Wernicke’s)
  • visual agnosia
    • impaired visual recognition
  • tactile agnosia
    • fork in box, pt cant tell you its a fork
53
Q

Apraxia of Speech

AOS

*Speech→ motor programming diff’s

A

damage to Broca’s

neurogenic speech disorder involves sensorimotor probs in positioning and sequentially moving mm’s for volitional speech prod.

54
Q

AOS

diff. lies where?

A

Diff lies in executing the voluntary mvmts involved in speech

*often co-exists w/ aphasia

55
Q

Communication Deficits in AOS

*Apraxia of Speech

A
  • gen awareness of problem
  • probs w/ volitional or spont. sequencing of mvmts reqd for speech
  • high variability of speech errors, changing patterns of errors
  • subs, distortions and omissions of speech sounds
  • incd freq of errors on longer words
  • slowed or delayed initiation of speech**
  • groping or struggling
  • attempts at self-correct
  • prosodic probs
56
Q

Interventions for Apraxia of Speech

*important to PT

A
  • emphasize total comm. (combine use of verbal express, gestures, writing, AAC
  • articulatory accuracy, slower rate
  • cueing, singing
  • SEVERE→ speak slowly, shorter sentences, reduce background noise, talk only when pt focused, use total comms
57
Q

Dysarthrias

Think_______

A

Slurred speech!!!

58
Q

Dysarthria

A

group of motor-speech disorders

  • impaired mm control of speech mech, PNS or CNS patho
  • manifest probs in respiration, phonation, articulation, prosody and resonance
59
Q

Communication Disorders Assocd w/ Dysarthria (motor-speech probs)

A
  • resp probs
  • phonatory probs: pitch, loudness, etc..
  • articulation probs
  • prosodic disorders
  • resonance disorders
    • hyper/hypo nasality
60
Q

Tx of Dysarthria

In terms of PT*

A
  • compensatory strats
  • mirrors, tape recording/phone ex’s
61
Q

Dysphagia

A

Impairment swallowing

62
Q

Dysphagia think _______

A

ASPIRATION!!!

*preventing it

63
Q

Dysphagia is impaired execution of 3 phases of swallow

3:

A
  1. Oral
  2. Pharyngeal
  3. Esophageal

*chewing food, preparing for swallow, initiating swallow, propelling bolus thru pharynx and passing to esophagus

64
Q

Dysphagia Causes

A
  • CVA→ brainstem and Ant. Cortical
  • neuro dis’s
  • sx or radiation therapy head, neck, brain
  • TBI/C/S disease
  • polio, COPD, CP
  • genetics
  • SE’s drugs
65
Q

Dysphagia and stroke pts

A

75% affected

66
Q

LEAD CAUSE of dysphagia

A

Brainstem strokes

67
Q

Assessment of Dysphagia

main ones she mentioned

A
  • Barium Swallow Study (MBSS)
  • Swallow eval (bedside)
68
Q

S/S Aspiration

Dysphagia think Aspiration

A
  • cough/choke/throat clearing
  • watery eyes
  • runny nose
  • wet vocal quality
  • breathing diff
  • fever
  • PNA
69
Q

Compensatory strats for Dysphagia

A
  • chin tuck
  • head turn/tilt
  • alt solids/liqs
  • cough/throat clear
  • hard swallows
  • small bites/sips
70
Q

VitalStim

A

*for dysphagia

Like NMES for swallow mm’s

After MBSS test

71
Q

Dementia

A

Acquired neuro. syndrome assoc’d w/ persistent or progressive deterioration in intellectual functioning

  • decline in cognition, visuospatial, lang, memory, emotion, personality
  • progressive but reversable when due to metabolic disturb (UTI)
72
Q

3 types of Dementia

A
  1. Cortical
  2. Subcortical
  3. Mixed
73
Q

Cortical Dementia

A
  • intellectual and lang deterioration precede motor defs
  • alzheimers type
74
Q

subcortical dementia

A

motor sxs

Parkinson’s

Huntington’s

Reduced dopamine due to loss of cells in substantia nigra

75
Q

Clinical mgmt Dementia

Early stages

A

communication, memory and behavioral mgmt

76
Q

Clinical mgmt Dementia

Later stages

A
  • family ed.
  • approach slowly
  • eye contact
  • speak slow/clear
  • keep convo concrete
  • ask Y/N?
  • restate important info
  • structure surroundings
  • establish routine***
77
Q

Rt. Hemisphere Syndrome

A
  • Rt. Hemi→ processing holistic-gestalt stimuli, visual/spatial info, face recognition, drawing/copying
  • Attentional and perceptual deficits are dominant
78
Q

RHD (Rt. Hemi Syndrome)

Attn and Perceptual defs:

A
  • Left neglect
  • denial of illness
  • confab regarding disability
  • face recognition defs
  • constructional impairs
  • attn. deficits
  • disorientation
  • visuoperceptual defs
79
Q

Communication defs w/ RHD

A
  • prosodic defs
  • impaired narrative skills
  • confabulation (made up truths), excessive speech
  • diff w/ abstract ideas
  • pragmatic defs
    • body lang/context cues/approp.
  • naming probs, diff comprehending complex verbal mats
80
Q

Cognitive therapy for TBI:

A
  • lang
  • memory
  • orientation
  • prob solving/abstract reasoning
  • attn/concentration
  • initation diffs/slowed responses
  • organization
  • executive functions→ plan/initiate/regulate
  • perseverations/inflexibility
81
Q

TBI: Important Factors to Consider

A

see pics

82
Q

TBI: More Important Factors to Consider

A

see pics

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