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Aphasia etc.
Neurogenic Communication Disorders
| Question | Answer |
|---|---|
| What is the neural pathway for AUDITORY comprehension? | 1. Ear 2. Vestibularcochlear nerve (CN VIII) 3. Cochlear nucleus 4. Inferior Colliculus (Mesencephalon) 5. Medial Geniculate (Diencephalon) 6. Primary Auditory Cortext (41 & 42) 7. Auditory Association Cortex (22) 8. Wernicke's area (posterior 22) |
| What is the neural pathway for SILENT READING comprehension? | 1. Eye 2. Optic nerve 3. Optic Chiasm 4. Optic tract 5. Lateral Geniculate (diencephalon) 6. Optic Radiations 7. Primary Visual Cortex (17) 8. Visual Association Cortex (18 & 19) 9. Wernicke's Area (posterior 22) |
| What is the neural Pathway for EXPRESSIVE language? | 1. Wernicke's area 2. Arcuate Fasciculus 3. Broca's area (along with opercular portion of inferior frontal gyrus and anterior insular cortex) 4. Linguistic sequence is sent to pre-motor cortex |
| What is the beginning neural pathway for producing speech? | 1. Premotor cortex 2. Anterior portion of insular cortex 3. Basal Ganglia & Circuitry (IAS) 4. Thalamus 5. Primary, premotor, and primary sensory cortex's (DAS) 6. Cortico-bulbar/spinal tracts (DAS) 7. Synapse w/ LMN 8. Coordinated muscle |
| What is the ending neural pathway for speech? | 9. Aerodynamics are produced and modulated 10. Aerodynamic energy creates acoustic signals 11. Acoustic signals are monitored by Wernicke's 12. Motor output produces afferent feedback, which is monitored and refined by the sensory-motor system |
| What is the ending neural pathway for writing? | 9. Visual signals are monitored by Visual cortex and Wernicke's area 10. Motor output produces afferent feedback, which is monitored and refined by the sensory-motor system |
| What is the function of Wernicke's area? | 1. Sorts through semantic representations to finding meaning of words 2. Syntactic rule system is applied to determine relationship/meaning 3. Literal interpretation determined 4. Figurative meaning determined (via RH) 5. Instructions sent to respond |
| What is Aphasia? | An impairment of language, affecting the production/comprehension of speech and the ability to read/write. It is always due to injury to the brain (stroke most common), particularly in older individuals. May also arise from TBI, tumors, or infections. |
| What area's will you seen differences between of the Aphasia's? | 1. Expressive 2. Receptive 3. Reading 4. Writing |
| What is Broca's Aphasia? | NON-FLUENT Anomia, short phrase length (0-5), relatively good auditory comprehension, relatively poor repetition |
| What is Wernicke's Aphasia? | FLUENT Anomia, poor auditory comprehension, poor repetition, say a lot but speech is empty |
| What is Conduction Aphasia? | FLUENT Anomia, fluent output with normal average phrase length, although flow of speech may be interrupted by word finding pauses or attempts to self-correct errors |
| What is Anomic Aphasia? | FLUENT Word-finding problems across tasks requiring retrieval of specific words |
| What is Transcortical Motor Aphasia? | NON-FLUENT Impaired initiation of verbal output, anomia, short phrase length (0-5), good auditory comprehension, and unlike Broca's good repetition relative to speech output |
| What is Transcortical Sensory Aphasia? | FLUENT Significant anomia and poor auditory comprehension but relatively good repetition skills (unlike Wernicke's). Verbal output is marked by severe anomia that may disrupt flow |
| What is Global Aphasia? | NON-FLUENT Profound anomia and virtually no speech output under any conditions and very poor auditory comprehension |
| What is Mixed Nonfluent Aphasia? | NON-FLUENT Lies somewhere between Global and Broca's with severe anomia, relatively poor auditory comprehension, poor repetition, with performances in these modalities being neither as poor as Global or good as Broca's |
| What is Thalamic Aphasia? | SUBCORTICAL Anomia, variable phrase length, variable auditory compression, relatively good repetition, verbal output may be somewhat hypophonic, paraphasic, and perseverative |
| What is Anterior Capsular/Putaminal Aphasia? | SUBCORTICAL Anomia, variable phrase length (6-8), relatively good auditory comprehension and repetition skills. Verbal productions include hypophonia, imprecise articulation (dysarthria), phonemic and semantic paraphasias, and grammatical constructions |
| What is Posterior Capsular/Putaminal Aphasia? | SUBCORTICAL Anomia, variable phrase length, poor auditory comprehnsion and repetition skills. Verbal production includes hypophonia, well-articulated, grammatical speech with semantic, phonemic, and neologistic paraphasias. |
| What is dementia? | A condition of imparmented memory, intellect, personality, and insight resulting from brain injury or disease. May be progressive (e.g., Alzheimer's etc.) Language impairments fairly prominent in dementia, but overshadowed by intellectual loss. |
| How is the prognosis of dementia different than that of aphasia? | Dementia is often a progressive disorder, resulting in: 1. Diffuse impairment of memory, intellect, and cognition 2. Alterations in behavior/personality 3. Physical impairments (movement/sensory) |
| What are the American Psychiatric Association's defined symptoms of Dementia? | 1. Impaired short-term memory 2. Impaired long-term memory 3. Impaired in at least one of the following: Abstract thinking, personality, judgement, constructional abilities (interpreting), language, praxis (skill, habitual practice), visual recognition |
| What are the American Psychiatric Association's defined conditions of Dementia? | 1. Insidious onset 2. Not delirium, schizophrenia, major depression 3. Acquired 4. Persistent condition (progressive) 5. Cross several mental functions 6. Mental impairments must be severe enough to interfere w/ work, social, and relationships |
| What are the early signs of dementia? | 1. Memory failure 2. Disorientation 3. Lapse in judgement 4. Difficulty performing activities 5. Difficulty performing mentally challenging activities 6. Misplace items 7. Apathy, loss of initiative 8. Change in mood |
| What are the most common medical diagnosis for dementia? | 1. Alzheimer's disease (most common) 2. Multi-infarct dementia: (2nd most common) Common theme across pathophysiologies: progressive disease process, onset later in life |
| What are the 3 classifications of dementia? | 1. Cortical (Alzheimer, Pick's) 2. Sub-cortical (PD, Huntington's) 3. Mixed (Multiple infarct) |
| What are the hallmarks of Cortical dementia? | 1. Pathological changes to the cortex 2. Changes to memory, intellect, and language appear early 3. Motor changes appear later |
| What are the hallmarks of Sub-cortical dementia? | 1. Pathological changes to the basal ganglia, thalamus, and brain stem 2. Motor changes appear early 3. Changes to intellect and language appear later |
| What are the hallmarks of Mixed dementia? | 1.Pathological changes to cortical and sub-cortical structures 2. Changes noted depend on site of damage |
| What is Right Hemisphere syndrome? | Damage on right side of brain, which controls cognitive functioning (thinking skills). Damage leads to cognitive-communication problems such as impaired memory, attention, and reasoning. Individual may not be aware of such problems (anosognosia). |
| What are some cognitive-communication problems that can occur from right hemisphere damage? | 1. Attention 2. Left-side neglect 3. Memory 4. Organization 5. Orientation 6. Problem solving 7. Reasoning 8. Social communication (pragmatics) |
| Do right hemisphere patients have the same kind of language problems seen in Aphasia? | No, however some do have specific linguistic problems. Thus RHD patients should be given an aphasia battery like the Boston. |
| What is Traumatic Brain Injury (TBI)? | Cognitive and communication problems that significantly impair the ability to live independently due to brain injury. TBI patients may have anomia. Deficits will mostly be cognitive, but aphasia may result from a TBI causing language deficits too. |
| What cognitive difficulties are common in TBI patients? | 1. Awareness of ones surroundings 2. Attention to tasks 3. Memory 4. Reasoning 5. Problems solving 6. Executive function (planning, initiation, self monitoring/awareness,etc.) |
| Problems vary depending on location/severity of the TBI. What are some problems that may be affected? | 1. Trouble concentrating with distractions 2. Slow processing of information 3. Problems with recent memory 4. Executive functioning problems (e.g., starting tasks, setting goals, organization, etc.) |
| What areas of cognition might an individual experience with normal aging? | 1. Visual and verbal/non-verbal memory 2. Visuospatial abilities 3. Immediate memory 4. Ability to name objects |
| What abilities remain unchanged during the aging process? | 1. Vocabulary 2. Verbal reasoning |
| What is alertness? | Readiness to respond to stimulation |
| What is Tonic alertness? | Alertness lasting over longer time intervals (minutes to hours) |
| What is Phasic alertness? | Alertness that is momentary, rapidly occurring changes in receptivity to stimulation |
| What is focused attention? | Basic responsiveness to stimulation (similar to phasic alertness) |
| What is sustained attention? | Attention maintained over time |
| What is Selective attention? | Attention maintained in the presence of competing stimuli |
| What is alternating attention? | Attention shifted from one stimulus to another (changing tasks) |
| What is Divided attention? | Attending to more than one activity concurrenty. |
| Why is attention important to communication? | Attention is important to communication because it assures topic maintenance, proper responses, and social acceptance. |
| What is the sensory register (memory)? | Incoming info is retained in modality-specific form (auditory, visual or tactile) - registration. It the means by which perceptions are introduced in to the memory system, not under voluntary control. Utilizes perceptual, attentional, encoding processes. |
| What is immediate memory? | Short term memory, has limited capacity and info in immediate memory decays within a few seconds unless it is rehearsed (retention span). |
| What is long-term memory? | This is secondary memory, extremely large capacity and decays slowly (recurrent vs. remote) |
| What is working memory? | This resembles immediate memory but is considered a mental space where temporary outcomes of cognitive operations are stored during complex cognitive processing. |
| What is retrospective memory? | This denotes retention and recall of info about past experiences/events |
| Retrospective memory: What is the difference between declarative and procedural memory? | Declarative: What we know about things (how to do something). 2 types: episodic and semantic Procedural: collection of habits that can be applied automatically (knowing how to perform a task) |
| Retrospective - Declarative - What is episodic and semantic memory? | Episodic: personal experience Semantic: organized knowledge of the world |
| What is prospective memory? | Permits intentions formed in the past to govern present behavior A(remembering to remember) |
| How does memory impact a persons ability to communicate? | By affecting topic maintenance, correct responses to partner, and social acceptance. Daily interactions can be difficult and hinder communication exchange. |
| What does the area of "cognition" include? | 1. Attention 2. Memory 3. Executive function |
| what does "executive function" include? | 1. Initiating intentional behavior 2. Planning behavioral routines to accomplish intentions 3. Maintaining and regulating goal-directed behavior 4. Monitoring and modifying behavior in response to situational variables |
| Assessing cognition: Tonic alertness? | Estimate tonic alertness in interviews, reports, other testing |
| Assessing cognition: Phasic alertness? | Reaction-time testing |
| Assessing cognition: Vigilance? | Assessed with strings of computer-presented auditory or visual stimuli presented over long and purposefully monotonous intervals |
| Assessing cognition: Selective attention?? | 1. Paper and pen cancellation task 2. Stroop test (reading of colors/names) 3. Choice reaction-time tests: (respond every time they hear the letter "a") |
| Assessing cognition: Alternating attention? | Assess how they transition attention (can be asses during sustained attention tasks) |
| Assessing cognition: Divided attention? | 1. Retain info while performing other tasks/digits backwards 2. Dual task format: two tasks at once |
| Assessing cognition: Attention in ADL (activities of daily life): | The test of everyday attention (TEA). May be better because it assesses their performance on everyday tasks instead of just on standardized measures (Research not conclusive) |
| Assessing cognition: Retrospective memory | Retention span: 1. Immediate retention-digit span test(verbal) repeating/block tapping test (nonverbal) 2. Short-term retention-delay/interruption after presentation |
| Retrospective memory assessment: short-term memory retention-delay/interruption after presentation types? | 1. Supspan: repeating until the patient can produce without error 2. supraspan: repeat as many as you can remember over and over until learned |
Created by:
aly435
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