Lang disorders ~ Exam 3

Neurogenic communication disorders

a problem with communication as a result of damage to the brain or nervous system

Neurogenic communication disorders include:

aphasia

dysarthria

apraxia of speech

dementia

right hemisphere disorder

Treatment settings

skilled nursing facility (SNF)

Acute care (hospital)

Rehabilitation facility

Outpatient (OP)

Home health

Hospice

Pediatrics

Cognition

ability to think

acquire and process knowledge about the world

to process thought

Cognitive processes underlie_______

communication

Subcategories of cognition:

Arousal, Orienting, Attention, Working memory, Orientation, Problem solving, Inferencing, Executive function

Arousal

level of wakefulness; ability to respond to stimuli

Orienting

ability to direct attention toward a stimulus

Attention

ability to hold focus on a stimulus

Vigilance

ability to stay alert for possible stimuli

Sustained attention

ability to hold attention on a single stimulus for a span of time

Selective attention

ability to hold attention on a stimulus while ignoring competing stimuli

Alternating attention

ability to move attention back and forth between two stimuli

Divided attention

ability to attend to one stimulus while simultaneously attending to another stimulus

Working memory

ability to store and retrieve information

Short-term memory

ability to store and recall info for up to an hour

Long-term memory

ability to store and recall info over months or years

Procedural memory

recalling sequences of actions in order to complete tasks

many are automatic due to routine

Declarative memory

recall of facts

Episodic memory

recall of specific episodes (events)

Orientation

knowledge of self and place in space and time

who you are, where you are, when you are

Problem solving

ability to find appropriate solutions to a problem

Inferencing

ability to make a leap in judgement to a correct interpretation of overall meaning

reading between the lines

Executive function

high-level cognitive processing which utilize lover-level functions to accomplish a task

ability to initiate, plan, and self monitor

Language

a set of symbols used to communicate meaning

expressive & receptive

Speech

sounds made by vocal and articulatory structures to create verbal language

Language deficits and cognitive deficits can _____

co-occur but one can occur without the other

Changes in speech as you age:

it shouldn’t change

Changes in language as you age:

slight delays in processing

reading may slow but comprehension remains

decline in word finding ability

Changes in cognition as you age:

slower performance with selective attention

decreased performance with divided attention

decline in short term and episodic memory

Neurons

transmit and process info; motor and sensory

Nueroglia (glial cells)

provide structural support to neurons

not directly involved in info processing

Synapse

connection point between neuron

Three basic types of neurons

sensory neurons

motor neurons

interneurons

Sensory neurons

transmit sensory info from body to brain; afferent

Motor neurons

tranmit motor impulses from brain to body; efferent

Interneurons

process info within the brain

Anatomy of a neuron

Soma (cell body)

dendrites

axon

terminal buttons

myelin sheath

Neuroglia / Glial Cells

provide metabolic support for neurons

regulate blood flow to neurons

play a role in neuron development

Types of Glial cells:

Oligodendrocytes

Astrocytes

Microglia

Schwann Cells

Oligodendrocytes

produce the myelin sheath on axons of neurons

Astrocytes

star-like; provide structural support to neurons

clear waste products from synapses; glial scar

Microglia

immunological cells

consume cellular waste, neural tangles, and damaged neurons

Schwann cells

produce the myelin sheath on one axon of a motor or sensory neuron in PNS

The nervous system is composed of

CNS ~ brain and spinal cord

PNS ~ nerves that connect the rest of the body to the CNS

The brain:

coordinates and regulates all body functions

the seat of consciousness, intelligence, and language

The brain is divided into:

cerebrum

brainstem

cerebellum

Cerebrum

sits atop the brainstem

houses the highest and most complex functions including cognition, language, and motor movement

Cerebral Cortex

the surface tissue of the cerebrum; the most superficial layer of the cerebrum

Gray matter

unmyelinated neurons responsible for processing and regulating info within the nervous system

White matter

myelinated neurons responsible for transmitting impulses from brain to body or to other areas of brain

3 primary types of white matter tracts in the CNS

Association fibers

Commissural fibers

Projection fibers

Gyri

ridges on the cerebral cortex

Sulci

grooves on the cerebral cortex

Fissures

very deep sulci

Cerebral meninges

3 anatomic layers of tissue between the brain and skull

dura, arachnoid, and pia mater

Dura Mater

tough mother

superficial layer; dense protective layer of tissue

Arachnoid mater

spider-mother

more delicate, covers the CNS, supplies blood to the brain

Pia mater

gentle mother

most delicate layer; closely covers the CNS

Ventricular system

between arachnoid and pia maters

cushions brain from trauma

Ventricular system houses _____

Cerebrospinal fluid (CSF) ~ nutritive, colorless fluid

CSF delivers nutrients to the brain and removes waste

Cerebral Hemisphere details

Longitudinal fissure: deep groove seperating the 2 hemispheres

corpus collosum: mass of white mater located at the base of the longitudinal fissure

For the most part, R hemisphere controls L body and L hemisphere controls R body which is known as….

contralateral (opposite)

Right hemisphere

deals with emotions, facial expression, prosody, gestures, gestalt processing, visuospatial processing, and attention

Left hemisphere

language dominant

brocas and wernickes area

Brocas area

responsible for planning and carrying out oral movements for speech; and for finding and assembling words to express thoughts

Wernickes area

located near auditory cortex

responsible for interpreting and understanding speech

Cerebral lobes

frontal lobe

parietal lobe

temporal lobe

occipital lobe

Frontal lobe

expressive thought; brocas

primary motor cortex

personality and inhibition

some memory

Parietal lobe

primary sensory cortex

proprioception: awareness of where your body is in space

Temporal lobe

primary auditory cortex

receptive language; wernickes

most memory

Occipital lobe

primary visual cortex

processing visual info

Subcortical structures includes:

brainstem

cerebellum

thalamus

basal ganglia

limbic system

Cortex

high-level cognitive skills

Subcortex

automatic functions

The Brainstem

oldest part of the brain

connects spinal cord to the cerebrum

3 major sections of the brain stem

midbrain

pons

medulla

Midbrain

produces dopamine

Pons

attaches cerebellum to rest of CNS

Reticular formation

nuclei running in the brainstem

regulates arousal, respiration, blood pressue

Cerebellum

“little brain“

coordinates smooth, error free movements

important for producing smooth and precise articulation

Cerebellum resembles the ______ hemispheres

cerebral

Thalamus

“relay station“

receives sensory info and directs it to cerebrum for interpretation

relays motor info from cerebellum

Basal Ganglia

production of dopamine

fine tunes voluntary movements

Limbic system

collection of subcortical structures

deals primarily with emotion

Spinal Cord

begins in medulla

Ventral & Dorsal horns

involved in basic reflexes

Reflex

production of a physical movement that occurs automatically in response to a stimulus

involuntary

initiated below the level of awareness

Types of Reflex

pupillary light reflex

gag reflex

cough reflex

swallow reflex

startle reflex

withdrawal reflex

grasp reflex & rooting reflex (infants)

Blood supply to brain

Internal carotid arteries

anterior cerebral arteries

MCA

Vertebral arteries

posterior cerebral arteries

_____ % of the body’s oxygen and glucose are used by the brain

20-25

Circle of Willis

ensures equal blood flow if blockage occurs

Peripheral nervous system

nerves that connect the rest of the body to the CNS

Etiology

underlying cause of a symptom or disorder

Idiopathic

unknown origin

CVA

cerebrovascular accident

aka stroke

TBI

traumatic brain injury

Degenerative

worsening over time

Common etiolgies of neurogenic communication disorder

CVA

TBI

Surgical trauma

degenerative disease

CVA occurs when…

an interuption to blood flow to the brain

causes destroyed brain tissue and cell death

Anoxia

lack of oxygen