Adult Acquired Lang Disorders

Also includes cognitive based dysfunction

blood supply to the brain

Strokes disrupt the __________ or the blood that circulates to the brain (leads to tissue damage)

Ischemic stroke

Occurs due to an occlusion in an artery (blockage can be a thrombosis or embolism)

80

________% of strokes are ischemic

Hemorrhagic stroke

Occur due to bleeding in the brain from rupture of an artery

20

_______% of strokes are hemorrhagic

thrombosis

Stationary ischemic occlusion

embolism

Traveling ischemic occlusion

False

True or false: thrombotic (ischemic) strokes result from traveling blood clots

False

True or false: embolic (ischemic) strokes result from stationary blood clots

Face, arms, speech, time

What does the FAST mnemonic stand for?

True

True or false: hemorrhagic strokes lead to bleeding into brain tissues

uncontrollable

The following are ________ risk factors: age, sex, racial or ethnic background, family hx

False

True or false: strokes affect more females than males

True

True or false: African Americans are twice as likely to suffer a stroke compared to Anglo Americans

modifiable

The following are ________ risk factors: hypertension, diabetes, smoking, alcohol use

brain, spinal cord

The CNS is composed of…

peripheral nerves

The PNS is composed of…

speech production

Broca’s area is responsible for language and __________

posterior portion of the left frontal lobe

Broca’s area is located in the________

comprehension

Wernicke’s area is responsible for language___________

Arcuate fasciculus

The _________ connects Broca’s area to Wernicke’s area, which is a fiber tract that connects and allows for communication between these areas

Broca’s area, Wernicke’s area, Arcuate fasciculus in left hemisphere

‘Language areas’ of the brain include these structures and surrounding areas

Aphasia

Describes language disorders due to damage to the language areas of the brain

strokes

________ are the most common cause of aphasia

acquired, motor speech

Aphasia is an _______ disorder, not a psychiatric problem, and not a ________ disorder

nonfluent, fluent

Anterior lesions cause _______ aphasias, while posterior lesions cause ______ aphasias

production, comprehension, repetition

Aphasia can affect these three language components

agrammatism

Leaving out grammatical markers in sentences and phrases

anomia

Difficulty thinking of words or names of items

telegraphic speech

Phrases and sentences with content words, but no function words

paraphasias

Substitution of one word for another (e.g., “picture for mirror”)

jargon

Language that has no meaning

neologisms

Making up a new word (e.g. “The whozit over there.”)

Effortful articulation

Labored speech

Initiation difficulty

Difficulty or inability to initiate speech

Comprehension deficits

Difficulty or inability to understand language

Impaired repetition

Inability to repeat sounds, words, or phrases

Broca’s, Wernicke’s, transcortical motor, transcortical sensory, mixed transcortical, global, conduction, anomic

List the eight classic aphasia syndromes

Production/repetition impaired, comprehension preserved

Describe how production, comprehension, and repetition are affected in Broca’s aphasia

prefrontal cortex

Transcortical motor aphasia is caused by damage to the _______(i.e. “watershed area” around Broca’s area)

Comprehension/repetition preserved, production impaired

Describe how production, comprehension, and repetition are affected in transcortical motor aphasia

Comprehension/repetition impaired, production preserved

Describe how production, comprehension, and repetition are affected in Wernicke’s aphasia

Wernicke’s

Which type of aphasia will the person be unaware of their deficits or speech difficulties

temporal & occipital lobes

Transcortical sensory aphasia is caused by damage to the ______ (i.e. “watershed area” around Wernicke’s area)

Production/repetition preserved, comprehension impaired

Describe how production, comprehension, and repetition are affected in transcortical sensory aphasia

multiple areas of the brain

Global aphasia is caused by damage to ______

True

True or false: patients with global aphasia have extensive deficits across domains

All severely impaired

Describe how production, comprehension, and repetition are affected in global aphasia

Broca’s area, Wernicke’s area, & the arcuate fasciculus

Mixed transcortical aphasia is caused by damage to “watershed areas” around ____________.

production/comprehension impaired, repetition preserved

Describe how production, comprehension, and repetition are affected in mixed transcortical aphasia

arcuate fasciculus

Conduction aphasia is caused by damage to the __________

production/comprehension preserved, repetition impaired

Describe how production, comprehension, and repetition are affected in conduction aphasia

Anomic

_______ aphasia is not associated with damage to any specific brain region and is the most mild classic aphasia syndrome. But it’s the most pervasive type of chronic aphasia, after treatment

production/repetition/comprehension preserved

Describe how production, comprehension, and repetition are affected in anomic aphasia

True

True or false: Impairments in reading and writing are similar to impairments in comprehending and speaking for aphasia

neurodegenerative disease

Primary Progressive Aphasia (PPA) is aphasia due to ________

Primary Progressive Aphasia (PPA)

__________ is not a classic aphasia syndrome, acquired, due to neurodegenerative disease (i.e. progressive), and the language deficit is the most prominent aspect of the clinical picture (i.e. primary)

production

The following assessments are testing what? Answering questions, describing a picture, participating in informal or structured conversations

naming

The following assessments are testing what? identify objects/pictures, categories, completing phrases

comprehension

The following assessments are testing what? answering yes/no questions, pointing to objects or pictures as they are named, following directions

remediation

Speech-language therapy to improve skills

compensation

Implementing multimodal communication, using strategies such as circumlocution, caregiver strategies

True

True or false: The right hemisphere is responsible for many non-language functions such as comprehending visuospatial information, emotional expression

cognition, perception, & behavior

When the right hemisphere is damaged, it can lead to disruptions in

Right Hemisphere Dysfunction (RHD)

When an area of the right hemisphere does not function as it should due to damage. Can cause language impairment, but it usually looks very different from aphasia caused by left hemisphere damage

Unawareness/denial of cognitive-linguistic deficits

Unawareness/neglect of the left side of the body/external stimuli

Difficulty recognizing faces

Poor pragmatic skills

Wordy/tangential language

Difficulty understanding or using higher-level cognitive-linguistic skills (problem solving/abstract thought)

List six RHD characteristics

Improved attention to stimuli across visual fields

Higher-level cognitive-linguistic tasks (solving functional problems, understanding and using figurative language)

Pragmatics (turn taking, topic maintenance, eye contact)

Therapy targets for RHD may include…

traumatic brain injury (TBI)

Damage to the brain from external forces

Open-head TBI

Skull & meninges penetrated - tend to be more localized/focal injuries (ex: gun-shot wound)

Closed-head TBI

Brain is jostled, more diffuse (falls, concussions). More common injury.

Diffuse

Affects large area of brain

Focal

Affects only one specific region

Frontal/temporal

________ lobes are most susceptible to TBI

both sides of the brain

With closed-head injury, damage often occurs on _______

coup

Injury occurs on the side of impact

contrecoup

Injury that occurs on the side opposite the impact

Level of consciousness

TBI severity is characterized by…

Glasgow Coma Scale

Scores selected to describe an individual’s responses, lowest scores indicate serious comatose state

Rancho Los Amigos Scale

Scores individual to a level 1-8 based on level of responsiveness

Dementia

A general term to describe chronic and progressive decline in memory, cognition, language, & personality

central nervous system dysfunction

Dementia is caused by …

Metabolic disturbances (“metabolic encephalopathy”)

Infections (e.g. UTI)

Drug toxicity

Vitamin deficiency

Thyroid disease

List some acute medical conditions resemble dementia but are reversible

memory/cognitive skills impairment, aphasia/apraxia/agnosia

Individuals with dementia may experience…

agnosia

Inability to recognize objects, words, sounds

mild

Identify the severity - mild,moderate, or severe: forgetfulness, decreased vocabulary, decreased length of utterances in conversation, misplaces things

moderate

Identify the severity - mild, moderate, or severe: Disoriented to time and place, poor attention and memory, significant anomia, empty conversations, tends to roam

severe

Identify the severity - mild, moderate, or severe: Extreme disorientation, profound language deficits

True

True or false: Therapy for dementia usually focuses on compensation instead of remediation. Not looking to fix/improve things (no cure).