Adult Neuro Disorder Midterm

Frontal lob function

Personality, mood, control of executive decisions, and relating cognitive functions (such as reasoning and self-monitoring).

Anterior portion of the frontal lobe

Prefrontal cortex is located

Executive function

Prefrontal cortex function is

Inferior frontal lobe

Brocas area location

44 and 45

Brocas Area Broadmanns Area

Brocas area function

motor planning of speech, grammatical formulation.

Precentral gyrus

Primary Motor cortex location

4

Primary motor cortex broadmanns area

Primary motor cortex function

responsible for initiating and executing our voluntary movements by sending direct signals to the muscles

6

Premotor cortex brodmanns area

Coordination and planning of movement

Premotor cortex function

Parietal lobe function

spatial awareness (orientation), cross-modality integration, recognition, emotion prosody, interpretation of sensation.

Post-Central Gyrus

Primary Sensory Cortex location

3,1,2

Primary Sensory cortex broadmanns area

processing sensory information from the body.

Primary Sensory Cortex function

senses: touch, pain, temperature, body position

Somatosensory Association Cortex function

40

Supramarginal gyrus broadmanns area

Supramarginal gyrus function

phonological processing, important for repetition.

39

Angular Gyrus broadmanns area

Angular Gyrus Function

Reading, writing, and semantic processing.

Temporal lobe function

Languae comprehension (both visual and spoken language), thought elaboration, olfaction, and memory.

42 and 41.

Primary Auditory Cortex broadmanns area

receives auditory input

Primary Auditory Cortex function

22

Wernicke's Area Broadmanns Area

Auditory comprehension

Wernicke's Area Function

occipital lobe

vision processing center

Arcuate Fasciculus

white matter bundle connecting Broca's and Wernicke's areas.

language

A dynamic process that contains universal characteristics and is made of shared rules that we share as a society.

form

content

use

3 components of language

Form

phonology (speech sounds), morphology (smallest unit of sound), syntax

Content

semantics

Use

pragmatics

1. auditory cortex (Herschl's gyrus)

2.Wernicke's area

3.Angular gyrus (integration)

4. Semantic networks

Spoken language comprehension steps

1. Visual cortex (occipital lobe).

2. Angular gyrus

3. Wernicke's area

4. Semantic system

Reading steps

1. prefrontal cortex

2. broca’s area

3. premotor cortex

4. primary motor

5. speech muscles

1. Conceptualization (association cortex).

2. Wernickes area (lexical selection)

3. Arcuate fasciculus

4. Brocas area (motor plan).

5. Primary motor cortex

Speaking (Oral Expression) Steps

1. Conceptualization

2. Angular gyrus

3. Exner's area (posterior middle frontal gyrus).

4. Motor cortex (hand).

Writing steps

Aphasia

a disorder of language resulting from damage to the language-dominant hemisphere of the brain that impairs comprehension and/or expression of both oral and written language

an acquired language disorder resulting in the inability to produce, repeat, and/or understand language (spoken/writen/gestures)

an acquired neurogenic language disorder resulting from an injury to the brain, involving varying degrees of impairment in the four primary areas (spoken, written, spoken and reading comprehension)

an acquired selective impairment of language resulting from a focal brain lesion affecting one’s communicative and social functioning, QOL, and QOL of caregivers

-acquired

-neurological

-multimodal; affecting language reception and expression

-language; not a sensory, psychiatric, or intellectual disorder

what are the 4 elements to defining aphasia?

1. intellectual disability

2. sensory

3. speech

4. psychiatric

Aphasia is not:

1. Expressive- Speaking

2. Expressive- Writing

3. Receptive- Listening

4. Receptive- Reading

Modalities impaired by aphasia

1. Intelligence

2. Primary motor function

3. Sensory systems

Aphasia does not primarily affect

TBI

Stroke/CVA

Tumors

Neurodegenerative

Infection

Common causes of aphasia

Ischemic

Hemorrhagic

Two types of strokes

Thrombotic and embolic

Types of Ischemic strokes

Thrombotic stroke

when arterial blockage has accumulated in the same area of an artery, where the blockage eventually occurs

Embolic stroke

Clot originates elsewhere but moves to the brain

tPA (tissue plasminogen activator)

Common medical treatment for strokes

3-4.5 hours

tPA must be given with what time frame

TIA

a temporary blockage that usually lasts less than 30 minutes but serves as a major warning sign for a future stroke; temporary neurologic symptoms, no permanent infarct

TBI Types

closed

open

blast

coup

contracoup

transational

roational

concussion/mTBI

Symptoms of fluent aphasia

paraphasia (phonemic or semantic)

perseveration

anomia

paragrammatism

circumlocution

Conduit d'approche

Logorrhea

Press of speech

symptoms of nonfluent aphasia

agrammatism

sterotypy

neologism

Echolalia

Telegraphic Speech

Anomia

word-finding difficulty not due to sensory or cognitive deficits.

Anomia

Which symptom is a hallmark of aphasia?

Agrammatism

Impaired use of grammar, especially omission of function words.

Neologisms

words that are not real phonologically or semantically although they usually follow the orthographic rules of the language.

Literal/Phonemic paraphasia

a similar sounding word is substituted.

Verbal/Semantic paraphasia

a word that is related in meaning to the desired target word.

Logorrhea

excessive, fluent verbal output that lacks meaningful or relevant content.

Press of speech

Speech that is delivered very rapidly and forcefully with an urgent quality. The person feels compelled to keep talking and is difficult to interrupt.

Anosognosia

A person is unaware of, or denies, their own impairment despite clear evidence of it.

Verbal Perseveration

The inappropriate repetition of a word, phrase, or response beyond the point where it is relevant.

Telegraphic speech

Short, simplified sentences made up mostly of content words.

Dysnomia

Difficulty retrieving the correct word; tip-of-the-tongue

Circumlocutions

Talking around a word when unable to retrieve it.

Effortful speech

slow, labored speech requiring visible effort to produce words.

Emotional lability

Sudden, exaggerated, or inappropriate emotional expressions (crying or laughing) that are difficult to control after neurological injury.

Sterotypy

A fixed repetitive utterance that is produced repeatedly and automatically, often in the place of meaningful speech.

Conduit d'approche

Repeated self-correcting attempts to approximate a target word. The patient recognizes their error and keeps trying to fix it.

bad fluency

bad comprehension

bad repetition

Global Aphasia overview

Sterotypy

Global Aphasia error types

large perisylvian lesions in frontal/temporal/parietal lobes

Global aphasia lesion site

MCA

Global aphasia blood supply

bad fluency

bad comprehension

good repetition

Mixed Transcortical Aphasia overview

Lesions to the frontal and temporal watershed regions

Mixed Transcortical Aphasia lesion site

general watershed insufficiency of ACA, MCA, and PCA

Mixed Transcortical Aphasia blood supply

bad fluency

good comprehension

bad repetition

Broca Aphasia Overview

Telegraphic speech

Dysnomia

Effortful speech

Broca's Aphasia symptoms

Inferior frontal lobe

Broca's aphasia site of lesion

MCA

Broca's aphasia blood supply

bad fluency

good comprehension

good repetition

Transcortical Motor speech overview

frontal lobe, watershed regions

transcortical motor aphasia lesion site

ACA, MCA

tanscortical motor aphasia blood supply

good fluency

bad comprehension

bad repetition

Wernickes aphasia overview

Neologisms

Literal and Verbal Paraphasia

Loggorhea

Press of speech

verbal perseveration

Wernickes aphasia symptom hallmarks

posterior portion of the superior temporal gyrus

Wernickes aphasia site of lesion

MCA

Wernickes aphasia blood supply

good fluency

bad comprehension

good repetition

Transcortical Sensory Aphasia overview

Temporal lobe water-shed regions (angular gyrus)

Transcoritcal sensory site of lesion

MCA/PCA

Transcortical sensory aphasia blood supply

good fluency

good comprehension

bad repetition

Conduction Aphasia overview

Conduit d'approche

Conduction Aphasia hallmark symptoms

Arcuate fasciculus, supramarginal gyrus

Conduction aphasia site of lesion

MCA

Conduction aphasia blood supply

good fluency

good comprehension

good repetition

Anomic aphasia overview

dysnomia

cicumlocutions

Anomic aphasia symptoms

often angular gyrus

Anomic aphasia site of lesion

MCA

Anomic aphasia blood supply

Screenings

quickly determine the presence of the problem, but cannot diagnose the subtype.

Comprehensive assessment

Identify the type, severity, strengths, and weaknesses.