Speech Pathology Exam Notes

Embolus

• An embolus is a traveling blood clot that moves through the bloodstream and can block an artery, often causing a stroke.

Thrombosis

• Thrombosis is a blood clot that forms slowly over time, usually due to plaque buildup in the arteries.

Aneurysm

• An aneurysm is a weak spot in an artery wall that balloons out.
• If it bursts, it can cause a hemorrhagic stroke.

Edema

• Edema is swelling in body tissue, including the brain.
• It happens after injury like a stroke and can interfere with recovery.

Clot

• A clot is a clump of blood cells and protein that forms to stop bleeding, but in the brain it can block blood flow and cause a stroke.

Bolus

• A bolus is the soft mass of food or liquid that is formed in the mouth and swallowed.

Tumor

• A tumor is an abnormal growth of tissue.
• It can be benign (non-cancerous) or malignant (cancerous), and it may cause pressure or damage to the brain.

Stroke (CVA)

• A stroke (CVA) is when blood flow to the brain is stopped either by a blockage (ischemic) or bleeding (hemorrhagic), causing brain damage.

Neoplasm

• A neoplasm is a new and abnormal growth of tissue, often a tumor.

Jargon (in speech disorders)

• Jargon refers to speech that is fluent but filled with made-up words or meaningless phrases.
• It is often seen in Wernicke’s aphasia.

Aspiration

• Aspiration is when food or liquid enters the airway (trachea) instead of the esophagus, increasing the risk of pneumonia.

Penetration (in swallowing)

• Penetration is when food or liquid enters the larynx but doesn’t go below the vocal folds.

Deglutition

• Deglutition means the act of swallowing.

Hydration

• Hydration refers to having enough fluid in the body.
• It is essential for overall health and safe swallowing.

Nutrition

• Nutrition is the intake of food to meet the body's energy and health needs.
• Swallowing problems can lead to poor nutrition.

Radiation (in dysphagia context)

• Radiation therapy to the head or neck (e.g., for cancer) can damage muscles or nerves used in swallowing, causing dysphagia.

Dysphagia

• Dysphagia means difficulty swallowing.
• It can lead to malnutrition, dehydration, and aspiration pneumonia.

Aphasia

• Aphasia is a language disorder caused by brain damage, often from a stroke, and affects speaking, understanding, reading, and writing.

Swallowing & Dysphagia

• Swallowing has four sequential stages:
  • Anticipatory – thinking about food; sensory awareness.
  • Oral – chewing and pushing food to the back of the mouth.
  • Pharyngeal – triggering the swallow reflex; closing airway.
  • Esophageal – moving food through the esophagus to the stomach.
• What happens at each stage of the swallow:
  • Anticipatory: Smelling, seeing, and preparing to eat.
  • Oral: Chewing (mastication), forming bolus, tongue pushes bolus back.
  • Pharyngeal: Swallow reflex starts, vocal folds close, epiglottis covers airway.
  • Esophageal: Bolus moves through esophagus to stomach via peristalsis.

Causes of Dysphagia

• Dysphagia can be:
  • Structural (e.g., oral cancer, cleft palate)
  • Neuromuscular (e.g., stroke, ALS)
  • Psychogenic (e.g., anxiety)
  • Radiation-related (e.g., cancer treatment)
  • Developmental (e.g., premature infants)

Gurgling or Wet Voice After Eating

• It often suggests aspiration or penetration—food or liquid entering the airway.

Brainstem and Swallowing

• The brainstem, specifically the medulla, contains nuclei for cranial nerves that control swallowing (e.g., vagus, glossopharyngeal, hypoglossal).

Dysphagia in Dementia

• Dementia affects memory and attention, leading to problems with initiating swallowing, forgetting to chew or swallow, and poor coordination.

Gastric Tube

• A tube inserted into the stomach to provide nutrition when oral feeding isn’t safe or possible.

Purposes of Eating

• Eating provides:
  • Nutrition
  • Hydration
  • Pleasure/social interaction
  • All are important for quality of life.

Dysphagia in Oral Cancer

• Surgery, radiation, or tumors can damage the tongue, jaw, or throat structures involved in swallowing.

Swallowing in Premature Babies

• Preemies often lack coordination between sucking, swallowing, and breathing.
• Feeding specialists help train these skills.

Dysphagia Assessment: Adults vs. Children

• Adults can often describe their symptoms; children may not.
• In pediatrics, SLPs use observation, parent reports, and check feeding milestones.

Chronological vs. Developmental Age in Children

• Chronological age = actual age in months/years.
• Developmental age = level at which the child functions (e.g., speech, cognition).
• SLPs use developmental age to choose appropriate assessment tools.

Language Impairment

• Language impairment means difficulty with form, content, or use of language.

Language Impairment Effects on Children

• Infancy: Delayed babbling, poor eye contact.
• Preschool: Trouble forming sentences, vocabulary gaps.
• School-age: Struggle with reading, writing, following directions.

Dementia vs. Aphasia vs. Dysarthria vs. Apraxia

• Dementia: Memory + language decline (e.g., Alzheimer’s).
• Aphasia: Language problem (not motor). Often stroke-related.
• Dysarthria: Slurred speech due to weak muscles.
• Apraxia: Motor planning issue—can’t say words even if muscles work.

Conditions Affecting Short-Term Memory

• Dementia, especially Alzheimer’s.

Brain Hemisphere Responsibilities

• Left hemisphere: Language, math, logic.
• Right hemisphere: Emotions, attention, facial recognition, prosody.

Effects of Damage to Left vs. Right Hemisphere

• Left hemisphere damage: Aphasia, language problems.
• Right hemisphere damage: Pragmatic problems, emotion reading, neglect.

Alzheimer’s Causes

• Alzheimer’s is caused by brain degeneration, plaque buildup, and tangled proteins (neurofibrillary tangles) disrupting neuron function.

Jargon in Aphasia

• Jargon is fluent but nonsensical speech, often seen in Wernicke’s aphasia.

Communication Difficulties in Children with Autism

• They may struggle with:
  • Pragmatics (use of language in social situations)
  • Nonverbal communication (eye contact, gestures)
  • Delayed language development
  • Literal interpretation (trouble with figurative language)