Aphasia Exam Flashcards

Terms Definitions
Spatial agraphia
know 4,5,1,2,3,44,40,41,42,22,39,19,18,17
motor speech disorder
Orbitofrontal; pre-rolandic
Broca aphasia
Only problem- severe naming
Phonetic impairment is
Dysarthria, Broca
What is #39
Angular Gyrus
Conductio Aphasias is AKA
Parietal-Insular syndrome
Bleeding in the cerebral tissue
Broca's profile
Speech and Writing-non-fluent, agrammaticAud. comp and reading-mostly preserved (some breakdowns)Repetition-impairedPhysical Symptoms-R hemparesis, R hemianopia, apraxiaLesion location-Broca's (BA 44) and surrounding cortical areas
What is area #6
secondary motor
writer's cramp
disturbance associated with people writing for a very long time for many years..
motor planning disorder - have physical ability & desire
disruption of the grammtical structure of the language. Broca
parietal lobe
contains the supramarginal gyrus, angular gyrus (supramarginal plus angular gyrus=inferior parietal lobule)
emotional lability
emotional incontinence; poor control over emotion that often results in uncontrolled crying or laughing, which can be a disconnect between expressed emotion and internal feelings affecting up to 50% of stroke patients and often resolves over time; more common in patients with frontal and or basal ganglia damage, which results in poor executive functioning
Caregiver concerns
Marital problems (stress, sexual changes, role reversal); higher risk for psychological problems (esp. if aphasia dx); female caregiver higher risk; initial assessment not predictive of 6 mo. post
Fractionation Assumption
selective impairments of specific processes can occur; yet stroke rarely affects only one area or process; patients with identical lesions may have varying aphasia profiles
An acquired impairment of language characterized by:Impairment of comprehension of language, Impairment of production of language, Word retrieval errors and problems with word selection.
Divide the brain into 4 sections
Conduction Aphasias
speech full of pausesgood auditory comprehensionseverely impaired repetition
extrasylvian motor aphasia
non fluent language, good comprehension and good repetition. prosody, articulation, long latencies in lang. poor expressive lang. and occasional verbal paraphasias. semi-mutism, echolalia, perseveration. open questions are slow and incomplete patient tends to repeat the words included in the question.impaired ability to make use of the language. (pragmatics)
prefrontal writing disturbances
agraphia without alexia; dysexecutive agraphia
AKA Tumor; any growth of abnormal cells, or the uncontrolled growth of cells
Franz Gall
end of 18th c; phrenlogy:cerebral hemispheres are composed by independent organs that support different intellecutal and moral characteristics
Non fluent; repetition good
Understanding poor Mixed transcorticalUnderstanding good Motor Transcortical
functor word
glue in phrases; closed class; auxiliary, pronouns, determiners, etc.; connects meaningful parts
cell death forming a liquid cavity with surrounding scar tissue
perisylvian language zone
contains major neurologic components of language (in language dominant hemisphere) including Broca's, Wernicke's, supramarginal gyrus, angular gyrus, and major association tracts that connect other language centers
plays a role in attention and memory
systematic lupus erythematosus
autoimmune disease causing increased risk for infection and other complications
narrowing of arteries that can cause either ischemic stroke due to blockage or hemorrhagic stroke due to bursting of weakened vessel walls
Subcortical Aphasias-Anterior capsular/putamenal
speech and writing-reduced phrase length, initiation deficits, dysarthria; good grammaraud. comp and reading-goodrepetition-relatively intactphysical-right hemiplegia
Psychological Problems following stroke
fear, fatigue, anxiety/stress, depression, feeling of loss of control, sleep disturbances, frustration/embarrassment, aggression, catastrophic reaction
Perisylvian lesions
Critical for the comprehension and production of language.
zone for language includes:
portions of frontal,parietal, temporal lobes, Broca's and Weirnicke's areas-also includes subcortical white matter pathways such as the arcuate fasciculus and superior longitudinal fasciculus
Characteristic of Wernicke's aphasia
cursive writing styleSEVERELY impaired auditoryexcessive empty speechsevere naming problems
Phonological agraphia
ability to spell words (familiar and unfamiliar) but unable to spell non-words; good performance in legit weird spelled words with low frequency; striking inability to write legitimate pseudowords in dictation; spelling errors observed in these pts are not usually phonologically correct but may present a high degree of visual similitude with target word
There is 1 type of aphasia; wernicke aphasia. Broca aphaisa is an anarthria plus some aphasic sypmtoms, depending upon the extension of the damage
harold Goodglass
most influential in US in therotical, assesment and rehab. 1 0f 2 authors of major aphasia battery: boston diagnostic aphasia examination
Area 37 is associated with
anomic, amnesic, nominal aphasia
carotid artery system
supplies most of the cerebral hemispheres
Symptoms of stroke (5)
facial drooping, slurred speech, weakness of paralysis on one side, confusion, severe headache accompanied by vomiting and dizziness (often signals hemorrhagic stroke)
limb apraxia
inability to carry out desired action associated with dominant hemisphere damage
(island of Reil) located deep to the temporal lobe and plays a role in language
Subcortical Aphasias-Left Thalamic lesion (ischemic)
speech and writing-non-fluent with phonemic paraphasiasaud. comp and reading-impairedrepetition-relatively unimpairedphsyical-right hemiplegialesion location-ventral and anterior thalamus (tuberothalamic artery)
What are the 3 main fissures?
central, lateral, longitudinal
Where are the tho large lateral ventricles?
cerebral hemisphere
-Differ in length and diameter and may be a few milimeters to several feet long-longer are are larger in diameter due to more____laid down on it
Axons, myelin
-largest of 4 lobes-anterior to the Rolandic fissure and superior to the Sylvian fissure-larger in humans-uniquly human
Frontal lobe
Writing in Broca
difficult to test (hemiparesis - left hand); agrammatism may be more severe; left hand clumsiness
Circle of Willis
Basilar arter divided into the 2 posterior communicating arteries; the carotid artery results into the anterior cerbreal artery and the middle cerebral artery; 2 comm. arteries; anterior communicating arter - the right and left anterior coumunication artery and posterior communicating artery - communicating carotid system and vertebral-basilar system
Cannot begin to produce the word. damage in the language motor areas
articulatory initiation anomia
What tasks is agrammatism obeserved (Broca)
Spontenous language, language understanding, repetition, wriing, reading
an impairment in language due to an abnormal brain condition before the acquistion of language has been completed
childhood aphasia
cerebellum and linguistic functions
no direct responsibility, but affects language through diaschisis phenomenon (reduced input from cerebello-ponto-thalama-cortical pathways
defining syntax for families
grammar or rules for forming sentences
Paul Broca
-presented the case of Tan in 1865 (showed damage to BA44 on autopsy)-work formed basis of localizing language to LH and separation of cognitive functions
What important stuff is in the temporal lobe?
primary auditory cortex
Where is the supplemetary motor cortex?
dorsal to premotor cortex
Regions of the brain and spinal cord containing clusters of nerve cells bodies.-3 to 5 milli. thick-covers entire surface of the cerebellum
Gray matter
spatial agraphia is a consequence of:
left hemi spatial neglect; constructional difficulties in writing; general spatial defects; some motor disautomatization and tendency to perseverate
Associated neurological signs for conduction
Motor system - mild hemiparesis; praxis - apraxia
Pragmatic level of language
how to use langague; Good Morning Sir
Glasgow coma scale
eval severity of TBI; 13 mild; 9-12 moderate; 8 severe. See Response chart
cerebellar contribution to language function
word finding (lateral cerebellar areas during verbal fluency tasks); syntax production esp. grammatical morpheme use; syntax comprehension, may cause transcortical motor aphasia if right cerebellar stroke
elements of fluent speech
normal phrase length, high # of functors (less substantives), diversity in grammatical structures, frequent paraphasias, good prosody and articulatory agility, low effort
What are the two important principles of functioning for understanding the effects of brain lesions on cognitive processes
contralaterality (left controls right)
hemispheric specialization (lang more in left)
ASsociated with social behavior, personality-damage may result in disinhibition
Orbitofrontal area of the frontal lobe
Infection can affect brain tissue because
interefere with the cerbral blood flow; alter the metabloc capacity of the cekll or the characeristics of the cell membrane, or chaning its electric properties
6 possible productions of TBI
Direct damage to the brain, interrupt cerebral blood flow, hermorrhages and hematomas, swelling (edema), infenction/Meningitis, epileptic focus- focal damage in the brain a scar will be observed
thrombotic ischemia
caused by build up of a clot within a cerebral vessel and associated with atherosclerosis, occurs most often in areas of bifurcation
What are the methods by which the structure and function of the brain can be investigated
behavioral assessment
medically based techniques (lesions, direct stimulation)
Imaging techniques
Where does the anterior cerebral artery supply?
the medial portions of the cortex
(issues here will affect, motor to lower extremities, prefrontal lobe syndrome
Speech and language characteristics of TBI
Dysarthria in 1/3 cases (60% acure; 10% long term fllow-up; Most often mixed dysarthria; sub-clincial aphasia (word-finding defects, difficulties with complex language)
What does the middle cerebral artery supply?
a lot of the brain
areas lateral
main vessel is within sylvian fissure
Most involved with speech (supplies, somatosensory cortex, motor cortex, broca's area, heschl's gyrus, wernicke's area, angular and supramarginal gyrus)
Symptoms of moderate or severe TBI
headache worsens or does not go away, vomiting, convulsions or seizures, inabilty to awaken form sleep, dialtion of one/both pupils, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessnes, or agitation
What happens when there is a loss of CSF?
extremely painful
stabbing pains each time head moved 
Brain tumors are classified depending on
the exact site of the tumor, the type of tissue involved, benign or malignant tendiencis, and others
Where is the angular gyrus? why is it important?
posterior inferior parietal lobe (just post to wernickes)
Broadmans area #39
involved with processing of auditory and visual input and language comprehension
processes letters with corresponding sounds
imp for reading, writing, abstract thinking and calculation
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