Neurologically Based Disorders

Question 1

stroke caused by a blocked or interrupted blood supply to the brain. Blockage or itneruption may be caused by two kinds of arterial diseases: thrombosis or embolism

Answer 1

Ischemic strokes

Question 2

a collection of blood material that blocks the flow of blood.

Answer 2

thrombus

Question 3

a traveling mass of arterial debris or a clump of tissue from a tumor that gets lodged in a smaller artery and thus blocks the flow of blood

Answer 3

embolus

Question 4

stroke caused by bleeding in the brain due to ruptured blood vessels. Ruptures may be intracerebral (within the brain) or extracerebral (within the meninges, resulting in subarachnoid, subdural, and epidural varieties)

Answer 4

Hemorrhagic strokes

Question 5

Nonfluent Aphasias (4)

Answer 5

• Broca’s Aphasia
• Transcortical Motor Aphasia (TMA)
• Mixed Transcortical Aphasia (MTA)
• Global Aphasia

Question 6

• often caused by damage to Broca’s area (Brodmann’s areas 44 and 45)
• nonfluent, effortful, slow, halting, uneven speech
• limited word output, short phrases and sentences
• misarticulated or distorted sounds
• agrammatic or telegraphic speech
• impaired repetition of words and sentences
• impaired naming, especially confrontation naming
• rarely normal, but better auditory comprehensions of spoken language than production
• difficulty in understanding syntactic structures
• poor oral reading and comprehension
• monotonous speech
• May have apraxia or dysarthria
• may have right-sided paralysis or paresis
• may have emotional symptoms

Answer 6

Broca’s Aphasia

Question 7

• often caused by lesions in the anterior superior frontal lobe often below or above Broca’s area
• initial speechlessness
• echolalia and perseveration
• absent or reduced spontaneous speech
• nonfluent, paraphasic, agrammatic, and telegraphic speech
• intact repetition skill, a distinguishing characteristic
• awareness of grammaticality
• refusal to repeat nonsense syllables
• unfinished sentences
• limited word fluency
• simple and impreciese syntactic structures
• attempts to initiate speech with the help of such motor activities as clapping, vigorous head nodding, and hand waving
• generally good comprehension of simple conversation; possibly impaired for complex speech
• slow and difficult reading aloud
• seriously distrubed writing
• often exhbitit motor disorders such as rigidity of upper extremity, akinesia, bradykinesia, buccofacial apraxia, and weakness of legs
• emotional symptoms

Answer 7

Transcortical Motor Aphasia

Question 8

• caused by lesions in the watershed area or arterial border zone
• limited spontaneous speech
• automatic, unintentional and involuntary nature of communication
• severe echolalia
• repetition of an examiner’s statement
• severely impaired fluency
• severely impaired auditory comprehension for even simple conversation
• mostly unimpaired automatic speech
• severely impaired reading, reading comprehension, and writing
• varied neurologic symptoms

Answer 8

Mixed Transcortical Aphasia

Question 9

• most severe form of nonfluent aphasia
• caused by extensive lesions affecting all language areas
• profoundly impaired language skills and no significant profile differential skills
• greatly reduced fluency
• expressions limited to a few words, exclamations, and serial utterances
• impaired repetition
• impaired naming
• auditory comprehension limited to single words at best
• persevration
• impaired reading and writing
• verbal and nonverbal apraxia may be present
• strong neurological symptoms
  
  • right side paresis or paralysis
  • right sided sensory loss
  • neglect of left side of the body

Answer 9

global aphasia

Question 10

Fluent Aphasias

Answer 10

• Wernicke’s Aphasia
• Transcortical Sensory Aphasia
• Conduction Aphasia
• Anomic Aphasia

Question 11

• often caused by lesion in Wernicke’s area
• incessant, effortlessly produced, flowing speech with normal, or even abnormal, fluency with normal phrase length
• rapid rate of speech
• good articulation
• severe word-finding problems
• paraphasic speech containing semantic and literal paraphasias, extra syllables in words and creation of neologisms
• circumlocution
• empty speech
• poor auditory comprehension
• impaired conversational turn taking
• impaired repetition skill
• reading comprehension problems
• writing problems
• generally poor communication despite of fluent speech
• may sound confused
• generally free from obvious neurological symptoms

Answer 11

Wernicke’s Aphasia

Question 12

• caused by lesions in the temporo-parietal region
• fluent speech with normal phrase length, good prosody, normal articulation, and apparently appropriate grammar and syntax
• paraphasic and empty speech
• severe naming problems and pauses due to those problems
• good repetition skills but poor comprehension of repeated words
• echolalia of grammatically incorrect forms, nonsense syllables, and words from foreign languages
• impaired auditory comprehension of spoken language
• difficlty in pointing, obeying commands, or answering simple yes/no questions
• normal automatic speech
• tendency to complete poems and sentences started by the clinican
• good reading (aloud) but poor comprehension
• generally better oral reading skills
• writing problems that parallel those in expressive speech
• hemiparesis at onset, may disappear

Answer 12

Transcortical Sensory Aphasia

Question 13

What is the main difference between Wernicke’s and Transcortical Sensory Aphasia?

Answer 13

repetition is intact in patients with TSA, whereas it is impaired in patients with Wernicke’s aphaisa

Question 14

• caused by lesions in the region between Broca’s area and WErnicke’s area, especially in the supramarginal gyrus and the arcuate fasiculus
• disproportionate impairment in repetition
• variable speech fluency across patients
• paraphasic speech
• marked word-finding problems
• empty speech because of omitted content words
• good syntax, prosody, and articulation
• severe to mild naming problems
• near-normal auditory comprehension, especially for routine conversational speech
• being better at pointing to a named stimulus than at confrontation naming
• highly variable reading problems
• writing problems in most cases
• buccofacial apraxia
• some neurological symptoms
  *

Answer 14

Conduction Aphasia

Question 15

What is the main difference between Wernicke’s Aphasia and Conduction Aphasia?

Answer 15

Unlike patients with Wernicke’s Aphasia, those with conduction aphasia have good to normal auditory comprehension

Question 16

• may be caused by lesions in different regions, including angular gyrus, second temporal gyrus, and the juncture of the temporoparietal lobes
• a most debilitating and pervasive word-finding difficulty, which is the distingusihing feature; however, pointing to named objects is unimpaired
• generally fluent speech
• normal syntax except for pauses
• use of vague and nonspecific words, rsulting in empty speech
• verbal paraphasia
• circumlocution
• good auditory comprehension of spoken language
• intact repetition
• unimpaired articulation
• normal oral reading skills and good reading comprehension
• normal writing skills
• most language functions, except for naming are relatively unimpaired

Answer 16

anomic aphasia

Question 17

• typically produced by cortical damage
• fluent speech, which may include pauses and hesitations
• intact repetition skills
• normal auditory comprehension for routine conversation
• articulation problems
• prosodic problems
• word-finding problems
• semantic paraphasias
• relatively perserved writing skills
• limb apraxia if the lesions extend posteriorly to deep white matter in the parietal area
  *

Answer 17

Subcortical Aphasia

Question 18

Apraxia of Speech is often associated with…

Answer 18

lesions in Broca’s area

Question 19

Who developed Semantic Feature Analysis?

Answer 19

Boyle and Coelho, 1995

Question 20

• Developed by Byng, Nickels, & Black, 1994
• theory is that patients are unable to relate sentence form to meaning
• e.g., lexical deficit in which verb fails to provide info about its thematic structure
• or procedural deficit in which the rules assigning thematic roles to moved argument structures are lost
• affects both comprehension and production
• both treated

Answer 20

Mapping Therapy

Question 21

• treatment for agrammatism
• developed by Loverso et al., 1988
• progression through 6 hierarchically arranged steps divided into two levels
  
  • level 1: produce subject-verb sentences
  • level 2: produced subject-verb-object sentences

Answer 21

Cueing Verbs Treatment (CVT)

Question 22

• treatment for agrammatism
• developed by Edmonds et al., 2009
• train verbs along wiht the nouns that typically occur with them
• treatment involves several steps

Answer 22

Verb network strengthening treatment (VNeST)

Question 23

• Treatment for jargon
• clinician signals client to stop during a strain of jargon
• boosts communicative efficiency and helpful to caregivers

Answer 23

Stop strategy

Question 24

Treatments targeting discourse production (2)

Answer 24

• story retelling
• procedural discourse

Question 25

* treatment of verbal expression * developed by Pulvermuller et al., 2001 and Maher et al., 2006 * based on PT literature * restraining good limb results in improvement of function of paretic limb * force person with aphasia to use language * one way is with a physical barrier * initial results promising

Answer 25

Constraint induced language therapy

Question 26

Treatments for severe expressive language problems (2)

Answer 26

* Melodic Intonation Therapy (MIT) * Amer-Ind Code

Question 27

* Treatment of reading * developed by Rothi & Moss, 1992) * present word breifly * prevents letter by letter reading

Answer 27

Brief Orthographic Exposure

Question 28

* treatment for spelling * Beeson, 1999 * copy words, cover up model and try to write again

Answer 28

copy and recall (CART)

Question 29

Compensatory strategies for persons with global aphasia (4)

Answer 29

* Amer-Ind * Communication boards, devices * Drawing * Pace

Question 30

* treatment for persons with global aphasia * emphasizes communication rather than talking * teach individual with aphasia and partner to use multiple modalities of communication * train partner in use of strategies to promote both receptive and expressive language * assess interaction to develop goals

Answer 30

Supported Communication/Partner Training

Question 31

* Developed by Davis and Wilcox, 1985 1. The clinician and patient exchange new information 2. The clinician and patient participate equally as senders and receivers of messages 3. The patient has a free choice as to the communicative modes used to convey a message 4. The clinician's feedback as a receiver is based on the patient's success in conveying the message

Answer 31

Promoting Aphasic's Communicative Effectiveness (PACE)