Term
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Definition
| Physician who specializes in rehab medicine |
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Term
Treatment - Chronic
When does therapy begin?
What is the nature of the treatment? |
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Definition
1. As soon as the patient is medically stable
2. Multidisciplinary in nature |
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Term
Diagnostic Studies:
What is included in a laboratory evaluation (7)? |
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Definition
1. Blood counts
2. Screen Panel - blood electrolytes, glucose level, liver and kidney function
3. Syphilis serology
4. Connective Tissue Disease
5. Electrocardiogram & monitoring
6. Noninvasive carotid - ultrasound
7. Cerebral angiography |
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Term
Brain Imaging:
What are the static techniques (2)? |
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Definition
1. Computer Tomography (CT) - creates a 3D image of the brain with multiple 2D x-ray images
2. Magnetic Resonance Imaging (MRI) |
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Term
Brain Imaging:
What are the dynamic techniques (4)? |
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Definition
1. fMRI
2. Regional Cerebral Blood Flow (rCBF)
3. Positron Emission Tomography (PET)
4. Single Photon Emission Computed Tomography |
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Term
| Other Brain Diagnostic Techniques (4) |
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Definition
Sodium Amytal Infusion
Electroencephalography
Electromyography
Evoked Potentials |
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Term
Neurosurgical Procedures
Name all (5) and be able to explain each |
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Definition
1. Craniotomy - Neurosurgical procedure to remove pathological brain tissue
2. Stereotactic Surgery - Placing a lesion or an electrode at a precise location for management of involuntary movement or intractable pain
3. Endarterectomy - Surgical technique to open an artery that becomes obstructed by plaque & typically involves carotid artery
4. Aneurysm Clipping - Clip used at the neck of an aneurysm & remove the bulge
5. Aneurysm Coiling - Coils placed via catheter through femoral artery |
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Term
Classification Systems of Aphasia:
Name all (4) systems
What is the model that we use now? |
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Definition
1. Localizationist
2. Receptive vs. Expressive
3. Anterior vs. Posterior
4. Broca's vs. Wernicke's
Localizationist-connectionist model is the one used |
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Term
| List the (7) Cortical Aphasia's |
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Definition
1.Broca's
2.Wernicke's
3.Conduction
4.Anomic
5.Transcortical Motor
6.Transcortical Sensory
7.Global |
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Term
| List the (4) Sub-Cortical Aphasia's |
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Definition
1.Anterior Capsular/Putaminal
2.Posterior Capsular
3.Global Capsular
4.Thalamic |
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Term
| List the (1) additional type of Aphasia that is not cortical or sub-cortical |
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Definition
| Primary Progressive Aphasia |
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Term
Hierarchy of Differential Diagnosis:
List the (4) levels in descending order |
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Definition
1.Naming Problems
2.Speech Fluency
3.Auditory Comprehension
4.Repetition Skills |
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Term
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Definition
| Explain the Differential Diagnostic Model and how it classifies the (8) the Types of Aphasia |
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Term
| Broca's Aphasia Descriptors (13) |
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Definition
Non-fluent
effortful
slow
halting verbal output
incomplete
syntactically simplified
Telegraphic
Reduced Phrase Length
Prosodic Disruption
Awkward Articulation
Auditory Comprehension
Repetition, Reading & writing often parallel input/output |
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Term
| Broca's Aphasia: What are the Specific Findings (2)? |
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Definition
Grammatical morphemes frequently omitted = agrammatic
Specifically function and inflectional endings
Stress & position in sentence may contribute to likelikhood of omission |
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Term
Broca's Aphasia:
Expressive Language, Bound Morphemes
What is easier (2)?
What is more difficult (2)? |
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Definition
plurals and progressive verbs easier
"ed" past tense and "s" for subject-verb agreement is more difficult |
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Term
Broca's Aphasia:
Do nouns tend to be retained at a higher rate than verbs?
Are verbs ever nominalized or omitted? |
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Definition
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Term
Broca's Aphasia:
Does canonical order tend to be preserved?
Is word order reversed? |
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Definition
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Term
Broca's Aphasia:
Is auditory comprehension preserved and does it allow functioning in daily contexts? |
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Definition
| Yes it is relatively preserved and allows functioning |
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Term
Broca's Aphasia:
Give 4 examples of comprehension problems |
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Definition
1. Complex syntactic construction
2. Reversibles more difficult
3. Tend to rely on semantic content
4. Increasing length is problematic |
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Term
Severity of Broca's Aphasia:
What is the range of verbal abilities?
What is the range of comprehension
To what degree is repetition impaired? |
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Definition
1-2 word utterances to a mild disruption of speech fluency
difficulty w/commands (3+) and/or L-R confusion as well as Complex Y/N Questions to Minimal problems
Repetition tends to be moderate to severely impaired |
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Term
What are the Associated Signs and Symptoms of Broca's Aphasia?
There are (6) |
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Definition
Mild dysarthria
AOS
Contralateral hemiparesis
Orofacial-rightt sided facial weakness
Swallowing problems
Possible somatosensory problems |
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Term
| Features to examine during differential diagnosis (6) |
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Definition
Rate
Prosody
Content
Syntax
Word Finding
Comprehension |
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Term
Broca's APhasia: Pathophysiology
Are lesions always present?
Does a lesion guarantee Broca's Aphasia? |
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Definition
Usually associated with a large lesion in Broca's area extending to the deep subcortical tissue
Usually included premotor and motor regions immediately above and behind
Metabolism decreased throughout left hemisphere
NO
NO |
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Term
Transcortical Motor Aphasia
Location?
What do people typically maintain good command over (2)? |
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Definition
Anterior and Superior to Broca's area; anterior frontal paramedian
Good auditory comprehension
Good repetition |
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Term
Wernicke's Aphasia:
Other names for this Aphasia (4)? |
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Definition
Sensory Aphasia
Receptive Aphasia
Central Aphasia
Jargon Aphasia |
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Term
| Wernicke's Aphasia General Descriptors (4) |
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Definition
Fluent
Auditory comprehension - impaired
Repetition of words/sentences - impaired
Reading/writing - impaired |
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Term
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Definition
| Grammatical structure appears to be normal but content words are missing or replaced |
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Term
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Definition
Press for speech
Continual talking beyond the point requiring interruption
Possibly related to lack of correction exercised by sensory over motor areas |
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Term
Wernicke's Aphasia:
Receptive language |
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Definition
Most severely impaired (except for Global)
Problems w/semantic & syntactic processing
Difficulty making use of subject - verb agreement
Problems w/reversible sentences
Problems w/passive sentences
Mixed findings related to plausibility
Reading comprehension impaired |
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Term
Wernicke's Aphasia:
Associated signs and symptoms (5) |
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Definition
Hemiparesis - not common
Somatosensory deficits - if parietal lobe involved
Swallowing problems are possible
Auditory processing problems - possible
Dysarthria - not common |
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Term
Pathophysiology
core location? |
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Definition
Lesion in Wernicke's area - 1st temporal gyrus (auditory association area)
Core location = posterior portion of superior temporal gyrus
Supramarginal gyrus & angular gyrus were usually involved |
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Term
Transcortical Sensory Aphasia:
General Descriptors (4) |
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Definition
Similar to Wernicke's aphasia
Posterior parieto temporal, sparing Wernicke's area
Poor auditory comprehension
Good repetition |
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Term
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Definition
Hypothetical disconnection of auditory association & speech production areas
Relatively rare 5-10% of all cases |
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Term
Two types of conduction Aphasia
which one is true conduction aphasia? |
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Definition
Repetition
Reproduction = true conduction aphasia |
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Term
| General descriptors of Conductive Aphasia |
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Definition
1.Fluent, paraphasic SPONTANEOUS speech
2.Verbal Repetition is disproportionately impaired
3.Auditory comprehension is relatively spared
4.Predominance of phonemic paraphasias |
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Term
Conductive Aphasia:
Expressive Speech and Language |
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Definition
Fluent
-easy production
-normal phrase length
-normal prosody
-good articulation
-hesitations & self corrections can interrupt
WORD RETRIEVAL PROBLEMS
-increased latency
-circumlocation
-empty speech
-paraphasias
Impaired Repetition
-word level
-longer utterances
-phonemic paraphasia/rewording
-repetition of numbers may be intact |
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Term
Conductive Aphasia:
Receptive Language |
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Definition
May range from near normal to moderate deficits
Sufficient for everyday functioning
Problems
-complex commands
-paragraph level |
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Term
Conductive Aphasia:
Signs/Symptoms |
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Definition
Oral & limb apraxia - possible
Parietal lobe signs - possible |
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Term
Conductive Aphasia:
Pathophysiology |
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Definition
Frequent associated sites
-supramarginal gyrus
-arculate fasciculus
-Insula & contiguous auditory cortex & underlying white matter
Possible similar & smaller than Wernicke's
Left Hemisphere metabolic abnormalities |
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