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What is Aphasia?
an acquired language disorder in which there is an impairment of any language modality (speaking, listening, reading, and writing)
What are the characteristics of fluent aphasia?
speech output refers to extended length of utterances that are interrupted - includes paraphasias, word finding difficulties, impaired repetition
List 4 types of fluent aphasia
- Transcortical sensory
Describe Wernicke's aphasia
- Receptive, sensory, posterior
- posterior temporal gyrus in left hemisphere
- impaired auditory comprehension
Describe Anomic aphasia
- posterior temporal gyrus in left hemi (same as Wernicke's)
- word finding difficulty during fluent speech
Describe Conduction aphasia
- Arculate fasciculus - which carries info from wernicke's to broca's
- impaired repetition
- lateral paraphasias
- neurogenic stuttering
Describe Transcortical sensory aphasia
- Auditory vocal mechanism okay
- good comprehension
- perseverative repetition (ecolalia) in the context of severe wernicke's
What are the characteristics of non fluent aphasia?
speech output refers to impaired flow of speech at levels of initiation, finding and sequencing articulation movement, production of grammatical sequences
List 4 types of non fluent aphasia
- Transcortical motor
Describe Broca's aphasia
- Expressive, motor, anterior
- lesion frontal lobe left hemi towards motor strip
- awkward articulation
- restricted vocab/grammar
- perseveration of auditory comprehension
Describe transcortial motor aphasia
- anterior or posterior to frontal lobe left hemi towards motor strip (broca's)
- perseveration of repetition
- poor comprehension
Describe Mixed aphasia
- middle cerebral artery
- output like Broca's (awkward articulation, restricted grammar/vocab, perserveration of auditory comprehension) but with worse auditory comprehension
Describe Global aphasia
- Massive damage in middle cerebral artery
- severe deficits in all areas
What are Literal paraphasia?
(Phonemic) - transposing sounds in a word such as tevelision for television
What are verbal paraphasias?
(Semantic) - incorrect word such as saying knife for fork
What is an Embolism?
artery abruptly occluded by material (more frequent)
What is a thrombosis?
artery slowly occluded by material
What is an aneurysm?
pouch formed by a weakened artery wall - leaking can be easier to repair, but ruptured is not
What is an infarct?
a loss of blood supply
What is a TIA?
a transient ischemic attack - mini stroke, change in blood supply to a particular area of the brain resulting in brief neurological dysfunction
What is the function of CN I?
What is the function of CN II?
What is the function of CN III?
What is the function of CN IV?
What is the function of CN V?
- mastication, facial sensation
What is the function of CN VI?
What is the function of CN VII?
- facial movement and sensation
What is the function of CN VIII?
- hearing and balance
What is the function of CN IX?
- tongue/pharynx movement and sensation
What is the function of CN X?
- heart, blood vessels, movement larynx/pharynx
What is the function of CN XI?
- Spinal accessory
- neck muscles
What is the function of CN XII?
- tongue muscles
What are the different types of acquired communication disorders?
- Motor speech - 41%
- Aphasia - 19%
- Other Cognitive - 11%
- Anatomic deficiency - 8%
- Voice - 8%
- Idiopathic - 8%
- Psychogenic - 4%
- Other - 1%
Describe flaccid dysarthria
- Lower motor neurons
Describe spastic dysarthria
- Bilateral upper motor neurons
Describe ataxic dysarthria
Describe hypokinetic dysarthria
- Basal ganglia
- rigidity or reduced range of movement
Describe hyperkinetic dysarthria
- Basal ganglia
- abnormal movements
Describe unilateral upper motor neuron dysarthria
- Unilateral upper motor neurons
- weakness, incoordination, spasticity
Describe apraxia of speech
- Left hemisphere dominant
- motor planning or programming difficulty
What is a motor speech disorder?
A speech disorder resulting from neurological impairment affecting the motor planning, programming, neuromuscular control, or execution of speech - they include the dysarthrias and apraxia of speech
What is dysarthria?
A disturbance in muscle control over the speech mechanism due to damage of the central/peripheral nervous system
What is apraxia of speech?
Impaired capacity to plan or program speech - NOT muscle weakness
What are the subsystems assessed with motor speech disorders?
What is right hemisphere dysfunction as it related to the manifestation of speech and language?
For most people the right hemi is the non dominant hemi for speech and language. They typically have both communication and cognitive deficits which can be addressed in S/L therapy.
What are some deficits that can be seen in right hemi dysfunction?
- Left neglect
- executive function difficulty
- inability to integrate information
- literal/figurative meanings
- flat affect
- disorientation to time and direction
What is dysphagia?
The interruption in eating pleasure or in the maintenance of nutrition and/or hydration - the inability to transfer the bolus from the mouth to the stomach
What are some common etiologies of dysphagia?
- head injury
- cervical spinal cord injury
- progressive neurological disease
- head/neck cancer and/or radiation
What are the primary concerns of dysphagia?
- quality of life
What is aspiration?
the entry of food/liquid into the airway below the vocal folds
What is penetration?
food/liquid enters the laryngeal vestibule at the level of the true vocal cords
What are the 4 stages of swallowing?
- oral preparatory stage
- oral transit stage
- pharyngeal stage
- esophageal stage
What are the 6 stages of the pharyngeal swallow?
- prompt trigger of the pharyngeal swallow
- velar elevation/velopharyngeal closure
- base of tongue retraction
- epiglottic retroflection
- laryngeal elevation
- cricopharyngeal opening
What are some compensatory strategies for dysphagia?
- chin tuck
- head rotation
- head tilt
- multiple swallows
- alternate solids and liquids
- effortful swallow
- cough/clear throat
- modify bolus size
- modify food consistency (last option)
What are the 2 components of the respiratory system?
- UPPER nose
- Nasal cavity
- LOWER larynx
What the components of the Gastro-intestinal tract?
- small intestine
- large intestine