Term
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Definition
| cell bodies- cortex, parts of cerebellum, subcortical structures |
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Definition
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Term
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Definition
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Definition
| one hemisphere to the other (e.g. corpus callosum) |
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Term
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Definition
| within the hemisphere and then project out |
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Term
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Definition
| white matter pathway Wernicke’s to Broca’s |
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Term
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Definition
| e.g. corticobulbar tract; corticospinal tract |
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Term
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Definition
| e.g. cranial nerves, spinal nerves, final common pathway (no other way to get information to muscle of information to go back up) |
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Term
| connecting fiber most important for speech/expressive language |
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Definition
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Term
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Definition
tiny blood vessel for each neuron
-silk is to corn as capillary is to neuron |
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Term
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Definition
| sees what the blood looks like in your head |
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Term
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Definition
| blood flows easily through clear artery |
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Term
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Definition
| plaque fragment and/or blood clot blocks artery, reducing blood flow to the brain possibly causing a stroke |
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Term
Blood Supply
oBlockage cleared |
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Definition
| the plaque or blood clot dissolves or breaks up quickly, restoring blood flow to the brain this may occur during a TIA with brain cells recovering and no permanent brain damage occurring |
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Term
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Definition
| occurs when an embolus or thrombus lodges in an artery that supplies the brain, blocking the flow of oxygen-rich blood. If nearby blood vessels cannot deliver enough blood to that area supplied by blocked artery, brain cells begin to die and some body functions are impaired |
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Term
Hemorrhagic Stroke
Intracerebral Hemorrhage) |
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Definition
| hemorrhages that are caused by bleeding from blood vessels within the brain are called intracerebral. High blood pressure may cause small blood vessels to bulge and eventually burst spilling blood into the brain. The bleeding damages brain cells and the damaged area cannot function properly. |
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Term
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Definition
| secondary to stroke (sequelae); language impairments result of a stroke |
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Term
| After 10 seconds without oxygen |
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Definition
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Term
| After 20 seconds without oxygen |
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Definition
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Term
| After a few minutes without oxygen |
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Definition
| irreversible damage usually begins |
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Term
| Arterial supply has what two branches |
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Definition
| 1- internal carotids; 2- vertebral arteries |
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Term
| Anterior Cerebral Artery (ACA) |
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Definition
oruns….?medially then enters longitudinal fissure; arches back to supply medial aspects of frontal and parietal lobes; some branches extend into watershed surface of hemisphere
olesion=restricted contralateral motor and sensory deficits o innervated by ICA |
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Term
| Anterior Choroidal Artery |
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Definition
ooriginates from:ICA (rarely from MCA)
osupplies:optic chiasm, optic tract, lateral geniculate body, corpus striatum
olesion=contralateral hemiplegia |
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Term
| Medial cerebral artery (MCA) |
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Definition
Supplied by ICA
ogoes…? laterally into lateral sulcus
osupplies?insula, lateral surface of cerebral hemisphereolesion= major motor and sensory deficits
oif Left hemisphere? severe language deficits |
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Term
| Posterior Cerebral Artery (PCA) |
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Definition
Supplied by vertebral-basilar
oinnervates….? medial and inferior surfaces of occipital and temporal lobes, cerebellum o lesion= primarily visual deficits |
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Term
Anterior Communicating Artery (ACoA) and
Posterior Communicating Artery (PCoA) |
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Definition
typically have little pressure/flow
•When needed ACoA and PCoA can act as connectors to complete the Circle of Willis
ocan actually enlarge to accommodate extra flow |
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Term
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Definition
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Term
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Definition
| A general language deficit that crosses all language modalities and may be complicated by other sequelae of brain damage (Schuell et al., 1964, p.113) |
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Term
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Definition
-where? inferior frontal gyrus, unilateral
-generally = speech production |
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Term
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Definition
-where? posterior STG (superior temporal gyrus), posterior to PAC (primary auditory cortex)
-what does it do? storage and retrieval of mental representations of words, grammar, and linguistic rules |
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Term
| Primary Auditory Cortex PAC |
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Definition
- aka? heschl’s gyrus
- what does it do?
perception and discrimination of auditory stimuli |
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Term
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Definition
-primary visual cortex
-important to discuss with aphasia because vision is important for reading and writing |
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Term
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Definition
| -Association area of association areas; allow for associations between vision, touch, and hearing; alexia (loss of the ability to read) without agraphia (loss of the ability to write) |
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Term
| Comprehension of speech- pathway is |
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Definition
-ears to ascending fibers to primary auditory cortex (PAC; encode acoustic information) to Wernickes area
-role of corpus collosum? information from hemisphere to hemisphere
-Wernickes finds meanings and consults rules
-literal vs. figurative
-send appropriate response signal |
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Term
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Definition
| -V1 (primary visual cortex) to angular gyrus to Wernicke then same as auditory comprehension |
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Term
| Spontaneous speech- pathway is |
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Definition
-Wernicke (remember FCU- prefrontal cortex- ideation) to arcuate fasciculus to Broca to PMC (primary motor cortex)
-PMC to insular cortex (deep)
-Pyramidal tract to cranial nerves (CN)
-Wernicke’s monitors |
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Term
| watershed area-less damage because |
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Definition
| because area still getting some blood |
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Term
| pathway in brain from hearing something to answering: 5 steps |
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Definition
1. primary auditory cortex (heschl’s)
2. prefrontal cortex
3. Wernicke
4. Broca
5. Primary Motor Cortex |
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Term
| From most likely to impair to least |
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Definition
1. posterior part of left superior temporal lobe
2. primary auditory cortex in left temporal lobe
3. low on left primary motor strip
4.superior part of left primary sensory strip (post-central gyrus) |
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Term
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Definition
| monotone, nonfluent, telegraphic speech, poor writing, may have subtle impairments in comprehension |
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Term
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Definition
| paraphasias, fluent, blur word meaning (good/wonderful), impaired ST retention/recall, normal intonation, handwriting resembles speech, few are hemiplegic, may see visual deficits (optic fiber pathways) |
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Term
| paraphasisas= speech errors |
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Definition
-literal/phonemic paraphasia=phonetic errors (pattern of articulation errors though not dysarthric)
-semantic/verbal=semantically related (mix up meaning)
-Also see perseverations=unintentional substitutions; perseverate on certain words |
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Term
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Definition
| usually trunk of MCA, severely impaired, may be socially appropriate (different diagnosis between dementia and aphasia) |
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Term
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Definition
olocation? arcuate fasciculus
omain symptom? no repetition
owhat is spared? PAC and Wernicke
oincreased difficulty with?
task difficulty (bo, boom, boomer, boomerang)
oimpaired?reading aloud
oauditory comprehension?
good- the connection between Wernicke and Broca is what is affected |
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Term
Transcortical Sensory
MCA watershed area; high parietal lobe |
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Definition
orepetition? good
omuch better conversationalists (no frontal lobe involvement)
omay see echolalia
odeficits in…auditory comprehension and reading comprehension due to isolation of Wernicke’s area- limited information gets through
omost patients are unaware of errors
ono attempts to self-correct
ocan repeat of read along long sentences but cannot comprehend |
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Term
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Definition
olocation? damage that not only spares the major areas, but isolates each area- usually caused by IC artery stenosis
oisolation of the speech area?
ocan repeat but profound impairment with all else
omay see automatic speech with?
rhymes/songs |
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Term
Transcortical Motor
anterior superior frontal lobe of language dominant hemisphere |
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Definition
oreduced? speech output
ogood repetition and auditory comprehension
odifficulty with initiation (frontal lobe)
oRight hemiparesis present?
ogood comprehension, repetition, and oral reading
opoor conversationalists (short sentences, delays, once going through, may be good) |
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Term
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Definition
| impaired word retrieval in speech and writing; fluent speech but with word finding problems; see pauses, circumlocution, substitution of nonspecific words (e.g. thing, it) |
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Term
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Definition
| limb, oral, speech- could be present; voluntary/volitional motor impairment |
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Term
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Definition
| generic label group of perceptual impairments where patient fails to recognize specific stimuli: visual, auditory, tactile |
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Term
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Definition
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Term
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Definition
| cannot discriminate between colors |
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Term
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Definition
| cannot recognize a whole image although individual deficits are seen |
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Term
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Definition
| cannot perceive objects through tactile stimulation |
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Term
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Definition
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Term
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Definition
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Term
Assessment
•2 primary activities |
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Definition
1 Assimilation of information;
2 Clinical decision making |
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Term
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Definition
1. Gather information
2. Evaluate subjective reports
3. Determine if signs/symptoms represent a syndrome
4. Correlation among signs/symptoms
5. Make a prognosis
6. Use patients history to determine handicap or disability
7. Estimate effects of therapy; based on clinical expectations, patient themselves, and research |
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Term
Ax
•Where to get the information |
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Definition
o Medical chart
o Family
o Patient
o Nursing
o Other disciplines/professions |
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Term
| Does diagnosis drive therapy or does patient behavior and signs/symptoms drive therapy |
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Definition
| patient behavior and signs/symptoms |
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Term
| How important is it to label or classify the type of disorder |
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Definition
| not very important; quality of life and what most important to family and patient |
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Term
| The referral- why the MD wants the patient seen |
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Definition
-demographic information: age, vocation etc.
-services requested: what does MD want? just evaluat? do therapy? |
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Term
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Definition
-rule of thumb- know the answer to the questions
-find a quiet place (attention)
-explain what about to do and show respect and empathy |
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Term
| Behaviors seen with brain injury (not just CVA) |
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Definition
-altered responsiveness, delayed reaction time, attention, memory, perseveration, difficulty with abstract thought, personality changes
-emotional lability aka pseudobulbar effect |
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Term
| emotional lability aka pseudobulbar affect |
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Definition
secondary to bilateral damage to midbrain/above pons
loss of cortical inhibition
can manifest itself as laughter, crying, smiling
all secondary to pathological reason though
may also be related to dementia, psyche issue, ALS degeneration, MS |
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Term
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Definition
oPros:
-thorough, able to compare, label, identify, where to go from here
oCons:
-take a long time to administer, insurance company not always reimburse for all |
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Term
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Definition
oPros:
-faster, fit for patient (individually tailored), saves time
oCons:
-not standardized so cannot compare to others, no score |
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Term
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Definition
o diagnose a patient
o develop prognosis
o determine nature/severity of impairment
o apply to therapy
o establish baseline
o determine efficacy |
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Term
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Definition
failure to perceive sensory information from contralateral side of the body
typically see in patients with right hemisphere damage
diff dx with deficit specific to visual field
-failure to respond to people, sound, objects move or attend to left side of the body
-attend only to right side of self care activities
-displace writing to right side of the page |
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Term
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Definition
naming vocabulary test
Records:
-correct response
-latency in seconds
-stimulus cue (e.g. “a piece of furniture)
-phonemic cue (e.g. give part of word-sound-“h”ouse)
-error code (classify the errors)
-multiple choice ( go back through ones got wrong and give multiple choice)
-age range (5.0-79) |
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Term
MIRBI
oMini Inventory of Right Brain Injury |
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Definition
o 4 big tests: vision, language, emotion, behavior
olooking for -damage/extent of damage in right hemisphere
-identification
-severity
-strengths and weaknesses
-specific areas of dysfunction
ospecific deficits:
-visual scanning
-integrity of gnosis
-integrity of body image
-visuoverbal
-general behavior
-integrity of praxis
-higher level language skills
-affect
-psychic integrity etc. |
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Term
RIPA-G
oRoss Information Processing Assessment- Geriatric |
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Definition
oquantifies and describes: cognitive-linguistic deficits in individual over age 65 who experience confusion, disorientation, or altered level of awareness
oSome of the core subtests:
-immediate memory
-recent memory
-temporal orientation
-spatial orientation
-orientation to environment
-recall of general information
-problem solving and abstract reasoning
-organization of information
-auditory processing and comprehension
-problem solving and concrete reasoning |
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Term
WAB-R
oWestern Aphasia Battery-Revised |
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Definition
1. Spontaneous Speech-Content
2. Spontaneous Speech-Fluency
3. Auditory Verbal Comprehension- Y/N
4. Sequential Commands
5. Repetition
6. Object Naming
7. Reading
8. Writing
9. Apraxia (optional)
oafter score, gives guidelines for determining types (Global, Brocas, Isolation, Transcortical Motor, Werncke’s, Transcortical Sensory, Conduction, Anomic)
ofor adults or teenage children |
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Term
BDAE-3rd Edition
oBoston Diagnostic Aphasia Examination |
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Definition
- fluency
- conversation/expository speech
- auditory comprehension
- articulation
- recitation and music
- repetition
- naming
- paraphasia
- reading
- writing |
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Term
ABCD
oArizona Battery for Communication Disorders of Dementia |
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Definition
oage range 20-76 years old
osome subtests:
-mental status
-story retelling-immediate
-following commands
-comparative questions
-word learning-free recall, total recall, recognition
-repetition
-object description
-reading comprehension-word, sentence
-generative naming
-confrontative naming
-concept definition
-general drawing
-figure copying
-story retelling-delayed |
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Term
| Who’s part of the treatment team for Aphasia |
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Definition
| neurologist, physiatrist (rehab medicine physicians), OT, PT, ST, RT (respiratory or recreation therapist)psychiatry, dietary, social worker |
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Term
| Who to treat? Here are some guidelines to this |
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Definition
oAmount and location of brain damage- severe damage in communication area means poor prognosis
okeep in mind acute phase vs. what the brain may look like post-acute
oweak/depressed/unmotivated
owhat’s the support system like
omay decide to do trial therapy to see if appropriate |
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Term
| What 3 things go towards Cortical Reorganization? (dictate how brain organize) |
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Definition
1. Behavioral manipulation (e.g. tell kid “Don’t do that” over and over again)
2. Alterations to sensory input (e.g. artic therapy; visual input- show how to produce a sound, tactile input- feel where put tongue)
3. Cortical Injury |
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Term
| Normal Sequelae of Stroke |
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Definition
oResults of CVA due to loss of O2/glucose
-if long enough, cell death occurs
-immediate effects |
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Term
Secondary efffects of CVA
1. Transneural degeneration |
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Definition
| areas receiving input or projecting to the infracted area degenerate due to loss of connections (similar to muscle atrophy) |
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Term
Secondary efffects of CVA
2. Denervation supersensitivity |
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Definition
| neurons that lose input from affected area become increasingly sensitive to any residual input being received from that area (e.g. movie theater- eyes become overly sensitive to small amounts of light, then walk out and get overloaded) |
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Term
Secondary efffects of CVA
3. Diaschisis |
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Definition
| a sudden loss of function in a portion of the brain that is at a distance from the site of injury, but is connected to it by neurons |
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Term
Secondary efffects of CVA
4. Collateral sprouting |
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Definition
| axons from nearby neurons establish new axonal contacts on the neurons that have lost their connections |
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Term
| Secondary efffects of CVA |
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Definition
Transneural degeneration
Denervation supersensitivity
Diaschisis
Collateral sprouting |
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Term
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Definition
oregeneration of lost neurons and their efferent and afferent connections does not occur
oRehab goal: focus on effects of behavioral and environmental influences on brain post-injury; we can’t do anything about how much damage there is or the secondary neuronal changes that occur |
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Term
| Neural Substrates and Neural Plasticity |
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Definition
Yes you can teach an old dog new tricks but the old dog has to want to learn voluntarily
-example with the mice: let a mouse run caused increased space on motor cortex; make a mouse run caused no increase |
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Term
| Changes in the nervous system |
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Definition
o An enriched visual environment means more dendrite branching in visual cortex
o highly associated with task-specific demands; not going to see broad cortical increases with one activity
o see increases in dendritic branching in same area on cortex opposite injury; helping out the other side |
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Term
| Aphasia treatment is efficacious if conditions are met |
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Definition
treatment delivered by qualified professionals
patients with irreversible aphasia are excluded
content, intensity, duration and timing of treatment are appropriate for those receiving therapy
sensitive and reliable measures are used to track changes in performance
**emphasis should shift from efficacy (treatment yields change in test) to effectiveness (treatment yields change in meaningful changes in real life) |
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Term
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Definition
o shorter amount of weeks, intense, early
8.8 hours/week for ~11 weeks recommended vs. 2 hours/week for 22 weeks |
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Term
The Localizationists
believed in localization of function |
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Definition
-Franz Gail early 1800s proposed Phrenology Faculties- bravery, love etc.
-Localizationists led to Broca and Wernicke (late 1800s)
Broca: ‘loss of articulate speech’
Wernicke: sensory aphasia caused by lesion in posterior temporal lobe |
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Term
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Definition
| e.g. Hughlings Jackson – said brain worked together |
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Term
| How many homunculi do you have in your head |
|
Definition
| 4; your left and right motor and sensory |
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Term
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Definition
| lesion in optic nerve, optic tract, or visual cortex |
|
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Term
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Definition
| partial blindness in the same visual field resulting from a lesion on optic tract or pathway to occipital lobe (including visual cortex) |
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Term
| Right retina picks up the ____ visual field |
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Definition
Left
•Left field- right of each retina- right hemisphere |
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Term
| Left retina picks up the ____ visual field |
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Definition
Right
•Right field- left of each retina- left hemisphere |
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