Chapter 8

Improved blood circulation

spontaneous recovery can be due to improved blood circulation and because other areas of the brain take over functions of the damaged ones.

Ribot's rule

states that the first learned language will be less impaired, recovered first, and relearned most completely

Expressive Language Disorders

Broca's aphasia (includes apraxia of speech), anterior aphasia, motor aphasia, confluent aphasia, predominantly expressive aphasia, telegraphic speech

Expressive and Receptive Language Disorders

Complete aphasia, global aphasia, irreversible aphasia syndrome, severe aphasia, profound aphasia

Major Psychological Concomitants of Aphasia

Emotional liability: exaggerated emotions Catastrophic reactions: panic attacks and the need to flee or flight Perseveration: tendency for a thought or motor act to persist Organic depression: chronic severe negative emotions as a results of a chemical imbalance Greif response: moving through predictable stages of adjustment to unwanted changes

Word Retrieval Behaviors

1st behavior: try to retrieve the acquaintance's name by searching your memory for words that rhyme with it. (phonemic paraphasia, literal paraphasia, and approximation errors) 2nd behavior: search your memory for the context or situation in which you known him or her. (semantic paraphasia, verbal paraphasias, and association errors) 3rd behavior: you seen the person in your mind, but cannot remember his or her name. you might engage in description of their face, hair, etc. (description)

Loss of self

First dimension in which loss can occur in aphasia; aspects of self can be lost in aphasia, including understanding speech of others, speaking, reading, writing, and the ability to do simple arithmetic

Motor speech programming (apraxia of speech)

Person has trouble planning, sequencing, and executing the actions necessary to make speech sounds

Graphic modalities

Reading and writing. when they are disturbed in aphasia, it is not because of vision acuity deficits or hand paralysis

Language recovery in multilingual aphasic patients

Ribot, Pitres, and Minkowski

Loss is person

Second dimension in which loss can occur in aphasia; because communication with friends and loved ones can be devoted by aphasia, there can be a sense of separation

Loss of object

Third area that can cause the grief response in aphasic patients; because of communication disorders, paralysis and other infirmities, aphasic patients often lose the ability to use valued objects. they cannot use or enjoy a motor home, sewing machine, the ability to use valued objects

Receptive Language Disorders

Wernicke's aphasia, fluent aphasia, jargon aphasia, predominantly receptive aphasia, posterior aphasia, sensory aphasia

Temporal urgency

a catastrophic reaction occurs when a patient is given too many demands that have a temporal urgency to them; several tasks that are to be completed in a short period of time.

Flight or fight response

a catastrophic reaction prompts the flight to fight response. this is a primal response to threatening situations. the human brain has retained the ability to mobilize the body's physiological abilities to run from or fight a potential dangerous threat.

Auditory agnosia

a deficit where the patient has problems with the perception of all auditory input. it includes language and non language signals. with regard to non language signals, the patient may not appreciate the significance of common environmental sounds such as the ringing or pulsing of a telephone , knock on a door..etc

Fantasy escape

a patient may also be engaging in a psychological defense called fantasy escape where he or she fantasizes about something pleasurable rather than confront the disability

Agnosia

a perceptual disorder where the patient has trouble attaching meaning to sensory information

Clinical depression

a prolonged, sever bouts of negative emotions; often caused by no apparent reason

Acoustic agnosia

a specific type of auditory agnosia where the patient has trouble distinguishing speech sounds, specially similar ones. to the patient, the individual sounds in your request to pass the salt, pepper, and sugar may seem foreign and unrecognizable to them

Diffuse axonal injury

damage to nerve cells in the connecting fibers on the brain. (cont)

Melodic Intonation Therapy (MIT)

an aphasia therapy. some patients can sing simple songs much better they can talk. by using the medley and rhythm of songs, patients can be taught to have better verbal expressions.

Global aphasia

aphasia completely eliminates the ability to speak, understand, read, write, and use sophisticated gestures for communication

Modalities

aphasia is a language disorder that disrupts all modalities, or avenues, of communication. the expressive modalities of communication are verbal expression, writing, and expressive gestures. The receptive avenues are auditory comprehension, reading and receptive gestures

Syndrome

aphasia is a syndrome, a combination or cluster of symptoms that usually occur together

Word blindness

aphasic alexia is sometimes called word blindness. word blinds is an inaccurate way of describing reading disturbances because it suggests that the problem is with the patient's eyes.

Random error

aphasiologists called a n among error which is neither an association, description or an approximation of the desired word a random error.

Quality of life

as more patients survive a stroke, head trauma, or brain disease, and live longer lives, their quality of life has become a concern. clinicians are concerned about the patient's happiness and satisfcation with life.

Contusions

automobile accidents, gunshot wounds, falls, shrapnel, and blows to the head, can cause head trauma. damage may included bruises on the surface of the cortex, (cont)

Neologism

aware that neurogenic communication disorders can evolve into different types, at first you suspects she uttered a made-up word, a neologism.

Behaviors of tip-of-the-tongue phenomenon

awareness of errors: patient known when he or she makes a naming mistake. there is an awareness that the wrong words have been spoken ability to self-correct: patient corrects mistake

Posterior and inferior

behind and below the central sulcus

Aphasia rehabilitation

can create new ways of communicating and strengthen existing ones. It can also help the patient, and his or her family cope and adjust to major life-challenges during this difficult time.

Intracerebral

coupled with this damage may be hemorrhages within the brain or

Overcoming loss

denial, anger, and bargaining

Abstract-concrete imbalance

early in the study of aphasia, it was found that language disorder causes an abstract-concrete imbalance in many patients. people with aphasia do not do as well as non-aphasic people with solving higher level abstract problems, putting things into categories, interpreting proverbs, and the like. this loss of an abstract attitude is thought to be a results of impaired language and the resulting inability to bring order to the world

Classifying aphasia

expressive or receptive language disorders

Corpus collosum

extremely rate is agraphia of a specific hand which is seen in lesions in the corpus callosum (neural fibers connecting the two brain hemispheres)

acceptance

final stage; resolution of the losses. patient is no longer trying to overcome the losses or is no longer depressed by them. he or she accepts what happened and feel neither good nor bad about it.

Psychological integrity

flight or fight (natural defense) is activated in some aphasic persons when confronted with threats to their psychological integrity. they feel threatened and biological reactions to flee or fight arise. but there is no where to run, no one to fight and no place to hide

Jargon

fluent speech that is empty of meaning

Transivity and complexity

gestures can be evaluated with regard to these body movements. a transitive action on an object is dialing the telephone. a transitive action without an object is displaying the thumbs up sign. the complexity of gestural expression ranges from single movements such as pantomiming the drinking of code from a cup to sequenced gestures such as showing the steps necessary to get out of bed and go to the bathroom.

Hemorrhagic stroke

happens when there is a "blowout" of a blood vessel. usually because of high blood pressure, an area in the vascular system bursts. when the burst is in the brain, a stroke occurs. blood cannot flow to areas that need it. in addition, blood spills into other areas of the brain, increasing the pressure inside the skull

Partial aphasia

impaires and interrupts the ability to communicate normally and naturally.

Self-esteem

in aware patients the knowledge they have suffered a brain injury results in reduced self-esteem. there is an altered self-concept

Clinical syllogisms

logical alternative therapy for aphasia therapy; clinical syllogisms related to intuition, authority, and relative application are methods for evaluating nonscientifically based therapeutics in aphasia. they should only be used when there is no appropriate evidence-based therapeutic research for a particular type of aphasia

Tip-of-the-tongue phenomenon

most people have experienced a situation where they jbiwb the name of something but they cannot retrieve is. they are close to saying it, the word seems on the surface of their memory but it lacks a trigger to be able to recall it. it is one of the most frustrating aspects of aphasia

Obsessive-compulsive disorder (OCD)

obsession is the inability to stop thinking about something. a thought continues in a person's mind and not be stopped. when a person does an activity repeatedly and cannot stop, she is engaged in a compulsive behavior

Organic depression

occurs because of brain injury and the disruption of chemicals that control and regulate moods. it is, at least in part, a result of brain chemicals gone awry

Grieving depression

occurs when the patient finally becomes aware that he or she is permanently separated from abilities, people, and things he or she once values

Occlusive stroke

occurs when there is a blockage or "plug" in an artery. the blockage can be a blood clot or other type of obstruction.

Spontaneous recovery

of speech and language abilities occurs in the majority of patients with aphasia, it is the period of time post-onset where the brain naturally resolves part, or in rare cases, all of the language disturbance

Stroke

one of the leading causes of aphasia and other neuropathology's of speech and language. a stroke occurs when the blood supply to the brain is interrupted. two categories of strokes: hemorrhagic and occlusive; third leading cause of death in persons older than 55, and approx. 700,000 strokes occur per year

auditory fade

opposite of slow rise time. in auditory fade, the patient attends to and comprehends the initial aspects of the input, but the final parts are ignored

Dyscalculia

partial deficits doing simple math problems, a less severe form of acalculia

dyslexia

partial reading deficits, a less severe form of alexia.

Alexia without agraphia

patients cannot read what they have just writing

Perseverate

patients may perseverate on the answer and utter the same word repeatedly

Automatic speech (subcortical speech)

person has difficulty with purposeful speech but has little problem fluently and clearly saying some words with little forethought. sometimes call subcortical speech because it is non purposeful and convolitional

Wordfinding problem (anomia)

person has trouble recalling and retrieving the correct words for expression

Functional communication

practical gestures, such as pointing to picture and being able to accurately to nod yes/no can be taught to many aphasic patients to help them learn functional communication.

Wernicke's area

primarily in the temporal love. it is named after the nineteenth century neurologist Karl Wernicke who discovered the area of the brain where reception and understanding of speech occur.

Minkowski's rule

proposes that the language with the strongest affective ties will be least impaired in aphasia. in addition, the strong affect the patient has for the language may result in him or her having preferential recovery of that language

two types of attention deficits:

slow rise time and auditory fade

Pseudobulbar emotional liability

some patients have exaggerated emotional reactions following brain injury. it is associated with damage to the upper motor neurons in the brain. it is more common in patients who have spastic dysarthria, a common motor speech disorder

Aneurysm

sometimes a stroke is preceded by this, a swollen part of an artery.

Pitre's rule

states that the language most used before the brain damage will be recovered first and most completely. the uneven recovering will favor the one being used at the time of the brain injury

Lacerations

tearing of structures and blood vessels, (cont)

Agraphia

the agraphia seen in aphasia is the inability to express oneself in writing not due to paralysis

Broca's area

the anterior of fissure of Rolando also contains this area, named after Pierre Paul Broca, who identified the area of the brain in the frontal love which is responsible for combining the movements of the articulatory structures into words

Anterior

the area in the front of the fissure of Rolando, is important in motor movements

Hemispheres

the brain is divided into two halves. these two sides are almost identical in appearance but they are not in function. the right side of brain controls the left side of the body and vise versa

Alexia

the complete inability to read

Central sulcus

the dividing line, a fissure which separates the frontal lobe from the parietal lobe, also known as "fissure of Rolando"

Grief

the human response to loss. grieving involved several stages that people go through when learning to accept unwanted changes associated with loss

Acalculia

the inability to do and understand simple mathematics due to brain damage

Apraxia of speech

the motor programming disorder where the person has trouble planning, sequencing, and executing the actions necessary to make speech sounds

Pure dysgraphia / Agraphia without alexia

the patient's writing and spelling are impaired, but reading is only slightly affected if at all.

Spatial-temporal

the right hemisphere is involved in spatial-temporal planning and execution. spatial-temporal functions corner planning and executing movements over space and time. the right hemisphere is also more intuitive, artistic, and creative

Anomia

the second aspect to expressive aphasia is a word finding problem. the patient has trouble recalling and saying the correct words for expression

Echolalia

the tendency to to repeat words or phrases which are spoken. sensory preservation

Telegraphic speech (agrammatism)

third aspect of to expressive aphasia, where function words (articles and conjunction) are omitted and the patients uses only content words (nouns and verbs). sometimes called agrammatism, an impairment in the ability to use words in their proper sequence.

Motor strip

this area in the anterior of fissure of Rolando, is involved in causing movements

Broca's aphasia

when a person has damage to the Broca's area of the brain, a person with this has choppy and confluent speech with pauses, fillers, and struggled attempts to speak

Wernicke's aphasia

when a person has damage to the Wernicke's area. it causes difficulty comprehending the language of others. most of the time, damage to this area does not result in the patient having problems initiating and planning speech whereas patients with Broca's have trouble with the expressive aspects of communication and are confluent, patients with Wenicke's aphasia have problems comprehending language and their speech tends to be fluent

slow rise time

when patient has trouble attending to and comprehending the initial part of the request

Cerebral thrombosis

when the blockage originates in the brain

Tranisent ischemic attack

when the blood flow to the brain is interrupted for less than 24 hours, and the person's symptoms are temporary. when these events result in communication disorders, they are only temporary. TIAS are sometimes called "mini strokes"

Cerebral embolism

when the plus originates else where in the body, and finally lodges in the brain,

Meninges

within tissue coverings of the brain that form hematoma (areas of encapsulated blood)

factors that can trigger a bout of emotional liability

words and thoughts, people, and situations