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Praxis (Treatment - Cognitive aspects of communication)

Terms in this set (33)

Types of nonfluent aphasia
1. Broca's
2. Transcortical Motor
3. Global
4. Mixed transcortical
Broca's aphasia
-Damage to Broca's area in posterior inferior frontal gyrus, supplied by the middle cerebral artery
Transcortical Motor aphasia
-Damage to anterior superior frontal lobe (below or above Broca's), supplied by anterior cerebral artery and anterior branch of middle cerebral artery
-Laborious, halting, telegraphic, akinesia, bradykinesia, apraxia, good repetition
Global apraxia
-Most severe form
-Extensive damage to all language areas (perisylvian region)
-Supplied by middle cerebral artery
-Verbal and nonverbal apraxia
-Strong neurological symptoms
Mixed Transcortical aphasia
-Damage to watershed areas/arterial border zone
-Severe echolalia & reading and writing difficulty
-Unimpaired automatics
-Associated with bilateral UMN and visual field deficits
Types of fluent aphasia
1. Wernicke's
2. Transcortical sensory
3. Conduction
4. Anomic
Wernicke's aphasia
-Damage to Wernicke's area in the posterior portion of the superior temporal gyrus
-Supplied by the posterior branch of the middle cerebral artery
-Paralysis is uncommon
Transcortical Sensory aphasia
Damage to the temporoparietal region (posterior portion of the middle temporal gyrus)
-Supplied by the posterior branch of the middle cerebral artery
-Good repetition
Conduction aphasia
Damage to supramarginal gyrus and arcuate fasciculus (between Broca's & Wernicke's)
-Good to normal auditory comprehension
Anomic aphasia
-Damage to different regions including angular gyrus & temporal gyrus
-Language functions other than naming are generally normal
Subcortical
-Damage to areas surrounding basal ganglia and thalamus
-Fluent speech
-Word-finding problems
Assessment
-Repetition
-Naming
-Auditory Comprehension
-Comprehension of single words
-Comprehension of sentence/paragraphs
-Reading
-Writing
-Gestures/pantomine
-Automated speech and singing
Alexia
Loss of previously squired reading skills due to recent brain damage
Agraphia
Loss of normally acquired writing skills due to lesions in the foot of the second frontal gyrus
Agnosia
Impaired understanding of the meaning of certain stimuli even though there is no peripheral sensory imapirment
Dementia of the Alzheimer Type (DAT)
-Cortical dementia
-Neuropathology: neurofibrillary tangles, neuitic plaques, neuronal loss, neurochemical changes
Alzheimers early-stage symptoms
Subtle memory problems, pronounced difficulty learning, poor reasoning and judgment, behavior changes
Alzheimers later-stage symptoms
Sever problems recalling remote and recent events, widespread intellectual deterioration, hyperactivity, restlessness, agitation, seizures
Alzheimers language problems
Verbal and literal paraphasias, problems comprehending abstract meaning, impaired picture description, echolalia, palilalia, logoclonia (repeating last syllable of words), empty jargon
Frontotemporal dementia (including Pick's disease)
-Presence of Pick bodies and cells (dense intracellular neurons)
-Symptoms: behavior changes initially, emotional disturbances, impaired judgement
Associated with Parkinson's
Brainstem degeneration, presence of Lewy bodies, frontal lobe atrophy, bradykinesia, rigidity, reduced volume, dysarthric speech
Associated with Huntington's
Subcortical, huntingtin (malformed protein), kills brain cells that control movement, chorea, deterioration of intellectual functions, dysarthria
Infections dementia
HIV, Creutzfeldt-Jacob
Dementia - Cognitive problems
Attention, executive functioning, memory, awareness, processing speed, agitation
Dementia - Lang problems
Word finding, social pragmatics, reading, writing, verbal expression
Dementia - Speech problmes
Motor speech, voice
Dementia - Jill's list of what to assess
Medical comorbidities, Glasgow scale, multiple trauma, diffuse TBI implications, trach tube status, minimally responsive, g-tube feeding status, means of communication, levels of agitation, cognitive functioning, environmental concerns, premorbid skills/lifestyle/education, multidisciplinary team member roles
TBI - accident info to gather
Location of infarct, neuroimaging, time since accident, type of injury
TBI - recovery info to gather
Infections, where they recovered, amnesia, coma
Non-traumatic TBI - etiology
Time since diagnosis, toxicity (overdose?), anoxic (no oxygen), or hypoxic (oxygen)
Non-traumatic TBI - Recovery
Reparative surgery, time since event, metastatic tumor to the brain, pump-head (poor cognition and recovery after bypass surgery), chemo-brain (diffuse cognitive damage after chemo)
Glascow Coma Scale
Scores range between 3-15
-Eye opening
-Verbal response
-Best motor response

The scale is more objective and can be used to tell a good rehab candidate
Ranchos Los Amigos Scale of Cognitive Function
I = no response, can't do anything for themselves
II = generalized response, can't do much, looking for evidence of moving to III
III = localized response, beginning to do something purposefully
IV = confused and agitated, SLP: look at attention, capacity, awareness, orientation
V = confused and inappropriate, family will think it's okay to go home, but it's not yet safe
VI = confused and appropriate, family beginning to understand more
VII = automatic and appropriate, more safe to be home
VIII = purposeful and appropriate
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