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Name the two camps in the history of aphasia |
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Definition
localizationists, antilocalizationists |
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Pure localizatoinists believe that every type of linguistic behavior can be localized in a particular part of the brain. |
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Pure antilocalizationists view the brain as an integrated unit like a hologram and believe that damage to one area of the brain will affect the functioning of the brain as a whole. |
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Edwin Smith Surgical Papyrus |
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(Egyptian) earliest known record of loss of speech recoreded before 3500 BC |
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(400 BC) Described cases distinguishing aphasia from other speech problems |
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(1758-1828) was the firs man to relate speech to particular area of the brain, the first to clearly identify "gray" (neural functions) & white (conductive) matter. His patient was Rampan who had a posterior left frontal lobe sword wound, right hemiparesis and anomia. Gall died of a stroke in 1828. |
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one of Gall's theories that postulated 27 discrete brain centers of behavior based on the outward appearance of the skull. Only two were confirmed: language and word memory. |
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Differentiated sensory & motor nerves and specified antonomic nervous system. |
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116/850 patients with frontal lobe lesions had speech defect. Strong supporter of localization. |
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Antilocalizationist -- all brain parts had equal potential. if damaged, other areas would take over function. |
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Professor of surgery & anthropology in Paris, discovered the motor speech area in the 3rd convolution. He first called aphasia "aphemia" |
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Carl Wernicke (1848-1905) |
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Definition
German neurophsychiatrist who discovered "sensory aphasia" when he had a patient who had a stroke and was able to speak & hear, but barely understood what was said to him. |
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Controversy: Anti-localizationists |
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Definition
Late 1800's & early 1900's - linked the impariment of language to the impairment of underlying intellectual capacity by applying general psychological principles and they formed psychological-based taxonomies explaining aphasia. |
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Term
Origin of Simplistic concept: expressive vs. receptive |
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Definition
screened 234 aphasic patients and concluded 3 types of aphasia: predominantly receptive, predominantly expressive, amensic |
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discovered 2 types of aphasia: fluent and non-fluent. |
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>5 words per utterance but without semantic meaning. |
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<5 words per utterance and without syntactic features. |
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Contemporary viewpoint of aphasia |
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Definition
Aphasia is both an anatomical (localized) and cognitive neurolinguistic disorder (syntax, semantic, pragmatic) |
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Flaccid paralysis opposite side |
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Cognitive deficits, distractability, personal/intellectual deterioration |
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visual motor deficits, initiation of speech & cognition |
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Motor speech deficits,less complicated dysarthria to Broca's aphasia |
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inappropriate emotion & gestures to corresponding language. |
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Lack of spontaneity; akinetic mutism |
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unable to maintain motor act-tongue protrusion |
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faulty judgment, memory, lability, disoriented |
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indifferent; unconcerned; apathetic; unmotivated |
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Right frontal lobe pathology |
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Definition
Aprosodia or dysprosodia, abulia, motor impersistence, confusion, and emotions |
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Term
Right temporal lobe pahtology |
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Definition
Low scores on perceptual & memory tasks; facial agnosia; impaired nonverbal auditory discrimination; tonal memory deficits; anterior tip: behavioral deficits |
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Right Parietal lobe pathology |
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Definition
dressing apraxia; somatoagnosia; visual spatial deficits; facial agnosia; spatial dyslexia; spatial dysgraphia; arithmetic difficulties; writing problems; construction aphasia |
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Definition
visual association areas, unable to recognize objects on the basis of visual information although visual acuity is normal. |
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Language-based communication disorder |
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Definition
An impairment of comprehension or production of communication secondary to cognitive, linguistic, and/or pragmatic impairment. |
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Definition
processes by which sensory input is transformed, reduced, elaborated stored, recovered and used. |
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Processes of language content, form & use |
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rule-based processes for conversing with different partners & contexts & intitiating, maintaining & terminating discourse & conversation |
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generalized intellectual deficit; apraxia of speech; sensory deficit; psychiatric disorder; dysarthria |
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motor speech incoordination/weakness disorder |
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____% right handed are left hemisphere dominant for language |
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Definition
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___% of left handers are left hemi dominant, ___ % right dominant and ___% have language competence in both hemispheres. |
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Definition
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Hemisphere dominant for preferred hand is usually dominant for _____________ |
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When is brain dominance complete? |
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Definition
studies of brain damaged children suggest that dominance is not complete before adulthood. |
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Term
Anatomic model for spoken language (1) |
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Definition
Auditory patterns with meaning (phonemes) stored in Wernicke's area in the left temporal lobe. Activated when a spoken word is recognized or when an intended word is to be spoken. |
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Term
Anatomic model for spoken language (2) |
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Definition
Word to be spoken, its auditory form (phoneme) is sent from Wernicke's area through supplemental motor area, cingulate gyrus & connections via the caudate nucleus to Broca's area then to primary motor cortex (atriculem). Sent via large fiber bundle(arcuate fasciculus) |
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Anatomic Model for Written language (1) |
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Definition
Perception of written symbols (visulems) in primary visual cortex & visual association area of occipital lobe. Information sent to angular gyrus in parietal lobe. Symbols associated with acoustic image (phonemes) as meaningful word. |
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Definition
Extremely non fluent; halting & labored speech production; misarticulations (paraphasias); agrammatic to very restricted vocabulary availability; grammar structures restricted to overlearned forms; naming difficutlies; auditory comprehension relatively intact, but is affected; reading mild to moderately affected; handwriting usually poor (hemiparalysis); resembles speech output |
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Anatomical Locus for Broca's aphasia |
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Definition
3rd inferior frontal convolution; close proximity to motor area of face, hand arm, leg on motor strip. |
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Phenomenology of Broca's Aphasia |
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Definition
Linguistic difficulties arise from the inability to plan & execute coordinated sequences of movements necessary for fluent speech; not due to paralysis of speech muscles; structures cannot produce coordinated voluntary speech output without struggle; reflexive, automatic movements are normal. |
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Definition
Extremely non-fluent; severe impairment across all modalities; little to no speech production; severe auditory comprehension deficit; inability to repeat or name; inability to write (severe paralysis); better copying than matching; inability to read; significant oral & limb apraxia & construction apraxia; emotionally labile. |
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Anatomical Locus of global aphasia |
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Definition
Very large left frontal lobe lesion; may encompass entire middle cerebral artery coverage area (frontal, parietal, and temporal lobes) |
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Transcoritcal Motor Aphasia |
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Definition
Non fluent aphasia; non-fluent verbal output within the context of relatively spared comprehension (Visual & auditory); no conversational speech; spared repetition for words & sentences; Reading ability variable; writing is always impaired. |
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Transcortical Motor Aphasia Anatomical locus |
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Definition
An anterior "border zone" lesion -- vascular area where middle cerebral artery and frontal cerebral artery merge. Just anterior or superior to Broca's area and involving some subcortical areas. |
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fluent aphasia -- significant auditory comprehension deficit (common names of objects; more significant for sentences); word finding severely restricted with speech content empty & with circumlocution. Speech may be rapid & unaware of output errors. |
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Production of unintended word, syllables or phrases. |
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Literal Paraphasia (phonemic paraphasia) |
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Definition
Easily articulated individual sounds; syllables in wrong order; word distortion with unintended sounds |
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verbal paraphasia (semantic paraphasia) |
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Definition
Unintended word inavertently used in place of another. |
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Wernickes'a Aphasia anatomical locus |
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Entire posterior portion of the first temporal gyrus. Lesions spreading more posterior into angular gyrus area may produce severe reading & writing disorders. |
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Term
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Definition
AKA disconnect syndrome -- speech fluent but with significant phonemic paraphasias; tries to correct errors; may resemble stutter-like blocking; relatively preserved auditory comprehension; significant anomia; remarkably preserved auditory comprehension; significant anomia; remarkably poor repetition of words/sentences; reading comprehension relatively well-preserved; oral reading mirrors speech output; writing selectively impaired paralleling speech output. |
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Conduction aphasia anatomical locus |
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Definition
A selective white matter lesion of the arcuate fasciculus; lesions more likely in the supramarginal gyrus area. |
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Term
Transcortical sensory aphasia |
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Definition
Fluent and paraphasic; significantly impaired auditory comprehension; remarkably well-preserved repetition; aside from excellent repetition, appear very much like Wernicke's aphasics; Paraphasia: semantic word substitutions; severe anomia; reading & writing significatnly impaired. |
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Transcortical sensory anatomical locus |
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Definition
Deep lesions in the angular gyrus area and between the posterior end of the Sylvan fissure and the teporo-occipital junction |
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Term
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Definition
Notable word-finding failure affecting primarily nouns & words of high content values; may attempt vague circumlocution substitutions; speech is fluent-rate, syntactic form, articulation normal |
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Anomic Aphasia anatomical loci |
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Definition
Angular gyrus, frontal lobe, inferior temporal gyrus; characteristics my vary with each location. |
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Definition
Knowing classifications has merit; knowing if patient is Broca's or conduction is of limited value in treatment; SLPs must assess for all features of communication and make decisions for treatment based on clinical observations and not medical diagnoses or classifications. |
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