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Left hemisphereControls LanguageSpecialization within hemisphereBrain damage occurs fromBlood flow problemsPressure against brain cells from injurySwelling all lead to death of brain cellsTwo centers for language in the brain both on the left sideBroca’s AreaIn the frontal lobe/anteriorWernicke’s AreaIn the temporal & parietal lobe/posteriorWernicke’s AreaInformation from the outside (what you hear/see) allows us to understand what we read or hearArea for language comprehensionBroca’s AreaImportant for expressive language and production of speechAbility to put words into sentences (morphemes)AphasiaA language disorder that results from damage to the left hemisphereCan affectExpressive languageSpoken languageReceptive languageAbility to understand spoken languageReadingUnderstanding written informationWritingProviding written informationEx- A person with aphasia may not be able to write words, but could spell them out loud.Damage affected patients writing modality, but not the ability to spell out loudCaused byStrokeHemorrhagic strokeBleeding in brainIschemic strokeBlockage of arteries in brainBrain tumors, loss of oxygen, and diseaseWernicke’s AphasiaDamage seen in Wernicke’s areaResults inPoor comprehension of languageCan affect both spoken and written languageCan’t name objects/peopleDescribe something without being able to use the exact word for itLanguage is jumbled and doesn’t make senseUse neologisms- new, made up wordsPatient is unaware of language problemNo general movement problems because movement is controlled by a different part of the brainReferred to as “fluent aphasia” because speech is fluent and has normal intonationBroca’s AphasiaComprehensive but not perfectAgrammaticSpeech is telegraphic and doesn’t contain grammarEx- Mom kid dog playWord endings are left outStruggle to find the word they want to usePatient is oftentimes frustrated because they’re aware of their errorsReferred to as “Non-fluent aphasia” because it’s slow, labored, and doesn’t flow like normal speechMay result in hemiparesis and hemiparalysis because the Broca’s area is close to the motor cortexMovement problems occur on the right side of the body because damage is on the left side of the brainGlobal aphasiaSymptoms of both Broca’s and Wernicke’s AphasiaDamage to both language and speech areasLanguagePoor auditory comprehensionPoor expressive languageMay use jargonDepending on area of legion, may have speech deficitsREVIEWAny time there is damage to LEFT hemisphere it affects someone’s speech and language, and its called aphasiaIf damage is on the RIGHT hemisphere, they may have language problems but its not called aphasiaCan affect any of the language areas (expressive, receptive, reading, writing)Expressive and writing often go togetherReceptive and reading go togetherIn aphasia testing you don’t have the patient read out loud because its not a skill adults useInstead, you want to know how well they understand what they readTreatmentRestorative treatmentOne part of the brain takes over for the damaged partCompensatory treatmentWorking on alternative ways to communicate in order to compensate for the problemExperiment to test for efficacy of therapy-Put 10 stroke patients in the group with therapyPut 10 stroke patients in the group without therapySee results of both groupsHOWEVER, it’s unethicalRisk factors that can lead to strokesHistory of stroke5 times more likely to have a stroke if you’ve already had oneHigh blood pressurePressure in arteries makes arteries weaken, and can potentially burstSmokingWeakens arteriesHigh CholesterolArteries become cloggedDiabetesObesityPrognostic Factors- factors that can predict the rate of recoveryAgeSeverity of damageGeneral healthFamily supportEarly speech-language therapySpontaneous recoveryFirst, language deficits are seen immediatelyThen, swelling decreases and blood in brain is reabsorbedFinally, rapid improvement is seenTraumatic Brain InjuryMost often seen in males 18-35Caused by concussionsResults in cognitive-linguistic disordersBrain DamageWhen you have a small part of your brain cut off from oxygen because of a clogged artery, a small part of brain dies.It occurs in a particular place with a particular functionThat function is lostEx-If a person has a car accident, and hits their head on the windshield, the first thing that happens is bruising in the brain where they were hit. Since the brain is floating around in fluid, brain goes forward as you go forward and then comes back and damages the back of the brain as well. Damage is seen on both sides of the brain. Bleeding will likely occur. Worse thing that could happen is that the brain stem swells, and tearing occurs, which can result in death.Patients with traumatic brain injury suffer from cognitive linguistic disordersCognitive linguistic disordersAttentionDon’t have a high attention spanMemoryDon’t remember incident that occurred that resulted in brain injuryLearning problemsDecreased inhibitionSay things that they otherwise wouldn’t of saidPoor pragmatic skillsCan’t use language appropriatelyOrganizational problemsCant initiate, plan or problem solveRecovery from traumatic brain injuryProgressive recoveryNeed an ongoing evaluationSome people enter with a coma, and are treated until they’re ready to go out into the communityMay result in speech and/or swallowing problemsOften do not have a complete recovery depending how severe and the location of the damageRight Hemisphere DisordersNot considered aphasiaSpecific kinds of tests used to identify problems on right side of brainResults inCognitive-linguistic deficitsProblems with memory, orientation, and awareness deficitsVisual neglectUnilateral vision- on one sidePoor visual recognition of both objects and peoplePoor visual perceptionExpressive language is confused, irrelevant, tangential (go off on tangents) and confabulatory (lying)Treatment of Right Hemisphere DisorderWork on visual problems with particular attention to the left visual sideGet patients to look all the way to the left when they read so they don’t miss information that they wouldn’t see otherwiseTeach pragmatics so patients can initiate conversations as well as have facial expressionsProgress depends on severity of damage and ability to recognize problemsDementiaDamage to cognitive skills, as well as language, that is progressive and irreversibleAlzheimer’s- most common form of dementiaEarliest

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UMD HESP 202 - Final

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