Study Guide Test 4 SPA 2001 Please pay careful attention to the following but not to the exclusion of everything else in the chapters Terminology Aphasia meaning without language describes the most severe varieties of this impairment an impairment due to localized brain injury and affecting understanding retrieving and formulating meaningful and sequential elements of language problems in word retrieval and auditory comprehension common to varying degrees and varieties may affect listening speaking reading writing expressive deficits reduced vocabulary omission addition of words stereotypic speech receiving receiving delayed or reduced output of speech hyperfluent speech receiving word substitution and characterized by few pauses incoherence inefficiency pragmatic inappropriateness Hyperfluent speech very rapid speech found in people with fluent aphasia Hemiparesis muscle weakness on one side of the body resulting in reduced strength and control Hemiplegia paralysis on one side of the body Hemisensory impairment loss of the ability to perceive sensory information may accompany hemiparesis or hemiplegia Hemianopsia blindness in the left or right visual field of both eyes caused by lesions on the temporal or lower parietal lobe will affect the individual s ability to read Dysphagia a disorder of swallowing may be accompanied by drooling or gagging caused by paralysis and or sensory impairment in the neck and face Fluent aphasia lesions typically found in posterior portions of left hemisphere fluent aphasia is speech characterized by word substitutions neologisms verbose verbal output Types of Fluent aphasia Wernicke s aphasia rapid fire strings of sentences with little pause for acknowledgment or turn taking Content may seem to be a jumble and may be incoherent or incomprehensible although fluent and well articulated Individuals often unaware of their differences Characterized by fluent or hyperfluent speech poor auditory and visual comprehension verbal paraphasia or unintended words and neologisms sentences formed by strings of unrelated words called jargon mild to severe impairment in naming and imitative speech Anomic aphasia naming difficulties and mild to moderate auditory comprehension problems mostly normal with exception to word retrieval Characterized by sever anomia in speech and writing fluent spontaneous speech marred by word retrieval difficulties mild to moderate auditory comprehension problems Conduction aphasia individual s conversion is abundant and quick although filled with paraphasia Characterized by anomia mildly impaired auditory comprehension if at all extremely poor repetitive or imitative speech paraphasia Transcortical sensory aphasia rarest of fluent aphasias conversation and spontaneous speech as fluent as in Wernicke s aphasia but filled with word errors Characterized by unimpaired ability to repeat or imitate words or phrases and sentences verbal paraphasia or word substitutions lack of nouns and sever anomia poor auditory comprehension Subcortical aphasia result of lesions in thalamus and basal ganglia below levels of the cortex couldn t be confirmed until neuro imaging Characterized by fluent expressive speech paraphasia and neologisms repetition unaffected auditory and reading comprehension relatively unaffected cognitive deficits and reduced vigilance Non fluent aphasia lesions generally in or near frontal lobe characterized by slow labored speech struggle to retrieve words and form sentences Type of Non fluent aphasia Broca s aphasia damage to anterior or forward parts of the frontal lobe of the left cerebral hemisphere centered in Broca s area which is responsible for both motor planning and working memory Characterized by short sentences with agrammatism in which auxiliary or helping verbs the verb to be prepositions articles and morphological endings are omitted anomia problems with imitation of speech because of overall speech problems slow labored speech and writing articulation and phonological errors Transcortical motor aphasia difficulty initiating speech or writing characterized by impaired speech especially in conversation good verbal imitative abilities mildly impaired auditory comprehension Global or Mixed aphasia profound language impairment in all modalities most severely debilitating form of aphasia characterized by limited spontaneous expressive ability of a few words or stereotypes such as over learned utterances or emotional responses imitative speech and naming affected auditory and visual comprehension limited to single words or short phrases Stroke cerebrovascular accident CVA the most common cause of aphasia resulting when the blood supply to the brain is blocked or when the brain is flooded with blood Cerebrovascular accident CVA another name for a stroke third leading cause of death in the United States Ischemic strokes more common of the two types of strokes result from complete or partial blockage occlusion of the arteries transporting blood to the brain as in cerebral arteriosclerosis embolism and thrombosis Cerebral arteriosclerosis thickening of the walls of cerebral arteries in which elasticity is lost or reduced the walls become weakened and blood flow is restricted The resulting ischemia or reduction of oxygen may be temporary or may cause permanent damage through the death of brain tissue Embolism obstruction to blood flow caused by a blood clot fatty materials or an air bubble The obstruction may travel through the circulatory system until it clocks the flow if blood in a small artery Blockage results in lack of oxygen carrying blood depriving brain cells of needed oxygen If it travels to the brain it may cause a stroke Thrombosis also blocks blood flow a blood clot within a blood vessel of the body May result in an ischemic stroke Transient Ischemic attack TIA sometimes called a mini stroke a temporary condition whose symptoms mirror those of a stroke Occurs when blood flow to some portion of the brain is blocked or reduced After a short interval the symptoms decrease as blood flow returns Can be warning sign of increased likelihood of a stroke occurring in the future Hemorrhagic stroke when the weakened arterial walls burst under pressure as occurs with an aneurysm or arteriovenous malformation Aneurysm a saclike bulging in a weakened arterial wall The thin wall may rupture causing a cerebral hemorrhage most occur in the meninges the layered membranes surrounding the brain and blood flowing into this space can