RHD/TBI
Ability to take previous knowledge and experience and apply it effectively to the interpretation of small details.
Inferencing
True or False
Dementia is an acquired global loss of brain function with a slow insidious onset. It includes memory impairment and at least one of the following:
◦Aphasia
◦Agnosia
◦Apraxia
◦Executive functioning
True
True or False:
Conversion disorders are intentional; often the speaker is trying to avoid personal conflict or an unpleasant situation.
FALSE
What is peristalsis?
The sequential contraction of muscles within the esophagus that propels the bolus downward to the stomach.
True or False?
As SLPs, we need to focus on giving the right advice in a counseling situation - we need to say just the right thing when a client is experiencing grief, loss, or any other of the emotions that people with communication disorders frequently feel.
FALSE
Which types of attention are regulated by the right hemisphere?
Sustained and selective
This is a mixed dementia that includes the presence of small or unnoticed ischemic strokes. It is characterized by memory loss, aphasia, apraxia of speech, and difficulties with executive functioning that have an acute onset followed by stepwise progression of degeneration.
Vascular Dementia
Unilateral fluid-filled lesions that may result from a single incident of hard collision are called
A. Vocal polyps
B. Vocal nodules
C. Contact ulcers
Vocal polyps
What is the difference between aspiration and penetration? What happens before both?
•Aspiration: food/liquid enters laryngeal vestibule and goes beneath vocal folds and into trachea
•Penetration: food/liquid enters laryngeal vestibule but does not go beneath the level of the vocal folds
•Premature spillage: food/liquid starts entering pharynx before swallow is triggered
What is the main purpose of counseling as an SLP?
To reduce the impact that negative reactions may have on the therapeutic process and to promote positive progress in therapy.
Describe:
Somatophrenia
Hemispatial neglect
Neglect - the inability to attend to sensory stimuli from:
-One side of their body (hemibody neglect)
Somatohrenia - the inability to perceive their own body parts as being part of themselves
-Environment (hemispatial neglect)
Hemispatial neglect
Severe cases: inability to recognize the existence of neglected world via vision, auditory, and olfactory information
This category of dementia is typically characterized by speech, voice, and language disorders.
Mixed dementia
One method of speaking after the larynx has been removed includes a device that is inserted through a surgical opening in the throat. This device directs air from the trachea into the esophagus allowing the speaker to use respiratory air and esophageal muscles for voicing.
What is the device called?
Tracheo-esophageal puncture or shunt (TEP)
What would cause a person to be referred for (or independently seek) a swallowing evaluation?
(Name 3 reasons)
-Difficulties feeding/swallowing have been observed by others
-The client is at risk of aspirating or has a history of aspirating
-The client appears not to be receiving adequate nourishment
-The client is post head, neck, or throat surgery
-A tracheostomy tube (trach) has been removed and eating by mouth may be resumed
One of the most frequent emotions people feel when diagnosed with a communication disorder is__________.
Describe the role of the SLP when patients talk about this emotion.
Loss
Acknowledge the grievous loss by listening to patients and care partners talk about the loss of communication abilities, relationships, jobs, their previous lives, and independence.
Focus counseling on making positive progress in treatment.
Avoid toxic positivity.
Describe expressive and receptive prosodic deficits that may occur in RHD.
Describe how this would impact daily living.
Receptive
◦Unable to identify emotions behind an utterance
◦Literal interpretations of verbal language
Expressive
◦Difficulty using prosody to express emotions
◦May be seen as monotone and emotionless
◦Still possess the full range of emotions
Goals of speech therapy
a.) include
b.) do not include
a.) Improve the quality of life and ensure the individual is operating at the highest level possible despite deficits
-Strengthen abilities that can improve
-Reduce demands on impaired abilities
-Increase use of intact cognitive abilities
-Provide stimuli that evoke positive emotions and memories
b.) "treat to deficit"
Name one of the two CNS disorders discussed in class associated with hyperadduction.
Spastic dysarthria
Spasmodic dysphonia
What are the 4 stages of swallowing? Name one symptom of dysphagia for each phase.
Oral Preparatory: drooling, spillage, leakage, unchewed food
Oral Transit: poor transit (tongue muscle weakness), pocketing, prolonged chewing
Pharyngeal: aspiration, substances going into and out of the nose (velopharyngeal port), insufficient pressure in the pharynx (tongue mobility)
Esophageal: the complete bolus might not be transported to the stomach
What quadrant on the CI matrix does this describe:
As speech therapy moves along, clients may start to realize that the process will be more difficult and longer than expected. This realization can be defeating and lessen their willingness to change.
This might look like attending therapy but not participating in the activities
Clients associate themselves very closely with their disorder
Q2: High-Low
A.) Name 1 impairment characteristic of RHD
B.) Name and describe 2 treatments for this impairment as discussed in class.
:)
List the stages, timeframe, and 1 descriptive feature of each stage of Alzheimer's Disease.
Mild/Early Stage: ~2 years
-Disorientation to time; impaired short-term memory
-Language similar to Wernicke’s patient
-Mild semantic and pragmatic impairment
Moderate/Mid Stage:4-10 years
-Negative impact on ADLs and increased reliance on others
-Poorer memory and disorientation; attention deficits, more perseverative, no self-correction
-Dramatic personality changes, visuospatial deficits
Advanced/Late Stage: >10 years
-Loss of motor function
-Severe impairment in semantic and pragmatic aspects
-Memory, cognition, and expressive language are profound
A.) List 3 behaviors that contribute to voice problems
B.) List 3 practices to reduce vocally traumatic behaviors (i.e., 3 healthy vocal hygiene practices)
A.)
-talking loudly over noise
-coughing
-throat clearing
-poor hydration
-excessive alcohol or smoking
-reflux
B.)
-drink plenty of water
-talk at a moderate volume
-avoid excessive alcohol/smoking/foods that cause reflux
The number one predictor of a patient getting aspiration pneumonia.
Poor oral hygiene
Upper right quadrant (Q1)—“High-High”
-High negative impact on quality of life, high willingness to change
Upper left quadrant (Q2)—“High-Low”
-High negative impact on quality of life, low willingness to change
Lower left quadrant (Q3) —“Low-Low”
-Little impact on quality of life, low willingness to change
Lower right quadrant (Q4) —“Low-High”
-Little impact on quality of life, high willingness to change