Stroke
What are the two types of strokes?
Ischemic and hemorrhagic
What are two ways that we can evaluate a client’s naming abilities?
Confrontation naming, generative naming, divergent naming, responsive naming, naming in conversation
You are asking a client to name a picture of a dog to confrontation. Their response is “bear.” This error would be an example of what type of paraphasia?
Semantic/lexical paraphasia
What is the name for when there is insufficient oxygen reaching the tissues of the brain?
Hypoxia
What kind of dementia is caused by multiple strokes and results in a step-wise pattern of deterioration?
Vascular Dementia
Name 3 signs/symptoms of a stroke
Unilateral weakness, severe headache, dysarthria/speech difficulty, vision changes, balance issues, facial droop
What four areas are essential to evaluate when making a diagnosis of aphasia based on the Aphasia Decision Tree?
Naming, auditory comprehension, repetition, fluency
While in conversation with your client with aphasia, they describe their favorite type of coffee as “bazelnut.” This would be an example of what type of paraphasia?
Phonemic/formal paraphasia
What is one factor that may negatively impact a client’s recovery from concussion?
Exertion or cognitive stress, repeat concussion, not getting rest after their injury due to sports seasons, history of depression/anxiety
What is the name of the disorder caused by damage to the substantia nigra, resulting in reduced dopamine production, tremors, and hypokinetic dysarthria?
Parkinson’s Disease
What is it called when there is a temporary disruption of cerebral circulation?
Transient Ischemic Attack (TIA)
What are three characteristics that we need to evaluate to determine if someone’s profile is fluent or nonfluent?
Length of utterance, articulatory agility, ease/flow of speech production, grammatical form, use of paraphasias
Define "insight" in the context of CVA. How might poor insight negatively impact prognosis?
Insight is awareness of one's own deficits, typically impacted by R CVA (but also TBI and dementia). Reduced insight can increase safety concerns. Education is necessary for both the patient and caregivers!
Name 3 post-concussive syndrome symptoms
Headache, fatigue, dizziness with movement or mental exertion, nausea, light/noise sensitivity, tinnitus, reduced attention/concentration, reduced short-term memory, slowed thinking, feeling foggy, sleep disturbances, mood changes
Which type of dementia looks similar to Parkinson's Disease in terms of physical deficits but has fluctuating cognition and visuospatial deficits as well?
Lewy Body Dementia
Define “aneurysm”
Pouches formed in weakened arterial walls
What are 3 ways that we can assess someone’s auditory comprehension abilities?
Yes/No questions, command following, basic word discrimination, complex ideational materials, responding to comprehension questions about lengthier info, observing in conversation
You ask your client to complete a procedural narrative (i.e. how to make a peanut butter and jelly sandwich). Their response is below. What do you suspect is their diagnosis?
“Put peanut butter on the bread. I like to have JIF peanut butter. I always had it when I was a kid, but a lot of the other kids in my school were allergic to peanut butter. I couldn’t bring peanut butter sandwiches to school. Anyway, you also add jam. It could be any flavor - grape, strawberry, blueberry, mixed berry. I don’t like strawberry jelly, but my mom does. Put them together, and that’s it.”
Right Hemisphere Disorder/ Right hemisphere CVA
Name and briefly describe 2 secondary injuries resulting from traumatic brain injury
Cerebral edema (swelling), Elevated intracranial pressure (pressure within the brain), Ischemic brain damage (blood can’t reach tissue due to pressure/swelling), Injury disrupts regulation of which substances cross the blood-brain barrier into brain tissue
Your client presents with complaints of slowly increasing difficulty with word finding and language. They are 65 years old, and have not experienced a stroke. What diagnosis may be probable, and what is one thing you would focus on in treatment?
Primary Progressive Aphasia/Frontotemporal Dementia
Focus on training of compensatory/word finding strategies
What is it called when there is increased cerebrospinal fluid in the ventricles, and what is a medical intervention that may be performed to treat this?
Hydrocephalus, putting in a shunt to drain CSF
Name four domains that are essential to evaluate in someone who experienced a right-sided CVA?
Memory, attention, orientation, problem solving, reasoning, organization, visual processing, pragmatics, executive functioning
Your client is a TBI survivor. They are not oriented to place or time, consistently reporting that they are in a McDonalds in their hometown and asking for a hamburger. They are not agitated, however if they are left alone they attempt to wheel their wheelchair toward the elevator with a vague intention of going home. They occasionally make inappropriate comments when frustrated. They can sustain their attention for brief periods, but not long enough to complete simple tasks without support. What level of the Ranchos Los Amigos scale do you think is most consistent with their performance?
Level 5, confused, inappropriate, not agitated
Define coup and contrecoup in the context of a movement injury, and give an example of when this may occur.
Coup = first point of impact. Contrecoup = the impact of the ricochet. There are usually multiple impacts until the brain stops moving. May occur in a MVA or when an unrestrained head is struck by an object.
Give one reason that SLP services can be beneficial for people with dementia, despite their progressive diagnosis.
Compensatory strategies, caregiver support/education, safety, emotional wellbeing