What are SLPs interested in?
where is the damage? |
- anatomy |
What is the function of the damaged area? |
- Areas important for speech and language processing, swallowing |
what has caused the brain damage? |
- Sudden incident (potential to improve) or progressive disease (symptoms getting worse over time) |
What are the language/ speech/ swallowing symptoms? |
- What are the signs and characteristics of abnormalities ; Severity |
- Different methods for the assessment and investigation of neurologically-based communication disorders
Nervous system
Complex collection of nerve cells (billions) |
that transmit signals between different parts of the body - allows you to do things like walking, speaking, swallowing |
Structurally – NS has TWO components |
Central nervous system (CNS) - Brain (incl. cerebellum & brain stem → image) ▪ Spinal Cord |
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Peripheral nervous system (PNS) - Nerves outside of the brain & spinal cord ▪ Connects CNS to limbs & organs |
Contralateral innervation |
one side of the brain essentially controls the opposite side of the body |
BROCA’S AREA & WERNICKE’S AREA
BROCA’S AREA
Paul Broca
patients who lost the ability to speak
Most had lesions in posterior part of left frontal lobe
in the posterior part of the frontal lobe of left hemisphere
region for expressive language
WERNICKE’S AREA
Karl Wernicke
patients with fluent speech but impaired comprehension
Most had lesions in the superior part of the left temporal lobe
in the superior part of the temporal lobe of left hemisphere
region for receptive language |
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Anatomy and Function
Brain |
➢ Grey matter (nerve cell bodies) |
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➢ Wrinkly appearance |
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➢ Bumps – gyri |
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➢ Grooves – sulci and fissures |
Divided lengthways into two hemispheres |
➢left & right |
FRONTAL LOBE – Function |
➢Attention |
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➢ Language production |
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➢ Voluntary movement |
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➢ Behaviour and Personality |
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➢ Planning of movement |
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➢ Reasoning and problem solving |
TEMPORAL LOBE – Function |
➢ Hearing e.g., words, laughing, baby crying |
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➢ Language comprehension |
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➢ Interpret other people's emotions |
PARIETAL LOBE – Function |
➢ Processing of sensory information e.g., touch, pressure, pain, temperature, taste, position |
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➢ Body orientation |
OCCIPITAL LOBE – Function |
➢ Processing of visual information e.g., in reading, recognising faces/ objects |
LANGUAGE AREAS IN THE BRAIN |
➢ Left hemisphere |
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➢ Frontal lobe (and Broca’s area) vital for language and speech production |
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➢ Temporal lobe (and Wernicke’s area) vital for language comprehension |
Grey is the surface – cerebral cortex
Children with soft non wrinkly brains will have intellectual issues
common causes of acquired communication disorders
Sudden incidences are;
➢ Stroke
➢ Traumatic Brain Injury (TBI)
Progressive diseases are;
➢ Alzheimer’s disease
➢ Parkinson’s disease
➢ Multiple Sclerosis (MS) |
Nervous system requires a high blood flow
➢ Brain made up of cells (nerve cells)
➢They are the key players BUT to function properly;
▪ Nerve cells depend on adequate supply of
oxygen and nutrients (e.g., glucose)
through a dense network of blood vessels |
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Brain lesions
Stroke |
Rapid loss of brain function due to an injury to blood vessels in the brain |
Risk factors - |
Overweight - Physical inactivity - Heavy drinking - Use of illegal drugs - High blood pressure - Cigarette smoking - High cholesterol - Diabetes |
Blood supply disturbed due to |
A clot (Infarct/ Ischemic stroke) - 80% |
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Bleeding (Haemorrhage/ Haemorrhagic stroke) - 20% |
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Blood flow is suddenly interrupted to an area of brain (↓ oxygen & ↓ glucose) → Nerve cells begin to die |
Symptoms and effects depend on the lesion site |
Vision problems |
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Change of behaviour |
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Sensory deficits |
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memory loss |
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speech/language problems |
Paralysis/hemiplegia |
complete paralysis of half of the body |
hemiparesis |
weakness of one entire side of the body |
If the stroke occurs in the left side of the brain, the right side of the body will be affected, and vice versa |
Traumatic Brain Injury (TBI) - OPEN HEAD INJURY |
Sudden damage to the brain caused when the scalp/ skull is broken, fractured, or penetrated |
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Damage to brain tissue and blood vessels |
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Damage is typically widespread or diffuse to an area or areas within the brain |
TBI - CLOSED HEAD INJURY |
Results when an outside force impacts the head BUT the skull is not broken, fractured, or penetrated |
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shaking of the brain inside the bony skull results in bruising and tearing of brain tissue and blood vessels |
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Damage is typically widespread or diffuse to an area or areas within the brain |
TBI – Symptoms |
Effects largely dependent upon location and extent of the brain injury |
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Change of behaviour |
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Vision impairments |
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Sensory deficits |
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Paralysis, movement difficulties |
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Swallowing disorders |
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Speech and language problems |
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Progressive diseases
ALZHEIMER'S DISEASE |
Most common type of dementia in older adults |
Dementia |
progressive deterioration in cognitive functions (e.g., thinking, communication) |
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Significant loss of brain volume (nerve cell death) |
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Incidence rising with ageing population |
Clients with Alzheimer's Disease |
Inappropriate social behaviour |
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Poor memory |
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Problems performing routine tasks |
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Problems with abstract thinking and judgement |
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Confusion |
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Speech, language and swallowing difficulties |
PARKINSON’S DISEASE |
Degeneration/ death of nerve cells leads to movement & cognitive impairments |
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Occurs in around 1% of the population aged over 60 |
Symptoms |
Tremor (can affect limbs + jaw, tongue, face in some cases) |
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Absence of/ Reduced movement |
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Muscle rigidity |
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Stooped posture |
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Dementia (40% cases) |
MULTIPLE SCLEROSIS |
Demyelinating disease |
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▪in which the protective cover (Myelin) of nerve cells in the brain and spinal cord are damaged |
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▪ Disrupts the ability of the nervous system to communicate properly (i.e. information transfer affected) |
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➢ More common in women 20-40 years old |
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➢ Cause not known (genetics & environmental factors such as infections proposed) |
Symptoms |
vary depending on the lesion sites |
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Fatigue |
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Mobility problems |
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Problems with thinking, learning and planning |
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Speech and swallowing difficulties |
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