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COMD 4500- Exam 1 COMD 4500- Exam 1
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where do SLPs work - schools, universities, hospitals, residential facilities, nonresidential facilities what percent of slps work in education - 56% what percent of slps work in healthcare - 39% who are the slps treating - -those with speech language and swallowing difficulty t/f: setting influences practice - t in acute care what is the majority of your practice - -mostly consultation -emphasis on diagnostic evaluation in rehab facilities what is the majority of your practice - -treatment is focus -capitalize on physiologic recovery in home care what is the majority of your practice - continued rehab in nursing homes what is the majority of your practice - -monitoring of communication and swallowing -maintenance of abilities over time Credentials as an SLP - -graduate as a generalist -continuing education -"apprentice" training graduate as a generalist - -entry level skills -all ages -all disorders continuing education - -seminars and conferences -online training "apprentice" training - -head and neck cancer
-trach and ventilator care t/f: the practices are in constant change - t SLP and education/counseling - -teaches family about disorder -counsels patient (prognosis, realistic expectation) -teaches communication strategy multidisciplinary teams - -slp does not work alone -each member brings expertise -physicians, nurses, PT, OT, RT, dietician, psychologist -avoid turf wars -collab is more productive than competition Principle of Ethics I - "hold paramount the welfare of persons they serve professionally" principle of ethics I includes: - -competence using all appropriate resources/referrals -bears responsibility when aides/technicians help in services -reasonable expectation of benefit from planned service -confidentiality of patient records -report ethical breaches observed in colleagues Principle of Ethics II - maintain the highest level of professional competence and performance principle of ethics II includes: - -only engage in task you are trained/qualified for -refine competence through continuing ed. -administrators must not require clinicians to do tasks beyond their training and certification -use technology in ways consistent with professional guidelines Principle of Ethics III - advocating for the unmet communication and swallowing needs of the public.. provide accurate info principle of ethics III includes - -do not misrepresent your credentials/competence training -avoid conflicts of interest -no fraud -give accurate info to the public -full honesty in advertising services training competence Principle of Ethics IV - uphold the dignity and autonomy of the professions... harmonious interprofessional and intraprofressional relationships
oxygen and glucose gray matter - neuron itself white matter - myelin sheath soma and the cell body are - gray matter parts of the neuron - -soma(cell body) -dendrite -nucleus -axon -myelin sheath nerve impulses(electrochemical event) - -resting potential -excitation -inhibition -reaching threshold -action potential -refractory period excitation - brings target neuron closer to threshold inhibition - takes target neuron further from threshold reaching threshold - triggers rapid voltage change action potential - an all or nothing electrochemical event how many synapses in the brain - 100 trillion t/f: a neuron can form thousands of connections to others - t central nervous system consists of - brain and spinal cord gray matter is for - processing signals
white matter is for - surrounding axons connecting neurons what protects the CNS - meninges meninges have - 3 protective layers blood brain barrier - small things pass- big things dont brain lobes - frontal parietal occipital temporal frontal lobe - voluntary movement, cognition parietal lobe - sense of taste touch movement (sensory) temporal lobe - hearing and memory processes occipital lobe - vision cerebellum - not a lobe, but very important brainstem consists of - midbrain, pons, medulla midbrain - vision and auditory processing, eye movement pons - motor control medulla - controls autonomic functions (breathing heart rate BP) spinal cord - runs through vertebrae spinal reflex - -sensory input -local processing -motor output -rapid response
-sequencing of complex movements -integration of sensory signals -coordination upper motor neurons are named due to role in - hierarchy NOT anatomic description upper motor neurons contain both - direct and indirect pathways, complex interconnections upper motor neurons are used in - origination planning refining movements lower motor neurons - peripheral motor nerves where is the origin of lower motor neurons - in the brainstem or spinal cord where is the destination of the lower motor neurons - the neuromuscular junction lower motor neurons are also called - the final common pathway neuromuscular junction - synapse connects axon terminal button to muscle fiber motor unit - -1 lower motor neuron innervation ratio - fine or gross motor control neurological assessment - -behavioral assessment by physician -patient performs specific tasks -observation of responses -interpretation, diagnosis based on clinical skill -subsequent instrumental testing may be orders xray imaging - -broad xrays pass through tissue -2d view of object -excellent spatial resolution -relatively inexpensive -widely available xrays cannot show - neural tissue
xrays can show - fractures or bone erosion cerebral angiology - -uses xray -catheter in right femoral artery -passed via aorta to carotid artery -dye injected -frontal and lateral view -images taken during and after injection -arteries then veins are visible advantages of angiography - -available in most hospitals -reveals speed of circulation -shows occlusion, aneurisms, arteriovenous malformations (AVM) -allow inferences about tissue disadvantages of angiography - -invasive -bleeding at artery puncture -stroke (1 in 200) -dye reaction (1 in 10,000) -xray exposure computer tomography (CT) - -based on xray -images in single slices -shows bone and neural tissue -can distinguish gray and white matter pros of CT - -creates image in 1-2 sec -good spatial resolution -shows bone and neural structures -contrast agents can show defects with blood brain barrier -tool of choice for viewing acute trauma cons of CT - -dense bone makes imaging hard -exposure to radiation Positron emission tomography (PET) - -isotope inhaled or injected -isotope incorporated into glucose or neurotransmitter -isotope decay emits a positron -positron collides with electron -collision destroys both and emits gamma rays at 180 degrees from each other -sensors around the head detect gamma rays that arrive simultaneously
pragmatics - social appropriateness language modalities - -hearing -speaking(most common) -reading -writing neuroanatomy of language - 1-limits of localization 2- complex networks activated 3- interior frontal lobe (brocas area) 4- superior temporal gyrus (wernickes area) 5- angular gyrus 6- suprasegmental gyrus brain circulation consists of - arteries, capillaries and veins the brain has a constant need for - glucose and oxygen The carotids arise from the ________? - aortic arch vertebral arteries supply the - brainstem, cerebellum, spinal cord anterior cerebral artery (ACA) circulation loss - -foot and leg paralysis -frontal lobe symptoms (impaired judgement, reasoning limitations, poor self monitoring) middle cerebral artery (MCA) circulation loss - -contralateral hemiplegia -impaired sensation -aphasia _______% of the population is left handed - 10 ______% of the population is left hemisphere language dominant - 93 left hemisphere processing - -segmental accuracy -rapid events right hemisphere processing -
-prosodic understanding, production -melodic contours etiologies of aphasia - -stroke(ischemic or hemorragic) -TBI -dementia global aphasia characteristics - -severe comprehension and production deficits -poor repitition -communication via gesture, facials, intonantion brocas aphasia characteristics - -relatively intact comprehension -nonfluent (speech halting, effortful, better @ content vs function words) -poor repitition skills wernickes aphasia (AKA fluent/jargon aphasia) characteristics - -impaired comprehension -syntax relatively intact -speech fluent but lacks meaning -neologisms -poor repitition skills What are neologisms? - words that have no real meaning conduction aphasia characteristics - -poor repetition skills -fairly fluent expression -paraphasia -comprehension relatively intact -word finding difficulties two types of transcortical aphasias - sensory and motor transcortical motor aphasia characteristics - -nonfluent expression -effortful speech -good repetition -good comprehension transcortical sensory aphasia characteristics - -fluent expression -paraphasia -echolalia -good repetition -poor comprehension
involving the family - -education -counseling -homework aphasia groups - -generalization -naturalistic practice -social benefits generalization of aphasia groups - experience success beyond small social circle naturalistic practice of aphasia groups - exercises helpful, but group is not drill it is functional communication social benefits of aphasia groups - supportive environments a credo - relates to the vision and mission of an institution The recurrent laryngeal nerves - loop down around large blood vessels in the body and come back up to the larynx The control of coordinated movements relies heavily on - the cerebellum When a stroke is caused by a clot that travels in the bloodstream and blocks an artery, it is called aortic - embolic Risks associated with multiple sclerosis are - -genetic factors -environmental factors -infections factors (e.g., virus) -cigarette smoking Rigidity, tremor, and an inexpressive face are characteristic of - Parkinson's disease An imaging technique that can reveal aneurysms and blood vessel stenosis is - cerebral angiography An imaging technology that can detect disease processes before there are visible, structural changes to the brain is - positron emission tomography
Functional MRI works by - detecting differences in hemoglobin oxygen levels An EEG evoked potential is - an EEG wave that results from the presentation of a stimulus Which technology relies on the different relaxation properties of protons in different tissues?