Flashcards in APRAXIA & APHASIA Deck (8)
1. Broca aphasia may result from occlusion of which of the following arteries?
A. Anterior temporal artery D. Operculofrontal artery
B. Anterior choroidal artery E. Angular artery
C. Medial striate artery of Heubner
1-D The Broca speech area, which is located in the lower frontal gyrus of the left hemisphere, is supplied by the operculofrontal artery. This area may also be perfused by the prerolandic artery. Both of these arteries arise from the middle cerebral artery.
2. A patient is given a pipe, tobacco, and matches and is asked to smoke the pipe. The patient rubs the matches on the pipe. Which of the following neurologic diagnoses best describes this behavior?
A. Construction apraxia D. Prosopagnosia
B. Ideomotor apraxia E. Dysprosocy
C. Ideational apraxia
2-C The patient, who is unable to light a match and smoke the pipe in proper sequence on command, has ideational or sensory apraxia, a disorder of a multistep action sequence, Construction apraxia is the inability to draw an entire clock face; patients with nondominant parietal lobe lesions cannot draw the left side of the clock (sensory neglect). Ideomotor apraxia is the inability to follow simple commands (i.e., “stick out your tongue” or “make a first”). Prosopagnosia is the inability to recognize faces. Dysprosody is the difficulty producing or understanding the normal pitch, rhythm, and variation in stress in speech.
3. A 65 year old man complains of difficulty walking. He has a history of chronic subdural hematomas. Neurologic examination reveals psychomotor slowing. Sphincter incontinence, and enlarged ventricles withour convolutional atrophy. The most likely diagnosis is
A. Huntington disease D. progressive supranuclear pasly
B. normal pressure hydrocephalus E. Wilson disease
C. Parkinson disease
3-B Normal pressure hydrocephalus is characterized by the triad of gait apraxia (frontal lobe ataxia), incontinence, and dementia. The ventricles are moderately dilated. Huntington disease is a neurodegenerative disorder, characterized by chreocathetosis, tremor, and dementia. Parkinson disease is characterized by a pill rolling resting tremor, cog wheel rigidity, and bradykinesia (slowness in movement). Progressive supranuclear palsy is a movement disorder characterized by paresis of downgaze. Wilson disease (hepatolenticular degeneration) is a disease of copper metabolism characterized by a coarse “wing beating” tremor. The corneal Kayser Fleischer ring is pathognemonic.
4. Neurologic examination indicates that a 50 year old woman with hypertension has a left homonymous hemianopia but is not aware of her deficit (anosognosia). When asked to copy a drawing of a clock face, she neglects to draw the numerals on the left side of the clock. Based on this examination, the lesion would most likely be in the
A. frontal lobe D. right parietal lobe
B. insule E. right temporal lobe
C. left parietal lobe
4-D Lesions of the nondominant (right) parietal lobe have the following deficits : anosognosia, topographic memory loss, dressing apraxia. Sensory neglect, “sensory extinction,” and a left homonymous hemianopia. Frontal lobe signs may include motor abnormalities, impairment of cognitive function, personality changes (disinhibition of behavior), and incontinence. The insula receives olfactory and gustatory input. Temporal lobe signs may include Wenicke aphasia, auditory, visual, olgactory, and gustatory hallucinations, and loss of recent memory.
5. A 48 year old woman who has had a stroke complains of weakness of her right arm and weakness of her right lower face. Language assessment reveals the following speech dificits; slow labored speech, dysarthric telegraphic speech, usually good comprehension, and poor repetition. These neurologic findings best deacribe which of the following types of aphasia?
A. Broca aphasia D. Transcortical sensory aphasia
B. Conduction aphasia E. Wernicke apasia
C. Transcortical motor aphasia
5-A Key features that point to Broca aphasia are slow, labored dysarthric telegraphic speech; relatively good speech comprehension; poor repetition; frequent depression; and frequent buecolingual dyspraxia. Broca aphasia is also called motor, expressive, and anterior aphasia. See figure 24-1
6. A 65 year old male physician suffers a cerebrovascular aceident. Language assessment reveals the following speech abnormalities impaired comprehension; impaired repetition; and paraphrasic speech, including non sequiturs and neologisms. Spontancity and fluency are normal. This evaluation best fits which of the following types of aphasia?
A. Broca aphasia
B. Conduction aphasia
C. Mixed transcortical aphasia
D. Transcortical motor aphasia
E. Wernicke apasia
6-E Wernicke aphasia is characterized by fluent speech, poor comprehension, poor repetition, and paraphrasic errors (e.g., driveling speech, nonsequiturs, and neologisms)
7. A 50 year old man has a mass lesion underlying the left frontoparietal operculum. Language assessment reveals good comprehension. Fluent speech, poor repetition, anomia, and agraphia. This case best fits which of the following types of aphasia?
A. Broca aphasia D. Transcortical sensory aphasia
B. Conduction aphasia E. Wecicke aphasia
C. Global aphasia
7-B Condustion aphasia results from a lesion that transects the arcuate fasciculus, thus separating the Broca speech area from the Wernicke speech area. This condition is characterized by markedly impaired repetition, with preserved fluency and comprehension. Conduction aphasia is usually associated with agraphia