Cerebral Cortex Flashcards
(44 cards)
The cerebral hemisphere that controls language is called the _______. In most people, language functions are processed in the _______.
dominant hemisphere; left hemisphere
Almost all right-handed individuals and about half of left-handed individuals are _______.
left cerebral dominant
Language can be selectively impaired (no effect on vision or hearing) by damage to…
the parietal-temporal junction or the frontal lobe (aphasia)
What is aphasia?
A disturbance of the comprehension and formulation of language, not a disorder of hearing, vision, or motor control
The left (dominant) side of the brain is responsible for:
- Language (writing, speech)
- Praxis (motor program)
- Arithmetic, Musical ability (skilled)
- Sense of direction (via sequence of written directions)
Also, insular cortex (planum temporale) larger on average in left hemisphere
The right (nondominant) side of the brain is responsible for:
- Prosody (emotion of voice)
- Visual/spatial gestalt
- Arithmetic, Musical ability (unskilled)
- Sense of direction (via spatial orientation)
- Global & selective attention (prefrontal gyrus for motor, posterior parietal cortex for sensory, anterior cingulate gyrus for motivation)
Broca’s Aphasia (nonfluent, expressive aphasia) is caused by…
Lesion to pars orbitalis and pars triangularis of inferior frontal gyrus (areas 44, 45) of left hemisphere
Difficulty converting the concept of speech into meaningful sounds (loss of ability to speak fluently)
Broca’s aphasia is characterized by:
- Halting speech
- agraphia
- disordered syntax, grammar, and individual word structure
- intact comprehension
- frustration and distress regarding condition
- In most severe form, can’t speak (mutism)
During recovery, a Broca patient first…
Recovers habitual phrases first (however slowed, and telegraphic speech is observed)
What are the most common causes of Broca’s aphasia?
Tumors and occlusion of M4 (branches of MCA)
Full aphasia results from Broca’s and insular cortex and subjacent white matter
Involvement of M1 (lenticulostriate) in Broca’s aphasia can lead to:
Contralateral motor signs and symptoms
- weakness (paresis) of the lower part of the face
- lateral deviation of the tongue when it is protruded
- weakness of the arm
Wernicke Aphasia (fluent, receptive aphasia) is caused by…
Lesion to superior temporal gyrus area 22 and supramarginal/angular gyrus (area 37,39,40) of left hemisphere
Wernicke aphasia is characterized by:
- unable to understand what is said to them
- unable to read (alexia)
- unable to write comprehensible language (agraphia)
- display fluent paraphasic speech
- no recognition of problem (anosognosia)
What is paraphasic speech?
Ability to produce clear, fluent, melodic speech at a normal or even faster than normal rate. The content of the speech may be unintelligible because of frequent errors of word choice, inappropriate use of words, or use of made-up nonsense words.
Wernicke aphasia may result from…
occlusion of temporal and parietal M4 branches of the MCA - also, hemorrhage into the thalamus (or tumors in the thalamus) may produce Wernicke aphasia by extending laterally and caudally to invade the subcortical white matter
Contralateral homonymous hemianopsia can occur in Wernicke patients if ________
damage impinges on optic radiations
What is conduction aphasia (disconnection syndrome)?
Disruption of the arcuate fasciculus connecting Broca and Wernicke’s area –> normal comprehension and expression is fluent but difficult exists in translating what is said into an appropriate reply
What is global aphasia?
Occlusion of left ICA or proximal MCA (M1) / Lesion to Broca’s and Wernicke’s area as well as the arcuate fasciculus
Lack of fluency of speech, comprehension and repetition in voicing (COMPLETE loss of language)
Damage to basal nuclei (such as head of caudate on left side) can result in…
Language disorders similar to Wernicke aphasia
A right parietal lobe lesion can interfere with…
a patient appreciating the prosody of speech
What is contralateral neglect?
Patient seems to be completely unaware of objects and events in the left half of his or her surrounding space
From a lesion of right parietal association cortex (nondominant)
Syndrome of Nondominant Inferior Parietal Lobule:
- topographic memory loss (patient gets lost)
- anosognosia (no recognition of a problem)
- asomatognosia (not recognizing one’s body)
- construction apraxia (cannot draw collective objects; understand spatial relationships)
- dressing apraxia
- contralateral hemineglect
- left homonymous hemianopia
Disorders of affect that can also accompany: reduced ability to understand and appreciate humor, a loss of the ability to appreciate the prosody of speech, and often an inappropriate cheerfulness and lack of concern for or even awareness of the implications of the illness
Contralateral hemineglect results from…
Lesion to the centers for sensory attention within the (non-dominant) posterior parietal cortex (5,7) causing neglect of anything within the left (typically) visual field
- Serious cases show asomatognosia in which he/she doesn’t recognize left side of body –> dressing apraxia
Prosopagnosia typically results from a _________
right-sided lesion of temporal lobe