Disorders of Language

Question 1

Define aphasia?

Answer 1

Disturbance in language as result of brain damage

Question 2

What is the difference between language and speech disorders?

Answer 2

Speech disorders happen because of sensory and/or motor problems

Question 3

What are some causes of acute onset aphasia?

Answer 3

Strok
Penetrating head injury
Surgical resection

Question 4

What are some causes of insidious onset aphasia?

Answer 4

Dementia

Neoplastic change

Question 5

What is the time course of insidious onset aphasias?

Answer 5

Progressive

Question 6

What are some causes of paroxysmal aphasia?

Answer 6

Focal seizure if activity spreads to language cortices

Migraine

Question 7

What is the time course of paroxysmal aphasias?

Answer 7

Episodic

Present same way each time

Question 8

What are the corresponding Broddman’s areas of Broca’s area?

Answer 8

44 and 45

Question 9

What is the hemispheric dominance in terms of language?

Answer 9

Right hemisphere for visuospatial function

Left hemisphere for language

Question 10

What proportion of right and left handers have left lateralised language?

Answer 10

95% of right handers

70% of left handers

Question 11

What might be the role of the right hemisphere in language?

Answer 11

Non-propositional speech
Prosody
Paralinguistic aspects

Question 12

What are the divisions of the middle cerebral artery?

Answer 12

Superior

Inferior

Question 13

What does the superior division of the middle cerebral artery supply?

Answer 13

Sensorimotor cortex

Ventrolateral prefrontal cortex

Question 14

What does the inferior division of the middle cerebral artery supply?

Answer 14

Temperoparietal cortex

Visual tracts

Question 15

What is the clinical significance of the relationship between which branch of the middle cerebral artery is affected and language?

Answer 15

Language disturbances depend on which branch is affected

Question 16

Define language production

Answer 16

Producing appropriate output sequences

Question 17

Define language selection

Answer 17

Choosing appropriate content

Question 18

What part of language is affected in non-fluent language disorders?

Answer 18

Production

Question 19

What part of language is affected in fluent language disorders?

Answer 19

Selection

Question 20

Describe non-fluent aphasias

Answer 20

Anterior lesion
Loss of grammatical (sequential) structure
Intact selection of content
Eg: Broca’s aphasia

Question 21

Describe fluent aphasias

Answer 21

Posterior lesion
Impaired selection of content
Intact grammatical (sequential) structure
Eg: Wernicke’s aphasia

Question 22

Which division of the middle cerebral artery is affected in Broca’s aphasia?

Answer 22

Affects Broca’s area > superior division

Question 23

Which division of the middle cerebral artery is affected in Wernicke’s aphasia?

Answer 23

Affects Wernicke’s area > inferior division

Question 24

What is the function of the arcuate fasciculus?

Answer 24

Join’s Broca’s and Wernicke’s areas

Joins Wernicke’s area to premotor cortex

Question 25

What does the dorsal language stream map?

Answer 25

Sound

Question 26

What does the ventral language stream map?

Answer 26

Sound to meaning

Question 27

What does damage to white matter tracts involved in the language system produce?

Answer 27

Very specific language disorders | Shows importance of systems rather than isolated areas

Question 28

Describe Wernicke's aphasia

Answer 28

``` Fluent jargonistic language output - Neologisms - Paraphasic errors - phonemic and semantic Impaired comprehension Right quadrantanopsia No motor weakness Affects written language too Often don't know that they don't make sense ```

Question 29

What does an exam of language measure?

Answer 29

Output Comprehension: easy > hard Ability to follow instructions Repetition

Question 30

Describe Broca's aphasia

Answer 30

Non-fluent, highly effortful language output Telegrammatic Preserved comprehension Right face and arm weakness Written language a little better than with Wernicke's area Usually good insight into their issues

Question 31

Describe conduction aphasia

Answer 31

Fluent aphasia, but more meaningful than Wernicke's Relatively intact basic auditory comprehension Poor repetition of words

Question 32

Describe transcortical motor aphasia

Answer 32

Non-fluent aphasia Muteness at most severe - lack motivation and effort to talk Repetition preserved

Question 33

What does ipsilateral versus contralateral transfer after recovery depend on?

Answer 33

Many factors, including - Age - Stage of recovery - Size and location of lesion

Question 34

On what side will recovery happen if you are young?

Answer 34

Younger the person, more likely of contralateral functional switch

Question 35

Describe the way the roles of the two hemispheres change over time in adults, post-stroke

Answer 35

``` Controls - Left = a lot of activity - Right = a little activity Acute - Left = very little activity - Right = no activity Subacute - Left = a lot of activity - Right = a lot of activity > maybe to support other hemisphere Chronic - Left = a lot of activity - Right = moderate activity ```

Question 36

What is the relationship between the size of the lesion and which side recovery happens on?

Answer 36

Larger lesions may mean more contralateral reorganisation