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Lecture 1 Flashcards

1
Q

Aphasia

A

Acquired disorder of language caused by brain damage
May impact comprehension of language, expression of language, or both
May involve any modality (speech, writing, etc)

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2
Q

Clinically Important Consideration

A

Historically confusing disorder; involves multiple disciplines, and is often thought of demographically as “a disorder associated with aging”

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3
Q

Scientifically Important Consideration

A

Relationship between the brain & language; correlation between affected areas of the brain with lost or impaired language vs. unimpaired areas
Allow us to query whether specific areas of the brain control or modulate particular language functions

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4
Q

Early Perspectives on Aphasia

A

Multiple early misunderstandings: some thought the ventricles controlled cognition & some thought aphasia resulted from a paralyzed tongue

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5
Q

Gesner

A

1770: coined term “speech amnesia”
German anatomist/phrenologist who 1st suggested that language was localized in the brain along with other intellectual functions

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6
Q

Phrenology

A

Associates mental & intellectual functions topographically on the skull

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7
Q

Phrenological Organs

A

37 faculties

Johann Kaspar Spurzheim

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8
Q

Paul Broca

A

1824-1880
French neurosurgeon
1st to offer clinical & pathological evidence relating frontal lobe & left brain to language production
Research was especially fixated on lower portion of frontal lobe: area concerned with motor speech (aka Broca’s area)

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9
Q

Broca’s Work

A

Aphemia

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10
Q

Aphemia

A

Reduced speech fluency
Agrammatic, telegraphic speech
Many language production errors
Limited impairment of comprehension of spoken language

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11
Q

Carl Wernicke

A

1848-1905
German neuropsychiatrist
1st to describe a type of aphasia opposite in part to that of Broca’s work
His work purported that a different type of aphasia resulted from lesions in posterior portion of left superior temporal gyrus

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12
Q

Wernicke’s Work

A

Sensory aphasia; proposed that other types of aphasia existed: TCM, conduction aphasia, TCS

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13
Q

Handedness Theory

A

1936: Johannes Nielson suggested that language was in hemisphere opposite of preferred hand; research has discounted hypothesis: handedness not a reliable indicator of hemispheric language dominance
~85% of general population is right-handed; 15% is left-handed

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14
Q

Language Location in the Brain

A

Language is left-dominant for majority of world’s population

~15% of the (15% left-handed) are right hemisphere dominant for language

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15
Q

Cerebrum

A

The final integrative & executive structure of the nervous system; responsible for all higher-brain functions

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16
Q

Higher Brain Functions

A

Everyday thinking, logical reasoning, abstract reasoning, mathematical reasoning, memory, speaking, language production, artistry, scientific achievement, language comprehension, judgment, emotional experience, attention, problem solving, executive functioning

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17
Q

About the Brain

A

Contains billions of neurons with trillions of synapses
Weighs 3-3.5 pounds
Comprised of 6 layers w/ outermost layer consisting of gray matter
2 hemispheres connected by thick bands of long fibers (axons)
Regions w/ in the hemispheres connected by shorter association fibers
Surface is comprised of gyri & sulci

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18
Q

Gyri

A

Hills, folds, & convolutions on the brain surface

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19
Q

Sulci

A

grooves, valleys, & fissures on the brain

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20
Q

LCF

A

Longitudinal Cerebral Fissure

Separates the left/right hemispheres

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21
Q

Fissure of Rolando

A

aka Central Sulcus

Runs laterally, downward, & forward dividing the anterior half of the brain from the posterior half

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22
Q

Lateral Cerebral Fissure

A

aka Sylvian Fissure

Moves laterally and upward

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23
Q

Perisylvian Area

A

Regions surrounding this area are especially involved in speech, language, & hearing

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24
Q

Cerebral Lobes

A

Each cerebral hemisphere divided into 4 lobes: frontal, parietal, temporal, occipital
Each lobe associated with predominant functions

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25
Frontal Lobe
Extremely important lobe for speech/language; largest lobe (1/3 of cortical surface)
26
Precentral Gyrus & the Frontal Lobe
Major portion of the primary motor cortex via the PS Movements modified by EPS Controls voluntary movements on opposite side of body Anterior to motor strip is premotor area & supplementary areas
27
Prefrontal cortex
intellectual tasks (thinking, reasoning, decision-making, etc.)
28
Other important gyri of the frontal lobe
superior, middle, & inferior gyri
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Inferior Frontal Gyrus
for most people, the left one is of special significance for speech Contains Broca's Area (the motor speech area)
30
Frontal Lobe Impairments
Loss of simple movement, loss of ability to problem solve, mood changes, inability to speak, poor spontaneity, perseveration, personality changes, difficulty sequencing, loss of flexible thinking, inability to focus on a task, changes in social behavior, motor control issues
31
Temporal Lobe
Lowest 1/3 of the brain; lies just under the temporal bone Has no natural demarcation between it & occipital lobe Contains primary auditory cortex & Wernicke's area
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3 important gyri of the temporal lobe
Superior, Middle, & Temporal gyri
33
Primary Auditory Cortex
Concerned with hearing; Heschl's gyrus | Area adjacent is called the secondary auditory cortex
34
Primary Auditory Cortex location
Present in both hemispheres but is typically larger in left than right Suggestive of left-dominance for receptive language skills
35
Right Temporal Lobe
less active but may be responsible for nonverbal memory, appreciation of musical experience, & rhythm
36
Wernicke's Area location
Posterior 2/3s of the superior temporal gyrus in the left dominant hemisphere; may be up to 7x larger than its homologue in the right hemisphere Connected to frontal lobe (motor speech area) via the arcuate fasciculus
37
Wernicke's Area Function
Vital for comprehension of written & spoken language
38
Hippocampus
Medial part of the temporal lobe that forms the medial wall of the lateral ventricle Mediates memory & learning
39
Overall Temporal Function
Site of auditory reception, interpretation, & AV association; comprehension of spoken & written material as well as processing of semantic/syntactic sounds; music
40
Temporal Lobe Impairments
Prosopagnosia, not comprhending spoken words, poor selective attention, STM Loss, Interference w/ LTM, increase/decrease in sexual behaviors, inability to categorize, logorrhea, Increased aggressive behaviors
41
Occipital Lobe
Smallest of the Lobes | Major structures include the primary visual cortex & the secondary visual cortex
42
Occipital Lobe Impairments
Visual field cuts, inability to locate objects, inability to recognize drawn objects, poor recognition of movement, poor color recognition, visual illusions, decrease in "seeing" objects, word blindness, inability to recognize words, difficulty reading & writing
43
Parietal Lobe Location
posterior to the frontal lobe
44
Post-Central Gyrus
Sensory cortex or sensory strip Primary sensory area controlling & integrating somesthetic sensory impulses Concerned w/ perception, sensation of touch, pressure, position, position sense, & body awareness Controls understanding of spatial relations & selective attention
45
Damage to right post-central gyrus may cause...
left neglect
46
Important gyri of the parietal lobe
angular gyrus & supramarginal gyrus
47
Damage to the supramarginal gyrus may result in...
agraphia &/or conduction aphasia
48
Agraphia
writing problems
49
Damage to the angular gyrus may result in...
deficits of reading, writing, &/or naming | May also cause TSA or transcortical sensory aphasia
50
Parietal Lobe Impairments
Inability to attend to I+; alexia, agraphia, inability to recognize words, difficulty with goal-directed movement, dyscalculia, difficulty drawing objects, difficulty knowing L/R, decreased awareness of body parts, poor manipulations of objects, unilateral neglect, inability to focus visual attention, inability to have hand-eye coordination, impaired perception of touch
51
Cerebral Ventricles
system of cavities deep within the brain that are filled with CSF Contain the choroid plexus that produces CSF of which totals are 130mL (30mL in the ventricles, 75mL in the spinal system, 25mL in the cranium
52
How many cerebral ventricles?
total of 4: 2 lateral, 3rd, and 4th ventricles
53
Turnover of CSF
around 500mL daily from the choroid plexus to the 4th ventricle to subarachnoid space & arachnoid villi
54
When CSF is blocked or absorption is impaired...
result is hydrocephalus
55
The CNS's protective mechanisms
Layer of skin, bones of the skull, & layers of tissue called meninges CSF as cushion for brain & spinal cord Spinal cord protected by vertebral column Brain maintains shape secondary to these supports as gravity would distort structure
56
SCALP
Provides that outermost protective & includes 5 layers 1st line of defense in protection of bony skull & brain S: skin; C: connective tissue; A: aponeurosis; L: loose areolar tissue; P: periosteum/pericranium
57
Meninges
protective layers that cover the brain & spinal cord
58
Outermost membrane of meninges
Dura Mater (2 layers)
59
Middle membrane of meninges
Arachnoid (contains blood vessels)
60
Innermost membrane of meninges
Pia mater (covers the brain)
61
Space between the Arachnoid & Pia mater
subarachnoid space (CSF)
62
Cerebrovascular system
Many neurological problems arise from disrupted blood supply to the brain Major etiologies of neurogenic language d/o's esp. aphasia are vascular pathologies &/or hemorrhage Brain depends on blood for nourishment & ability to function
63
Effects of disrupted blood supply on brain
LOC after 10 seconds of blood interruption | Permanent brain damage after 4-6 minutes
64
Brain's weight, blood & O2 use
weights roughly 2% of body weight receives 17-20% of body's blood receives 25% of body's oxygen
65
External Carotid Artery
muscles of the face & neck; oral/nasal cavities; skull & dura mater
66
Internal Carotid Artery
Major blood supplier to the brain
67
2 Main Branches of the Internal Carotid Artery
Anterior cerebral & middle cerebral arteries
68
Anterior Cerebral Artery
Supplies the middle portion of the frontal & parietal lobes, basal ganglia, & corpus callosum
69
Damage to anterior cerebral artery
causes disruption of blood to the midsagittal portions of the motor cortex Motor symptoms include: paralysis of legs & feet Associated cognitive deficits: impaired reasoning, judgment, & concentration
70
Middle Cerebral Artery
Largest branch of internal carotid; supplies blood to entire lateral surface of cortex including major portions of frontal lobe Supplies somatosensory cortex, motor cortex in precentral gyrus, Broca's area, primary auditory cortex, Wernicke's area, angular & supramarginal gyrus; putamen, caudate nucleus, globus pallidus, & portions of thalamus
71
Damage to middle cerebral artery
frequent result of stroke & aphasia; will cause contralateral hemiplegia Impaired sense of touch, position sense, pain, & temperature; reading/writing deficits
72
Vertebral Artery
branches of the 2 subclavian arteries that emerge from aortic arch; left/right join together to form basilar artery
73
Basilar Artery
Divides to form 2 posterior cerebral arteries Supplies lower/lateral temporal lobes & middle/lateral portions of occipital lobe Other branches supplies pons, cerebellum, inner ear
74
Watershed Areas of Brain
Anterior, middle, & posterior cerebral arteries supply majority of blood to brain; each 1 ends individual distribution & supply in small branches of arteries
75
What happens if watershed areas are damaged
somewhat inefficient supply of blood if blood supply to these areas is interrupted, specific kinds of aphasias can result in addition to other vascular diseases TCS & TCM

Aphasia (8 decks)

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