S3: Speech Flashcards
(46 cards)
1
Q
Cortical Speech Centers
A
2
Q
Cortical Speech Centers
- receptive (Sensory)
A
3
Q
Cortical Speech Centers
- Executive
A
- Broca’s area (area 44)
- Exner’s area (area 45)
4
Q
Cortical Speech Centers
- Association
A
Language formulation area (area 37)
5
Q
Subcortical association fibers
A
- connect various areas of cortex in the same hemisphere together and also communicate with corresponding cortical areas in the other hemisphere through the corpus callosum.
6
Q
Peripheral NM Control of Speech
A
7
Q
Peripheral NM Control of Speech
- Msucles
A
Phonation and articulation involve movements of the jaw, lips, tongue, palate, larynx, and the respiratory muscles.
8
Q
Peripheral NM Control of Speech
- Nerves
A
9
Q
Peripheral NM Control of Speech
- Nuclei
A
- Trigeminal and facial nuclei, the nuclei ambiguous & hypoglossal nuclei.
- These nuclei innervate the jaw, lips, palate, larynx, and tongue.
10
Q
Co-ordinating Mechanisms of Speech
A
11
Q
Controlling hemisphere:
- In 93% of the population who are right-handed, the speech function is subserved by the left cerebral hemisphere (the dominant hemisphere).
- In > half of the remaining 7% who are left-handed, the left hemisphere remains dominant and controls speech function. In the rest of people, speech is controlled by the right hemisphere.
A
…
12
Q
Disorders of speech
A
- Aphasia (Dysphasia)
- Dysarthria
- Aphonia
13
Q
Def of Aphasia (Dysphasia)
A
It is an impairment of formulation of speech.
14
Q
Types of Aphasia (Dysphasia)
A
15
Q
Def of Motor/expressive/verbal/Broca’s aphasia
A
- Inability to formulate a meaningful speech.
- Patient understands the spoken words & will obey commands.
16
Q
Lesion in Motor/expressive/verbal/Broca’s aphasia
A
- Broca’s area (in the posterior part of the inferior frontal gyrus and the lower part of the precentral gyrus)
17
Q
Def of Nominal or amnestic aphasia
A
- Inability to name objects or subjects properly although the patient knows their nature and value.
18
Q
Lesion in Nominal or amnestic aphasia
A
- angular gyrus or the superior temporal gyrus of the dominant hemisphere
19
Q
Def of Sensory or receptive aphasia
A
- Inability to understand spoken or written words.’
- The patient’s speech is fluent, but words are used inappropriately leading to neologism
20
Q
Lesion in Sensory or receptive aphasia
A
- the posterior part of the superior temporal gyrus, and part of the adjacent parietal lobe of the dominant cerebral hemisphere.
21
Q
Def of Jargon/central/syntactical aphasia
A
- form of severe receptive aphasia with failure to produce correct words leading to neologisms and paragrammatism
22
Q
Lesion in Jargon/central/syntactical aphasia
A
left temporoparietal region.
23
Q
Def of Word Deafness
A
- Inability to understand spoken words but Speech production, reading and writing are normal
24
Q
Lesion in Word Deafness
A
- posterior part of the superior temporal gyrus of the dominant hemisphere.
25
Def of **Word Blindness**
- Inability to recognize written words or letters,
26
Def of **Alexia with agraphia (Visual Asymbolia)**
- Inability to read or write
27
Lesion in **Word Blindness**
- the angular or supramargina! gyri of dominant parietal lobe
28
Lesion in **Alexia with agraphia (Visual Asymbolia)**
- left angular gyrus
29
Def of **Agraphia**
- Inability to write.
* It is a form of expressive aphasia
30
Lesion in **Agraphia**
- Near Broca's area or association pathways in the posterior part of the middle frontal gyrus.
31
Def of **acalculia**
Inability to calculate.
32
Lesion in **acalculia**
left angular gyrus
33
Def of **Amusia**
Inability to appreciate musical sounds.
34
Lesion in **Amusia**
....
35
Def of **Global Aphasia**
Impairment of both the expression and comprehension of speech.
36
Lesion in **Global Aphasia**
In the dominant hemisphere involving both Broca's and Wernicke's areas.
37
Def of **Dysarthria**
- It is an impairment of articulation due to a disorder of the neuromuscular mechanisms responsible for it
38
Causes of **Dysarthria**
39
Causes of **Dysarthria**
- Bilateral UMNL (supranuclear) lesion of cranial nerves 9, 10, or 12 (pseudobulbar palsy)
- Due to; congenital diplegia, double stroke, M. S., motor neuron disease or upper brainstem lesions.
- Results in: Spastic dysarthria results with slurred speech.
40
Causes of **Dysarthria**
- Bilateral LMNL of CN 9, 10, 12 (True Bulbar Palsy)
Due to diphtheritic polyneuritis or bulbar poliomyelitis.
41
Causes of **Dysarthria**
- Extrapyramidal Lesion
- Due to: Parkinsonism.
- Results in: rigid dysarthria leading to slow, quiet and monotonous speech.
42
Causes of **Dysarthria**
- Cerevellar Lesions
- Due to; MS, hereditary ataxias, cerebellar and cerebellopontine angle tumors, or anticonvulsant toxicity.
- Results in: ataxic dysarthria (slurred, explosive staccato or scanning speech).
43
Causes of **Dysarthria**
- Disorders of Ms
- **Myasthenia gravis:** produces a slurred speech with nasal tone and hoarseness which T with fatigue.
- **Myotonia:** leads to a "strangled" speech due to stiffness of the tongue.
- F**acioscapulohumeral muscular dystrophy:** leads to inability to pronounce labials.
44
Causes of **Dysarthria**
- Oral Lesions
such as false teeth, cleft palate, and tongue-tie.
45
Def of **Aphonia**
Loss of the ability to phonate but the patient can talk in a whisper.
46
Causes of **Aphonia**
1. Laryngitis.
2. Tumor or paralysis of the vocal cords.
3. Hysterical: as a trial to escape from a stressful situation, the patient's ability to phonate when coughing is a clue to the diagnosis of hysterical aphonia.
