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Neuro Pt 3 > Speech and aphasia > Flashcards

Flashcards in Speech and aphasia Deck (14)
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1

What does a thorough mental status exam test?

Arousal and attention – level of consciousness, digit span, serial sevens
Memory – orientation, 3 words at 5 minutes, remote events
Language – fluency, comprehension, repetition, naming, reading, writing
Visuospatial function – clock drawing, tests for hemineglect
Mood and affect – inquiries about feelings, observations of affect
Complex cognition – executive function, similarities, proverbs, judgment, insight

2

Aphasia

Acquired disorder of language (capacity to communicate using verbal symbols) caused by brain damage

Most asphasics also have alexia and agraphia

3

Amnesia

Impaired recent memory, with deficient new learning

4

What is the relationship between handedness and cerebral language dominance?

99% of dextrals (right-handers) are left dominant for language, and 67% of sinistrals (left-handers) are also left dominant for language

5

Neuroanatomy of Broca's aphasia

Nonfluent, effortful speech with relatively preserved auditory comprehension

Damage to the left inferior frontal lobe (Broca's area- Brodmann areas 44 and 45)

Nonfluent speech, good comprehension, poor repetition, poor naming

6

Neuroanatomy of Wernicke's aphasia

Left posterior superior temporal lesions (Wernicke’s area- posterior part of Brodmann area 22)

Impaired auditory comprehension

Characterized by fluent, paraphasic speech with poor auditory comprehension

Fluent speech, poor comprehension, poor repetition, poor naming

A pt with this won't understand his own speech!

7

Neuroanatomy of conduction aphasia

Involves damage to the arcuate fasciculus (white matter tract connecting Wernicke’s and Broca’s areas)

Repetition deficit is the salient feature

Fluent speech, good comprehension, poor repetition, poor naming

8

Neuroanatomy of global aphasia

Most severe form of aphasia, and results from destruction of the entire perisylvian language zone

Patients have essentially no language function and right hemiplegia

Nonfluent speech, poor comprehension, poor repetition, poor naming

9

Speech vs language

Speech is necessary but not sufficient for language, which requires cerebral cortical regions dedicated to linguistic function

Speech is the mechanical act of uttering words using the neuromuscular apparatus responsible for phonation and articulation

10

Dysarthria

A disorder of speech due to motor system involvement

11

Dysphonia

Disorder of voice related to laryngeal disease

12

The Aphasia Examination (components) and how you test them

Spontaneous speech – Nonfluency is characterized by labored, effortful speech and

13

What causes most cases of aphasia?

A left middle cerebral territory infarct

14

Treatment of aphasia

Treat the causative lesion so as to maximize spontaneous recovery

Most functional improvement occurs in the first year

No drug therapy has yet been shown effective

Speech/language therapy is offered as early as possible

Psychiatric care is often helpful

Substantial benefit can be achieved by adaptation to disability