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Neuro 3 (mine) > Speech and Aphasia > Flashcards

Flashcards in Speech and Aphasia Deck (22)
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1
Q

Recognize the importance of a comprehensive and systematic mental status examination.

A

Can localize problems of the brain, particularly good with language.
Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are 30-point measures often used for brief assessment of mental status, not totally sufficient.
-arousal/attn, memory, language, visuospatial function, mood and affect, complex cognition.

2
Q

Recognize the distinction between aphasia and amnesia

A

aphasia: an acquired disorder of language resulting from damage to brain areas subserving linguistic capacity
amnesia: impaired recent memory with deficient new learning

3
Q

Explain the relationship between handedness and cerebral language dominance.

A

Language is lateralized, so that in most people it is represented in the left hemisphere.

About 90% of the population is right-handed and 10% left-handed. However, whereas 99% of right-handed people are left dominant for language, about 67% of left-handers are also left dominant for language.

SO: pts with aphasia usually have a left hemisphere lesion.

4
Q

Define the syndrome of aphasia

A

-an acquired disorder of language caused by brain damage.
-language is the capacity to communicate using verbal symbols.
-Language is a means to communicate thought.
(Whereas speech is a mechanial act; uses motor cortices, corticobulbar tracts, basal ganglia, cerebellum, LMNs innervating pharynx and larynx, and pharyngeal and laryngeal muscles. Speech is necessary but not sufficient for language)

5
Q

Broca’s aphasia

A

Broca’s aphasia: infarct in left frontal region including Broca’s area; charcterized by nonfluent, effortful speech with relatively preserved auditory comprehension. Speech is telegraphic and agrammatic.

6
Q

behavioral neurology

A

subspecialty of neurology concerned with the effects of structural brain disease or injury on behavior

7
Q

dysarthria

A

dysarthria a disorder of speech due to motor system involvement

8
Q

dysphonia

A

disorder of voice related to laryngeal disease

9
Q

Mutism

A

can be due to severe aphasia.

Can be due to anarthria, aphonia or can be a psychiatric disease.

10
Q

Aphasia examination

A

spontaneous speech: nonfluency is characterized by labored, effortful speech and

11
Q

Language regions of the brain

A

Perisylvian zone, including Broca’s (Brodmann areas 44, 45) and Wernicke’s areas (Brodmann area 22; responsible for auditory cognition; left posterior superior temporal lesion)
-Adjacent extrasylvian/transcortical cortex also participates

12
Q

Paraphasias

A

Unintended syllables or words, more easily heard in a fluent speaker.

Three types:

  1. literal (phonemic): pipe becomes hike
  2. verbal (semantic): my wife becomes my mother
  3. Neologism (new and meaningless word): may lead to jargon aphasia
13
Q

Wernicke’s aphasia

A

Wernicke’s aphasia: subacute ischemic infarct in left superior temporal region; characterized by fluent, paraphasic seech with poor auditory cognition. Speech may be very rapid, with “press of speech” or logorrhea

14
Q

Conduction aphasia

A

Conduction Aphasia: involves damage to the arcuate fasciculus, a white matter tract connecting Wernicke’s and Broca’s areas. Many cases also have supramarginal gyrus damage. Repetition deficit is salient feature. T2 weighted MRI shows focal ischemic region in left hemisphere that extends into the subcortical white matter and thus involves the arcuate fasciculus.

15
Q

Global aphasia

A

**the most severe form of aphasia.
Results from destruction of the entire perisylvian language zone. Patients have essentially no language function and right hemiplegia.
CT shows large ischemic infarct involving almost entire left hemisphere. Most cases: left middle cerebral territory infarct is responsible, as with most aphasias.

16
Q

Broca’s aphasia

spont speech, comprehension, repetition, naming, localization

A

spont speech: nonfluent, comprehension: good, repetition: poor, naming: poor, localization: Broca’s area

17
Q

Wernicke’s aphasia

spont speech, comprehension, repetition, naming, localization

A

spont speech: fluent, comprehension: poor, repetition: poor, naming: poor, localization: Wernicke’s area

18
Q

Conduction aphasia

spont speech, comprehension, repetition, naming, localization

A

spont speech: fluent, comprehension: good, repetition: poor, naming: poor, localization: arcuate fasciculus

19
Q

Global aphasia

spont speech, comprehension, repetition, naming, localization

A

spont speech: nonfluent, comprehension: poor, repetition: poor, naming: poor, localization: perisylvian zone

20
Q

What do most aphasics also have?

A

alexia (acquired disorder of reading)
reading aloud impaired in anterior lesions, reading for comprehension more impaired in posterior lesions.

agraphia
written output parallels spoken output (sparse, effortful with anterior lesions; expansive and paragraphic with posterior lesions)

21
Q

Right hemisphere contributions to language

A

automatic speech (expletives), prosody (inflection w/ emotion), music, humor, metaphor, recovery

22
Q

Treatment of Aphasia

A
  • treat causative lesion
  • most functional improvement in first year
  • no drug therapy
  • speech/language therapy offered as early as possible
  • psychiatric care
  • adaptation to disability