0% Matter of Mind : A Neurologist's View Kenneth M. Heilman Introductory Chapter 2 Flashcards
Aphasia
loss of speech or a disruption in using and/or understanding language following neurological injury or disease.
Thalamus
Relay station deep in the brain, sensory information travels from a specialized organ such as the ear or eye to this part of the brain
Primary sensory areas
Recieving area of the cerebral cortex. Sensory information travels from the thalamus to the cerebral cortex to the primary sensory areas. Each sense has its own receiving area in the brain.
This primary sensory area is located in the upper part of the temporal lobe.
Primary auditory area
Wernicke’s model of how the left hemisphere mediates speech:
- Auditory information enters the primary auditory cortex. (AI)
- The auditory cortex is part of the superior highest temporal lobe.
- After an auditory analysis the information is sent to the part of the left association cortex that is Wernicke‘s area. (WA)
- Wernicke’s area is connected to Broca’s area by a pathway called the,
______________ ____________, that is curved and travels to the back of the Sylvia fissure.
Wernicke’s model of how the left hemisphere mediates speech:
- Auditory information enters the primary auditory cortex. (AI)
- The auditory cortex is part of the superior highest temporal lobe.
- After an auditory analysis the information is sent to the part of the left association cortex that is Wernicke‘s area. (WA)
- Wernicke’s area is connected to Broca’s area by a pathway called the,
arcuate fasiculus that is curved and travels to the back of the Sylvia fissure.
Area that projects to the motor cortex that is important in programming the movements necessary to produce words.
Broca’s Area
Controls the nerves running to the muscles that move the mouth tongue lips palate and vocal chords.
Motor cortex
If the connections between Wernicke’s area and Broca’s area were injured then it would make it so that their are speech errors. This is because..
The information about word sounds could not travel to the area that programs movement.
If the connections between Wernicke’s area and Broca’s area were injured then it would make it so that their are speech errors.
The person would still comprehend speech with representation of word sound intact.
True or false
In this instance the person would not recognize that he or she had made errors or attempt to correct them.
If the connections between Wernicke’s area and Broca’s area were injured then it would make it so that their are speech errors.
The person would still comprehend speech with representation of word sound intact.
In this instance the person would not recognize that he or she had made errors or attempt to correct them.
This is false.
The truth is in this instance the person would recognize that he or she had made errors and also attempt to correct them.
Type of Aphasia where the lesion is in the arcuate fasiculus.
Conduction Aphasia
Wernickes area stores information about…
Wernickes area stores information about how words sound(Phonological lexicon)
Broca’s area.programs ..
Broca’s area programs speech movements needed to make sounds.
Pure word deafness
Patients speak and name objects normally but cannot understand speech or repeat because speech sounds cannot access Wernicke’s area.
Wernicke’s aphasia
Patients cannot comprehend repeat or name but have fluent speech that contains neoligisms and words with phonological errors
Broca’s aphasia
Patients can understand but have trouble speaking because they cannot program their mouth, lips tongue, palate and vocal cords to make correct speech sounds
Voice and sound recognition are not verbal and can be mediated by the non dominant _____hemisphere.
Voice and sound recognition are not verbal and can be mediated by the non dominant right hemisphere.
Lesions of the primary auditory cortex on both sides causes__________ _________
Cortical deafness
Echolalia
Involuntary echoing of others speech in coversation.
Transcortical sensory aphasia
Able to repeat words, fluent speech with good english words but wrong word selection, so spontaneous speech carries little meaning.
Primary auditory cortex function:
Analyze sounds entering the brain.
Memories of how words sound are stored in ______ area
Memories of how words sound are stored in Wernicke’s area
Phonological lexical representation
Familiar with the sounds and can recognize them
Anomic Aphasia
Have a problem naming or finding words when speaking. Their speech is fluent, allowing them to descibe items which names they cant recall.
Cause of Anomic Aphasia pg 28
An inability of the semantic conceptual field to access phonological lexicon
Apraxia
the inability to carry out representational motor acts on instruction in the absence of difficulty comprehending the instruction or neuromuscular weakness or discoordination.
Apraxia of speech:
difficulty volitionally planning, programming and positioning speech articulators for the production of speech sound sequences.
Broca’s aphasia:
acquired language disorder characterized by nonfluent language output and relatively spared language comprehension.
Conduction aphasia:
aphasia characterized by disproportionately significant expressive problems during repetition, but with relatively good comprehension, fluent spontaneous speech, and naming deficits.
Fluency
in aphasia, refers to phrase length in the speech production of patients, as well as speech melody, articulatory agility, speech rate, and grammatical form
Neologisms
in aphasia, the substitution of non-words for intended words.
word substitutions constituting errors in naming in aphasia.
Paraphasias:
speech prosody refers to the rhythm, stress, and intonation of speech production.
Prosody:
Telegraphic speech:
describes the agrammatic speech associated with nonfluent aphasia (e.g. in Broca’s aphasia).
Due to injury in the primary auditory cortex located just anterior to Wernicke’s area
Patient is able to speak and recognize environmental noises and people’s voices, but cannot understand speech or repeat speech
Pure Word Deafness
Due to injury in the primary auditory cortex located just anterior to Wernicke’s area
Auditory information cannot gain access to Wernicke’s area, which contains the memories of how words sound.
Pure Word Deafness
Due to injury in the primary auditory cortex located just anterior to Wernicke’s area
Patient is still able to hear nonverbal sounds because the primary auditory cortex is still intact in right hemisphere
Pure Word Deafness
Transcortical Sensory Aphasia: Semantic Access and Egress Deficit
Characterized by echolalia (involuntary echoing or repeating of speech), and an inability to name or comprehend
Spontaneous speech has little or no meaning because patient selects the wrong words
According to Lichtheim semantic representations are disconnected from Wernicke’s area
Patients are able to perform an auditory analysis, but are not able to perform a semantic analysis
Patients can activate memories of words sounds to repeat words but they cannot understand the meaning of these words.
Patients with Alzheimer’s disease may also exhibit this type of aphasia
According to Lichtheim semantic representations are disconnected from Wernicke’s area
Transcortical Sensory Aphasia: Semantic Access and Egress Deficit
Patients have a problem naming or finding words when speaking
Anomic Aphasia: Inability to Access the Memories for Word Sound
Their speech is otherwise fluent and they are able to repeat and comprehend
Inability of semantic field to access the phonological lexicon
Anomic Aphasia: Inability to Access the Memories for Word Sound
Transcortical Aphasia with Intact Speech: Inability of Word Memories to Access Semantics
What is intact?
Repetition is completely intact
Semantic-conceptual field is able to access phonological lexicon which allows naming and intact spontaneous speech
Transcortical Aphasia with Intact Speech: Inability of Word Memories to Access Semantics
What does a person with Transcortical Aphasia have trouble with?
Phonological lexicon has trouble accessing the semantic-conceptual field which impairs comprehension
Difficulty initiating speech but able to comprehend speech, similar to Broca’s aphasia
Excellent repetition and naming ability, unlike Broca’s aphasia
Frontal lobes important in initiating behavior
Transcortical Motor Aphasia: Inability to Activate Semantics
Patients with Transcortical motor aphasia usually have lesions in …
Patients with Transcortical motor aphasia usually have lesions in left frontal lobe superior to Broca’s area
Patients with _________ _________ aphasia usually have lesions in left frontal lobe superior to Broca’s area
Injury in this frontal lobe region creates a deficit of intention keeping patients from spontaneously activating the semantic-conceptual field
Patients with Transcortical motor aphasia usually have lesions in left frontal lobe superior to Broca’s area
Injury in this frontal lobe region creates a deficit of intention keeping patients from spontaneously activating the semantic-conceptual field
Callosal Agraphia
An Interhemispheric Disconnection Disorder
Must learn two things in order to write:
(1) the movements used to form letters (2) how to spell
Must learn two things in order to write. In most right handers this information is stored in the _____ __________ which controls the motor function of the right hand
In most right handers this information is stored in the left hemisphere which controls the motor function of the right hand
If the right hander attempted to use his left hand this information would have to cross the _______ ________ (connects the right and left hemispheres of the brain) to reach the right hemisphere
If the right hander attempted to use his left hand this information would have to cross the corpus callosum (connects the right and left hemispheres of the brain) to reach the right hemisphere
If the corpus callosum is damaged, for example by alcohol abuse, then information can still cross between the two hemispheres (True or false)
False
If the corpus callosum is damaged ________then motor knowledge for the movement to form letters would be impaired
If the corpus callosum is damaged anteriorly then motor knowledge for the movement to form letters would be impaired
If the corpus callosum is damaged ________then spelling knowledge will be impaired
If the corpus callosum is damaged posteriorly then spelling knowledge will be impaired
If the corpus callosum is damaged posteriorly then spelling knowledge will be impaired
This results in two major types of Agraphia: apraxic (which is_______) and linguistic (loss of spelling knowledge)
If the corpus callosum is damaged posteriorly then spelling knowledge will be impaired
This results in two major types of Agraphia: apraxic (loss of motor skill) and linguistic (loss of spelling knowledge)
