Aphasia Flashcards
Where is Broca’s area located? (As much detail as possible)
Posterior-inferior portion of the frontal lobe in the left hemisphere (for most ppl)
Where is Wernicke’s area located?
Posterior-superior portion of the temporal lobe in the left hemisphere (for most ppl)
What is the structure that connects Broca’s area and Wernicke’s area?
Arcuate fasiculus
What structure of the brain is responsible for understanding and relaying WRITTEn language to other areas of the brain?
Angular gyrus
Lesion site of Transcortical Aphasia (Sensory)
Around Wernicke’s area (does not include it)
Lesion site of Transcortical Aphasia (Motor)
Around Broca’s area (does not include it)
Lesion site of Mixed Transcortical Aphasia
In/around Broca’s, in/around Wernicke’s and around the Arcuate Fasiculus
Where is the lesion site for anomic aphasia?
Angular gyrus
(Posterior-inferior region of parietal lobe; Brodman 39)
Clinical profile of conduction aphasia
- Good spontaneous speech (motor)
- Good comprehension (sensory)
- Difficulty or inability with repetition
- Possible phonemic paraphasias
- Recognize mistakes - tries to correct
T/F: Paraphasias are often found in Broca’s aphasia
False - uncommon
Transcortical SENSORY Aphasia
- Good spontaneous speech (motor)
- Some difficult/inability to comprehend
- Can repeat fluently
- Semantic paraphasias common
**Similar to Wernicke’s but able to repeat
Transcortical MOTOR Aphasia
- Non-fluent speech (may be able to speak 1-2 words at a time normally)
- Good comprehension
- Good repetition of long+complex sentences (differential dx feature)
- Poor naming
**Similar to Broca’s but able to repeat
Transcortical MIXED Aphasia
- Non-fluent speech
- Poor comprehension
- Able to repeat long+complex sentences
- Poor naming
**Similar to Global Aphasia but good repetition
Clinical profile of Nonfluent (Broca’s) Aphasia
- Non-fluent speech
- Good language comprehension
- Poor repetition
- Poor naming
- Poor grammatical speech+ability to write (but main idea is often conveyed)
- Paraphasias uncommon
Fluent (Wernicke’s) Aphasia - clinical profile
- Good fluent speech (*but often meaningless)
- Poor comprehension of written+spoken language
- May use numerous neologisms
- Uses paraphasias (both types)
- Unaware of errors
- Can’t repeat
T/F: Agraphia and alexia present in all types of aphasia
Somewhat true – CAN be found in all types
Between Ischemic and Hemorrhagic strokes, which is more common?
Ischemic
What is a TIA?
Trasient Ischemic Attack
Self-resolves in 24 hours
Minimal long-term damage
Atherosclerosis
Build up of fat, cholesterol, proteins, calcium and immune cells form a plaque and start to obstruct arterial blood flow
Embolism
Part of a blood clot from somewhere else breaks off and travels to get caught in a thinner vessel.
Typically emerge from atherosclerosis but can come from the heart as well (after heart attack for example)
What does CVA stand for?
Cerebrovascular Accident (stroke)
What is a hemorrhagic stroke?
Bleeding in the brain due to ruptured blood vessels
What % of those who survive a stroke have aphasia?
About 50%
Causes of aphasia that are not strokes
Brain trauma
Tumors
Infections
Subcortical aphasia lesions sites
Basal ganglia + surrounding areas
Thalamus
Possible involvement of left cortical structures
Clinical profile of subcortical aphasia due to lesion in left basal ganglia + surroundings
- Fluent speech w/ possible hesitations
- Good repetition
- Normal auditory comprehension (possibly more difficult for complex material)
- Motor speech problems (Broca’s + prosody)
- Preserved writing
*Possible semantic paraphasias
*Possible limb apraxia
(Anomia, Broca, Wernicke, TMA)
Clinical profile of subcortical aphasia due to lesion to thalamus
Fluent aphasia with paraphasias and comprehension difficulties
- Word finding + naming
- Limited verbal output
- Neologisms
Clinical profile of subcortical aphasia due to lesion to the cerebellum
- Decreased fluency
- Mild anomia
- Agrammatism
- Mild speech comprehension difficulties
T/F: Individuals with expressive (Broca’s) aphasia have better prognosis than receptive (Wernicke’s)
True
Factors that can impact rehabilitation
- Age
- Comborbidities + Etiology of problems
- Site + size of lesion
- Duration before beginning intervention
- Motivation/behaviour
- Type of aphasia*
- Psychosocial support
When are the biggest gains made post-stroke?
Within the first 6-8 weeks
Window for intesive therapy w/ ++ gains
3-6 months
Total recuperation is very rare if gains not made within ___
One week
Which lobe is responsible for executive functioning and motor planning?
Frontal lobe
Which lobe is considered the sensory processing centre?
Parietal lobe
Sight and visual info processing centre
Occipital lobe
Auditory processing, memory and emotion centre
Temporal lobe
Balance, posture, equilibrium and movement control centre
Cerebellum
Vital body functions control centre
Brainstem
Part of the brainstem involved in regulating eye movement, arousal hearing and alertness
Midbrain
Main relay station btwn the brainstem and the cerebral cortex
Thalamus
Involved in chewing, facial movement, blinking and some balance
Pons
Involved in breathing, heartbeat, blood pressure and blood flow
Medulla
(also the site of decussation for many cranial nerves)
Involved in regulating body temperature, heart rate, thirst and hunger
Hypothalamus
Lexical-syntactic breakdown
- Increased use of non-specific language
- Omissions of various grammatical components
- Ability to convey feelings/opinions greatly reduced
T/F: For most bilingual individuals, a stroke will affect both of their languages
True
T/F: Bilingualism is associated with better recovery for patients with aphasia
False - myth
What is pure alexia?
- Not able to recognize series of letters as familiar words, even if they recognize the individual letters
- Main difficulty with the “voie d’adressage” but also assemblage
rTMS (non-invasive brain stimulation) has benefits for what kind of aphasia?
Can’t be confidently recommended yet, but:
Chronic/acute nonfluent (?)
What is agnosia?
Impaired understanding of the meaning of certain stimuli despite having no peripheral sensory impairment
You are assessing a woman with buccofacial apraxia. This alone suggests she might have what type of aphasia?
Broca’s aphasia, transcortical motor aphasia, or conduction aphasia
A 48-year-old stroke patient was misreading words that were irregularly spelled (e.g., Wednesday) but had no problems with non-words that they had never encountered before (e.g., Diggle). This patient probably presents with:
Surface alexia
(Difficulty with whole word recognition but voie d’assemblage is in tact)
A 68-year-old man experienced a stroke and had problems with reading; however, other language related skills like auditory comprehension, naming, writing, or oral repetition were not affected. This condition referred to as pure word blindness or alexia without agraphia is also called:
Pure alexia
Perisylvian region
Includes Broca’s area and Wernicke’s
Around the lateral sulcus in the left hemisphere
Transference plasticity
Plasticity as a result of one training experience can improve the acquisition of comparable behaviours
Surface agraphia
- Phonemic errors, issues with homophones
- Dictation of non-words relatively in tact
- Less frequent words more likely to be impaired
Deep agraphia
- Sound-letter conversion problem
- ## Often produces non-words that look visually similar to target word
