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Neuropsychology > Apraxias and Aphasias > Flashcards

Apraxias and Aphasias Flashcards

1
Q

Which two parts of the brain are used in motor processing

A

Primary motor cortex and secondary motor cortex

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2
Q

Where is the primary motor cortex

A

In the pre central gyrus, anterior to the central sulcus

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3
Q

Relationship between primary motor and somatosensory cortex

A

Reciprocity in info sharing

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4
Q

Structural build up of the primary motor cortex

A

Homunculus, contralateral

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5
Q

Damage to primary motor cortex

A

Hemiplegia - loss of voluntary movement in half the body

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6
Q

What is hemiparesis?

A

Loss of sensation over half of the body

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7
Q

Three sections of the secondary motor cortex

A
  1. Supplementary motor area
  2. Promotor area
  3. Cingulate motor area
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8
Q

Location of the three components of the secondary motor cortex

A

Supplementary motor - anterior to the primary motor cortex
Premotor area - lateral to that
Cingulate motor - beneath the supplementary area

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9
Q

Function of supplementary motor area

A
  • Plans motor sequences

- Stimulation elicits an urge or anticipation to make a movement or an internally cued readiness for action

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10
Q

Function of premotor area

A
  • Externally cued readiness for action

- Sequencing, timing and initiation of voluntary movement

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11
Q

Function of cingulate motor area

A
  • Emotional and motivational momentum for movement
  • Has a role in the initiation of speech
  • Damage can lead to a lack of spontaneous motor activity
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12
Q

Two mor regions used in movement and their functions

A
  1. Posterior parietal lobe: coordinating spatial mapping with motor programming
  2. Dorsolateral prefrontal cortex: executive programming for movement
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13
Q

Three sections of the secondary motor cortex

A
  1. Supplementary motor area
  2. Promotor area
  3. Cingulate motor area
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14
Q

Location of the three components of the secondary motor cortex

A

Supplementary motor - anterior to the primary motor cortex
Premotor area - lateral to that
Cingulate motor - beneath the supplementary area

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15
Q

Steps for planned movement

A

Prefrontal cortex plans –> premotor cortex sequences –> motor cortex the executes

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16
Q

Three definitions of apraxia

A
  1. Disorder of skilled and symbolic movement
  2. Mental movement disorder (it’s not physical)
  3. Loss of voluntary movement
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17
Q

How are apraxias usually acquired?

A

Generally not developmental, generally from damage to the left hemisphere but symptoms are bilateral

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18
Q

What does Limb Kinetic Apraxia look like?

A

Problems executing precise, independent and coordinated finger movements, usually only affecting finer movements on one upper extremity

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19
Q

How do limb kinetic apraxia patients present?

A

No kinetic melody, poor motor control and large grasping movements

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20
Q

Testing for limb kinetic apraxia

A

Doing up a button, opening a safety pin, putting a letter in an envelope, a key in a lock

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21
Q

Lesion site for limb kinetic apraxia

A

Precentral gyrus, contralateral to the side effected. Commonly found with Broca’s aphasia, with right upper limb hemiparesis

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22
Q

Presentation of ideomotor apraxia

A

A loss of meaning of movement and ideas associated with movement, patients can perform previously learnt motor acts accurately. There is a disconnected between intention and motor sequence

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23
Q

Three kinds of impairment seen in ideomotor apraxia

A
  1. Buccofacial (oral, orofacial)
  2. Upper or lower limb (generally, but not always, bilateral)
  3. Truncal
24
Q

Tests for ideomotor apraxia

A

Perform an imaginary movement (blow a kiss, drink through a straw, kick a ball etc.)

25
Q

Lesion site for ideomotor apraxia

A

Left angular and supra marginal gyri

26
Q

Presentation of ideation apraxia

A

Disturbance of complex motor planning of a higher order than ideomotor apraxia with an inability to manipulate the environment successfully

27
Q

Testing for ideation apraxia

A

“Show me how you would make a cup of tea”

  • actions may be performed out of order
  • sometimes only individual actions can be performed
28
Q

Lesion site for ideation apraxia

A

Dorsolateral prefrontal cortex, bilateral brain disease in the parietal lobe - is often seen with Alzheimer’s

29
Q

Presentation of conceptual apraxia

A

Loss of concept of objects and their uses, so misusing of objects, not knowing which object to use for which task and difficulty matching objects and actions

30
Q

Lesion site for conceptual apraxias

A

Posterior regions of the left hemisphere

31
Q

Six areas in the brain important for language

A
  1. Broca’s
  2. Inferior frontal gyrus
  3. Wernicke’s
  4. Arcuate fasciculus
  5. Supramarginal gyrus
  6. Angular gyrus
32
Q

Role of Broca’s area in language and its location

A

Language production, lies adjacent to facial area of the motor cortex

33
Q

Role and location of the inferior frontal gyrus

A

Prepares speech into grammatically correct, semantically sound output (before the motor strip makes it out loud) - in the premotor area

34
Q

Wernicke’s area’s role

A

Language comprehension

35
Q

Role and location of the arcuate fasciculus

A

White matter fiber band that connects Wernickes to Broca’s and allows for collaboration for coherent speech

36
Q

Function of the supramarginal gyrus

A

Assists in reading comprehension

37
Q

Function of the angular gyrus

A

Comprehension, reading and writing, as well as being partially responsible for understanding metaphors

38
Q

What is language?

A

Process of rapid translation, understanding and expression of symbolic information, be it written or spoken. It’s interactive, between external input and an extensive internal store of knowledge

39
Q

What is an aphasia?

A

A disruption in a level of language that is higher mental functioning, not mechanical. It is acquired, through neurological damage and they come in degrees

40
Q

Things that aren’t aphasia

A
  • Developmental disorders of language
  • Purely motor speech disorders, stemming from issues with the oral motor apparatus
  • Language disorders that are secondary to primary thought disorders
41
Q

Six components of language

A

Reading, writing, repetition, production, naming and comprehension

42
Q

Fluent vs non fluent aphasias

A

Anatomically correlate dichotomy, anterior vs posterior lesions

43
Q

Markers of fluent speech

A

Abundant output, flowing, normal intonation, articulated, normal length phrases, few substantive words

44
Q

Markers of non fluent speech

A

Scarce output, poor articulation, short sentences, only meaningful words, no articles or prepositions

45
Q

Presentation of Broca’s aphasia

A

Non-fluent, aggrammatic, telegrammatic.

46
Q

Symptoms of Broca’s aphasia

A

Relatively intact comprehension, anomia (has difficulty finding words), impaired repetition, can read and understand but not aloud

47
Q

Add ons found with Broca’s

A

Right hemiplegia in the face and arm, limb kinetic apraxia on the left and tend to be painfully aware of the deficit.

48
Q

Paraphasias in Wernicke’s

A
  • Semantic (there is a semantic relationship between the error and the intended word)
  • Remote (words are unconnected)
  • Neologistic (words aren’t in the patient’s language)
  • Literal or phonemic (half of the intended word is there, but the other half has been substituted, rearranged or extra added)
49
Q

Presentation of Wernicke’s

A

Inappropriate intonation, comprehension impaired, anomia, poor repetition, often impaired reading, usually anosognosic

50
Q

Presentation of conduction aphasia

A

Fluent, frequent paraphasias, preserved comprehension, bad anomia, bad repetition

51
Q

Presentation of transcortical motor aphasia

A

Non fluent, repetition is fine, comprehension spared, anomia
Lesion is superior/anterior to Broca’s

52
Q

Presentation and lesion site of transcortical sensory aphasia

A

Fluent, repetition in tact, impaired comprehension, reading and writing
Lesion site is the angular gyrus, left parietal

53
Q

Presentation and lesion site of mixed transcortical aphasia

A

Literally can only repeat, the combo of the transcortical aphasias makes it impossible to comprehend or produce language
Lesion site is the mesial surface of the supplementary motor area

54
Q

Presentation of anomic aphasia

A

Everything is pretty much fine, the only issue is producing nouns

55
Q

Lesion site for anomic aphasia

A

Focal damage to the left temporal and parietal areas; temporal is nouns, parietal is verbs

56
Q

Presentation of global aphasia

A

Everything is impaired, often seen with hemiplegia.

Neuropsychology (17 decks)

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