Case 4 - Speech and Language

Question 1

what is sensory aphasia

Answer 1

• occurs from a lesion to the Wernicke’s area
• there is fluency of language but words are middled
• this varies from insertion of a few incorrect or non-existent words into speech to a profuse outpouring of jargon

Question 2

why does sensory aphasia happen

Answer 2

because the patient is unable to understand their own speech due to damage that has occurred in the Wernicke’s area

Question 3

what is motor aphasia

Answer 3

• occurs from a lesion in Broca’s area
• there is reduced speech fluency with relatively preserved comprehension
• the patient makes great efforts to initiate language, which becomes reduced to a few disjointed words with failure to construct sentences
• patients who recover say they knew what they wanted to say but could not get the words out

Question 4

what is conductive aphasia

Answer 4

• occurs from a lesion in the arcuate fasiculus
• these are the association fibres connecting the Wernicke’s and Broca’s areas
• the output of speech is fluid but paraphrase, comprehension of spoken language is intact, and repetition is severe impaired
• naming and writing is also impaired
• reading aloud is impaired but reading comprehension is preserve

Question 5

what is global aphasia

Answer 5

this means the combination of the expressive problems of brocas aphasia and loss of comprehension of Wernicke’s with loss of both language production and understanding

Question 6

what is the circuit for understanding spoken language

Answer 6

• when a person hears a sentence, this is transmitted via the auditory apparatus to the primary auditory cortex In the temporal lobe
• this then connects the Wernicke’s area, which decodes the language into meaning
• If the sentence is to be repeated, or replied to, the information has to be transmitted forwards to Broca’s area via the motor programmes of the motor cortex, which activates the tongue and the laryngeal muscles

Question 7

what is the circuit for understanding written language

Answer 7

• visual inout is transmitted to the visual cortex in the occipital lobe
• inout from the visual associated area is sent to the left angular gyrus, where the objects are recognised and named
• input then goes to Wernicke’s area, where words are assembled into sentences, and the appropriate messages are sent via the arcuate and superior longitudinal fasiculi to Broca’s area
• Broca’s area activates motor programmes In the primary motor cortex that elicit speech via appropriate brainstem centres and muscles of the tongue and laryngitis