Chapter 11: Aphasia and Other Disorders of Higher Cortical Function

Question 1

Aphasia is…

Answer 1

Any acquired abnormality of language.

Question 2

Don’t confuse aphasia for…

Answer 2

Anything that may hinder the ability to speak or write like dysarthria, stuttering, decreased consciousness.

Question 3

Which feature is present in all aphasias…

Answer 3

Anomia and problems with writing

Question 4

Aphasia and writing

Answer 4

No aphasic patient writes normally. Asking a patient to write a paragraph can easily screen for aphasia.

Question 5

Broca’s Aphasia

Answer 5

Nonfluent, hesitant, telegraphic speech output, cannot repeat, but relatively preserved comprehension (cannot understand complex grammar). 
Phonemic substitutions (based on sound)
They are frustrated.
Singing is not impaired
Weakness in face and arm

Question 6

Telegraphic speech

Answer 6

Saying only the key nouns and verbs.

Question 7

Paraphasias

Answer 7

Word Substitution errors

Question 8

Wernicke’s aphasia

Answer 8

Fluent word salad; semantic paraphasias; neologisms; they would sound normal if you didn’t speak their language

Question 9

Conduction apahasia

Answer 9

Arcuate fasciculus; many paraphasic errors; or lesions involving temporal and parietal lobes but sparing Wernicke’s area

Question 10

Transcortical motor aphasia

Answer 10

Similar to broca’s, but less severe (can repeat)

Question 11

Transcortical sensory aphasia

Answer 11

Similar to Wernicke’s, but less severe (can repeat)

Question 12

Global aphasia

Answer 12

Think ICA stroke, everything in language is knocked out

Question 13

Subcortical aphasias

Answer 13

Dominant hemispheric deep structures: basal ganglia and thalamus.
Accompanied by hypophonia of the voice.
Can resemble Broca’s or Wernicke’s.

Question 14

Pure Alexia (alexia without agraphia) cause

Answer 14

Dominant occipital lobe and splenium of the corpus callosum.

Fibers connecting visual cortex on either side to Wernicke’s area in the dominant hemisphere is interrupted, preventing input of langugae through visual means.

Question 15

Commonly found with pure alexia

Answer 15

Contralateral homonymous hemianopia

Question 16

Apraxia is

Answer 16

The inability to perform a learned motor task despite preservation of the necessary basic motor, sensory, and cognitive capacities.
Dominant hemisphere

Question 17

How to test for apraxia

Answer 17

1. Ask patients to pretend they are performing an action
2. To mimic the examiner performing an action
3. To use actual objects in performing an action

Question 18

Frontal lesions in apraxia

Answer 18

Patient can identify task done correctly but can’t do it themselves

Question 19

Parietal lesions in apraxia

Answer 19

Patient cannot recognize the task done correctly

Question 20

Agnosia is

Answer 20

The inability to recognize objects despite preservation of the basic sensory modalities being used

Question 21

Visual agnosia

Answer 21

Can’t identify things with vision, but feeling it would help identify it.

Lesion of visual association area: Occipitotemporal region anterior to the primary visual cortex.

Question 22

Cause of agnosia

Answer 22

Lesions in the sensory association areas of the brain

Question 23

Prosopagnosia

Answer 23

Inability to recognize faces.

Lesion of visual association area: Occipitotemporal region anterior to the primary visual cortex.

Question 24

Gerstmann’s syndrome 4 elements

Answer 24

1. Agraphia
2. Acalculia
3. Right-left confusion
4. Finger agnosia

Question 25

Gerstmann’s cause

Answer 25

Lesion in the inferior parietal lobule of the dominant hemisphere (ANGULAR GYRUS)

Question 26

Which hemisphere gets neglect

Answer 26

The nondominant hemisphere

Question 27

Definition of neglect

Answer 27

Directed inattention, or relative lack of attention to one hemispace

Question 28

Most sensitive sign of Neglect

Answer 28

Extinction to double simultaneous stimulation. Touching one arm, then the other, then both and see if they miss any side.

Question 29

Neglect cause

Answer 29

Lesion in right frontal or parietal lobe, ultimately may get motor or sensory neglect

Question 30

Anosognosia definition

Answer 30

Being unaware of your deficit