Chapter 11: Aphasia and Other Disorders of Higher Cortical Function Flashcards
Aphasia is…
Any acquired abnormality of language.
Don’t confuse aphasia for…
Anything that may hinder the ability to speak or write like dysarthria, stuttering, decreased consciousness.
Which feature is present in all aphasias…
Anomia and problems with writing
Aphasia and writing
No aphasic patient writes normally. Asking a patient to write a paragraph can easily screen for aphasia.
Broca’s Aphasia
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
Telegraphic speech
Saying only the key nouns and verbs.
Paraphasias
Word Substitution errors
Wernicke’s aphasia
Fluent word salad; semantic paraphasias; neologisms; they would sound normal if you didn’t speak their language
Conduction apahasia
Arcuate fasciculus; many paraphasic errors; or lesions involving temporal and parietal lobes but sparing Wernicke’s area
Transcortical motor aphasia
Similar to broca’s, but less severe (can repeat)
Transcortical sensory aphasia
Similar to Wernicke’s, but less severe (can repeat)
Global aphasia
Think ICA stroke, everything in language is knocked out
Subcortical aphasias
Dominant hemispheric deep structures: basal ganglia and thalamus.
Accompanied by hypophonia of the voice.
Can resemble Broca’s or Wernicke’s.
Pure Alexia (alexia without agraphia) cause
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.
Commonly found with pure alexia
Contralateral homonymous hemianopia
Apraxia is
The inability to perform a learned motor task despite preservation of the necessary basic motor, sensory, and cognitive capacities.
Dominant hemisphere
How to test for apraxia
- Ask patients to pretend they are performing an action
- To mimic the examiner performing an action
- To use actual objects in performing an action
Frontal lesions in apraxia
Patient can identify task done correctly but can’t do it themselves
Parietal lesions in apraxia
Patient cannot recognize the task done correctly
Agnosia is
The inability to recognize objects despite preservation of the basic sensory modalities being used
Visual agnosia
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.
Cause of agnosia
Lesions in the sensory association areas of the brain
Prosopagnosia
Inability to recognize faces.
Lesion of visual association area: Occipitotemporal region anterior to the primary visual cortex.
Gerstmann’s syndrome 4 elements
- Agraphia
- Acalculia
- Right-left confusion
- Finger agnosia
