Concept and History of CAPD Flashcards
Where is the primary auditory area?
Heschel’s gyrus located in the sylvian fissure and posterior 1/3 of the superior temporal gyrus
What is the secondary auditory area?
Posterior superior temporal lobe
What is the tertiary auditory area?
Posterior-inferior part of the temporal lobe
What is the auditory association area?
Superior temporal gyrus
Includes wernicke’s (language comprehension)
What is the sylvian fissure?
A deep cleft seen in both hemispheres (more pronounced in the left)
Separates the temporal lobe from parietal and frontal
It runs between broca’s and wernicke’s (appears to be a marker for linguistic capacity)
Is phonetic awareness required for language?
Yes
Language comprehension requires that phonetically analyzed information be communicated to regions outside the perisylvian region (where sylvian fissure is), including the angular gyrus
What is the angular gyrus?
A region of the inferior parietal lobe of the brain involved in processing of auditory and visual input and language comprehension
Lies between the parietal, occipital, and temporal lobes
It plays an essential role in integration, processing, and connection of these different areas
Connected to both broca’s and wernicke’s (which are connected to each other by the arcuate fasciculus)
What do structures around the sylvian fissure mediate?
Auditory and language repetition
Language repetition is crucial for language acquisition and vocabulary development
Even short repetitive exposure to novel words causes an increase in the rapid neural response suggestive of the formation of trace-memory
What processes auditory signals?
Heschl’s gyrus
Phonemic analysis probably takes place in the adjacent auditory association cortex (Wernicke’s area)
Speech is encoded by more anterior regions, among them Broca’s area, that directs the adjacent motor cortex to produce appropriate movements for speech production
What does damage to any of the regions near the sylvian fissure (brocas, wernickes, etc.) result in?
Impairs language repetition
Hallmark of the perisylvian aphasias
Is CAPD a controversial issue?
Yes
It means different things to different people
What is aphasia?
An impairment of language, affecting the production or comprehension of speech and the ability to read or write
Expressive and receptive abilities affected
Linked to brain damage by Broca, Wernicke, and Freud
Is aphasia always due to a brain injury?
Yes
Most commonly following a stroke particularly in older individuals
But aphasias also may occur with other cerebral disorders including brain tumors, head trauma, infections, dementia, and multiple Sclerosis (MS)
What is wernickes?
Lies in the left temporal lobe, adjacent to the primary auditory area
Language development and usage can be seriously impaired by damage (sensory/receptive aphasia)
Many patients are unaware that they make little sense when they speak
Affects individuals reading and writing
They also may have trouble understanding the speech of others
What is wernickes aphasia?
Receptive aphasia
Fluent, but nonsensical speech
Flowing gibberish
Speech, while frequently containing strings that conform to the grammatical rules of language, has no coherent meaning and typically includes made-up words
Damage to this area leads to similar deficits in people with different native languages
Linguistic function of this area does not appear tied to sound in the modern brain, as shown by the evidence of deaf aphasics (signed gibberish)
Where is broca’s area?
Inferior frontal gyrus of the frontal lobe
Controls speech production
Leads to broca’s aphasia
What is broca’s aphasia?
Motor or expressive aphasia
A signer also has trouble articulating signs and cannot communicate fluently
Most patients are aware of these deficits and easily frustrated
What is brocas aphasia characterized by?
Non-fluent speech
Poor repetition
Few words, short sentences, and many pauses (trying to get the words out)
The words come with great effort and often sound distorted
Flat and monotonic intonation (telegraphic speech) because of the deletion of function words and disturbances in word order
Aural comprehension for conversational speech is relatively intact
Patients may be able to understand speech and read, but may have limited writing skills (due to the fact that it is very close to the motor strip)
Can the cerebellum be involved in certain symptoms of brocas?
Yes
The cerebellum coordinates movements related to exact timing
May have trouble understanding speech because the timing is jumbled
Cerebellum times the way speech is analyzed
Nerves not firing synchronously results in timing issues too
Cerebellum damage can cause agrammatic and imprecise enunciation
Is the ability to speak a quickly timed executed movement?
Yes
Takes skill and timing from the prefrontal cortex and the cerebellum to correctly speak
Needs some executive function to produce it
Are most cases of aphasia mixed?
Yes
Not usually so distinct
Probably due to close connections between brocas, wernickes, and auditory areas
Cortical damage is typically not limited to a small area
What is global aphasia?
When a stroke or other condition affects an extensive portion of the front and back regions of the left hemisphere
May have great difficulty in understanding words and sentences
May have great difficulty in forming words and sentences
May understand some words but not others
Be able to utter a few words at a time
Have severe speech/language difficulties that prevent them from effectively communicating
What is anomia?
A specific type of aphasia
Difficulty remembering the proper word to describe an attribute, action, or object
More evident with infrequent words
Results from cortical or subcortical strokes or cerebral insults
Circumlocutions
What is circumlocutions?
Using more words that necessary to identify an object because they cannot remember the exact word
The fuzzy things that you wear on your feet in winter
Common
