Jacewicz - Speech and Language Flashcards
1
Q
What is speech?
A
- Communication via vocalized sounds (phonation) that form spoken words and sentences
2
Q
What is phonation?
A
Distinct sounds produced by larynx
3
Q
What is a phoneme?
A
- A distinct sound that contrasts with others (American English has 25 consonant and 17 vowel phonemes)
4
Q
What is dysphonia?
A
- Disturbance of phonation causing alteration of volume (hyper- and hypophonia)
5
Q
What is dysarthria?
A
- Disturbance of articulation caused by impaired motor control, resulting in slurring of speech
6
Q
What is mutism?
A
Absence of phonation
7
Q
What is the anatomic substrate for speech?
A
- Neocortex w/sensory (blue) and motor (maroon) strips and overlying homunculi
- Sagittal section through lower face and neck to emphasize mm used in normal phonation
1. These mm incl the tongue, and mm controlling the lips, pharynx, vocal cords, etc - Any disruption to these motor pathways or the mm themselves can cause slurring of words denoted as dysarthria
8
Q
How can you examine a pt’s speech?
A
- Assess spontaneous speech, have subject read, and repeat selected phrases, e.g., “round the rugged rock the ragged rascal ran”
- Listen for:
1. Speech volume: INC in hearing deficits, DEC in vocal cord and extrapyramidal disorders, e.g., PD
2. Rate of speech: INC in fluent aphasia, DEC in non-fluent aphasia
3. Articulation: abnormal in many CNS and PNS disorders, and in end-organ lesions
9
Q
What is language?
A
- System of arbitrary symbols (sounds, written symbols, gestures) that permit communication of thoughts, ideas, emotions, etc.
10
Q
What is aphasia?
A
Loss of ability for spoken and written language
11
Q
What is alexia?
A
Loss of ability to read when no visual impairment exists
12
Q
What is agraphia?
A
Loss of ability to write when no motor impairment exists
13
Q
What is paraphasia? 2 types?
A
- Language errors due to word or sound substitution
1. Semantic paraphasia: substitution of one word for another, e.g., fork for spoon
2. Phonemic paraphasia: substitution of one sound for another, e.g., moon for spooon
14
Q
What is neologism?
A
Creation of meaningless words, e.g., woon for spoon
15
Q
What is semantics?
A
- Meaning or interpretation of a word, sentence, or other language form, i.e., language lexicon
18
Q
What is the anatomic substrate for language?
A
- Arcuate fasciculus and other peri-Sylvian fibers connecting Wernicke’s (BA #22) and Broca’s (BA #44-45) areas
- Not shown in this image are the connections bt the main language areas (W and B) and the o/association areas of the frontal, temporal, and parietal lobes
- It also does not demonstrate connections to the non- dominant hemisphere that provide emotional color to language
- Lesions of these connecting fibers will cause aphasia with unique characteristics
19
Q
What are the 3 main language disorders and their characteristics (image)?
A
21
Q
Imagine this is a R-handed split-brain subject. How will his responses vary based on the hand he uses to examine the objects blocked from his vision?
A
- When this R-handed split brain subject is asked to name small geometric objects w/o seeing them, he provides the correct answer when he handles the object w/his right hand -> sensory info registers in left hemisphere, which then connects w/language area
- However, when he handles the objects with his left hand (sensory info to the right hemisphere, which is disconnected from the language areas in the left hemisphere), he is unable to name the objects
- NOTE: split brain due to sectioning of the corpus callossum
22
Q
What does this image illustrate?
A
- Another method for testing split brain subjects: visual input restricted to either left or right calcarine (visual) cortex
- Same results are obtained as described in the tactile test, i.e. info transmitted to R visual cortex (seen with L eye) cannot reach language areas in L hemisphere -> although subject can see the objects he cannot name them
23
Q
What does this image illustrate?
A
- When subject is instructed to passively view a word, calcarine cortex lights up indicating INC metabolic activity and thus neuronal activation
- When subject listens to the word with no visual input, Hershel’s gyrus and Wernicke’s area light up
- NOTE: SPECT scans register changes in regional cerebral metabolism, measured with positron emitting isotopes, in this case radioactive deoxyglucose
24
Q
What does this image illustrate?
A
- When subject speaks the word, the facial area of the motor strip and Broca’s area light up
- When subject is asked for more complex language-related task, e.g., to generate word associations, the language association areas light up
- NOTE: SPECT scans register changes in regional cerebral metabolism, measured with positron emitting isotopes, in this case radioactive deoxyglucose
25
Q
Describe the left/right hemisphere language functions in a left hemisphere dominant individual (table).
A
- Orange boxes around specific lang funcs of the 2 hemispheres
- L HEMI: lexical and syntactic language, writing, and spoken word abilities
- R HEMI: some rudimentary spoken language and the emotional coloring of language (prosody)
- NOTE: stereognosis = mental perception of depth or 3-dimensionality by the senses, usually in reference to the ability to perceive form of solid objects by touch
37
Q
What will this lesion cause?
A
- Alexia without agraphia: unusual bc reading and writing typically are linked language functions
- Lesion that produces this syndrome shown in purple, and involved the left visual cortex and splenium of the corpus callosum
- Language areas of L hemisphere are intact, so pt able to speak normally and write normally, but they cannot read
- Pt has a R visual field deficit (R homonymous hemianopsia) -> they have no registration of R visual field and left visual field info (which registers normally in R visual cortex) cannot reach language areas bc of splenium lesion, so the pt is unable to read
38
Q
What is the language syndrome algorithm?
A
- Testing the patient for fluency, comprehension, and the ability to repeat simple phrases permits the categorization of all aphasic syndromes
- Color-coded circle under each type of aphasia helps to identify the anatomical lesion responsible for that aphasia
39
Q
What are the 9 language aphasias, and their differentiating features (table)?
A
- NOTE: only the first 4 columns are useful in separating one aphasic syndrome from all the others
