L29: Speech & Language

Question 1

What does speech require?

Answer 1

precise neuromuscular coordination of respiration, phonation, resonance & articulation systems.

Question 2

What are the 4 processes of speech?

Answer 2

1) respiration: breathing provides power
2) phonation: production of sound by muscle contraction
3) articulation: formation of recognizable speech by the mouth
4) resonation: sound quality shaped by throat

Question 3

What are the 5 dimensions of language?

Answer 3

1) phonology -rules determining how sounds can be sequenced
2) morphology -rules for meaning of sounds
3) syntax -rules for a language’s grammar
4) semantics -rules for the meaning of words
5) pragmatics -rules for communication (prosody, gestures, intonation)

Question 4

Define prosody

Answer 4

“melody of language” -pitch changes that convey emotions as well as linguistic info

Question 5

Broca’s area is in posterior aspect of inferior frontal gyrus (areas 44 & 45). Explain in more details what these areas 44 & 45 do.

Answer 5

Area 44 (posterior part of inferior frontal gyrus): involves in phonological processing & in language production, and is near face representations in cortical motor areas so controls mouth & tongue.

Area 45 (anterior part of inferior frontal gyrus): involved in semantics & plays a role in verbal memory.

Question 6

Wernicke’s area is formed by planum temporale of temporal lobe and supramarginal gyrus of parietal lobe. What is the general function of this area? Also, it is comprised of multiple functional subregions. Explain these 3 subregions.

Answer 6

General function is thought to relate to the representation of phonetic sequences, regardless whether the individual hears them, generates them himself or herself, or recalls them from memory.

It is comprised of 3 functional subregions:

1) responds to spoken words (including the individual’s own words) & other sounds
2) responds only to words spoken by someone else but is also activated by recall of a list of words
3) more associated with producing speech than perceiving it.

Question 7

The inferior parietal lobule is called the language processing node, and is composed of which 2 gyri?

Answer 7

1) angular gyrus –> semantic processing in both R & L hemispheres
2) supramarginal gyrus –> involved in phonological & articulatory processing of words.

Question 8

What areas of our brain are activated when understanding similar sounding and meaning words?

Answer 8

1) homonyms (wait vs weight) –> left hemisphere posterior central sulcus & inferior frontal gyrus are involved
2) synonyms (ship vs boat) –> broader regions in the inferior temporal & frontal lobes.

Question 9

Are subcortical areas (cerebellum, basal ganglia, limbic system) involved in speech?

Answer 9

Yes

Question 10

What are the 3 types of speech impairments?

Answer 10

1) articulation disorders -distortions, substitutions, omissions, addition
2) fluency disorders -stuttering & cluttering
3) voice disorders -voice sounds breathy, hoarse, husky, or strained.

Question 11

Broca’s aphasia vs Wernicke’s aphasia

Answer 11

Brocas

• halting speech
• repetitive
• disordered syntax, grammar, and structure
• comprehension intact

Wernickes

• fluent speech
• little repetitions
• syntax & grammar adequate
• contrived or inappropriate words
• comprehension intact

Question 12

What is global aphasia?

Answer 12

• both expressive & receptive aphasia
• poor prognosis
• extensive damage to frontal, temporal & parietal cortices

Question 13

What is conduction aphasia?

Answer 13

• normal language comprehension & normal spontaneous oral expression
• problems with expression (mix up sounds in words, omit words)
• destruction of arcuate fasiculus

Question 14

What is anomic aphasia?

Answer 14

• difficulty in finding certain words
• often caused by damage in parietal lobe around angular gyrus
• “can’t name things”

Question 15

What is anarthria?

Answer 15

-ppl can’t articulate words that would convey their thoughts (loss of ability to speak coherently)

Question 16

What is alexia?

Answer 16

-can’t read but can write due to damage to inferior part of left occipital & temporal lobes

Question 17

Alexia vs dyslexia

Answer 17

alexia is an acquired injury or disorder in adult life where people can’t read but can write

dyslexia is a developmental problem in children presenting with various degrees of difficulty in learning to read and write.

Question 18

What are some causes of communication disorders?

Answer 18

• trauma
• vascular disturbance
• tumor/infection
• environment (nutritional deficiency)
• neurodegeneration (Parkinson’s, alcoholism
• genetic
• idiopathic (autism)

Question 19

We’ve learned that the dominant hemisphere, which is commonly the left hemisphere is involved in language. Does the right hemisphere play a role in language?

Answer 19

-it has been seen that damage in the right hemisphere can lead to communication deficits involving the interpretation of contex, such as direct and indirect context disorders.

Indirect context disorders: difficulties interacting with your environment (hemineglect of left side & anosognosia -unawareness of such deficits)

Direct context disorders (aka pragmatic communication disorders): affect communication & cognition directly; disorders of prosody, discourse organization and comprehension of body language

Question 20

What is the WADA test?

Answer 20

• you paralyze one hemisphere to study effects of non-dominant hemisphere on language
• discovered that both hemispheres play a role in language

Question 21

What is socioeconomic status have on communication?

Answer 21

It has been shown that brain can change rapidly in response to enrichment (increased fractional anisotropy (FA) in white matter, which reflects more fiber density, axonal diameter & myelination). Higher socioeconomic status (better nutrition, more access to books, etc) is associated with higher levels of Broca’s activation.

Question 22

What is the effect of alcohol on broca’s area?

Answer 22

continued alcohol use has a profound effect on language areas by decreasing broca’s area.

Question 23

What is Velocardiofacial (VCFS) syndrome?

Answer 23

It is the 2nd most common genetic syndrome after down syndrome due to loss of 1 copy of 22q11.21. People will have elongated nose, almond-shaped eyes, slight chin. There are more than 150 traits associated with VCFS syndrome, such as alteration of facial appearance, cleft palate, speech problems, feeding problems, heart problems, learning & language deficits, middle ear infections, hypothyroidism (leading to seizures), immune system problems, and 1/3 of VCFS children have autism.

Question 24

what is the #1 cause of tetralogy of fallot (a heart condition)?

Answer 24

VCFS syndrome which is the 2nd most common after down syndrome.

Question 25

What are some symptoms of autism?

Answer 25

• social impairments
• communication difficulties
• problems with interpreting body language
• little empathy
• changes in cerebellum, amygdala
• very difficult to treat

Question 26

Which of the following areas is recognized as
a subcortical region involved in vocalization?

 A. Locus coeruleus 
 B. Insula 
 C. Nucleus tractus solitarius 
 D. PAG 
 E. Dorsal Raphe

Answer 26

D. PAG

Question 27

Your 68 year old patient presents with normal language
comprehension and spontaneous oral expression, but has
difficulty repeating words or phrases and shows a tendency
to omit words from her sentences. What is the diagnosis?

 A. Broca's aphasia 
 B. Dementia 
 C. Anomia 
 D. Wernicke’s aphasia 
 E. Conduction aphasia

Answer 27

E