Language

Question 1

what 2 things does speech consist of

Answer 1

phonation and articulation

Question 2

what controls speech

Answer 2

UMN control, modulated by extrapyramidal and cerebellar systems

Question 3

what is phonation

Answer 3

sound produced by moving vocal cords

Question 4

what controls phonation

Answer 4

laryngeal muscles innervated by CN X

Question 5

what is dysphonia

Answer 5

hoarse, whispering, breathy

Question 6

what is articulation

Answer 6

sound production by actions and varied posoitions of the lips, tongue, palate, pharynx

Question 7

what muscles and nerves are responsible for articulation

Answer 7

facial, oral muscles innervated by CN VII, IX, X, XII

Question 8

what is dysarthria

Answer 8

slurred, choppy, indistinct - (conversation will make sense)

Question 9

T or F those unable to speak may still be able to use language

Answer 9

T - language is multimodal or symbolic communication. Those unable to speak may still communicate by reading and writing or using gestures

Question 10

what is aphasia

Answer 10

a disorder of previously acquired language ability from a language center lesion in the dominant hemisphere

• patients have impaired communication by means of any modality including gestures, signing, braille, and others
• may speak but have trouble communicating

abnormal language

Question 11

what artery feeds the cortical language centers

Answer 11

middle cerebral artery (MCA)

Question 12

where are language centers located

Answer 12

around the lateral sulcus (sylvian fissure) of the dominant hemisphere

Question 13

if a patient is right handed which hemisphere is the dominant one

Answer 13

the left

Question 14

if a patient is left handed what hemisphere is dominant

Answer 14

50% left

50% right

Question 15

what is Wernicke’s area responsible for

Answer 15

language comprehension, via listening, reading, and other modes

Question 16

what is Broca’s area responsible for

Answer 16

language expression or execution, by speaking, writing and other modes

Question 17

what can cause lesions in cortical areas that could cause aphasia

Answer 17

• ischemic infarction (occlusion of dominant MCA or its branches)
• hemorrhage, tumor, trauma or dementia

Question 18

which modes of communication are affected by a lesion in the critical cortical areas of language

Answer 18

all modes (listening, speaking, reading and writing are similarly affected)

Question 19

what is fluency

Answer 19

ease, facility and quantity of speech, regardless of content or meaning

Question 20

what is paraphasia

Answer 20

word or syllable substituations (sully for silly or blue for green)

Question 21

what is neologism

Answer 21

nonsense words (type of paraphasia ) ie scatifang

Question 22

where is the lesion in Broca’s aphasia

Answer 22

posterior, inferior frontal lobe

• frequently involves the adjacent motor cortex causes right hemiparesis and facial weakness

Question 23

How would a patient with Broca’s aphasia present

Answer 23

• laborious, effortful, telegraphic nonfluency (I…up….early)
• preserved comprehension (leads to frustration)
• imperfect repetition

Question 24

where is the lesion in Wernicke’s aphasia

Answer 24

posterior, superior temporal lobe

Question 25

how would a patient present with Wernicke's aphasia

Answer 25

- very fluent, but many filler words, paraphasic errors, few meaningful words: "if you saw it, redness would schloodder over the alls, anyway" - poor comprehension - imperfect repetition

Question 26

what does nonsensical, spoken gibberish suggest in in a patient in absence of hemiparesis

Answer 26

patient is psychiatric or on drugs

Question 27

where is the lesion in conductive aphasia

Answer 27

arcuate fasciculus (tract between Broca's and Wernicke's areas)

Question 28

how does a patient with conductive aphasia present

Answer 28

- fairly fluent, with some paraphasic errors. - "intermediate" imperfect comprehension (like a milder version of Wernicke's aphasia) - imperfect repetition

Question 29

how does a patient with global aphasia present

Answer 29

- severely nonfluent (mute), poor comprehension

Question 30

where is the lesion in global aphasia

Answer 30

- extensive lesion of Broca's, Wernicke's and arcuate fasciculus

Question 31

what is alexia

Answer 31

impaired reading when visual cortex is disconnected from language centers

Question 32

what is agraphia

Answer 32

impaired writing when motor cortex for dominant hand is disconnected from the language centers

Question 33

what clinical symptoms does a lesion in the posterior dominant hemisphere cause

Answer 33

alexia and agraphia

Question 34

what does a lesion in the nondominant hemisphere cause

Answer 34

aprosodias (abnormal prosody)

Question 35

what is prosody

Answer 35

semantic and emotional meaning conveyed by changes in vocal pitch, inflection, melody or tone of speech (rising pitch at the end of a sentence = a question)

Question 36

what are the 2 types of Aprosodias

Answer 36

Sensory/receptive and motor/expressive

Question 37

where is the lesion in a sensory/receptive aprosodia

Answer 37

nondominant "wernicke's area" lesion

Question 38

how does a sensory/receptive aprosodia present

Answer 38

- poor prosodic comprehension when listening - speaks with normal prosody - unable to repeat prosody in other's speech can't tell the difference if I say "this is yours." vs "this is yours?" but can speak it themselves

Question 39

where is a lesion causing motor/expressive aprosodia

Answer 39

nondominant Broca's area lesion

Question 40

how does a patient with a motor/expressive aprosodia present

Answer 40

- good prosodic comprehension when listening - lack of prosody when speaking - unable to repeat prosody in other's speech

Question 41

how is language defined neurologically

Answer 41

communication by means of symbols

Question 42

what does perisylvian language center refer to

Answer 42

Braca's and Wernicke's areas

Question 43

where is a lesion that causes imperfect repetition located

Answer 43

either the perisylvian language center (Broca's or Wernicke's areas) or the connecting arcuate fasciculus

Question 44

paraphagia's are more common with lesions in what areas

Answer 44

Wernicke's ( lesions of the posterior perisylvian language center)