Language Flashcards
what 2 things does speech consist of
phonation and articulation
what controls speech
UMN control, modulated by extrapyramidal and cerebellar systems
what is phonation
sound produced by moving vocal cords
what controls phonation
laryngeal muscles innervated by CN X
what is dysphonia
hoarse, whispering, breathy
what is articulation
sound production by actions and varied posoitions of the lips, tongue, palate, pharynx
what muscles and nerves are responsible for articulation
facial, oral muscles innervated by CN VII, IX, X, XII
what is dysarthria
slurred, choppy, indistinct - (conversation will make sense)
T or F those unable to speak may still be able to use language
T - language is multimodal or symbolic communication. Those unable to speak may still communicate by reading and writing or using gestures
what is aphasia
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
what artery feeds the cortical language centers
middle cerebral artery (MCA)
where are language centers located
around the lateral sulcus (sylvian fissure) of the dominant hemisphere
if a patient is right handed which hemisphere is the dominant one
the left
if a patient is left handed what hemisphere is dominant
50% left
50% right
what is Wernicke’s area responsible for
language comprehension, via listening, reading, and other modes
what is Broca’s area responsible for
language expression or execution, by speaking, writing and other modes
what can cause lesions in cortical areas that could cause aphasia
- ischemic infarction (occlusion of dominant MCA or its branches)
- hemorrhage, tumor, trauma or dementia
which modes of communication are affected by a lesion in the critical cortical areas of language
all modes (listening, speaking, reading and writing are similarly affected)
what is fluency
ease, facility and quantity of speech, regardless of content or meaning
what is paraphasia
word or syllable substituations (sully for silly or blue for green)
what is neologism
nonsense words (type of paraphasia ) ie scatifang
where is the lesion in Broca’s aphasia
posterior, inferior frontal lobe
- frequently involves the adjacent motor cortex causes right hemiparesis and facial weakness
How would a patient with Broca’s aphasia present
- laborious, effortful, telegraphic nonfluency (I…up….early)
- preserved comprehension (leads to frustration)
- imperfect repetition
where is the lesion in Wernicke’s aphasia
posterior, superior temporal lobe
how would a patient present with Wernicke’s aphasia
- 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
what does nonsensical, spoken gibberish suggest in in a patient in absence of hemiparesis
patient is psychiatric or on drugs
where is the lesion in conductive aphasia
arcuate fasciculus (tract between Broca’s and Wernicke’s areas)
how does a patient with conductive aphasia present
- fairly fluent, with some paraphasic errors.
- “intermediate” imperfect comprehension (like a milder version of Wernicke’s aphasia)
- imperfect repetition
how does a patient with global aphasia present
- severely nonfluent (mute), poor comprehension
where is the lesion in global aphasia
- extensive lesion of Broca’s, Wernicke’s and arcuate fasciculus
what is alexia
impaired reading when visual cortex is disconnected from language centers
what is agraphia
impaired writing when motor cortex for dominant hand is disconnected from the language centers
what clinical symptoms does a lesion in the posterior dominant hemisphere cause
alexia and agraphia
what does a lesion in the nondominant hemisphere cause
aprosodias (abnormal prosody)
what is prosody
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)
what are the 2 types of Aprosodias
Sensory/receptive and motor/expressive
where is the lesion in a sensory/receptive aprosodia
nondominant “wernicke’s area” lesion
how does a sensory/receptive aprosodia present
- 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
where is a lesion causing motor/expressive aprosodia
nondominant Broca’s area lesion
how does a patient with a motor/expressive aprosodia present
- good prosodic comprehension when listening
- lack of prosody when speaking
- unable to repeat prosody in other’s speech
how is language defined neurologically
communication by means of symbols
what does perisylvian language center refer to
Braca’s and Wernicke’s areas
where is a lesion that causes imperfect repetition located
either the perisylvian language center (Broca’s or Wernicke’s areas) or the connecting arcuate fasciculus
paraphagia’s are more common with lesions in what areas
Wernicke’s ( lesions of the posterior perisylvian language center)
