Language

Question 1

Dominant v Non-Dominant + How to Tell?

Answer 1

• Dominant Hemisphere (normally L) - semantics, lexical, phonology, grammar, syntax and motor execution
• Non-dominant Hemisphere- prosody (rhythm, stress and intonation); reflects emotion, stress and sarcasm
• ***Can determine which side is dominant via Wada Test - inject barbiturate into R or L carotid via catheter in femoral artery one at a time and observe deficits; important prior to brain surgery

Question 2

Classical v Modern View of Language Anatomy

Answer 2

Wernicke’s Area - posterior, superior temporal gyrus - decoding and encoding language meaning (comprehension) –> arcuate fasiculus –> Broca’s Area - inferior frontal cortex or pre-motor of language - production (UNIDIRECTIONAL)

• Bi-directional
• Multiple other areas contribute (even outside peri-sylvian areas)
  
  • Ex) basal ganglia and thalamus involvement

Question 3

Gertsman Syndrome

Answer 3

• lesion in posterior temporal/inferior parietal area (angular gyrus)
  
  • Results = acalculia, agraphia, L-R disorientation, finger agnosia, alexia

Question 4

Primary Progressive Aphasia (+ 3 subtypes)

Answer 4

-if not acute or subacute; slow degeneration

• Subtypes
  - 1- Progressive Non-fluent Aphasia
  - 2- Semantic Dementia (speech fluent but comprehension impaired)
  - 3- Logopenic Progressive Aphasia (atypical form of AD)

Question 5

Lateral Frontal Cortex Function

Answer 5

Executive Function

Question 6

Medial Frontal Cortex Function

Answer 6

Self, theory of mind, social brain

Question 7

Anterior Cingulate Gyrus Function

Answer 7

decisions and response selection

Question 8

Orbitofrontal Cortex

Answer 8

judgment and reward contingencies

Question 9

Fluent Aphasia

Answer 9

Wernicke or inferior MCA distribution

Effortless production but errors, paraphasia (sub), word salad, poor comprehension, poor repetition, NOT frustrated

Accompanied by…Visual field defects (contralateral superior quadrantanopsia)

Question 10

Non-Fluent Aphasia

Answer 10

Broca or superior MCA distribution

Effortful and frustrated; frequent grammar and syntax errors; agraphia (writing); cannot repeat but comprehension intact so frustrated/aware of mistakes

Accompanied by… Contralateral facial weakness or arm weakness; hemiparesis

Question 11

Global Aphasia

Answer 11

Trunk of L MCA

Effortful AND trouble w/ comprehension and repetition

Accompanied by…Contralateral hemiparesis; gaze preference toward lesion; contralateral homonymous hemiapnosia

Question 12

Extra-Sylvian Motor Aphasia

Answer 12

ACA-MCA watershed

Non fluent aphasia but can repeat

Question 13

Extra-Sylvian Sensory Aphasia

Answer 13

MCA-PCA watershed

Fluent aphasia but can repeat

Question 14

Conduction Asphasia

Answer 14

Insular or inferior parietal

Fluent speech and good comprehension but cannot repeat