Language And Aphasias Flashcards
What do pragmatic deal with?
Context
What do semantics deal with?
Meaning
What do grammar and syntax deal with?
Phrases and sentences
What does morphology deal with?
Words
What does phonology deal with ?
Phonemes
What does phonetics deal with?
Speech siunds
Describe Broca’s case of aphasia
Leborgne (1811-1861) developed epilepsy in his youth, aphasia at age 30, and right-sided weakness at age 40
- Examined by Broca during final days
- Could only say the word “tan” but comprehension was intact
- Neuropath exam: “slow and gradual dissolution of left hemisphere”
What is the role of the left hemisphere?
Left hemisphere is dominant (in 95% of right-handers and 70% of left-handers) for:
- language comprehension
- language expression
- lexicon (although there is evidence of bilateral representations)
- phonetic assembly
- phonetic procession
What is the role of the right hemisphere?
Role of the right hemisphere:
• communicative and emotional prosody (stress, timing, intonation)
– right anterior damage: wrong intonation
– right posterior damage: difficulty in
interpretation
• pragmatics of language
– damage of right hemisphere: difficulty in
construction of sentences into a story
– difficulty in understanding jokes, sarcasm
What is the Wernicke’s-Geschwind model of language?
What are the parts of the brain that utilize auditory and visual language input?
What is the pathway of spoken word?
Incoming spoken word:
auditory signal → auditory pathway → Wernicke’s area → evocation of the word’s meaning in brain areas near to Wernicke’s area
Outgoing spoken word:
thoughts → conversion to a acoustic/auditory representations via Wernicke’s area → arcuate fasciculus → Broca’s area → motor cortex
Describe language processing for reading and writing?
Reading:
input from visual cortices → fusiform (visual word form area) → Wernicke’s area → evocation of the word’s meaning in brain areas near Wernicke’s area
Writing:
visual or auditory input / thoughts or memories → conversion to an motor / visual image in Wernicke’s area (and angular gyrus) → arcuate fasciculus → Broca’s area → premotor hand area → motor output
What is lexicon ?
Lexicon – the vocabulary of a person, language, or branch of knowledge
Lexical Access - The process by which the basic sound-meaning connections of language (i.e., lexical entries) are activated
At what point does aphasias cause?
What are the goals of aphasia examination?
- Characterize type of aphasia syndrome, which can inform cerebral localization of damage
- Measure level of performance across different domains to monitor change over time
- Assess strengths and weaknesses to inform therapeutic options
What are the types of aphasia examination?
Comprehension
– Spokenlanguage
– Written language
• Naming
– Visualconfrontationnaming
– Auditorynaming
– Tactile naming
• Repetition
• Expressive Speech – Fluent/nonfluent – Rhythm,prosody – Content(paraphasias?) – Articulation(dysarthria?)
• Writing
How do we classify aphasia?
To classify aphasia, it is necessary to determine whether a patient is able to:
• Understand spoken language, as evidence by accurate responses t spoken language and ability to follow spoken commands
• Read aloud accurately and with comprehension
• Consistently name common objects, presented visually, auditorily,
tactilely
- Accurately repeat spoken words, words and phrases
- Speak fluently with normal articulation and rhythm, without paraphasic syntactical or grammatical errors or usage of circumlocutory phrases
- Write legibly and grammatically
What causes Broca’s aphasia?
Damage to inferior frontal cortex (Brodmann’s areas 44 & 45)
What are the symptoms of Broca’s aphasia?
Pronunciation speech rhythm- dysarthria, stuttering, effortful
Speech content- missed syllables, agrammatical, telegraphic
Repition of speech- abnormal, but better than spontaneous
Comprehension of spoken language- normal
Comprehension of written language- normal
Writing- clumsy, agrammatical, misspelling
Naming- better than spontaneous speech
Other- hemiplegia, apraxia
What are the symptoms of Wernicke’s aphasia?
Pronunciation- normal, fluent, loquacious
Speech content- use of wrong or nonexistent words
Repetition of speech- abnormal
Comprehension of speech- very abnormal
Comprehension of written language- abnormal but better than for spoken
Writing- penmanship ok but misspelling and inaccuracies
Naming- abnormal, wrong names (paraphasias)
Other-sometimes hemaniopia
What causes Wernicke’s aphasia?
Damage to posterior sector of left auditory association cortex (posterior superior temporal gyrus, Brodmann’s area 22)
Where does Wernicke’s Aphasia cause?
What causes Gerstmann Syndrome?
Damage to the angular gyrus, Brodmann’s area 39
Left – right confusion, acalculia,
agraphia, finger agnosia, reading deficits
What are the symptoms of Gerstmann Syndrome?
Pronunciation speech rhythm - normal
Speech content -often normal
Repetition of speech -normal
Comprehension of spoken language- normal
Comprehension of written language- very abnormal
Writing- very abnormal spelling errors
Naming- often abnormal
Other- slight hemiparesis, hemianopsia
What causes Conduction aphasia?
Damage to the arcuate fasciculus (white matter connecting Broca’s and Wernicke’s)
What are the symptoms of conduction aphasia?
Pronunciation- normal
Speech content- some wrong words
Repetition - abnormal
Comprehension of spoken language- slightly abnormal, difficulty with complex syntax
Comprehension of written language- often normal
Writing- occasional spelling and language errors
Naming- occasional wrong names (paraphasias)
Other- slight hemiparesis,
neglect of right- sided stimuli
Explain Motor Articulation for Speech Vocalization
Explanation: The patient is right-handed which suggests a strong likelihood that language functions are lateralized to the left hemisphere. Right-sided numbness suggests left-sided damage in the vicinity of the somatosensory regions, but we cannot be sure if the damage involves gray or white matter (i.e., disrupted sensory regions or disrupted pathways to sensory regions). Speech is fluent so we can rule out Broca’s Aphasia. Comprehension is intact so we can rule out Wernicke’s Aphasia. There is no mention of the 5 hallmark symptoms of Gerstmann Syndrome. Repetition is damaged, making Conduction Aphasia the most likely diagnosis
What causes global aphasia?
Combination of Broca‘s, Wernicke‘s, and conduction aphasia
What are the symptoms of global aphasia?
Pronunciation speech rhythm- very abnormal
Speech content -very abnormal
Repetition of speech- very abnormal
Comprehension of spoken language- very abnormal
Comprehension of written language- very abnormal
Writing- very abnormal
Naming- very abnormal
Other- hemiplegia, hemiparesis
What causes transcortical sensory aphasia?
What are the symptoms of transcortical sensory aphasia?
What causes transcortical motor aphasia?
Damage to occipito-temporal-parietal watershed zone between posterior and middle cerebral artery territories
What are the symptoms of Transcortical motor aphasia?
What are the classifications of aphasia ?
What is alexia?
Definition:
Alexia
• word blindness, inability to read
• disconnection between visual and language system
• vision bilateral ………… language lateralized
• Alexia results from disruptions in transfer of visual
information to the areas of the left hemisphere
• Damage in the splenium (posterior part) of the corpus callosum
What is dyslexia?
Dyslexia (Specific Learning Disorder): developmental reading deficit
- Difficultyinreadingandspelling(despitenormal eyesight and hearing, adequate education and normal IQ)
- 10 – 30 % of population
• Some possible causes:
– Children with dyslexia have not developed phonological awareness (ability to attend individual sounds and associate them with letters).
– Abnormalities in ventral (word identification) and dorsal (orthographic-to-phonetic) visual-auditory pathways
