Language & aphasia Flashcards
Where is Wernicke’s area located?
Posterior 2/3 of superior temporal gyrus
Prognosis of transcortical sensory aphasia
Variable; pts with vascular etiology will often exhibit improvement of comprehension, improve to anomic aphasia, or nearly resolve
Subcortical aphasia Type III
Posterior & anterior extension (global aphasia)
Prognosis of transcortical motor aphasia
Variable, pts with vascular etiology may evolve to anomic aphasia or symptoms may nearly resolve
Prognosis of conduction aphasia
Variable; pts can recover & evolve to anomic aphasia or almost completely resolve
Subcortical aphasia Type I
Anterior superior extension; fluency marked by short phrases, impaired articulation, poor repetition for low frequency phrases, intact comprehension for semantic info, poor writing, poor comprehension of syntactic info
Word class effects
Tendency of aphasia pts to have differential ability depending on the type of word (e.g., Broca’s aphasics skip more connection words)
Paragrammatism
Inaccurate selection of function words
Where is Broca’s area located?
Opercular & triangular portions of the inferior frontal gyrus
Neuroanatomical correlate of transcortical motor aphasia
Lesion of dominant frontal lobe, often anterior or superior to Broca’s area
Role of Broca’s area
Translating neural word forms into their articulatory sequences & sequencing words & their endings into utterances that have meaning (appropriate syntactic structure)
Scanning speech
Speech disorder of cerebellar origin that is characterized by variable intonation assoc. w/ involuntary interruption between syllables
Profile of transcortical motor aphasia
Similar to Broca’s, but fluency less impaired, & repetition intact
What is the role of the right hemisphere in language?
Prosody, attitudinal, emotional, & gestural aspects of language & behavior
Typical course/presentation of subcortical aphasia
Usually mutism or hypophonic voicing, poor articulation; repetition better than speech due to fewer paraphasias & reduced dysarthria; comprehension often relatively preserved; frequently transient with acute onset
Neuroanatomical correlate of Wernicke’s aphasia
Lesion of dominant inferior perisylvian fissure, often extending superiorly to parietal region affecting the supramarginal gyrus
Morphemes
Smallest meaningful units of a word
Aphemia
Nonaphasic, nondysarthric impairment of fluency caused by problems with initiation & maintenance of motor mvmt
Profile of anomic aphasia
Impaired naming with frequent circumlocutions or paraphasias
Polygot
Individual who is fluent in more than on language, may display different patterns of language impairment & recovery for each language
Semantics
Meanings that correspond to all lexical items & all possible sentences
Prognosis of Wernicke’s aphasia
Variable; pts with vascular etiology often exhibit improvement of comprehension, can evolve to transcortical sensory or conduction aphasia
Prognosis of Broca’s aphasia
Variable; pts with vascular etiology frequently improve to anomic aphasia with mild reduced fluency
Profile of global aphasia
Impaired fluency, comprehension, repetition, naming, & writing
Profile of mixed transcortical aphasia
Similar to global but with intact repetition
Phonemes
Individual sound units whose connection, in a particular order, produces morphemes
Profile of Broca’s aphasia
Impaired fluency, repetition, naming, writing; relatively intact comprehension
Right hemisphere damage impacts on language
Affects prosody, gesturing, emotional aspects, may change vocab selection, responses to complex statements, understanding of metaphors, decreased fluency
Neuroanatomical correlate of Broca’s aphasia
Lesion of dominant anterior hemisphere
Neuroanatomical correlate of mixed transcortical aphasia
Isolation of perisylvian fissure area by diffuse dominant hemisphere lesion; spares arcuate fasciculus
Outcome of aphasia treatment is related to
Disease factors (profile, severity) Premorbid factors (intelligence, communication skills, vocab) Status of other skills (concurrent deficits) Pre/postmorbid coping
Neuroanatomical correlate of global aphasia
Large lesions affecting both anterior & posterior regions of the left hemisphere; involves both Broca’s & Wernicke’s
How is the angular gyrus involved in language?
Central area in processing of written language
Spontaneous recovery is generally better for what type of language deficits?
Comprehension vs. output problems
Profile of Wernicke’s aphasia
Fluent but unintelligible speech, impaired comprehension, repetition, & naming; fluent writing but with paraphasias & neologisms
Prognosis of mixed transcortical aphasia
Variable; pts with vascular etiology may evolve to Broca’s or anomic aphasia
Right hemisphere lesions can result in what language changes?
Changes in vocabulary selection, responses to complex statements; poor understanding of metaphors; reduction in understanding & use of prosody
Syntax
Admissible combos of words in phrases & sentences (grammar)
Profile of conduction aphasia
Fluent speech but with paraphasias & naming errors, intact comprehension & writing, markedly impaired repetition
Stimulation of parts of the thalamus lead to what language phenomena?
Speech arrests, naming problems, perseveration, & protracted speech
Neuroanatomical correlate of transcortical sensory aphasia
Lesion of dominant temporoparietal-occipital are or parieto-occipital area, posterior to Wernicke’s area
Profile of transcortical sensory aphasia
Similar to Wernicke’s, but with intact repetition
Neuroanatomical correlate of conduction aphasia
Lesion of dominant temporoparietal area, particularly supramarginal gyrus & underlying WM; arcuate fasciculus is damaged
Arcuate fasciculus
Subcortical white matter pathway connecting Wernicke’s & Broca’s
Subcortical aphasia Type II
Posterior extension; intact fluency but paraphasic, poor repetition, impaired names of letters but better naming of objects, poor comprehension but better than Wernicke’s, poor reading/writing
Other than Broca’s, what other cortical areas are involved in naming?
Anterior superior & middle temporal gyri, left anterior cingulate, left ventral frontal, left medial occipital
Disconnection of premotor & supplementary motor areas from Broca’s area may result in
Transcortical motor aphasia, aphemia
Prognosis of global aphasia
Typically evolves to Broca’s aphasia with improvement in comprehension
What is the role of Wernicke’s area?
Initial steps of language processing that enable particular sequences of sounds to be identified & comprehended as meaningful words
Lexicon
Collection of all words in a given language
