Language disorders

Question 1

Aphasia definition

Answer 1

impairment of language produced by brain dysfunction

differentiated from: dysarthria (disorders of articuation), auditory disorders, psychiatric illnesses

Question 2

Language anatomy

Answer 2

Hemispheric specialization
Dominant hemisphere: L in >95% of R-handed, 70% of L-handed people
Non-verbal aspects processed in non-dominant hemisphere (tone, prosody)
Broca’s area
Wernicke’s area

Question 3

Broca’s area

Answer 3

production of language

interacts with many surrounding areas in frontal cortex

Question 4

Wernicke’s area

Answer 4

comprehension of language
interacts with many surrounding areas in temporal and parietal cortex
including angular and supramarginal gyri

Question 5

Arcuate fasciculus

Answer 5

connects Broca’s and Wernicke’s areas

Question 6

Corpus callosum

Answer 6

Connects to non-dominant hemisphere

Question 7

Examinable components of speech

Answer 7

Articulation
Fluency
Effort
Word finding
Paraph

Question 8

Dysarthria

Answer 8

dysarthria is not a language disorder, per se
can be due to:
UMN/LMN lesions
NMJ lesions
cerebellar
extrapyramidal
etc

Question 9

Phonemic paraphasias

Answer 9

literal
sound substitutions
e.g. cable instead of table

Question 10

Semantic paraphasias

Answer 10

word substitution

e.g. hat instead of coat

Question 11

Neologisms:

Answer 11

made-up words

Question 12

Prosody

Answer 12

intonation of speech
convey emotion
disorder - dysprosody/aprosody, can be caused by lesions in non-dominant hemisphere

Question 13

Auditory comprehension

Answer 13

Yes/no, MC questions
Point to objects and parts
Commands (simple/complex)
Complex syntax

Question 14

Naming impairments

Answer 14

can be impaired in absence of any other language problem (pure anomia)

Question 15

Classification of aphasias

Answer 15

use a 3-step approach:
1) fluency
2) comprehension
3) repetition
do NOT simply say receptive/expressive

Question 16

Global aphasia characteristics

Answer 16

non-fluent, poor comprehension

poor repetition/naming

Question 17

Mixed transcortical aphasia characteristics

Answer 17

non-fluent, poor cmprehension
poor naming
good repetition

Question 18

Global aphasia cause

Answer 18

Usually due to damage of both Broca’s/Wernicke’s (MCA)

Question 19

Mixed transcortical aphasia cause

Answer 19

damage to areas that communicate with Broca’s & Wernicke’s
but Broca’s , Wernicke’s, articulate fasciculus are spared individually
MCA/PCA, MCA/ACA watershed territories

Question 20

Broca’s aphasia

Answer 20

non-fluent with good comprehension

poor repetition and naming

Question 21

Transcortical motor aphasia characteristics

Answer 21

non-fluent with good comprehension
good repetition
poor naming

Question 22

Transcortical motor aphasia causes

Answer 22

damage to other areas of frontal lobes that communicate with Broca’s area

Question 23

Wernicke’s aphasia

Answer 23

Fluent speech with poor comprehension

poor repetition and naming

Question 24

Transcortical sensory aphasia characteristics

Answer 24

fluent speech with poor comprehension
Good repetition
Poor naming

Question 25

Transcortical sensory aphasia causes

Answer 25

damage to other areas of temporal/parietal lobes that communicate with Wernicke’s area

Question 26

Conduction aphasia characteristics

Answer 26

fluent speech with good comprehension
poor repetition
poor naming with frequent paraphasias

Question 27

Conduction aphasia cause

Answer 27

damage to peri-Sylvian areas affecting articlate fasciculus

Question 28

Anomic aphasia characteristics

Answer 28

fluent speech with good comprehension
good repetition
Poor naming with occasional paraphasias

Question 29

Anomic aphasia cause

Answer 29

anatomically non-specific

usually due to smaller lesions

Question 30

Naming in aphasia

Answer 30

poor in ALL aphasias

good screening to test naming

Question 31

Agraphia without aphasia

Answer 31

impaired writing without other language impairments
due to lesions to angular gyrus
Gerstmann’s syndrome

Question 32

Gerstmann’s syndrome

Answer 32

lesion to inferior parietal lobule, including angular gyrus
4 components:
agraphia
acalculia
R/L disorientation
finger agnosia

Question 33

Alexia without agraphia

Answer 33

Lesions in L occipital cortex/posterior corpus callosum = PCA
Information from L visual field –> R occipital lobe, then should cross over to L angular gyrus and Wernicke’s to permit reading
Disconnection syndrome

Question 34

Apraxia

Answer 34

lack of ability to execute learned purposeful movements
Not due to primary motor/sensory deficit
Comprehension, attention, motivation intact

Question 35

Types of apraxia

Answer 35

ideomotor apraxia
ideational apraxia
apraxia of speech
most due to lesions in dominant hemisphere (frontal/parietal association cortices)

Question 36

Ideomotor apraxia

Answer 36

commonest
failure to perform skilled/learned motor sequences on command, or to imitation
brush teeth, comb, salute, hammer nail (limb)
whistle, blow match, suck straw (bucco-facial)
bow, stand like a boxer (trunk)
intent of movement usually still recognizable

Question 37

Ideational apraxia

Answer 37

conceptual deficit
difficulty performing sequence of steps to complete a task
loss of knowledge to select tools/objects
usually bilateral parietal lobes affected

Question 38

Apraxia of speech

Answer 38

difficulty translating motor plans into speech output
general buccofacial praxis intact
speech effortful, but not due to aphasia (writing intact)
trial and error, groping for words
Lesion in dominant prefrontal areas near Broca’s