Language System - LectureCapture Flashcards
What area is responsible for speech production?
Broca’s area
Where is Broca’s area located?
Superior frontal gyrus (heart shaped)
What area is responsible for language comprehension?
Wernicke’s area
Where is Wernicke’s area located?
Surrounding the primary auditory cortex and partially inside the lateral sulcus
What white matter tract connects Broca’s and Wernicke’s areas?
Arcuate fasciculus
Pathway of auditory processing
Info -> cochlear nuclei -> lateral lemniscus -> Broca’s -> MGN in thalamus -> primary auditory cortex -> Wernicke’s area
What connects Brocas on the right to Brocas on the left?
Corpus callousum
Dominant side for language processes what?
Semantic aspects of language
Non-dominant side for language processes what?
Prosody - tone, emotion, etc.
Most people are what side dominant for language?
Left
Which groups of people are protected more than others from unilateral lesions to the language systems?
Women and left handed people
In a right dominant person, which side processes semantics and which processes prosody?
Right = semantics, left = prosody
In order to read/name objects, what systems must be intact and communicating?
Visual and language
In order to read/name objects, what region passes information to the language areas?
Visual system -> Wernicke’s -> Brocas -> facial motor cortex for spoken response
Fluent speech is defined as
Effortless, articulate, and grammatical with normal prosody, not emotionally dull or flat
Non fluent speech is defined as
Laborous, inarticulate, missing words, adjectives, adverbs, etc.
Telegraphic speech
Using nouns and verbs only
If output is confluent, how do you find out if the patient comprehends?
Yes/no ? or nodding response ?
Volume of speech
Number of words, full sentences
Volume of speech for full sentences
Loud
Volume of speech for 2 word responses
Low
Which aphasia is characterized by absent comprehension, fluency, and high volume in which the patient thinks they are speaking coherently (but are actually speaking in nonsense sentences)?
Wernicke’s aphasia
Which aphasia is characterized by intact comprehension, but impaired production (low volume, non-fluency) in which the patient may be aware of the deficit and distressed by it?
Broca’s aphasia
What are the deficits if ONLY Brocas is damaged?
Cant write or speak
If the left Broca’s area is damaged, what are the deficits in writing?
Cant write with either hand
Not right because damage to left premotor cortex
Not left because we need an intact left premotor cortex to send projections to the right Brocas/premotor
Can patients with Brocas damage point?
Yes - just can’t give language based responses such as writing, speaking, or using sign language
In which type of aphasia do you see intact production of speech and intact comprehension of speech if tested separately?
Conduction aphasia
Patient can nod to answer questions (comp) or name family members if examiner points to them (production)
Damage to what causes conduction aphasia?
Arcuate fasciculus
MCA superior infarct would most likely cause
Broca’s or conduction aphasia
MCA inferior infarct would most likely cause
Wernicke’s aphasia
MCA superior and inferior infarct would most likely cause
Global aphasia
Watershed infarcts cause
transcortical aphasias
What kind of aphasia isolates an intact Broca’s from other motor areas and has deficits of low fluency, with spontaneous repeats?
Motor transcortical aphasia
Motor transcortical aphasia can cause what other motor deficits?
Proximal arm (shoulder) and leg (hip) weakness
Which aphasia is caused by an MCA-ACA watershed infarct?
Motor transcortical aphasia
Which aphasia is caused by an MCA-PCA watershed infarct?
Sensory transcortical aphasia
What kind of aphasia isolates an intact Wernicke’s from visual areas and has fluent aphasia with repeats and possible spatial hemineglect?
Sensory transcortical aphasia
In which aphasia is there an inability to name presented stimuli?
Anomic aphasia
In which aphasia is a patient unable to understand what they are reading, but can write a response?
Alexia without agraphia
Alexia
Inability to read
Agraphia
Inability to write
Alexia without agraphia is most often caused by what infarct
PCA
Alexia without agraphia causes what visual deficit
Right homonymous hemianopsia
Blocks projections from intact right visual cortex from crossing midline and reaching left angular gyrus (loss of reading using area 39)
MNEMONIC FOR DIAGNOSING APHASIAS
Got my big mac with sauce, cheese, avocado
Fries come, right?
