Language Systems And Aphasias Flashcards
What are the 2 principle structures of the neurocircuitry of language function
Broca’s Area
Wernicke’s Area
What connects Broca’s area and Wernicke’s area?
Accurate fasciculus and other peri-Sylvia connections
What happens if you disrupt the arcuate fasciculus
Both areas work, but problems connecting the 2 areas
Conscious auditory processing in primary auditory cortex
Lateral lemniscus to the MGN (medial = music)
Then to the
primary auditory cortex: superior temporal gyrus, within lateral fissure
Where is Heschl’s Gyrus
On the inside portion of the temporal lobe near the insula
Where is the temporal plane
On the temporal lobe, kind of a shelf when you pull it back
How are the language areas in each hemisphere connected
Via the corpus callosum
Hemispheric lateralization of language function
One “dominant side” processes the semantic aspects of language, while the “non-dominant” side processes non-verbal aspects of language: tone of voice, emotion, cadence, rhythm, accent
What does the dominant side processes
Semantic aspects of language
That does the non dominant side processes
Non verbal aspects of language: tone of voice, emotion, cadence, rhythm, accent
What side of the brain dominant are most people
Left
Non-verbal aspects: tone of voice, emotion, emphasis, cadence, rhythm, accent
Prosody
In people who are left dominant, what does the left side of the brain processes
Semantic aspects of language: meaning
In left dominant individuals, what does the right side of the brain process
Prosody
Sequence of regions and projections for language circuitry for reading aloud or naming objects
- Primary visual cortex
- Higher order visual cortical areas
- Parietal-temporal-occipital association cortex (angular gyrus)
- Wernicke’s area
- Broca’s area
- Motor region of the face
Fluent speech
- effortless, good articulation, grammatical
- prosody is intact: not a monotone or emotionally flat quality
- grammatical-caution: looking for change from patients own normal pattern
Non fluent
- laborious, inarticulate
- degradation in sentence structure: missing words, adjectives, adverbs
- in severe cases, reduced to telegraphic speech- nouns and verses only
How do you communicate with someone who does not have fluent speech
Switch from patient naming stimuli to asking yes-no questions
Volume of speech
Amount, not volume
Quantity/speed produced
Full sentences: high volume
Few words: low volume
Impaired/absent comprehension, but “fluent” and “high volume” of speech
Wernicke’s Aphasia
Coherency of the speech in Wernicke’s aphasia
May or may not be coherent, but will not understand questioning during exam
What’s another way of describing how the patient forms sentences in Wernicke’s aphasia
Word-Salad
-non-sense sentences with real words, real syllables, or non-words
Patients awareness of having Wernicke’s Aphasie
Typically unaware if deficit; frustrates by interactions until diagnosed
Intact comprehension, but impaired speech production
Broca’s Aphasia
Low fluency/volume of speech
Broca’s Aphasia
Patient awareness of having Broca’s aphasia
Patients may be aware of deficit (and distressed by it), especially before being examined and diagnosed
Damage to Broca’s also does what
Severs projections to ipsilateral (left) premotor cortex
What does the damage to the projections to ipsilateral premotor cortex in Broca’s area damage do
Makes it so patient cannot write with contralteral hand (right)
Spoken/written impairment
What do left sided infarcts do to the premotor cortex
Prevents activation of right premotor cortex (non injured side) thus writing apraxia for left hand
When the patient has a deficit in Broca’s area and the premotor cortex is damaged, what can the patient do to answer questions since they cannot write
They can still point to correctly answer questions (non language motor response, does NOT require Broca’s area)
