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Aphasia > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

Aphasia

A

Acquired disorder of language caused by brain damage
May impact comprehension of language, expression of language, or both
May involve any modality (speech, writing, etc)

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2
Q

Clinically Important Consideration

A

Historically confusing disorder; involves multiple disciplines, and is often thought of demographically as “a disorder associated with aging”

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3
Q

Scientifically Important Consideration

A

Relationship between the brain & language; correlation between affected areas of the brain with lost or impaired language vs. unimpaired areas
Allow us to query whether specific areas of the brain control or modulate particular language functions

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4
Q

Early Perspectives on Aphasia

A

Multiple early misunderstandings: some thought the ventricles controlled cognition & some thought aphasia resulted from a paralyzed tongue

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5
Q

Gesner

A

1770: coined term “speech amnesia”
German anatomist/phrenologist who 1st suggested that language was localized in the brain along with other intellectual functions

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6
Q

Phrenology

A

Associates mental & intellectual functions topographically on the skull

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7
Q

Phrenological Organs

A

37 faculties

Johann Kaspar Spurzheim

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8
Q

Paul Broca

A

1824-1880
French neurosurgeon
1st to offer clinical & pathological evidence relating frontal lobe & left brain to language production
Research was especially fixated on lower portion of frontal lobe: area concerned with motor speech (aka Broca’s area)

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9
Q

Broca’s Work

A

Aphemia

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10
Q

Aphemia

A

Reduced speech fluency
Agrammatic, telegraphic speech
Many language production errors
Limited impairment of comprehension of spoken language

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11
Q

Carl Wernicke

A

1848-1905
German neuropsychiatrist
1st to describe a type of aphasia opposite in part to that of Broca’s work
His work purported that a different type of aphasia resulted from lesions in posterior portion of left superior temporal gyrus

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12
Q

Wernicke’s Work

A

Sensory aphasia; proposed that other types of aphasia existed: TCM, conduction aphasia, TCS

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13
Q

Handedness Theory

A

1936: Johannes Nielson suggested that language was in hemisphere opposite of preferred hand; research has discounted hypothesis: handedness not a reliable indicator of hemispheric language dominance
~85% of general population is right-handed; 15% is left-handed

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14
Q

Language Location in the Brain

A

Language is left-dominant for majority of world’s population

~15% of the (15% left-handed) are right hemisphere dominant for language

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15
Q

Cerebrum

A

The final integrative & executive structure of the nervous system; responsible for all higher-brain functions

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16
Q

Higher Brain Functions

A

Everyday thinking, logical reasoning, abstract reasoning, mathematical reasoning, memory, speaking, language production, artistry, scientific achievement, language comprehension, judgment, emotional experience, attention, problem solving, executive functioning

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17
Q

About the Brain

A

Contains billions of neurons with trillions of synapses
Weighs 3-3.5 pounds
Comprised of 6 layers w/ outermost layer consisting of gray matter
2 hemispheres connected by thick bands of long fibers (axons)
Regions w/ in the hemispheres connected by shorter association fibers
Surface is comprised of gyri & sulci

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18
Q

Gyri

A

Hills, folds, & convolutions on the brain surface

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19
Q

Sulci

A

grooves, valleys, & fissures on the brain

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20
Q

LCF

A

Longitudinal Cerebral Fissure

Separates the left/right hemispheres

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21
Q

Fissure of Rolando

A

aka Central Sulcus

Runs laterally, downward, & forward dividing the anterior half of the brain from the posterior half

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22
Q

Lateral Cerebral Fissure

A

aka Sylvian Fissure

Moves laterally and upward

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23
Q

Perisylvian Area

A

Regions surrounding this area are especially involved in speech, language, & hearing

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24
Q

Cerebral Lobes

A

Each cerebral hemisphere divided into 4 lobes: frontal, parietal, temporal, occipital
Each lobe associated with predominant functions

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25
Q

Frontal Lobe

A

Extremely important lobe for speech/language; largest lobe (1/3 of cortical surface)

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26
Q

Precentral Gyrus & the Frontal Lobe

A

Major portion of the primary motor cortex via the PS
Movements modified by EPS
Controls voluntary movements on opposite side of body
Anterior to motor strip is premotor area & supplementary areas

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27
Q

Prefrontal cortex

A

intellectual tasks (thinking, reasoning, decision-making, etc.)

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28
Q

Other important gyri of the frontal lobe

A

superior, middle, & inferior gyri

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29
Q

Inferior Frontal Gyrus

A

for most people, the left one is of special significance for speech
Contains Broca’s Area (the motor speech area)

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30
Q

Frontal Lobe Impairments

A

Loss of simple movement, loss of ability to problem solve, mood changes, inability to speak, poor spontaneity, perseveration, personality changes, difficulty sequencing, loss of flexible thinking, inability to focus on a task, changes in social behavior, motor control issues

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31
Q

Temporal Lobe

A

Lowest 1/3 of the brain; lies just under the temporal bone
Has no natural demarcation between it & occipital lobe
Contains primary auditory cortex & Wernicke’s area

32
Q

3 important gyri of the temporal lobe

A

Superior, Middle, & Temporal gyri

33
Q

Primary Auditory Cortex

A

Concerned with hearing; Heschl’s gyrus

Area adjacent is called the secondary auditory cortex

34
Q

Primary Auditory Cortex location

A

Present in both hemispheres but is typically larger in left than right
Suggestive of left-dominance for receptive language skills

35
Q

Right Temporal Lobe

A

less active but may be responsible for nonverbal memory, appreciation of musical experience, & rhythm

36
Q

Wernicke’s Area location

A

Posterior 2/3s of the superior temporal gyrus in the left dominant hemisphere; may be up to 7x larger than its homologue in the right hemisphere
Connected to frontal lobe (motor speech area) via the arcuate fasciculus

37
Q

Wernicke’s Area Function

A

Vital for comprehension of written & spoken language

38
Q

Hippocampus

A

Medial part of the temporal lobe that forms the medial wall of the lateral ventricle
Mediates memory & learning

39
Q

Overall Temporal Function

A

Site of auditory reception, interpretation, & AV association; comprehension of spoken & written material as well as processing of semantic/syntactic sounds; music

40
Q

Temporal Lobe Impairments

A

Prosopagnosia, not comprhending spoken words, poor selective attention, STM Loss, Interference w/ LTM, increase/decrease in sexual behaviors, inability to categorize, logorrhea, Increased aggressive behaviors

41
Q

Occipital Lobe

A

Smallest of the Lobes

Major structures include the primary visual cortex & the secondary visual cortex

42
Q

Occipital Lobe Impairments

A

Visual field cuts, inability to locate objects, inability to recognize drawn objects, poor recognition of movement, poor color recognition, visual illusions, decrease in “seeing” objects, word blindness, inability to recognize words, difficulty reading & writing

43
Q

Parietal Lobe Location

A

posterior to the frontal lobe

44
Q

Post-Central Gyrus

A

Sensory cortex or sensory strip
Primary sensory area controlling & integrating somesthetic sensory impulses
Concerned w/ perception, sensation of touch, pressure, position, position sense, & body awareness
Controls understanding of spatial relations & selective attention

45
Q

Damage to right post-central gyrus may cause…

A

left neglect

46
Q

Important gyri of the parietal lobe

A

angular gyrus & supramarginal gyrus

47
Q

Damage to the supramarginal gyrus may result in…

A

agraphia &/or conduction aphasia

48
Q

Agraphia

A

writing problems

49
Q

Damage to the angular gyrus may result in…

A

deficits of reading, writing, &/or naming

May also cause TSA or transcortical sensory aphasia

50
Q

Parietal Lobe Impairments

A

Inability to attend to I+; alexia, agraphia, inability to recognize words, difficulty with goal-directed movement, dyscalculia, difficulty drawing objects, difficulty knowing L/R, decreased awareness of body parts, poor manipulations of objects, unilateral neglect, inability to focus visual attention, inability to have hand-eye coordination, impaired perception of touch

51
Q

Cerebral Ventricles

A

system of cavities deep within the brain that are filled with CSF
Contain the choroid plexus that produces CSF of which totals are 130mL (30mL in the ventricles, 75mL in the spinal system, 25mL in the cranium

52
Q

How many cerebral ventricles?

A

total of 4: 2 lateral, 3rd, and 4th ventricles

53
Q

Turnover of CSF

A

around 500mL daily from the choroid plexus to the 4th ventricle to subarachnoid space & arachnoid villi

54
Q

When CSF is blocked or absorption is impaired…

A

result is hydrocephalus

55
Q

The CNS’s protective mechanisms

A

Layer of skin, bones of the skull, & layers of tissue called meninges
CSF as cushion for brain & spinal cord
Spinal cord protected by vertebral column
Brain maintains shape secondary to these supports as gravity would distort structure

56
Q

SCALP

A

Provides that outermost protective & includes 5 layers
1st line of defense in protection of bony skull & brain
S: skin; C: connective tissue; A: aponeurosis; L: loose areolar tissue; P: periosteum/pericranium

57
Q

Meninges

A

protective layers that cover the brain & spinal cord

58
Q

Outermost membrane of meninges

A

Dura Mater (2 layers)

59
Q

Middle membrane of meninges

A

Arachnoid (contains blood vessels)

60
Q

Innermost membrane of meninges

A

Pia mater (covers the brain)

61
Q

Space between the Arachnoid & Pia mater

A

subarachnoid space (CSF)

62
Q

Cerebrovascular system

A

Many neurological problems arise from disrupted blood supply to the brain
Major etiologies of neurogenic language d/o’s esp. aphasia are vascular pathologies &/or hemorrhage
Brain depends on blood for nourishment & ability to function

63
Q

Effects of disrupted blood supply on brain

A

LOC after 10 seconds of blood interruption

Permanent brain damage after 4-6 minutes

64
Q

Brain’s weight, blood & O2 use

A

weights roughly 2% of body weight
receives 17-20% of body’s blood
receives 25% of body’s oxygen

65
Q

External Carotid Artery

A

muscles of the face & neck; oral/nasal cavities; skull & dura mater

66
Q

Internal Carotid Artery

A

Major blood supplier to the brain

67
Q

2 Main Branches of the Internal Carotid Artery

A

Anterior cerebral & middle cerebral arteries

68
Q

Anterior Cerebral Artery

A

Supplies the middle portion of the frontal & parietal lobes, basal ganglia, & corpus callosum

69
Q

Damage to anterior cerebral artery

A

causes disruption of blood to the midsagittal portions of the motor cortex
Motor symptoms include: paralysis of legs & feet
Associated cognitive deficits: impaired reasoning, judgment, & concentration

70
Q

Middle Cerebral Artery

A

Largest branch of internal carotid; supplies blood to entire lateral surface of cortex including major portions of frontal lobe
Supplies somatosensory cortex, motor cortex in precentral gyrus, Broca’s area, primary auditory cortex, Wernicke’s area, angular & supramarginal gyrus; putamen, caudate nucleus, globus pallidus, & portions of thalamus

71
Q

Damage to middle cerebral artery

A

frequent result of stroke & aphasia; will cause contralateral hemiplegia
Impaired sense of touch, position sense, pain, & temperature; reading/writing deficits

72
Q

Vertebral Artery

A

branches of the 2 subclavian arteries that emerge from aortic arch; left/right join together to form basilar artery

73
Q

Basilar Artery

A

Divides to form 2 posterior cerebral arteries
Supplies lower/lateral temporal lobes & middle/lateral portions of occipital lobe
Other branches supplies pons, cerebellum, inner ear

74
Q

Watershed Areas of Brain

A

Anterior, middle, & posterior cerebral arteries supply majority of blood to brain; each 1 ends individual distribution & supply in small branches of arteries

75
Q

What happens if watershed areas are damaged

A

somewhat inefficient supply of blood
if blood supply to these areas is interrupted, specific kinds of aphasias can result in addition to other vascular diseases
TCS & TCM

Aphasia (8 decks)

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