NB14-1 - Language and Aphasias Flashcards
List the Brodman areas we need to know.
S1 - 1, 2, & 3
M1 - 4
V1 - 17
A1 - 41 and 42
Broca’s Area - 44 and 45
Wernicke’s Area - 22
Angular Gyrus - 39
Which brain hemisphere dominates in language expression and comprehension? What is it responsible for, more specifically.
The left hemisphere is dominant in 95% of right handers and 70% of left handers for:
- Language comprehension
- Language expression
- Lexicon
- Phonetic assembly
- Phonetic procession
What is the role of the right hemisphere in language comprehension and expression?
- Communicative and emotional prosody (stress, timing, intonation)
- right anterior - intonation
- right posterior - interpretation
- Pragmatics of language
- construction of sentences into stories
- understanding jokes and sarcasm
Picture where the important components of the Wernick-Geschwind model of language are located.
Describe the neural circuitry involved with language processing of incoming and outgoing spoken word.
Incoming Spoken Word - auditory signal > Heschel’s Gyrus (A1) > Wernicke’s area (evocation of the word’s meaning)
Outgoing Spoken Word - acoustic image information from Wernicke’s area > arcuate fasciculus > Broca’s area > motor cortex
Describe the neural circuitry involved with language processing for reading and writing.
Reading - input to V1 > visual word form area > Wernicke’s area (evocation of word meaning)
Writing - nonverbal meanings get converted to a motor/visual image in Wernicke’s area and the angular gyrus > arcuate fasciculus > Broca’s area > premotor area
What is the take away messge from this question?
D
There are several different routes that our lexicon can be accessed by.
Where region of the brain is considered to be where the majority of lexical access occurs?
The lexical information is considered to be stored in the left middle tempora region, just inferior to Wernicke’s area
List the types of aphasias caused by damage to the following areas
What are the general goals of an aphasia examination?
- To characterized the type of aphasia syndrome, which can inform cerebral localization of damage
- Measure level of performance across different domains to monitor change over time
- Assess strengths and weaknesses to inform therapeutic options
Describe the major speech related functions an aphasia exam tests and how.
- Comprehension
- Spoken Language - can the patient follow verbal instructions
- Written Language - can the patient follow written instructions
- Naming
- Visual - can the patient name an object shown to them
- Auditory - can the patient name an object described to them
- Tactile - can the patient name an object based upon its feel
- Repetition - can the patient repeat something you say to them
- Expressive Speech - when the patient talks, is their speech
- Fluent/nonfluent
- Possessing appropriate rhythm and prosody
- Possessing the appropriate content/meaning
- Articulated well
- Writing
Define the following terms:
Phonemic error
Paraphasia
Dysarthria
- Phonemic error - saying an incorrect word that sounds very similar to the intended word (ie - saying symptom instead of syndrome)
- Paraphasia - the production of unintended syllables, words, or phrases when speaking
- Dyarthria - difficult or unclear articulation of speech that is otherwise linguistically normal
What areas of the brain are typically damaged in Wernicke’s aphasia? An occulsion of which vessels usually causes this?
The posterior sector of the left auditory association cortex (posterior superior temporal sulcus, Brodmann 22). Typically caused by an occulsion of the inferior branch or the MCA
Describe the typical results of an aphasia examination of a patient with Wernicke’s aphasia. What other non-language related symptoms could be seen as well?
- Pronunciation and Speech Rhythm - normal, fluent, and loquacious (talkative)
- Speech Content - use of wrong or nonexistent words
- Repetition - abnormal
- Auditory Comprehension - very abnormal
- Written Comprehension - abnormal but better than spoken
- Writing - penmanship is fine but misspelling and inaccuracies
- Naming - abnormal
- Other possible symptoms - hemaniopia (blindess over half the visual field)
What areas of the brain are typically damaged in Broca’s aphasia? An occulsion of which vessels usually causes this?
Damage to the inferior frontal cortex (pars opercularis & triangularis; Brodmann 44-45). This is typically caused by an occlusion of the superior branch of the MCA.
Draw out the aphasia classification descision tree? Which aphasia is missing from this tree and how do you distinguish it from the rest?
Gerstmann syndrome is missing. It is the only one where auditory comprehension is normal but written comprehension is very abnormal. It will also have left-right confusion, acalculia, agraphia, and finger agnosia
Name the type of aphasia
Name the type of aphasia
Transcortical sensory
Name the type of aphasia
Gerstmann Syndrome
Name the type of aphasia
Name the type of aphasia
Tanscortical motor
Name the type of aphasia
Name the type of aphasia
B
