Nonfluent Aphasias Flashcards
1
Q
Nonfluent Aphasias
A
may be referred to as: expressive aphasia, motor aphasia, or anterior aphasia
2
Q
Major characteristics of nonfluent aphasias
A
- major symptoms characteristic of nonfluent syndromes of aphasia (generalities)
1. decreased rate of speech
2. decreased phrase length
3. decreased prosody
4. decreased initiation of speech
5. decreased talking in general
6. increased effort
3
Q
Four types of nonfluent aphasias
A
broca’s aphasia
global aphasia
transcortical motor aphasia
mixed aphasia
4
Q
Broca’s Aphasia
A
- first described in 1861
- associated w/damage to the cerebral language areas surrounding the sylvian fissure but not extending to Wernicke’s area
5
Q
Neuroanatomical bases of Broca’s Aphasia
A
- posterior-inferior (third) frontal gyrus of the left hemisphere is known as Broca’s area (Brodmann’s areas 44 and part of 45)
- area known as the anterior language cortex
- middle cerebral artery blood supply
- lower part of the premotor cortex
6
Q
General Characteristics of Broca’s Aphasia
A
- more easily recognized than Wernicke’s pts
- typically present w/contralateral hemiplegia or hemiparesis
- weakness of [r] side facial muscles
- most motor problems improve over time
- pts are often very depressed; catastrophic reactions refusing to cooperate or continue testing
7
Q
Language Characteristics of Broca’s
A
- nonfluent and effortful speech
- agrammatic speech
- impaired repetition of words/sentences
- impaired naming
- questionable auditory comprehension
- oral reading
- writing problems
8
Q
Broca’s Aphasia:
- Lesion site
- Verbal expression
- Auditory comprehension
- Naming
A
- posterior-inferior frontal gyrus of the left hemisphere
- severely impaired; agrammatic; telegraphic; dysprosodic; possible AOS; minimal paraphasias
- better than expression; some degree of deficiency in some pts; essentially intact for most
- impaired (anomia)
9
Q
Broca’s Aphasia:
- Repetition
- Oral Reading
- Reading Comprehension
- Writing
A
- impaired; especially for grammatical features
- impaired; similar to oral expression
- impaired to some extent
- impaired
10
Q
Transcortical Motor Aphasia (TCM)
A
- extrasylvian aphasic syndrome; lies outside of the perisylvian language zones
- nonfluent aphasia w/good repetition skills
11
Q
TCM Neuroanatomical bases
A
- anterior superior frontal lobe
- usually above or below Broca’s area
- lesions often impact association pathways
- impacts supplemental motor area
- supplied by the anterior cerebral artery
12
Q
General Characteristics of TCM
A
- similar to Broca’s aphasia
- motor disorders: rigidity of UE, akinesia, bradykinesia
- hemiparesis
- pts may demonstrate apathy or behavioral withdrawal
- exhibit little to no interest in using language
13
Q
TCM Language Characteristics
A
- muteness, echolalic, reduced spontaneous speech
- agrammatic speech, paraphasic
- impaired naming w/intact repetition
- intact serial speech (relatively)
- intact knowledge of grammar/meaningfulness
- limited naming; may use motor prompts
- better comprehension than production
- essentially mute, motor prompts may help them
14
Q
TCM Aphasia
- Lesion site
- Vertical expression
- Auditory comprehension
- Naming
A
- deep portions of left frontal lobe below or above Broca’s area
- impaired; initially mute; paraphasic; agrammatic; telegraphic; limited word fluency; pt will have no apraxia of speech
- intact for simple; subtle problems w/complex material
- mildly impaired; better for confrontational naming
15
Q
TCM Aphasia
- Repetition
- Oral Reading
- Reading comprehension
- Writing
A
- intact; may demonstrate echolalic and perseverative speech
- Impaired
- good except for syntactically complex material
- impaired
16
Q
Mixed “Transcortical” Aphasia
A
- rare nonfluent aphasia type
- combine TMA and TSA
- language impairment is severe and extensive
- pts retain repetition skills
- has been labeled isolation aphasia
17
Q
Neuroanatomical Bases of Mixed Transcortical
A
- caused by various conditions that decrease blood flow throughout the cerebral arteries
- hypoxia of various origins
- cardiac arrest
- cerebral edema
- multiple embolic strokes
- supplied by the middle cerebral artery, and the anterior/posterior cerebral arteries
- Broca’s, Wernicke’s and the arcuate fasciculus are spared