Oct11 M1-Aphasia Flashcards
3 types of speech disorders
- dysphonia
- dysarthria
- aphasia (dysphasia)
dysphonia def
impairment in producing sound (phonation)
- problem in air stream, larynx, resonator sinuses (resonators)
- examples = injury to vocal cords, lesion of vagus n. recurrent largyneal branch
dysarthria def
impairment of articulation
- many causes: problem can be in lips, tongue, PNS, CNS. is a motor problem. something wrong with muscle control**
- DOESN’T help you localize the lesion
aphasia (dysphasia) def
impairment of language (problem in production and/or comprehension of language)
- usually both spoken and written (and sign language) production of language are impaired (in the production part)
- MOST PATIENTS = LESION IN LEFT CEREBRAL HEMISPHERE (cerebral cortex only and nowhere else)
aphasia is really a problem of what process
process by which we take written symbols, gestures, sounds and transform them into something with meaning so both understanding and production are affected
spectrum of problems in aphasia
- sometimes written (understand and prod) and spoken language (prod part)
- sometimes one of those affected and other is spared
handedness relation to speech lateralization
- most right handed pts (>96%) = speech is in the left hemisphere. and it’s bilateral in 0% of them
- left handed pts = 70% have speech in left hemisphere. 15% bilateral. 15% in right
2 areas important for language (in the two-operations model of language)
usually in left hemisphere, have:
- Wernicke’s area (upper part of temporal lobe) = decoding sounds from ear and give internal meaning
- Broca’s area (inferior frontal lobe) = motor programs turning concepts into movements of lips and mouth to make speech
* abnormalities in each = diff problems*
diff operations in Wernicke’s area
- speech repetition (repeat something someone said, which is easier in your mother language)
- speech comprehension (hear speech and give it a meaning)
- word retrieval (storing things and retrieving stored info to understand and eventually produce sound (Broca’s))
common presentation for aphasic pts
brought in by family members, usually saying person is confused. or say something wrong with person’s speech
4 things in evaluation of aphasia
- fluent ? (can produce words effortlessly)
- does the pt understand (not just follow what you’re saying). ask to do something without showing them
- paraphasic words (=paraphasia?) ? (substitute a word or a letter for another one, or create a new word (neologism)) (always better at assessing those if are in your mother tongue)
- repetition of sentences
2 classical types of aphasias
- non-fluent aphasia OR anterior aphasia with intact comprehension (Broca aphasia): prob in left inferior frontal lobe. (also called expressive aphasia bc problem in expression = fluency)
- fluent aphasia with paraphasia and impaired comprehension (Wernicke aphasia): left superior temporal lobe or inferior parietal lobe (which is just on top) (also called receptive aphasia bc problem in reception = understanding)
localization of aphasia IRL
can be the two classical types but OFTEN not mixed and not precise
prognosis of aphasia
depends on type
- comprehension, insight and social functioning are impaired (as in fluent with impaired comprehension type) = POOR prognosis
- comprehension relatively preserved (as in non-fluent or anterior aphasia) = good prognosis. excellent candidates for speech and language rehab. high likelihood of return to indep living.
in a pt with non fluent aphasia (understanding OK), smoker, meds for prostate, woke up with this problem, what’s the probable cause
stroke (bc sudden onset + focal lesion)
