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Y4R3 - Medicine II 🩺 > S3: Speech > Flashcards

S3: Speech Flashcards

1
Q

Cortical Speech Centers

A
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2
Q

Cortical Speech Centers

  • receptive (Sensory)
A
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3
Q

Cortical Speech Centers

  • Executive
A
  • Broca’s area (area 44)
  • Exner’s area (area 45)
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4
Q

Cortical Speech Centers

  • Association
A

Language formulation area (area 37)

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5
Q

Subcortical association fibers

A
  • connect various areas of cortex in the same hemisphere together and also communicate with corresponding cortical areas in the other hemisphere through the corpus callosum.
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6
Q

Peripheral NM Control of Speech

A
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7
Q

Peripheral NM Control of Speech

  • Msucles
A

Phonation and articulation involve movements of the jaw, lips, tongue, palate, larynx, and the respiratory muscles.

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8
Q

Peripheral NM Control of Speech

  • Nerves
A
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9
Q

Peripheral NM Control of Speech

  • Nuclei
A
  • Trigeminal and facial nuclei, the nuclei ambiguous & hypoglossal nuclei.
  • These nuclei innervate the jaw, lips, palate, larynx, and tongue.
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10
Q

Co-ordinating Mechanisms of Speech

A
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11
Q

Controlling hemisphere:

  • In 93% of the population who are right-handed, the speech function is subserved by the left cerebral hemisphere (the dominant hemisphere).
  • In > half of the remaining 7% who are left-handed, the left hemisphere remains dominant and controls speech function. In the rest of people, speech is controlled by the right hemisphere.
A

…

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12
Q

Disorders of speech

A
  • Aphasia (Dysphasia)
  • Dysarthria
  • Aphonia
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13
Q

Def of Aphasia (Dysphasia)

A

It is an impairment of formulation of speech.

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14
Q

Types of Aphasia (Dysphasia)

A
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15
Q

Def of Motor/expressive/verbal/Broca’s aphasia

A
  • Inability to formulate a meaningful speech.
  • Patient understands the spoken words & will obey commands.
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16
Q

Lesion in Motor/expressive/verbal/Broca’s aphasia

A
  • Broca’s area (in the posterior part of the inferior frontal gyrus and the lower part of the precentral gyrus)
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17
Q

Def of Nominal or amnestic aphasia

A
  • Inability to name objects or subjects properly although the patient knows their nature and value.
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18
Q

Lesion in Nominal or amnestic aphasia

A
  • angular gyrus or the superior temporal gyrus of the dominant hemisphere
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19
Q

Def of Sensory or receptive aphasia

A
  • Inability to understand spoken or written words.’
  • The patient’s speech is fluent, but words are used inappropriately leading to neologism
20
Q

Lesion in Sensory or receptive aphasia

A
  • the posterior part of the superior temporal gyrus, and part of the adjacent parietal lobe of the dominant cerebral hemisphere.
21
Q

Def of Jargon/central/syntactical aphasia

A
  • form of severe receptive aphasia with failure to produce correct words leading to neologisms and paragrammatism
22
Q

Lesion in Jargon/central/syntactical aphasia

A

left temporoparietal region.

23
Q

Def of Word Deafness

A
  • Inability to understand spoken words but Speech production, reading and writing are normal
24
Q

Lesion in Word Deafness

A
  • posterior part of the superior temporal gyrus of the dominant hemisphere.
25
Q

Def of Word Blindness

A
  • Inability to recognize written words or letters,
26
Q

Def of Alexia with agraphia (Visual Asymbolia)

A
  • Inability to read or write
27
Q

Lesion in Word Blindness

A
  • the angular or supramargina! gyri of dominant parietal lobe
28
Q

Lesion in Alexia with agraphia (Visual Asymbolia)

A
  • left angular gyrus
29
Q

Def of Agraphia

A
  • Inability to write.
  • It is a form of expressive aphasia
30
Q

Lesion in Agraphia

A
  • Near Broca’s area or association pathways in the posterior part of the middle frontal gyrus.
31
Q

Def of acalculia

A

Inability to calculate.

32
Q

Lesion in acalculia

A

left angular gyrus

33
Q

Def of Amusia

A

Inability to appreciate musical sounds.

34
Q

Lesion in Amusia

A

….

35
Q

Def of Global Aphasia

A

Impairment of both the expression and comprehension of speech.

36
Q

Lesion in Global Aphasia

A

In the dominant hemisphere involving both Broca’s and Wernicke’s areas.

37
Q

Def of Dysarthria

A
  • It is an impairment of articulation due to a disorder of the neuromuscular mechanisms responsible for it
38
Q

Causes of Dysarthria

A
39
Q

Causes of Dysarthria

  • Bilateral UMNL (supranuclear) lesion of cranial nerves 9, 10, or 12 (pseudobulbar palsy)
A
  • Due to; congenital diplegia, double stroke, M. S., motor neuron disease or upper brainstem lesions.
  • Results in: Spastic dysarthria results with slurred speech.
40
Q

Causes of Dysarthria

  • Bilateral LMNL of CN 9, 10, 12 (True Bulbar Palsy)
A

Due to diphtheritic polyneuritis or bulbar poliomyelitis.

41
Q

Causes of Dysarthria

  • Extrapyramidal Lesion
A
  • Due to: Parkinsonism.
  • Results in: rigid dysarthria leading to slow, quiet and monotonous speech.
42
Q

Causes of Dysarthria

  • Cerevellar Lesions
A
  • Due to; MS, hereditary ataxias, cerebellar and cerebellopontine angle tumors, or anticonvulsant toxicity.
  • Results in: ataxic dysarthria (slurred, explosive staccato or scanning speech).
43
Q

Causes of Dysarthria

  • Disorders of Ms
A
  • Myasthenia gravis: produces a slurred speech with nasal tone and hoarseness which T with fatigue.
  • Myotonia: leads to a “strangled” speech due to stiffness of the tongue.
  • Facioscapulohumeral muscular dystrophy: leads to inability to pronounce labials.
44
Q

Causes of Dysarthria

  • Oral Lesions
A

such as false teeth, cleft palate, and tongue-tie.

45
Q

Def of Aphonia

A

Loss of the ability to phonate but the patient can talk in a whisper.

46
Q

Causes of Aphonia

A
  1. Laryngitis.
  2. Tumor or paralysis of the vocal cords.
  3. Hysterical: as a trial to escape from a stressful situation, the patient’s ability to phonate when coughing is a clue to the diagnosis of hysterical aphonia.

Y4R3 - Medicine II 🩺 (35 decks)

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