speech and aphasia Flashcards
components of a mental status examination
- Arousal and attention - level of consciousness, digit span, serial sevens. 2. Memory - orientation, three words at five minutes, remote events 3. Language - fluency, comprehension, repetition, naming, reading, writing 4. Visuospatial function - clock drawing, tests for hemineglect 5. Mood and affect - inquiries about feelings, observations of affect 6. Complex cognition - executive function, similarities, proverbs, judgment, insight
define acute confusional state
a common and usually reversible disorder of attention
define amnesia
impaired recent memory, with deficient new learning
define aphasia
an acquired disorder of language resulting from damage to brain areas subserving linguistic capacity
define apraxia
impairment of learned movement, often associated with aphasia
define agnosia
impaired recognition in the visual, auditory, or tactile modality
define visuospatial impairment
difficulty interpreting spatial relationships
define hemineglect
failure to attend to one side (usually the left) of the body or extrapersonal space
define personality change
a departure from normal character or comportment that often implies a frontal lobe lesion
define dementia
multiple coexisting neurobehavioral deficits (e.g. amnesia, aphasia, personality change)
brain structures involved in speech
motor cortices, corticobulbar tracts, basal ganglia, cerebellum, lower motor neurons innervating the pharyx and larnyx, and pharyngeal and laryngeal muscles. Cerebral cortex is required for language.
what is dysarthria
a disorder of speech due to motor system involvement
what is dysphonia
a disorder of voice related to laryngeal disease
causes of mutism
severe aphasia, anarthria (no motor fuction) or aphonia (laryngeal failure) or psychiatric
describe cerebral dominance
language is represented in left hemisphere in most people. While 90% of population is right handed and 10% left handed, 99% of right handed people are left dominant for language but 67% of left handers are also left dominant for language.
testing for aphasia
requires the assessment of spontaneous speech, auditory comprehension, repetition, and naming. In literate individuals, reading and writing should also be examined, as impaired reading (alexia) and writing (agraphia) typically accompany aphasia
what is nonfluent spontaneous speech
labored, effortful speech and <6 word phrases
what area of brain is language associated with
perisylvian area, including brocas and wernickes area
what is a paraphasia
unintended sullables or words. 1. literal (pipe becomes hike), 2. verbal/semantic (wife becomes mother), 3. neologism (new and meaningless words)
What is impaired in all types of aphasias
naming common items
For Brocas aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Nonfluent spontaneous speech, good auditory comprehension, poor repetition, poor naming, localized to Broca’s area in left hemisphere
For Wernickes aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Fluent spontaneous speech, poor auditory comprehension, poor repetition, poor naming, localized to Wernicke’s area in left hemisphere
For conduction aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Fluent spontaneous speech, good auditory comprehension, poor repetition, poor naming, localized to Arcuate fasciculus area in left hemisphere
For global aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Nonfluent spontaneous speech,poor auditory comprehension, poor repetition, poor naming, localized to Perisylvian region in left hemisphere
For transcortical motor aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Nonfluent spontaneous speech, good auditory comprehension, good repetition, poor naming, localized to Anterior borderzone region in left hemisphere
For transcortical sensory aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Fluent spontaneous speech, poor auditory comprehension, good repetition, poor naming, localized to Posterior borderzone region in left hemisphere
For anomic aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Fluent spontaneous speech, good auditory comprehension, good repetition, poor naming, localized to angular gyrus region in left hemisphere
For mixed transcortical aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization
Nonfluent spontaneous speech, poor auditory comprehension, good repetition, poor naming, localized to angular gyrus region in left hemisphere
aphasia treatment
- treat causative lesion. Most functional improvement in language and cognition occurs in first year. Prognosis depends on size of lesion and age of patient (ie. Young patients with small lesions recover best). 2. speech/language therapy