speech and aphasia

Question 1

components of a mental status examination

Answer 1

1. 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

Question 2

define acute confusional state

Answer 2

a common and usually reversible disorder of attention

Question 3

define amnesia

Answer 3

impaired recent memory, with deficient new learning

Question 4

define aphasia

Answer 4

an acquired disorder of language resulting from damage to brain areas subserving linguistic capacity

Question 5

define apraxia

Answer 5

impairment of learned movement, often associated with aphasia

Question 6

define agnosia

Answer 6

impaired recognition in the visual, auditory, or tactile modality

Question 7

define visuospatial impairment

Answer 7

difficulty interpreting spatial relationships

Question 8

define hemineglect

Answer 8

failure to attend to one side (usually the left) of the body or extrapersonal space

Question 9

define personality change

Answer 9

a departure from normal character or comportment that often implies a frontal lobe lesion

Question 10

define dementia

Answer 10

multiple coexisting neurobehavioral deficits (e.g. amnesia, aphasia, personality change)

Question 11

brain structures involved in speech

Answer 11

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.

Question 12

what is dysarthria

Answer 12

a disorder of speech due to motor system involvement

Question 13

what is dysphonia

Answer 13

a disorder of voice related to laryngeal disease

Question 14

causes of mutism

Answer 14

severe aphasia, anarthria (no motor fuction) or aphonia (laryngeal failure) or psychiatric

Question 15

describe cerebral dominance

Answer 15

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.

Question 16

testing for aphasia

Answer 16

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

Question 17

what is nonfluent spontaneous speech

Answer 17

labored, effortful speech and <6 word phrases

Question 18

what area of brain is language associated with

Answer 18

perisylvian area, including brocas and wernickes area

Question 19

what is a paraphasia

Answer 19

unintended sullables or words. 1. literal (pipe becomes hike), 2. verbal/semantic (wife becomes mother), 3. neologism (new and meaningless words)

Question 20

What is impaired in all types of aphasias

Answer 20

naming common items

Question 21

For Brocas aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 21

Nonfluent spontaneous speech, good auditory comprehension, poor repetition, poor naming, localized to Broca’s area in left hemisphere

Question 22

For Wernickes aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 22

Fluent spontaneous speech, poor auditory comprehension, poor repetition, poor naming, localized to Wernicke’s area in left hemisphere

Question 23

For conduction aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 23

Fluent spontaneous speech, good auditory comprehension, poor repetition, poor naming, localized to Arcuate fasciculus area in left hemisphere

Question 24

For global aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 24

Nonfluent spontaneous speech,poor auditory comprehension, poor repetition, poor naming, localized to Perisylvian region in left hemisphere

Question 25

For transcortical motor aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 25

Nonfluent spontaneous speech, good auditory comprehension, good repetition, poor naming, localized to Anterior borderzone region in left hemisphere

Question 26

For transcortical sensory aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 26

Fluent spontaneous speech, poor auditory comprehension, good repetition, poor naming, localized to Posterior borderzone region in left hemisphere

Question 27

For anomic aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 27

Fluent spontaneous speech, good auditory comprehension, good repetition, poor naming, localized to angular gyrus region in left hemisphere

Question 28

For mixed transcortical aphasia, describe spontaneous speech, auditory comprehension, repetition, naming and localization

Answer 28

Nonfluent spontaneous speech, poor auditory comprehension, good repetition, poor naming, localized to angular gyrus region in left hemisphere

Question 29

aphasia treatment

Answer 29

1. 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