Speech and Aphasia Flashcards
Define behavioral neurology.
The subspecialty of neurology concerned with the effects of structural brain disease or injury on behavior
Define neuropsychiatry.
The subspecialty of psychiatry with essentially the same interests as behavioral neurology (behavioral neurology and neuropsychiatry are now formally affiliated).
What is neuropsychology?
The branch of psychology devoted to the study of brain-behavior relationships (neuropsychologists are PhDs who conduct neuropsychological testing, not neuropsychiatric testing).
Mental status exams –this lecture mentioned two –are good at tracking ____________, but they cannot __________.
decline over time; diagnosis conditions in the absence of other information
A person who has forgotten how to do a movement (or can no longer perform that movement because of an injury) is said to have ___________.
apraxia
Acute confusional state is also known as __________.
delirium
Impaired recognition –whether visual, auditory, or tactile – is called ___________.
agnosia
One way to describe the difference between neurology and psychiatry is that neurology deals with conditions that have __________, while psychiatry deals with conditions that __________.
identifiable structural lesions (such as Lewy bodies or neurofibrillary tangles); do not have an identified structural cause
What is aphasia?
An acquired disorder of language caused by brain damage
Dysarthria is a __________ disorder.
motor disorder (that is, the brain can still process language fine)
Dysphonia is due to impaired function of what structure?
The larynx!
Most people are _______ hemisphere dominant for language.
left (99% of right-handed people and 67% of left-handed people)
What does “parcellate” mean?
(v.) to divide into parcels
A person who has intact understanding of speech but whose speech is telegrammatic and effortful likely has a lesion/stroke in which part of the brain?
The left middle cerebral artery supplying Brodmann’s areas 44 and 45 (Broca’s aphasia)
Impaired understanding of language is processed in which Brodmann area?
22 (Wernicke’s aphasia)
Paraphasias are _____________.
unintended words or syllables
Someone with paraphasias might have a lesion in _________ area.
Wernicke’s
What is the band of white matter that connects Broca’s area to Wernicke’s area?
Arcuate fasciculus
Global aphasia often presents concurrently with ___________.
right-sided hemiparesis
Alexia with agraphia often localizes to the ____________.
left angular gyrus
Prosody is the ____________.
inflection of language with emotion
Impairments in what usually accompany aphasia?
Reading and writing
Those with Broca’s area deficits have good ______________.
understanding –their deficit is in producing language
Ischemia to the perisylvian region will lead to what kind of aphasia?
Global – perisylvian basically means the whole region next to the lateral fissure
There are two widely used mental status surveys: the MMSE and the MoCA. Which is newer?
The MoCA
“Extracortical” refers to regions that ______________.
are adjacent to the perisylvian region
“Press of speech” (i.e., rapid, unbridled speech) is called ____________.
logorrhea
What linguistic ability is spared in patients with transcortical aphasia?
Repetition
Describe the four types of transcortical aphasia.
Transcortical motor: problems initiating speech
Transcortical sensory: like Wernicke’s but less severe
Anomic: problem naming things
Mixed: only ability left is repetition (echolalia)
What are the broad principles of treating aphasia?
Treat the underlying lesion/mass/ischemia
Offer speech/language therapy as early as possible
Offer psychiatric care if needed
Most improvement occurs in the first year
No drug has been shown to be effective
