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4 Med Neuro > Speech and language > Flashcards

Speech and language Flashcards

1
Q

Intracarotid test

A

used in pts with intractable epilepsy being considered for surgical tx for epilepsy
catheter is routed into internal carotid and barbiturate injected to left or right side resulting in anestesia of greater part of hemisphere
pt has language tests to measure how well the unanaestetized hemi can perform them

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2
Q

invasive test and only for ind with pre-exsisting brain fnx abnormatilies so this test may not be a good representation of population as a whole

A

Intracarotid test

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3
Q

new imaging tech. Based on changes in ratio of oxyHb to deoxyHb in brain from moment to moment

A

fMRI

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4
Q

cognitive activity correlated w/ change in this ratio that are involved in performing the activity
used to identify regions activated by cognitive task… is noninvasive and used in healthy

A

fMRI

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5
Q

90% of population, Dextrals

A

right handed

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6
Q

10% of population, Sinistrals

A

left handed

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7
Q

Atypical dominance patterns include

A

‘bilateral’ and ‘right’ hemisphere dominance

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8
Q

more common in left handed relative to right handed individuals

A

Atypical dominance patterns

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9
Q

most pts w/out early damage regardless of handedness are left-hemi dominant

A

left-hemi dominant

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10
Q

incidence of atypical dominance ________in ind w/ early brane damage, ESPECIALLY for those w/ left or mixed handedness

A

increases dramatically

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11
Q

fMRI results
1. show the area of language activation include what 4 regions?
( see variability w/in individual pts.)

A

left frontal, temporal and parietal regions and rt cerebellum

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12
Q

More pts w/ epilepsy show __________ compared to healthy

A

symmetrc and rt hemisphere dominance

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13
Q

More variability in ind with early or late brain damage

A

EARLY

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14
Q

Simular dominance patterns found in health leftys and lefy epileptics with______ onset brain damage

A

LATE

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15
Q

lefty epileptic pts with evivdence of EARLY damage

A

see atypical dominance (crossed-dominance or symmetric dominance) which is high and associated with shift in handed: pathological left-handedness

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16
Q

In left hemisphere, devo of langauge after injury depends on

A

age at time of injury

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17
Q

Damage Early in life (before 1 yr)

A

a. develops language functions but usually has a generalize decline intelligence

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18
Q

Damage between 1-5

A

a. language devos typically but occurs at expense of development of non-linguistic skills (viso-spatial)
b. lang devo occurs in regions usually devoted to devo of non-linguistics and ‘crowds’ those areas

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19
Q

Damage After 5

A

a. specific abnormalities of lang skills that are apparent—implies the brain plasticity decreases w/ age

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20
Q

Selective injury to ant or post speech zones causes

A

shift of function associated w/ that zone only.

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21
Q

injury to core or central speech zone may cause a

A

complete shift in languate fnx to the right hemi; called crossed-dominance

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22
Q

Cerebral dominance and left-handedness

A

atypical speech representation is more frequent in lefty and ambidextrous then rightys
healthy ind w/ no left-handed 1st degree relatives (negative familial sinistrality) have more typical lang representation

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23
Q

Which is more predictive of atypical dominance family history of left-handedness

A

family history

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24
Q

Negative correlation between LI and age suggests

A

langauge processing more symettric w/ age

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25
Q

Damage to far anterior or poster results in

A

no shift in language

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26
Q

Damage tosomewhat anterior regio or centered around region of speech see

A

a complete shift in language

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27
Q

Anterior region of language zone is key for

A

retrival/syntax/exresspive aspect~ damage we see shit of anterior funx

28
Q

Damage to posterior or middle language zones:

A

Shift of posterior speech function when more posterior/middle damage we see comprehension affected

29
Q

Do both hemis involving language look the same?

A

hemis aren’t mirrior images of each other in either morphology or funx—see minor shape dif in cylvian fissure and occipital lobe

30
Q

How are hemis organized?

A

Hemis are organized dif in terms of how the perform secondary and tertiary levels of fnxs (like multi-modal funxs such as hand-eye coordination)

31
Q

Lateralization of fnx is relative and complementary and______ with age before pubery and______ thereafter

A

increases

decrease

32
Q

Disorders of speech all involve

A

malfunction of muscles of speech articulation!

33
Q

How are disorders of speech and disorders of language different (aphasias)

A

they are different from language disorders (aphasia) that you can get w/out the other and has own correlates

34
Q

can be psychological or neuro

neuro: IG occurs in context of syndrome such as akinetic mutism (thought to be d/t failure to initiate action)

A

Mutism

35
Q

Mutism can result from:

A

Extensive bifrontal brain disease or bilateral lesions in SUPPLEMENTARY motor area responsible

36
Q

D/t injury to peripheral NS enervating muscles of vocal chords and ≠ sound production

A

Aphonia

37
Q

Able to produce vocal sounds (grunts, groans, sound like features) but cant generate speech

A

Aphemia

38
Q

Aphemia is considered a

A

disconnected syndome

39
Q

d/t white matter lesion beneath Broca’s area that severs the final output path for speech production

A

Aphemia

40
Q

impaired capacity to articulate speech~ more about muscles of speech or discordination

A

Dysarthria

41
Q

All aphasias can be classified by integrity of speech:

A

fluency/comprehension and repetition

42
Q

Most important classification of integrity of speech

A

fluency is more important to focus on… heslp us localize brain dysnfunction to anterior or posterior regions

43
Q

Non-fluent aphasias—occur with dysfnx to

A

ANTERIOR regions

44
Q

Fluent aphasias—occur with dysfnx to

A

POSTERIOR brain regions

45
Q

Fluency;

evaluated on 3 dimensions

A

Phrase length (maximum number of words per utterance)
Degree of apparent effort in production of speech
Prosody—preservation of melodic elements of speech

46
Q

Nonfluent speech characterized by

A

contains less then 3 words in utterance, labroius in produciton and monotonic

47
Q

Evaluation of fluency:

A

a. ask pt open ended questions or to describe complex picture (Boston Asphasia Exam)

48
Q

Global aphasia
fluency:
comprehension:
repetition:

A

fluency: none
comprehension: none
repetition: none
when functions of both anterior and posterior aspects of core language zones impaired

49
Q

Isolation of speech
fluency:
comprehension:
repetition:

A

fluency: none
comprehension: none
repetition: intact

50
Q

Brocas
fluency:
comprehension:
repetition:

A

fluency: none
comprehension: intact
repetition: none

51
Q

Transcortical motor:
fluency:
comprehension:
repetition:

A

fluency: none
comprehension: intact
repetition: intact

52
Q

Wernickes
fluency:
comprehension:
repetition:

A

fluency: intact, paraphaisias present
comprehension: none
repetition: none

53
Q

Transcortical sensory
fluency:
comprehension:
repetition:

A

fluency: Yes, paraphiasias present
comprehension: none
repetition: intact

54
Q

Conduction
fluency:
comprehension:
repetition:

A

fluency: yes, paraphiasias present
comprehension: intact
repetition: none

55
Q

Nominal, anomic amnesic
fluency:
comprehension:
repetition:

A

fluency: intact
comprehension: intact
repetition: intact

56
Q

fluency: none
comprehension: none
repetition: none
when functions of both anterior and posterior aspects of core language zones impaired

A

Global aphasia

57
Q

nonfluent aphasia that has profound impairment in speech articulation. Repetition speech impared d/t articulaiton difficulties

A

Brocas

58
Q

Transcortical motor aphasis:

A

lesion to the premotor region or SMA

59
Q

Transcortical aphasias: repetition is

A

PRESERVED

60
Q

Transcortical sensory aphasia:

A

fluent aphasia associated with langague comprehension deficits at word level

61
Q

Transcortical sensory aphasia lesion IG is at

A
  • lesions IG at angular gyrus or post and infereior temporal lobe
  • repetition is preserved
62
Q

Isolation aphasia:

A

when lesions of both transcortical motor and sensory aphasia present

63
Q

when lesions of both transcortical motor and sensory aphasia present

A

Isolation aphasia

64
Q

effectively isolates core speech zones from remainder of hemisphere

A

Isolation aphasia

65
Q

Conduction aphasia: fluent aphasia associated with

A

profound impairment in repetition speech but preserved comprehension

66
Q

-repetition deficit d/t impairment in auditory storage buffer needed to repeat speech sounds or perhaps the transmission path (arcuate fasciculus) btwn speech sound recognition and articulation centers

A

Conduction aphasia

67
Q

The cortical zones in temporal, parietal and frontal regions that lie outside of the peri-Sylvain zone also makes

A

significant contributions to linguistic fnxs.

4 Med Neuro (9 decks)

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