Speech & Aphasia

Question 1

Cognitive domains (+ tests used) assessed by mental status exam

Answer 1

• Arousal and attention = level of consciousness, digit span, serial sevens
• Memory = orientation, three words at five minutes, remote events
• Language = fluency, conrehension, repetition, naming, reading, writing
• Visuospatial function = clock drawing, tests for hemineglect
• Mood & affect = inquires of feelings, observations of affect
• Complex cognition = executive fxn, similarities, proverbs, judgement, insight

Question 2

Amnesia vs. Aphasia

Answer 2

• Amnesia = impaired recent memory, w/deficient new learning
• Aphasia = aquired disorder of language

Question 3

Aphasia vs. Dysarthria vs. Dysphonia

Answer 3

• Aphasia = acquired disorder of language
• Dysarthria = disorder of speech due to motor system problems
• Dysphonia = disorder of voice due to laryngeal disease

Question 4

Handedness vs. Cerebral language dominance

Answer 4

• most people: language @ left hemisphere
• 90% of population = R-handed; 10% = L-handed
• 99% of R-handed people = LEFT language dominant
• 67% of L-handed people = LEFT language dominant
  
  • only ~8% of people are Right language dominant (and if they are, they are most likely left-handed)

Question 6

Important components of aphasia assessment

Answer 6

• spontaneous speech
• auditory comprehension
• repetition
• naming

Question 7

Presentation of aphasia

Answer 7

• due to complexity of language ==> various types of aphasia
• sydrome of aphasia = specific type/set of impairments ==> specific neuroanatomic lesion

Question 8

Broca’s aphasia: speech, auditory, repetition, naming, localization

Answer 8

• speech = nonfluent
• auditory = good
• repetition = poor
• naming = poor
• localization = Broca’s area (L hemisphere)

Question 9

Wernicke’s aphasia: speech, auditory, repetition, naming, localization

Answer 9

• speech = fluent
• auditory = poor
• repeitition = poor
• naming = poor
• localization = Wernicke’s area (L hemisphere)

Question 10

Conduction aphasia: speech, auditory, repetition, naming, localization

Answer 10

• speech = fluent
• auditory = good
• repetition = poor
• naming = poor
• localization = arcuate fasciculus (L hemisphere)

Question 11

Global aphasia: speech, auditory, repetition, naming, localization

Answer 11

• speech = nonfluent
• auditory = poor
• repetition = poor
• naming = poor
• localization = perisylvian region (L hemisphere)