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CNS > Unit 9 - Speech and Language > Flashcards

Unit 9 - Speech and Language Flashcards

1
Q

how does learning a 2nd language differ between children and adults

A

When learning a language when younger than 7 it’s easier - cortical area assigned overlaps with native language

Non overlapping cortex when an adult learns a new language

Small vascular lesion in adult means losing language aspect but not the other language

Stroke - may lose native but keep 2nd adult learned one

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2
Q

proportion of dominance in language

A

90% - left dominant

  1. 5% - right dominant
  2. 5% - share dominance
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3
Q

How is sound that enters outer ear transmitted

A

Amplified by ossicles in middle ear and is converted to pressure wave in cochlea - bends hair cells and creates signal in nerve branches

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4
Q

Define frequency of sound/pitch

A

no of times it passes a certain point per s = cycles per s = Hz

Corresponds the depth into spiral the pressure wave travels => specific axons transfer specific freq to auditory cortex

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5
Q

High pitch is detected at

A

Base of cochlea

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6
Q

Low pitch is detected at

A

apex of cochlea

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7
Q

Pathway of sound

A

Cochlea, cochlear nerve → pontine level brainstem → inferior colliculus of midbrain → medial geniculate nucleus of thalamus → acoustic radiations of internal capsule (sublenticular part) → primary auditory cortex → superior bank of sup. temporal gyrus and Heschl’s gyrus

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8
Q

Where is the primary auditory cortex

map preserved

A

Posterior superior bank of superior temporal gyrus

Heschl’s gyrus (BA 22) is included

tonotopic map

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9
Q

passively listening to tones involves

A

involves bilateral auditory cortex - wernickes - left - screening out non verbal material and frontal area 9 is supervisory role

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10
Q

Actively listening to words rather than tones involves

A

specific

  • middle temporal lobe (BA21)
  • posterior temporal lobe (BA37)
  • angular gyrus (BA39)

these are phonemes

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11
Q

Speech met-analysis - areas involved

A

Actively listening to words

Monitor for slips of tongue

lacking in cases of receptive aphasia - impaired ability to comprehend speech

  • Left dorsolateral prefrontal cortex (BA46)
  • Broccas area (BA44 and 45)
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12
Q

Receptive aphasia

A

Impaired ability to comprehend speech

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13
Q

what does the arcuate fasciculus connect

A

Mediates communication between wernickes and brocas areas

concerned with phonological aspects of language

Runs posteriorly, ascends posteriorly to space occupied to space occupied by lateral fissure, connects to inferior frontal gyrus

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14
Q

pathway of direct segment

A
  • direct from temporal lobe
  • superior to angular gyrus
  • goes to PT and PO
  • PHONOLOGICAL

(red)

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15
Q

Posterior short/indirect

A

(yellow)

wernickes → angular gyrus (IPL)

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16
Q

Anterior short/indirect

A

from angular gyrus (IPL) → broca’s

(green)

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17
Q

What is the uncinate involved in

A

semantic processing

(purple)

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18
Q

Conduction aphasia

A

Lesion of anterior indirect segment of arcuate (angular → broca’s)

cannot repeat words or phrases

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19
Q

Where is the angular gyrus

Function

A

Overhangs superior temporal sulcus

Neural lexicon involved in word meaning retrieval and conversion of grapheme → phoneme

active during listening to spoken words

MCA stroke would have significant impact here

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20
Q

areas composing broca’s

A

Pars triangularis and opercularis

also involves cortex slightly posterior to these within inferior frontal operculum

21
Q

Inferior parietal lobule =

A

Supramarginal and angular

22
Q

where is supramarginal found

A

At the posterior most extent of lateral fissure

23
Q

where is angular gyrus found

A

posterior part of superior temporal sulcus

posterior to supramarginal

24
Q

Afferents and efferenta of angular gyrus

A

afferents = From inferior part of left lingual gyrus

efferents = to temporal plane (wernickes)

25
Q

Function of Broca’s

A

Expressive aspects of spoken and written language

26
Q

PT and POperc. in right vs left hemisphere

A

Tend to be larger in left hemisphere - connections to face, tongue and motor cortex within precentral gyrus

Homologous area in right is involved in non verbal communication including facial expression, gesticulation, modulation of rate rhythm and intonation of speech - prosity

Damage to non-dominant area - monotone robotic type of speech

27
Q

CN V and speech

A

Trigeminal

Muscles of mastication

28
Q

CN VII and speech

A

Facial

Muscles of facial expression

29
Q

CN IX

A

glossopharyngeal

stylopharyngeus

deglutition

30
Q

CN X and speech

A

Vagus

Larynx and pharynx

phonation

31
Q

CN XI

A

Spinal accessory

laryngeal muscles

phonation

32
Q

CN XII

A

hypoglossal

muscles of tongue

tongue movement

33
Q

Where is speech initiated

A

In Broca’s

34
Q

Areas of brain used in singers

A

singing requires integration of feedback of auditory systems - pitch precisely controlled

Superior temporal gyrus on both sides as well as left putamen in singing -> Anterior cingulate cortex - singers

35
Q

aphasia

A

deficit affecting one’s ability to communicate

36
Q

Different types of stroke

A

Stroke is an event affecting blood vessels that can be either a blockage or occlusion, which results in tissue death termed ischemia in those tissues that lost blood supply

A stroke can be haemorrhagic type where a weakness in the wall of a vessel is eventually breached and there is bleeding in brain tissue – this bleed can cause both loss of blood to the tissues that the vessel was supposed to supply and pressure on tissues due to the volume of the bleed

37
Q

1 day after an acute infarction involving right middle cerebral territory

A

Left-most is a diffusion weighted image showing an area of infarct as a bright signal

To the right of that is a T1 weighted image which shows no evidence of blood in the area of infarct (blood would appear as white)

Next, moving right, is a post-contrast coronal image that shows vascular enhancement in the area of infarct

On the right is an MR angiography that show right MCA branches to be narrower in calibre as compared to left

38
Q

receptive aphasia - where is there damage to

A

Wernickes

e.g. relevant MCA branch

inability to understand speech, deficit in auditory comprehension

If the angular gyrus is affected, then it can involve a compromised ability to read – alexia

Patients may be unaware of mistakes, they may have difficulty in understanding speech of others and retrieving correct descriptive terms (accessing lexicon areas) or word finding

39
Q

how is speech comprehension facilitated

A

first arrival of a signal via the auditory branch of the vestibulocochlear cranial nerve in the superior posterior region of the superior temporal gyrus and Heschl’s gyrus (Wernicke’s area)

40
Q

Expressive aphasia

A

Broca’s cortex (area of inferior frontal gyrus) may be affected resulting in impairment in the ability to produce speech

This patient may make sounds or words that are not what was intended, and they may or may not be aware of this depending on whether or not they have concurrent damage to the primary auditory cortex (Wernicke’s area)

Expressive aphasia can involve difficulty in expressing themselves or slow, laboured speech

It can often present with agraphia – inability to write thoughts

Larger areas of cortex affected can be accompanied with motor weakness in the right lower face and right arm, right lips and tongue and it can present with dysarthria (arthria refers to articulation or movement between joints) resulting in slurring of syllables

41
Q

Conduction aphasia

A

When the arcuate fasciculus is affected (the white matter tracts subserving communication between Wernicke’s and Broca’s area)

This can occur independent of the other 2 types, and specifically involves the inability to repeat words or phrases

42
Q

Global aphasia

A

when all these impairments are present, and all regions affected

receptive

expressive

conductive

43
Q

prosody

A

Prosody is the pitch, intonation, cadence and musically or melodic aspects we use in speech to infer meaning beyond the words themselves

Most of language is subserved by the dominant hemisphere - left

Prosody appears to be associated with the non-dominant hemisphere (usually right hemisphere)

44
Q

Aprosodia

A

a disturbance in melodic function, such as comprehension of the prosody in speech, especially in the right posterior temporo-parietal region, and for the production of melody in the right inferior frontal gyrus

speech changes to a dull monotone

45
Q

dysphasia

A

acquired disorder of spoken and written language

It comes from the Greek -dys meaning disordered and -phasis meaning utterance

46
Q

expressive dysphasia

A

Lesions involving Broca’s area, on the inferior frontal gyrus

Speech is hesitant, fragmented and telegraphic, with word finding difficulty and a paucity of grammatical elements such as verbs and prepositions

Since comprehension is relatively spared, patients tend to become frustrated as they struggle to express themselves

47
Q

Receptive dysphasia

A

lesions in Wernicke’s area, on the superior posterior bank of the superior temporal gyrus and including Heschl’s gyrus as well

Speech is fluent but makes little sense, consisting of word fragments, substitutions and neologisms (a nonsense of words)

Since comprehension is affected, patients may be unaware of their own errors

48
Q

global dysphasia/aphasia

A

combination of receptive and expressive aphasia

49
Q

Conduction aphasia

A

specific problems repeating sentences

despite normal fluency and comprehension

attributed to a lesion in the arcuate fasciculus, which is said to disconnect the 2 primary language areas

CNS (36 decks)

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