Fluent vs. Nonfluent Aphasia
Terms in this set (17)
-Most common fluent
-Major Symptom: poor auditory comprehension
-Verbal: fluency is good. Speech is effortless. Rate is rapid. Normal Phrase length
-Semantic and literal paraphasias
-Repetition is impaired
-Reading comprehension is affected. May not recognize sounds associated with written words
-Writing problems are evident and patient is unaware
-Write with dominant hand and in cursive. Filled with neologisms which parallel in speech
-Depression is common. Likely to hurt themselves
Where is the lesion site for Wernicke's Aphasia?
Posterior portion of the first temporal gyrus of the left hemisphere. May extend into the second temporal gyrus and into parietal, particularly in angular gyrus. Most extend in to the cerebral depth compromising cortical and subcortical white matter
What is the lesion site for Conduction Aphasia?
Left perisylvian lesions involving the primary auditory cortex. Lesion is anywhere between Broca's and Wernicke's. Lesion in the arcuate fisciculus.
What is the arcuate fisciculus?
The fiber pathway that carries information from Wernicke's to Broca's.
-Distinguishing Feature=marked impairment in repetition
-AC may be near normal.
-Comprehension of conversational speech is generally good.
-Speech is paraphasic (semantic and neologisms are less frequent)
-Hesitations and self-corrections interrupt fluency. It is often unsuccessful as well
-Literal phonemic paraphasias
-Repetition may contain added or deleted phonemes; difficulty is most marked on phrases, sentences, unfamiliar phrases. Fx words are more difficult to repeat than content words
-have excellent change for significant or near-complete recovery of motor and language problems
What is the major difference between Wernicke's and Conduction?
The auditory comprehension. Wernicke's has poor auditory comprehension and Conductive is near normal.
Where is the lesion site for Anomic Aphasia?
Temporal parietal injury which may extend into the angular gyrus.
-Most debilitating and pervasive word finding difficulty is the major characteristic
-AC is generally good.
-Pointing to named objects is unimpaired.
-Speech is fluent except for interruptions created by word finding problems
-Verbal paraphasias are common (word substitution)
-Circumlocutions are common
-Repetition is intact
-Reading and writing are normal unless the angular gyrus is affected by the lesion.
-They may write as they speak. and the circumlocutions come out in writing as well
How does anomic aphasia differ from Wernicke's?
Anomic aphasia does not have literal paraphasias and they generally have good AC.
Transcortical Sensory Aphasia
-commonly seen with TBIs who have poorly defined lesions
-AC is defective like Wernicke's
-Phrase length is normal
-Prosody and articulation are good
-Speech is full of paraphasias
-Repetition is good, sometimes echolalic
-oral reading is significantly better than other skills but they do not understand what they are reading; reading comprehension is poor
-writing problems parallel those in expressive speech
-occasional hemiparesis at onset but they soon recover
-unilateral neglect is common
Where is the lesion located for TSA?
posterior portion of the middle temporal gyrus (area 37) and extending into both visual and auditory association as well as occasionally in to the angular gyrus. Typically in the temporal parietal region but Wernicke's is spared.
-Slow speech output with reduced phrase length and awkward articulation
-dominant symptom: aggrammatism
-Better AC of spoken language than production
-difficulty with pointing to named objects
-adequately follow simple commands
-limited word output
-lack of intonation
-trouble with naming
-impaired repetition and confrontation naming (moderately)
-poor oral reading and impaired comprehension
-typically recover their ability to ambulate (their legs)
-may act emotionally when they fail on assessment tasks
-good candidate for therapy
-can produce meaningful utterances
-aware of speech difficulty
Where is the lesion for Broca's located?
brodmann's area 44
Lesion involves the 3rd frontal convulution
Transcortical Motor Aphasia
-dominant symptom: intact repetition
-comprehension is generally good for simple conversation but impaired for complex speech
-patients may be echolalic
-able to provide one-word answers
-delays with initiation
-naming on request is much better than conversational speech
-phonemic priming helps
-ability to use memorized sequences is well preserved.
-reading aloud and reading comprehension both better preserved than speaking skills
-writing is often disturbed; often seriously
-transient urinary incontinence
What distinguishes Broca's from TMA?
TMA has language production problems but their repetition skills are still intact.
Where is the lesion for TMA located?
lesion is typically smaller than for Broca's area. left frontal lobe. the closer the lesion is to broca's area, the greater the resemblance between the two syndromes
Limited to single words
stereotypic utterances are common
repetition is impaired
literal and verbal paraphasias
most are attentive, alert, task oriented
-these patients alertness, social appropriateness, and task orientation help distinguish them from demented or confused patients