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51 Cards in this Set
- Front
- Back
Language development:
When does babbling start? Full sentences? infants recognize own name? focus on phonetic properties of language(s)? |
-6 mos
-3 yrs -4.5 mos -1 yr |
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how many words at:
6 yrs hs graduation med school |
-13k
-60k -1 million |
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When does 2nd language acquisition ability begin to drop off?
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3-7 years
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When is the "sensitive period" for phonetic learning?
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Between 8 and 10 months. The brain is a sponge for phonetics in this period. At 12 months, it really begins to shift to the primary language(s) of exposure.
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Where's the brain most asymmetric?
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Around the Sylvian fissure.
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Compared to the left side, the right Sylvian fissure is:
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-anterior and dorsal
-a region just posterior to the sylvian fissure is deeper on the right; a region just anterior is deeper on the left. |
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Asymmetric hemispheric specializations--
right side? |
-Emotional, spatial, artistic, intuitive, nonverbal
-prosodic features of speech and language |
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Asymmetric hemispheric specializations--
left side? |
-Verbal, intellectual, rational, analytical
-grammar and lexicon of speech and language |
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Asymmetry in the brain--planum temporale:
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bigger on the left side.
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What 3 key functions does the left hemisphere control in the vast majority of people?
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-reading, speaking, and writing.
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Observations/procedures regarding what 5 things serve as evidence for language asymmetry in the brain:
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-brain stimulation
-effects of lesions, strokes -the Wada test -effects of seizures -studies of split-brain patients |
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aphasia: 4 key points
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-partial or complete loss of language abilities following brain damage
-often without loss of other cognitive or sensory abilities or the ability to move muscles necessary for speech. -usually little regard for sphere in which it is expressed (speech, reading, writing) -can include impairment of language comprehension, production, or both |
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Describe the following in Nonfluent aphasia:
quantity quality production phrase length melodic line content paraphasia comprehension |
quantity- sparse
quality- dysarthric (poor articulation) production- effortful phrase length- short melodic line- dysprosodic content- substantive only, no structure paraphasia- infrequent comprehension- spared |
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Describe the following in Fluent aphasia:
quantity quality production phrase length melodic line content paraphasia comprehension |
quantity- normal
quality- normal production- normal ease phrase length- normal to excessive melodic line- normal content- empty, no substance paraphasia- frequent comprehension- seriously impaired |
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Broca's + Wernicke's =
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GLOBAL APHASIA, COMING AT YOU FROM ASIAAAAAAA.
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Where's the lesion in Broca's? What other problems can you get as a result of this?
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-Near the posterior end of the inferior frontal gyrus--in Broca's area.
-Right hemiplegia involving face and arm -May superimpose dysarthria on the aphasia. -Writing may also be impaired by the motor deficit. |
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Is patient aware of a problem in Broca's aphasia?
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oh yes
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Logorrhea describes:
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plentiful quantity of words in fluent (W) aphasia.
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In fluent aphasia, do pts know they are jacked up?
What's their mood like? |
-no clue they're messed up
-euphoric, undisturbed |
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Differences between deaf and normal hearing people suffering from the two main types of aphasias?
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-It's basically the same. Deaf folks suffer the same way, and fMRI shows their brain light up in the same places when they try to sign
-One difference is that language areas in signing are often bilateral. |
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Describe the flow of information hearing--speaking in the Wernicke-Geschwind model:
is this accurate? |
Auditory cortex - Wernicke's area - Angular gyrus - Broca's area (via arcuate fasciculus) - Motor cortex
*grossly oversimplified |
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Describe the flow of information reading--speaking in the Wernicke-Geschwind model:
is this accurate? |
Primary visual cortex - Angular gyrus - Wernicke's area - Broca's area - Motor cortex
*grossly oversimplified |
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Key points of a more contemporary model for language comprehension?
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-Prosody, accentuation, and intonation are processed on right side of brain, posterior side of lateral sulcus.
-Syntax, grammar, semantics, and integration occur on the left side, posterior side of lateral sulcus. |
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Describe conduction aphasia:
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-a form of disconnection syndrome
-arcuate fasciculus lesion (in the surrounding cortex as well); deep lesion that interrupts connection b/t W and B areas. -comprehension is good, speech is fluent, patient can express himself well with speech but is paraphasic; affect appropriate -primary deficit is in repetition of words; also trouble naming pictures and objects |
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Describe alexia without agraphia:
where's the lesion? |
-example of a disconnection syndrome
-patient can write, but cannot read -lesion restricted to left primary visual cortex (left occipital), splenium of corpus callosum -associated with right homonymous hemianopia; writing is seen only by right hemisphere, which is disconnected from language areas in left hemisphere. -analogous to pure word deafness. |
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two disconnection syndromes:
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conduction aphasia and alexia w/o agraphia.
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Alexia
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loss of the ability to read a written language. Alexia is not the same as illiteracy.
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Agraphia
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loss of the ability to write in a language. agraphia must be distinguished from illiteracy.
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Anomia
why can it be confusing to a physician? |
-a deficiency in recalling the names of familiar objects which are clearly recognized, i.e., the patient can illustrate their function.
-Naming disorders are the least localizing and specific of the clinical features of aphasia. They occur in almost all aphasics, but also in dementia and confusional states. |
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what causes mutism?
is it a language disturbance? |
-can arise in psychiatric disorders (schizophrenia, hysteria), metabolic diseases affecting the brain (dehydration, uremia intoxication), dementing disorders (Jacob-Creutzfeldt, Huntington's disease), and focal neurologic disease (pseudobulbar palsy, multiple lacunar infarcts of the basal ganglia, post thalamotomy, akinetic mutism).
-NOT a language disturbance |
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dysarthria
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Deficient motor control of the muscles involved in
speech production without concomitant weakness in the musculature itself is called dysarthria. Some refer to this as a form of apraxia. |
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What stroke advantage do left handers have?
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-Tend to recover more, although their language areas are on the same side as right handers.
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What stroke advantage do females have? Why?
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May recover better from left hemisphere lesions.
May not have the same degree of hemispheric specialization. |
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planum temporale:
where is it? What does it do? |
-The superior aspect of the temporal lobe contains a region known as the planum temporale which lies between Heschl's gyrus and the parietal lobe. This region is distinctly larger in the left than in the right hemisphere.
-Thought to be important in language performance. |
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Other names for non-fluent aphasia:
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also called expressive aphasia, motor aphasia, Broca's aphasia, anterior aphasia
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How are musical tasks in non fluent aphasia?
Affect? Reading? Writing? |
-Normal
-Normal -intact, but laborious -impaired like speech is |
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paraphasia:
what kind of aphasia is it in? |
introduction of incorrect sounds or words; e.g. booth instead of tooth, donner instead of dinner
W aphasia |
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How is affect in fluent aphasia?
Writing? Reading? |
-inappropriate
-impaired, like speech is -impaired, poor comprehension |
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how can you differentiate fluent aphasia from schizophrenia?
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Age!
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where's the lesion in fluent aphasia?
What "side effects" might there be a result of this location? |
W area--a lesion of the posterior superior temporal gyrus
Can get some quadrantanopia up in there due to damage to Meyer's loop. |
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Describe mixed and global aphasias:
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Shortly following a cerebrovascular accident a patient may show combinations of fluent, non-fluent, and conduction aphasias. As time passes this global aphasia
usually resolves toward one pattern but may retain characteristics of the various types. Global aphasics are usually severely impaired in all modalities. |
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Pure word deafness
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A specific form of language disturbance resulting from disconnection of a sensory receiving area from the language processing areas. This is a disconnection syndrome.
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Describe alexia with agraphia:
where's the lesion? |
-Speech is relatively intact.
-The major deficit is in translating written visual material into spoken language or language into writing. -The lesion is often in the angular gyrus which lies at the crossroads of connections between visual, auditory and somatic sensory cortices. |
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Why would you cut the corpus callosum and AWC?
What bad effect will that have? |
Intractable seizures.
Disconnects hemispheres from each other and causes alien hand syndrome. -Patients are unable to name objects placed in their left hands, though they can identify them in other ways indicating recognition. -They are unable to read words flashed into the left visual field. -They are unable to carry out movements of the left hand on verbal command but may carry these out spontaneously (this is a form of apraxia). -Since hemispheres may function independently, this can cause the troublesome alien hand. |
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Heschl's gyrus:
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Transverse temporal gyri, primary auditory cortex. buried within lateral sulcus.
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