Aphasia Types
read
Few globally aphasic patients can ______ even simple words, and the reading of sentences or longer printed material is nonfunctional.
receptive, sensory
Other names for Wernicke's aphasia are: ___________ aphasia, __________ aphasia, and posterior aphasia
expressive
Other names for broca's aphasia: ___________ aphasia, motor aphasia, or anterior aphasia
Broca's aphasia
Cause by damage in the Broca's area. Broca's area makes up the lower part of the premotor cortex. Patients with Broca's aphasia are nonfluent. They speak as if the motor plans for speech have gone wrong. Words come out singly or in groups of two or three, separated by abnormally long pauses. Multisyllable words may be produced syllable by syllable with abnormal pauses between syllables. Miss articulations are common, with distortion of consonants and vowels.
Paraphasias
Errors in spoken or written word production
Broca's aphasia
Example of someone speech with ___________ _______ un...mother...and dad...no...mother...and... and....disses...uh...runnin over....and waduh...and floor...and...they
Wernicke's aphasia
Example of speech of a person with ____________ ___________ Q: Tell me where you live A: well it's a meander place and it has two. Two of them. For dreaming and pending after supper. And up and down. Four of down and three of us.
conversationalists
Although they are attentive, task oriented, and cooperative, patients with transcortical motor aphasia are poor ___________________, content to sit quietly while the conversational partner carries the communicative burden
comprehension
Because brain damage that produces transcortical sensory aphasia isolates Wernicke's area for much of the rest of the brain, patients with this aphasia always have major impairments in ________________ of spoken and written language.
Empty speech
Hey Wernicke's aphasia patient with word retrieval impairments may produce what it's called__________ ___________ which is substituting general words such as, thing or stuff or pronouns without referents for more specific words
smoothly
In contrast with the slow laborious and halting speech of patients with Broca's aphasia, patients with Wernicke's aphasia talk ___________, effortlessly, and usually copiously. Wernicke's aphasia is a fluent aphasia. Patients with Wernicke's aphasia can produce long, syntactically well form sentences with normal intonation and stress patterns, although they may pause and muddle about when experiencing word retrieval difficulties which are common. This does not mean that the patient with Wernicke's aphasia have no difficulty communicating. Their connected speech maybe littered with verbal paraphasias (substitution or transposition of sounds within words) and neologisms (non words) the speech patterns of patients with mild to moderate wernicke's aphasia sometimes it's called paragramatism.
globally aphasic
Most __________ ____________ patients are attentive, alert, task oriented, and socially appropriate. (which helps to differentiate them from the confused or demented patient)
mild
Most patients with Wernicke's aphasia are: alert, attentive, and task oriented. Those ________ Wernicke's aphasia are aware of their errors, the content of their speech is semantically appropriate, and they generally follow conversational rules such as governing turn-taking.
Broca's aphasia
Patients with Broca's utterances consist primarily of content words: nouns, verbs, and in occasional adjective, but rarely ever. Some authors describe their speech errors as telegraphic
semantic distinctions
Patients with Wernicke's aphasia language comprehension may be compromised by blurring of ___________ _____________among words rendering them unable to appreciate differences between words with related meetings.
semantic typicality
Patients with Wernicke's aphasia lose their sense of __________ ____________.
nonwords
Patients with Wernicke's aphasia often exhibit this dissociations between sound or sight of words and their meanings. In extreme cases, they may be unable to discriminate between phonological a valid ___________ and real words
concern
Patients with Wernicke's aphasia usually show less outward __________ about their communication impairment than patients with Broca's aphasia. Part of their unconcern may relate to their lack of awareness, but many who do recognize errors and understand that they have communication impairments are remarkably complacent and unconcerned about them
Broca's
Patients with ______ aphasia are cooperative and task oriented in testing in treatment activities. They remember treatment procedures and goals from day today and may spontaneously generalized skills and strategies acquired in treatment to their daily life environment
mild or moderate
Patients with _______ ____ _________ Wernicke's aphasia usually get the overall point of conversations but miss the specifics.
Broca's
Patients with _______ aphasia comprehend spoken and written language better than they speak or write, although they are slow readers, and careful testing almost always reveals subtle impairment of both reading and listening comprehension. There self-monitoring usually is well preserved
anomia of the angular gyrus
Patients with ________ ____ _____ ________ _________ region speak fluently but with many word retrieval failures. The phenomenon that sets this syndrome apart from the other anomia syndromes is it the intermittent occasions on which the patient fails to retrieve a word and fails to recognize it when it is supplied by the examiner.
alienation of word meaning
Patients with anomia of angular gyrus often exhibit _____________ _____ _______ ___________ - repeating a word over and over without recognition. (it is possible that this anatomy is a mild form of transcortical sensory aphasia)
inferior temporal gyrus
Patients with anomia of the ___________ _________ __________ have severe word retrieval problems but speak fluently and grammatically and have normal reading, writing, and presumably near-normal auditory comprehension.
reading aloud
Patients with conduction aphasia have difficulty __________ ___________ because oral reading, like repetition, depends on communication between Wernecke's area and Brokas area
poor communication
Patients with conduction aphasia have difficulty repeating what they hear because of ___________ _________ between Wernecke's area and Broca's area.
paraphasias
Patients with conduction aphasia speak fluently, with speech rate, intonation and stress patterns that are normal. But their speech contains many literal ______________ and some verbal paraphasias.
language functions
Patients with global aphasia exhibit severe impairments in all __________ _____________. Most cannot perform even the simplest test of listening comprehension, and most cannot reliably answer simple yes or no questions, although some may respond two conversations in a way that suggests that they get at least a rudimentary sense of what is said.
comprehend
Patients with severe Wernicke's aphasia fail to ___________even simple spoken or written verbal materials
syntactically well formed
Patients with severe Wernicke's aphasia often produce strings in which major content words are replaced by neologisms but in which the connectives (articles, conjunctions, and prepositions) are real words. The strings seem ____________ ________ ___________
repeat
Patients with transcortical sensory aphasia like those with transcortical motor aphasia, do well when asked to __________ phrases or sentences. Unlike patients with transcortical motor aphasia, those with transcortical sensory aphasia speak without having to be carried by the their conversation partner. And some seem compelled to repeat what they hear even when instructed not to do so (a phenomenon called echolalia)
repetition
Preserved ___________ is a defining characteristic of transcortical aphasia does. Because Wernicke's area, Brokas area, and the arcuate fasciculus are spared, repetition of spoken words, phrases, and sentences is present, although other language functions may be substantially compromise.
Frontal anomia
Represent mild versions of transcortical motor aphasia. The major characteristic of patients with _________ ________ is the remarkable degree to which their word retrieval improves is the examiner provides the first sound of the target word.
short-term retention
Semantic impairments of patients with Wernicke's aphasia are exacerbated by impaired _______ _______ _________ and recall of verbal materials.
fiber tracts
Several aphasia syndromes are caused by damage in association _______ ________ between Wernicke's area and Brocas area or by damage to tracks that connect Wernicke's area and Brokas area to the rest of the brain.
Transcortical aphasia
Sometimes called isolation syndrome is caused by dominant hemisphere brain damage that spares the central region (wernicke's area, Brocas area and the arcuate fasciculus) but disconnects or isolates all or parts of the central region from the rest of the brain. Because association fibers or compromise in the transcortical aphasias Can also be called commisural dysphasia or white matter dysphasia
Literal paraphasia
Sometimes called phonemic paraphasia: denotes the substitution or transposition of sounds in words
Verbal paraphasia
Sometimes called semantic paraphasia, denotes substitution of one word for another
repeat
Striking characteristic of patients at transcortical sensory aphasia is their ability to _________ or read aloud material that they do not comprehend. They may be at a loss when asked to perform even simple manipulations in response to spoken instructions but they can flawlessly repeat line in complex instructions
Circumlocution
Talking around missing words
nonfluent
The Prototypical patient with mixed transcortical aphasia is ____________: in fact does not speak at all unless spoken to. And does not comprehend spoken language, cannot name, cannot read or write, but can repeat what is said by the examiner These patients often have a striking tendency to repeat, and parrot like fashion, what is said to them, and if examiner says the first few words of familiar songs are rhymes, these patients often complete the phrase and may go on to provide one or more following lines
Transcortical motor aphasia
The classic neurologic cause of this aphasia is damage to the anterior superior frontal lobe in the language dominant hemisphere. The defining characteristics of this aphasia are markedly reduced speech output, good repetition, and good auditory comprehension.
comprehend
The comprehension is preserved does not mean that conduction aphasic patients comprehension is intact. They typically exhibit mild to moderate comprehension impairments. The point is that their ability to repeat phrases and sentences is strikingly worse than their ability to __________ the same phrases and sentences.
comprehension
The defining behavioral characteristics of conduction aphasia are grossly impaired repetition and relatively preserved language ______________. Language comprehension is preserved in the conduction aphasia because the primary auditory cortex in Wernecke's area are spared
logorrhea
The ease with which Wernecke's aphasic patients produce speech, their circumlocution, and deficient self-monitoring may contribute to their well-known inclination to run on when they talk a phenomenon called press speech or ______________
speech
The handwriting of patients with Wernicke's aphasia usually resembles their ___________.
Anomic aphasia
The label __________ _________ usually is applied to patients is obvious symptom is imperative retrieval in speech and writing. These patients spontaneous speech is fluent and grammatically correct but marked by word retrieval failures. The word retrieval failures lead to unusual pauses, circumlocution, and substitution of nonspecific words for missing specific words. Careful testing usually reveals that patience with this aphasia have subtle comprehension impairments sometimes accompanied by other mild language impairments.
Transcortical motor
The lesion location: anterior, superior frontal lobe Fluency: fluent sparse (unusual delays in initiation) Speech: variable Word retrieval: variable with delays in initiation Repetition: good but delays in initiation Comprehension: good
Global
The lesion location: large, perisylvian Fluency: nonfluent Speech: literal, verbal paraphasia, verbal stereotypies Word retrieval: poor Repetition: poor, literal, verbal paraphasia, grossly restricted retention span Comprehension: poor
Conduction
The lesion location: parietal lobe Fluency: fluent, sensical Speech: literal phonemic paraphasia Word retrieval: fair with literal paraphasias Repetition: fluent, literal paraphasia; some restriction retention span Comprehension: fair to good
Broca's aphasia
The lesion location: posterior inferior frontal lobe Fluency: nonfluent, telegraphic Speech: phonetic dissolution (distortion of consonants and sometimes vowels) Word retrieval: fair but misarticulated Repetition: labored, misarticulated, telegraphic Comprehension: fair to good
Wernicke's aphasia
The lesion location: posterior superior Temporal lobe Fluency: fluent, empty Speech: verbal semantic paraphasia Word retrieval: poor, with verbal paraphasias Repetition: fluent, verbal paraphasia; grossly restricted retention span Comprehension: poor
Transcortical sensory
The lesion location: posterior, superior parietal lobe Fluency: fluent, empty Speech: variable Word retrieval: Poor Repetition: good Comprehension: Poor
Autonomic
The lesion location: temporal parietal lobe Fluency: fluent sensical Speech: verbal semantic paraphasia Word retrieval: fair with verbal paraphasias Repetition: good Comprehension: fair to good
initiating and maintaining
The reduced speech output of transcortical motor aphasic patients seem to be a consequence of anterior frontal lobe dysfunction. The anterior frontal lobes are important for initiation and maintenance of purposeful activity. It follows then that patients with damage in the interior frontal lobe of the language dominant hemisphere are likely to have problems with ___________ ___________ __________ speech
limited
The speech globally aphasic patients is severely __________, consisting of few single words, stereotypical utterances, over learned phrases, or expletives.
motor, sensory, mixed
There are three kinds of transcortical aphasia in literature. They are transcortical ________ aphasia, transcortical ____________ aphasia and _________ transcortical aphasia.
Mixed transcortical aphasia
This rare syndrome sometimes called isolation of the speech area. Patients with mixed transcortical aphasia restrain their ability to repeat what he said to them in the presence of profound impairment of all communicative abilities.
Temporal lobe
Wernicke's aphasia typically is caused by damage in the ________ ________of the language dominant hemisphere. One of the most striking language characteristics of patients with this type of aphasia is there impaired comprehension of spoken or printed verbal materials.
Conduction aphasia
___________ ____________ is typically caused by lesions in the upper Temporal lobe, lower parietal lobe or insula that damage the arcuate fasciculus but spare Wernicke's area and Broca's area.
Global aphasia
___________ ____________ most often follows occlusion of the trunk of the middle cerebral artery, causing massive damage throughout the sarasylvian region.
verbal paraphasias
_____________ ________________ -substitution or transposition of sounds within words
Transcortical sensory aphasia
______________ ____________ ___________sometimes called posterior isolation syndrome, is caused by brain damage that spares Wernicke's area, arcuate fasciculus, and Broca's area. The brain damage responsible for this aphasia typically affects the upper parietal lobe and the language dominant hemisphere.
Wernicke's
_________________ area is not affected in transcortical motor aphasia, so patients with this aphasia comprehend language relatively well. The arcuate fasciculus is spared in this aphasia, so patients with this aphasia are good at repeating what they hear and are good at reading out loud
residual aphasia
anomia as an expression of __________ ____________ probably represent the most common anomic syndrome. These are patients who have passed through a more severe form of another aphasia syndrome and have recovered nearly normal language function but continued to exhibit mild to moderate word retrieval impairments. (authors recommend that this be called residual aphasia)
neologisms
nonwords