Language system
Stroke
Aphasia
MSDs
Speech
100

Left hemisphere role

  • Dominant for language (in most people)

  • Handles:


    • Grammar (syntax)

    • Word meaning (semantics)

    • Speech production

    • Precise language processing

100

What is a stroke?

Loss of blood flow → brain tissue damage

100

What is aphasia

Language impairment due to brain damage

100

Apraxia of Speech (AOS)

  • Planning/programming problem

3 key signs:

  • Inconsistent errors

  • Worse with longer words

  • Choppy prosody

100

4 steps

L MMM 

Linguistic 

 motor planning, motor execution, monitoring

200

Arcuate fasciculus

  • Function: Connects Broca’s ↔ Wernicke’s

  • Location: White matter tract in left hemisphere

Damage → Conduction aphasia:


  • Poor repetition

200

Types

  • Ischemic (most common): blockage

  • Hemorrhagic: bleeding

200

4 modalities

  • Speaking

  • Listening

  • Reading

  • Writing

200

 Dysarthria

  • Execution problem (muscle weakness)

200

Which cranial nerve is especially important for phonation (laryngeal control)?

Vagus nerve (10)

300

Angular gyrus

  • Function: Reading & writing (links visual + language)

  • Location: Parietal lobe

Damage:

  • Alexia (reading problems)

  • Agraphia (writing problems)

300

 Ischemic stroke signs and treatment

Signs:

  • Sudden weakness (one side)

  • Speech problems

  • Vision loss

Treatment:

  • Clot-busting drugs (tPA)

300

Non-fluent aphasias

  1. Broca’s


    • Frontal

    • Effortful speech

  3. Transcortical motor


    • Frontal

    • Similar to Broca’s but good repetition

  5. Global


    • Large lesion

    • Severe impairment in all areas

300

 5 domains of cognition

  • Attention

  • Processing speed

  • Memory

  • Executive function

  • Social cognition

300

What are the speech roles of CN V, CN VII, CN X, and CN XII?

Trigeminal 5- jaw movement 

    Facial 7- facial expression, lip movement 

    Vagus 10-  resonance, phonaiton 

    Hypoglossal 12- tongue movement

400

 “Zone of language”

A network in the left hemisphere including:

  • Broca’s area

  • Wernicke’s area

  • Arcuate fasciculus

  • Angular gyrus

400

 Hemorrhagic stroke signs and treament

Signs:

  • Severe random headache

  • Nausea/vomiting

  • Rapid decline

Treatment:

  • Surgery 

400

Fluent aphasias

  1. Wernicke’s


    • Poor comprehension

  3. Transcortical sensory


    • Like Wernicke’s but good repetition

  5. Conduction


    • Poor repetition

  7. Anomic

400

 Focal vs diffuse TBIS

  • Focal → specific area

  • Diffuse → widespread damage

400

What is the role of the basal ganglia in motor speech?


    Selection and scale

500
Brocas area

Broca’s area

  • Function: Speech production (motor planning for language)

  • Location: Left frontal lobe (inferior frontal gyrus)

Damage → Broca’s aphasia:

  • Non-fluent, effortful speech

  • Short phrases (“telegraphic speech”)

  • Good comprehension

  • Aware of errors → frustration

500

Brain systems

  • Frontal → executive control

  • Frontoparietal → attention

  • Temporal/hippocampus → memory

  • Brainstem → arousal

500

 Lesion patterns

  • Anterior (frontal): non-fluent

  • Posterior (temporal): fluent

500

Types of TBIS

  • Closed (no skull break)

  • Open (penetrating)

500

What is the role of the cerebellum in motor speech?

Timing and error correction

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