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NEUROANATOMY OF LANGUAGE

SPEECH:

• Speech is the vocalized form of human communication.

• The formation of speech is unique to human, with the use of phonetics (using

consonants and vowels)

• Based upon the syntactic combination of lexicals and names that are drawn from very

large vocabularies (usually about 10,000 different words! uniqueness of our memory

bank 

• "ach spo#en word is created out of the phonetic combination of a limited set of vowel

and consonant speech sound units. In order to produce sounds, we need to use vowels.

Without vowels, sounds are nonsense because we cannot prolong the consonants.

• The production of speech must be in harmony with the works of entral !ervous "ystem, the articulatory 

system and as well as the respiratory system. Without the respiratory system, it is very hard to produce

sounds. #s the person e$hale, it results in the vibration of your vocal cords. Without the articulatory system,sound is nonsense. It consists of the union of the teeth, the movement of the tongue, the si%e of your 

resonators (cavities that are located in your facial area, oral cavity and ma$illary sinus). These chambers will 

tend to amplify the sound. &our articulatory system which includes your teeth and your tongue, are the

structures that will give rise to your vowels and your consonants. With the aid of the !", the speech or the

language is being understood by an individual so that the message becomes a two way process provided 

that we can understand that common language. 'ont label a patient as aphasic if youre using the ilipino

language while talking to a *erman. In clinical history, it is very important to take note of the !ationality of 

the patient as well as if they are speaking in different dialects.

LANGUAGE:

• $t is an arbitrary and abstract way to represent thought processes by means of

sentences and to present concepts or ideas by means of words. (figures forhieroglyphics)

• %efers to the specific human capacity for ac&uiring and using complex systems of

communication (nice to know according to doc 

• 'he scientific study of language in any of its senses is called )inguistics*

DOMINANT LANGUAGE HEMISPHERE

What particular aspect in your skill will dictate your dominant hemisphere+ andedness.

If you are right-handed, your dominant hemisphere is the left but this is only true for /0

of the population.

+ost components of the language system are located in the left hemisphere (providedthat you are a right-handed individual).

early all and -/ of left!handers have right cerebral dominance

  disturbance in language includes disturbances in the ability to comprehend (decoding

andor program (coding the symbols necessary for communication.

'ecoding- the brain cannot process what is brought to the wernickes area

oding- you have difficulty e$pressing a particular languange

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CORTICAL LANGUAGE AREAS

1. ernic#e2s rea

-. Broca2s rea

/. 'he rcuate 3asciculus

 

I. WERNICKE’S AREA

amed after 4erman eurologist, 5arl ernic#e

"xtensive region that includes the superior temporal gyrus (rea -- and the

angular gyrus (rea /6

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 #rea 11 is for comprehension of spoken language while #rea 2 is for

comprehension of written language

 rea -- is responsible for comprehension of spo#en language

ow do we comprehend the spoken language+ &ou need the help of the

visual pathway. Isnt it that the Wernickes area is located beside the occipital

lobe+  rea -- is responsible for comprehension of written language

Spo#en language is perceived in primary auditory area ('ransverse 'emporal

4yrus7eschl 4yrus rea 81 and 8- and transmitted to ernic#e2s rea

The sensory part of speech.

The clue for the location of this is the transverse temporal gyrus. &ou have to

open the lateral sylvian fissure in order to see this which is embedded at the

superior part of the superior temporal gyrus. 3ehind the transverse temporal

gyrus is the Wernickes area. &ou have to hear first, in order to understand.

II. BROCA’S AREA amed after the 3rench 9athologist, 9ierre Broca

%egion in the frontal lobe which includes the opercular (rea 88 and

triangular gyrus (rea 8: of inferior frontal gyrus.

%eceive inputs from ernic#e2s rea via the rcuate 3asciculus

ithin the Broca2s rea, a coordination program for vocalization is formulated

which is transmitted in the face, tongue, pharynx and larynx of the motor

cortex for speech execution.

3rocas area is the motor part of speech. If we place the homunculus in #rea

4, the head and neck musculature is located near the sylvian fissure and

beside the 3rocas area.REMEMBER BMWs!!! (Broca's for Motor, Wernicke's for Sensory)

III. ARCUATE FASCICULUS

$t is a long association bundle that lin#s the ernic#e2s rea to Broca2s rea

;amage to rcuate fasciculus is associated with impairment of repetition of

spo#en language (but the patient can still understand)

 # band of white matter that connect your Wernickes area to 3rocas area

 #!' IT I" !5T T6 5T67 W#& #758!'999 The direction of the stimulus

is from Wernickes it will pass the arcuate fasciculus then it will go to 3rocas

area.

Role of Non-Do!n"n# He!$%&e'e !n S%ee(&:

 lthough it is believed that the dominant hemisphere is the one responsible for speech

production, the non!dominant hemisphere is metabolically active during speech. 'hese areas

are believed to be concerned with melodic function of speech (9rosody

 prosody < )esions involving the right hemisphere render speech amelodic.

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LANGUAGE DISORDERS

APHASIA

3rom the 4ree# word * without, 9hasia* speech

 #ka phemia

)oss or impairment of the ability to produce andor comprehend language

;ue to damage to the language centers! Wernickes #rea, 3rocas #rea and #rcuate

asciculus (Stro#e, =erebral 'umors, ;egenerative ;iseases

=lassification>

o ;isturbance in receiving and decoding symbolic materials

o ;isturbance in central processes of meaning, word selection and message

formulation

o ;isturbance in expressing symbolic materials

/ reas ffected by phasia> (REMEMBER: FoRCe)

o FLUENCY

Spea#ing with normal grammar, syntax rate, intonation and stress

on!fluent>

• 9roblem of grammatism

• Speech is difficult to initiate, labored and halting. $ntonation

patterns are deficient

• )anguage is reduced to dis?ointed words (in tagalog: barok)

o COMPREHENSION

 bility to understand language (verbal or written

'5 !5T ;#36; &587 <#TI6!T WIT #<#"I# I T#T <#TI6!T I"

!5T #W#76 5 &587 !#TI=6 ;#!*8#*69 

o REPETITION

Saying by one individual of the spo#en vocalization made by another

individual (the only ability that can be done by lower form of animals like

 parrots)

TYPES OF APHASIA

). GLOBAL APHASIA (REMEMBER: globA)

 ll parameters (fluency, comprehension and repetition are impaired

!on-fluent type, comprehension is impaired and has no ability to repeat spoken

language

 lmost totally absent speech

Stereotypic utterances

@A =A' 4$C" 7A+" $S'%='$AS 3A% '7"S" 9'$"'SDDD

;o not label your patient with global aphasia if your patient is mute or deaf 

*. ISOLATION + MI,ED TRANSCORTICAL APHASIA (REMEMBER: R" in solation, it is

only t#e Re$etition t#at is nor%al)

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$nability to comprehend what is being said

;ifficulty in creating speech with meaning without affecting the ability to recite what has

been said

They have the repetition ability, they are like parrots

. BROCA’S APHASIA (REMEMBER: BC si BEA" in Broca's, Co%$re#ension is intactan& it is an E$ressie A$#asia)

3luency and repetition are impaired but comprehension is intact

The problem is musculatory control over the articulatory muscles

"xpressive aphasia (can understand but cannot spea#

)imited verbal output

$mpaired articulatory agility

Stereotyped grammar 

&58 #! *I=6 I!"T78TI5!" but dont let the patient repeat your instructions

. TRANSCORTICAL MOTOR APHASIA (REMEMBER: aMA CoRrect" in ranscortical

Motor A$#asia, co%$re#ension an& re$etition are nor%al)

3luency is impaired but comprehension and repetition are normal

 #a dynamic phasia

$nvolves the structures surrounding Broca2s rea, the BrocaEs rea is still intact

/. WERNICKE’S APHASIA (REMEMBER: W#at t#e F*ckeR" Wernicke's, Fl*ency is

nor%al an& is of Rece$tie ty$e)

3luency is normal but comprehension and repetition are impaired

%eceptive phasia (=an spea# but cannot understand

=opious verbal output

eologisms and ?argon, if severe

ormal articulatory agility

aming is impaired

&58 #!!5T *I=6 I!"T78TI5!" T5 <#TI6!T" WIT W67!I>6" #<#"I#

 #ccording to doc, ?salita ng salita pero walang sense? 

0. TRANSCORTICAL SENSORY APHASIA (REMEMBER: aSA si Fat#eR" in ranscortical

Sensory A$#asia, Fl*ency an& Re$etition is nor%al)

3luency and repetition are normal, comprehension is impaired

=onversation and comprehension resembles ernic#e2s phasia

"xtreme difficulty with nouns

The structures surrounding the Wernickes are impaired but the Wernickes is still intact 

1. CONDUCTION APHASIA (REMEMBER: CFCs" n Con&*ction a$#asia, Fl*ency an&

Co%$re#ension are nor%al)

3luency and comprehension are normal, repetition is impaired

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4ood articulation and phrase length

 cute awareness of errors

@A = 4$C" $S'%='$AS 'A '7" 9'$"'

2. ANOMIC APHASIA

 ll parameters are normal

Severe word finding deficits

 ppropriate grammatical forms

@ental block 

<roblems with naming parts

SITE OF LESION

). ANTERIOR LESIONS- Non-fl3en# "%&"$!"

! involving the frontal lobe

! BrocaEs, 'ranscortical motor, $solation, 4lobal

" (REMEMBER: B+ iMe si A)

*. POSTERIOR LESIONS- Fl3en# "%&"$!"

! involving the parietal, temporal and sometimes the occipital lobe

! ernic#eEs, =onduction, 'ranscortical sensory, nomic

" (REMEMBER: -.WER CAS an& F/)

B%A=ES +=, frontal lobe

'%S=A%'$=) +A'A% =, prefrontal

"%$=5"ES +=, 'emporal lobe

'%S=A%'$=) S"SA%@ 9=, 9arietoccipital

=A;='$A +=, arcuate fasciculus A+$= +=, angular gyrus

4)AB) +=, multilobes