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Definition
speech is a complex process used as means of Communication by which we express our thoughts. Types: It is either spoken or written its centers are in the categorial hemisphere ( dominant hemisphere) arranged along and near the sylvian fissure
Requirements of speech
Hearing
Understanding Thought and word finding Voice production Articulation
Aspects of speech
Sensory (receptive) and motor (expressive) aspects I. Sensory (receptive) aspect
Spoken speech
written speech
Speech has: Sensory and motor aspects I. Sensory (receptive) aspect Written speech Spoken speech Primary visual area Primary auditory area Visual association area Auditory association area Angular gyrus Wernicks area Wernicks area
Spoken speech
Written speech
Motor Aspect
A. spoken speech: Brocas area: In the inferior left frontal gyrus brodmann areas 44 and 45 Receives information from Wernicks area by the arcuate faciculus Transforms information reaching it to detailed coordinated pattern for vocalization Stores motor programs for speech and projects to the motor cortex
Written speech Exners area: Located in the frontal lobe adjacent to the arm motor area
projects to the arm motor area to the corticospinal tract and hand muscles
Transforms information reaching it into a coordinated pattern of movement which are stored to be projected to the motor cortex
Mechanism of speech
Wernicks Area
Area 22 Auditory association area
Brocas area
Area 4
Wernicks Area
Exners area
Hearing X
Disturbances of speech
Deafness
Understanding X
Aphasia
Aphasia
Aphasia means disturbance of speech due to lesions in the dominant hemisphere in absence of muscle paralysis or defects of vision or hearing
Types of aphasia
1.Sensory aphasia (receptive aphasia)
a. Auditory aphasia (word deafness) Lesion of auditory association area Patients can hear sounds , the discrimination between specific sounds which are closely spaced in time is lost unable to understand the meaning of spoken words
Types of aphasia
1.Sensory aphasia (receptive aphasia)
b. Visual aphasia (alexia) an acquired reading disability, where reading ability had previously been developed Cant understand the meaning of written words Lesion in areas of the occipital lobe
Types of aphasia
1.Sensory aphasia (receptive aphasia)
C. General sensory aphasia Damage to the Wernicks area Speech is effortless fluent produced at a normal rate, Difficulty in understanding speech. Frequent errors in the choice of words Impaired repetition of complex sentences No motor signs present
Wernicks Area
Area 22 Auditory association area
Brocas area
Area 4
Wernicks Area
Exners area
Associated with right hemiparesis (arm>leg), Due to damage of Bocas area and underlying structures: white matter insula and basal ganglia
Legion of the angular gyrus area 39: There is no difficulty with speech or understanding of auditory information there is trouble understanding written words or pictures and naming errors because visual information is not processed and transmitted to Wernicks area
Dysarthria
Wernicks Area
Area 22 Auditory association area BG
Brocas area
Area 4
Definitions
a group of speech disorders resulting from disturbances in muscular control over the speech mechanism due to damage of central or peripheral nervous system .
1.Impairment of the LMN of the cranial or spinal nerves. weakness and reduced muscle tone (Flaccid dysarthria )
3. Cerebellar disease: incoordination and reduced muscle tone resulting in slow and inaccurate force, range of motion, timing, ofspeech. (Ataxic Dysarthria) 4.basal ganglia disease. Hypokinetic dysarthria: rigidity and reduced force and range of movement. (parkinsonism)
This involuntary movement interferes with speech. The normal speech is executed but interrupted by abnormal, unpredictable, involuntary movements that distort, slow, interrupt it. (Hyperkinetic dysarthria)
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