Speech Year 6

7/30/2019 Speech Year 6

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Speech


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Definitionspeech is a complex process used as means of

Communication by which we express ourthoughts.

Types:It is either spoken or written

its centers are in the categorial hemisphere

( dominant hemisphere)

arranged along and near the sylvian fissure


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Requirements of speech Hearing

Understanding

Thought and word finding

Voice production

Articulation


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Aspects of speech

Sensory (receptive) and motor (expressive)

aspects

I. Sensory (receptive) aspect

Spoken speech written speech

II. motor (expressive) aspect

Spoken speech written speech


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I. The sensory aspectsA.Spoken speech:

1.Primary auditory area( area41,42)

in the temporal lobe in thesupratemporal

Hearing (detection of soundpitch intensity)

spoken words are perceived.

2.Auditory association area inthe supratemporal gyrusAssigning a meaning to sound


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3.Wernick s area (left side)in the posterior part of the superior temporal gyrus

Function

1.comprehension of the thought behind words

2.Arranging words into coherent thought (thought formation3.Finding the appropriate words

4.Involved in complex sensory experiences


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B. Sensory aspect of written speech

1.Primary visual area 17 in the occipital lobe inboth sides where read words are perceived

2.Visual association area (18,19)

For understanding the meaning of thewritten words

3. The angular gyrus ( area 39):

Located posterior to Wernicks area

converts written words into forms that can beinterpreted by Wernicks area

4. Wernick area


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Speech has: Sensory and motor aspects

I. Sensory (receptive) aspect

Spoken speech

Primary auditory area

Auditory association area

Wernicks area

Written speech

Primary visual area

Visual association area

Angular gyrus

Wernicks area

Spoken speech Written speech

II. Motor (expressive) aspect


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Motor AspectA. spoken speech:

Brocas area:

In the inferior left frontalgyrus brodmann areas 44and 45

Receives information from

Wernicks area by thearcuate faciculus

Transforms informationreaching it to detailed

coordinated pattern forvocalization

Stores motor programs forspeech and projects to themotor cortex


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Written speech

Exner s 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


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Mechanism of speech


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Wernick sArea

Area 41,42

Primaryauditory

area

Area 22

Auditoryassociation

area

Broca sarea

Area 4

Muscles ofspeech


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Wernick sArea

Area 17

Primaryvisual area

Area 18,19

Visualassociation

area

Exner sarea

Area 4

Muscles ofhand for

writting

Angulargyrusarea 39


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Disturbances of speech Hearing

Understanding

Thought and word finding

Voice production

Articulation

X Deafness

X Aphasia

X

Xx

Dysphonia

Dysarthria


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Aphasia

Aphasia means disturbance of speech due

to lesions in the dominant hemisphere in

absence of muscle paralysis or defects of

vision or hearing


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Types of aphasia1.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


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b. Visual aphasia (alexia)

an acquired reading disability, where reading ability had

previously been developed

Can t understand the meaning of written words

Lesion in areas of the occipital lobe


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C. General sensory aphasiaDamage 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


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Wernick sArea

Area 41,42

Primaryauditory

area

Area 22

Auditoryassociation

area

Broca sarea

Area 4

Muscles ofspeech


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Wernick sArea

Area 17

Primaryvisual area

Area 18,19

Visualassociation

area

Exner sarea

Area 4

Muscles ofhand for

writting

Angulargyrusarea 39


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Motor aphasia ( expressive aphasia)1. Broca s aphasia

May be damage to broca s area

Speech is difficult and slow, articulation is impaired

Defect to repeat complex sentences

Patients seem to comprehend

Associated with right hemiparesis (arm>leg), Due to

damage of Bocas area and underlying structures: whitematter insula and basal ganglia


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Motor aphasia ( expressive aphasia)2.Agraphia

Due to damage of Exners area

Understands both written and spoken speech

letter formation becomes labored, incoordinated, andtakes on a very sloppy appearance

the wrong letters may be chosen, and the patient may

seem to have "forgotten" how to form certain letters.


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Legion of the angular

gyrus area 39:

There is no difficulty withspeech 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


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Dysarthria


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Wernick sArea

Area 41,42

Primaryauditory

area

Area 22

Auditoryassociation

area

Broca sarea

Area 4

Muscles ofspeech

BG

Cerebellum


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Definitions

a group of speech disorders resulting from disturbancesin muscular control over the speech mechanism due todamage of central or peripheral nervous system .


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1.Impairment of the LMN of the cranial or spinal nerves.

weakness and reduced muscle tone (Flaccid dysarthria )

2. damage to the UMN.

weakness and spasticity (Spastic dysarthria)


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3. Cerebellar disease: incoordination and reduced muscletone resulting in slow and inaccurate force, range of

motion, timing, ofspeech. (Ataxic Dysarthria)

4.basal ganglia disease. Hypokinetic dysarthria: rigidityand reduced force and range of movement. (parkinsonism)


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5. basal ganglia diseases characterized by involuntarymovements e.g chorea

This involuntary movement interferes with speech.

The normal speech is executed but interrupted by

abnormal, unpredictable, involuntary movements thatdistort, slow, interrupt it. (Hyperkinetic dysarthria)


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Thank you

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Speech Year 6