9- Speech & Language

Speech

physical ability to produce sounds

Language

system of communication using words and symbols

Phonology

Sound structure

Syntax

Rules system or grammar

Morphology

Smallest units with meaning

Semantics

Meaning or context

Pragmatics

Appropriate use of language

Language is:

-complex system of symbols and rule used for communication

-speaking and understanding (oral), reading and writing, sign language

Speech is:

Pronunciation, fluency, voice, primary mode of expressing language

Communication can be verbal and nonverbal, what are the components of each?

Verbal: linguistic

Nonverbal: paralinguistic, nonlinguistic

Nonverbal communication:
Paraliguistics include:

Pitch, loudness, pause, quality, rate, tone

Nonverbal communication:
Nonliguistics include:

Body language, kinetics, proxemics, haptics, oculesis, posture

What is required for speech production?

Respiration

Phonation: pushing air through vocal chords

Articulation

Resonation

What is the role of the respiratory system/the function of lungs in speech?

-Air supply: provides airflow for sound production (vocal folds in larynx vibrate)

-Breath control: regulates airflow to control volume and pitch (changes in airflow modalities pitch and lowness of the voice)

Vocal cords addition function

To prevent aspiration of fluid into the lungs

What structure is the primary articulator?

Tongue

What are the key structures for sound production?

- Larynx: voice box that houses the vocal folds

- Vocal folds: muscular structures that vibrate to produce sound

What 2 things are important for sound production?

- Airflow: air from lungs pass through trachea into larynx

- Vocal fold vibration: air pressure causes vocal folds to rapidly open/close, creating sound waves

What 2 types of control are used for the modulation of sound?

- Pitch control: adjust tension and length of vocal folds to alter pitch

- Volume control: increased airflow = louder sounds

What is Resonance?

Sound waves in vocal tract

What is Articulation?

Movement of the tongue, lips, and soft palate shapes sound into recognizable speech

key structures of the articulatory system

-Tongue: Primary articulator

-Lips: bilabial sounds ("p", "b")

-Teeth: dental sounds ("t", "d")

-Palate: Hard and soft palate create different sounds

-Jaw: Adjusts position of mouth for various sounds

Consonant is a type of sound produced with ___________

obstructed airflow

Vowels produced with _____________, shaped by _____________

open airflow, position of the tongue and lips

Vowels produced are influenced by ___________

tongue height, tongue backness, and mouth roundness

Corticobulbar tract controls?

- motor control of muscles for SPEECH!

- movement of face, neck, tongue, and parts of the extraocular eye muscles

- skilled voluntary movement of muscles related to the execution of speech

- 3,4,5,6,7,9,10,11,12 all in corticobulbar tract but not all control speech

Explain the path of the corticobulbar tract

Descends through internal capsule going to midbrain, pons, and medulla where it projects ipsilaterally and contralaterally (lateral aspect of temporal lobe)

What artery is controlling info of the neck, brow, eyelid, nose, lips, tongue, larynx?

MCA

What CN are involved in speech?

CN 5, 7, 9, 10, 12 *double check!

Corticobulbar tracts: CN and the muscle it innervates

The left hemisphere of the brain mediates:

Language functions, analytical, logical (dominant language hemisphere)

The right hemisphere of the brain mediates:

Perceptual, prosodic, pragmatic, spatial functions

The two hemispheres work together in complementary manner. T/F?

True

In most people, language is processed in the _______ hemisphere (dominant) but dominant hemisphere depends on ____________

left, handedness

A person who is right handed is language function dominant in what hemisphere?

Left

A person who is left handed has dominant language function in what hemisphere?

Some in right & left

What are important areas in the Left hemisphere?

Broca’s (in frontal lobe)

Wernicke’s (in temporal parietal area)

Heshl’s gyrus

Angular gyrus

Arcuate fasciculus

Broca's area is responsible for:

Speech production and language processing, grammar and sentence structure

Wernicke’s area is responsible for:

Language comprehension; processes the meaning of words and sentences

Heshl's gyrus (superior temporal gyrus) is responsible for:

Processing auditory info, including spoken language sounds

Angular gyrus (area between Wernicke’s and parietal) is responsible for:

Integrates sensory info and plays a role in reading and writing

Arcuate fasciculus (white matter pathway of axons from Wernickes area to brocas) is responsible for:

bundle of nerve fibers connecting Broca's and Wernicke’s areas, essential for repeating heard speech

Neurogenic communication disorders are cause by:

Damage to the CNS and PNS
Most often caused by CVAs (strokes), tumors, TBI, infectious diseases

Blood supply

Blue = Anterior Cerebral Artery

Pink = Middle Cerebral Artery

Yellow = Posterior Cerebral Artery

What are examples of neurogenic communication disorders?

Aphasia/Dysphagia, Apraxia, Right Hemisphere Disorder, Dysarthria

Aphasia/Dysphasia

Loss or impairment of language function caused by brain damage (language content, comprehension, reading and writing)

Fluent

Receptive aphasias (ex. Wernicke’s)

Non-fluent

Expressive aphasias (ex. Broca’s)

What are the components of Broca's Aphasia?

•Non-fluent speech

•Agrammatism, Telegraphic, Effortful speech

•Phenomic paraphasias

•Some degree of comprehension deficit

•Agraphia with/without alexia

• Writing and possible reading deficits

•Repetition abnormal - drops function words

•Buccofacial apraxia, right hemiparesis

Semantic paraphasias examples

Fork/knife

Brush/comb

Phonemic paraphasias examples

Nuzzle/muzzle

Prograther/protractor

What are the components of Wernickes aphasia?

•Fluent, nonsensical speech

•Impaired comprehension

•Phonemic and semantic paraphasias

•Incapable of monitoring own output

•Grammar better preserved than in Broca's Aphasia

•Alexia without agraphia: reading impairment often present; writing is legible - letters formed (rarely have a concomitant

hemiplegia), but disjointed, repetitive text, few nouns and

verbs

•May be aware or unaware of deficit

•Repetition poor

What are the components of Global Aphasia?

•Deficits in repetition, naming, fluency and comprehension

•Gradations of severity exist

•May communicate prosodically

•Involve (typically) large lesions

•Outcome poorest

Dysarthria

impairment of the structures involved in speech production (tongue, throat, lips)

Aphasia and Speech Apraxia are a disorders of

Language

Dysarthria is a disorder of (the motor control) of

Speech (closely tied to swallowing function)

CNS disorders

- Aphasia: Wernicke's (receptive); Broca's (expressive); Global

- Cognitive/Linguistis (due to dementia or TBI; Problems with attention, memory, planning)

What are the key components of speech production?

Respiration, larynx and vocal folds (producing sounds), articulation, resonance

Describe the role of 2 key brain regions in speech and language

Broca’s: expressive nonfluent aphasia

Wernicke’s: receptive fluent aphasia

What is the difference between speech and language?

Speech: ability to produce the sounds

Language: involves symbols and rules

Peripheral disorders

Dysphagia, Tracheostomies, Voice disorders, Cranial Nerves (Muscles of jaw, face & tongue, pharynx), Dysarthria

What is the role of a PT in individuals with speech and language disorders?

- Slower and more deliberate speech when providing patient education

- Allow processing time (when taking history, switching tasks)

- Reduce background noise and interference

- Reduce dual tasking

- Don't assume speech disorder = cognitive disorder