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79 Cards in this Set
- Front
- Back
- 3rd side (hint)
Most of the brain is made up of _________ cortex.
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Association
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The 2 types of association cortex are:
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Unimodal (modality-specific)
Heteromodal (Higher-order) |
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Give 4 examples of unimodal association cortex
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Somatosensory Association
Visual Association Auditory Association Motor Association |
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What are the 2 motor association cortex areas?
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Premotor cortex
Supplementary Motor Area |
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From whence does the unimodal sensory association cortex receive its primary input
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Primary sensory cortex of a specific sensory modality
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What does the unimodal association cortex do with the input
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Performs higher-order sensory processing
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What connections does the heteromodal association cortex have (direction, areas)?
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Bidirectional connections with both motor and sensory association cortex of all modalities and bidirectional connections with limbic cortex
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What function does the heteromodal cortex serve?
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Highest-order mental functions.
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In what 2 areas is heteromodal association cortex found?
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Frontal lobes
Parieto-occipital junctions |
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What information does the limbic system provide to the heteromodal association cortex (2 types)?
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emotional
motivational |
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Simple motor movements are controlled by the __________ hemisphere while skilled complex motor tasks for both limbs are mainly controlled by the ______ hemisphere?
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contralateral
dominant/left (explains why apraxia usually due to dominant/left hemisphere damage) |
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Define apraxia
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A disorder of formulating skilled movements
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The left hemisphere is dominant for language in over ____% of R handers and ____ % of L handers
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95%
60-70% |
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List 5 skills associated with the dominant/left hemisphere
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Language
Skill motor formulation (praxis) Arithmetic (sequential, analytical calculation skills) Musical ability (sequential, analytical abilities in trained musicians) Sense of direction (following written directions in sequence) |
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List 5 functions of the nondominant/right hemisphere
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Prosody
Visuospatial analysis and spatial attention Arithmetic (correctly line up numbers on a page) Musical ability (untrained musicians; complex pieces for trained musicians) Sense of direction (finding way by overall sense of spatial orientation) |
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Define prosody
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Emotion conveyed by the tone of voice
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Which hemisphere is responsible for attention to both sides?
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Right (non-dominant)
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Which hemisphere is responsible for spatial perception of the overall gestalt?
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Right (non-dominant)
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Networks with connections to which 3 areas mediate dominant/non-dominant hemisphere functions?
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1. Frontoparietal
2. Connections with limbic structures 3. Reciprocal connections with subcortical nuclei |
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What 2 ways can these networks be disconnected?
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Within each hemisphere
Between hemispheres at the corpus callosum |
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Where is the primary auditory cortex located?
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The superior bank of the Sylvian fissure in the temporal lobe (See Blumenfeld p. 824 for diagram)
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What part of the brain is responsible for identifying particular sequences of sounds and comprehending words as meaningful?
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Wernicke's area
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What Brodmann's are is this?
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22
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Where is it located
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Posterior 2/3 of the superior temporal gyrus in the dominant hemisphere
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What adjacent Brodmann's areas/association cortex also produce Wernicke's aphasia
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37, 39, 40 (See Blumenfeld p. 828 for diagram)
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What part of the brain is responsible for articulation of sounds that result in speech
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Face area of the primary motor cortex
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Where is this located
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Inferior portion of the precentral gyrus
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What part of the brain is responsible for the motor program that activates sequences of sounds to produce words
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Broca's area
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What is/are the corresponding Brodmann's area(s)
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44, 45 (See Blumenfeld p. 828 for diagram)
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What is the mnemonic to remember Wernicke's and Broca's Brodmann's areas?
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Broca's (44) is twice Wernicke's (22)
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Describe where Broca's area is located in the brain
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In the opercular and triangular portions of the inferior frontal gyrus of the dominant hemisphere
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What other adjacent Brodmann's areas (6) also can produce Broca's aphasia
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9, 46, 47, 6, 8, 10
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What is the subcortical white matter pathway that connects Wernicke's and Broca's areas
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Arcuate fasciculus
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What other pathways are involved
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numerous polysynaptic connections that convey information along the intervening peri-Sylvian cortex
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To what areas does Broca's area connect for higher-order motor aspects of speech formulation and planning (3)
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Prefrontal cortex, premotor cortex, supplementary motor area
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What other important aspect of speech formulation are these areas responsible for
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Syntax (both in language comprehension and production)
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Define syntax
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Grammatical structure
According to the INS Dictionary of Neuropsychology: "The rules of language structure governing the assembly of words into sentences. Syntax represents the variety of relationships among words (i.e., word order) that helps convey information in a coherent and meaningful manner." (p. 155) According to answers.com: "The study of the rules whereby words or other elements of sentence structure are combined to form grammatical sentences. " |
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With which other brain areas does Wernicke's area have connections (3)
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Supramarginal gyrus of the parietal lobe, angular gyrus of the parietal lobe, other parts of the temporal lobe (e.g., Brodmann's area 37)
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In addition to comprehension, what other aspect of language do these areas assist with
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Lexicon (involved in both the comprehension and production of meaningful language)
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Define lexicon
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According to the INS Dictionary of Neuropsychology: "Knowledge of the phonological representation and grammatical aspects of words." (p. 97)
According to answers.com: "The morphemes of a language considered as a group." According to answers.com, a morpheme is: "A meaningful linguistic unit consisting of a word, such as man, or a word element, such as -ed in walked, that cannot be divided into smaller meaningful parts." According to the INS Dictionary of Neuropsychology, a morpheme is: "The smallest unit of meaning in a language. Morphemes include words as well as meaningful prefixes, suffixes, and affixes." (p. 109) |
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What part of the brain is also particularly involved in written language
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Language areas of the dominant parietal lobe, such as angular gyrus
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Describe the pathway taken by information that is read
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Primary visual cortex in occipital lobes, processed in visual association cortex, travels anteriorly via the angular gyrus to language areas
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What role does the right/non-dominant hemisphere play in language
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Recognition and production of affective elements of speech
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What pathway is involved
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Via the corpus callosum
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What language dysfunction do individuals with non-dominant hemisphere lesions display
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Difficulty judging the intended expression in the tone of voice, difficulty producing emotional expression in their voice
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Lesions in which subcortical areas reciprocally connected with language areas can produce similar language deficits (3)
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Thalamus, basal ganglia, subcortical white matter
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Define aphasia/dysphasia
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"A defect in language processing caused by dysfunction of the dominant hemisphere" (Blumenfeld, p. 829)
INS Dictionary of Neuropsychology: "Acquired disorder of symbolic language processing." (p. 15) |
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What 5 other general conditions/situations must be ruled out before giving a diagnosis of aphasia
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1. Disorders of speech production, 2. Auditory disorders, 3. Defects in arousal and attention, 4. Psychiatric disorders, 5. Lack of cooperation
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Name 3 disorders of speech production
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Dysarthria, aphemia (verbal apraxia), mutism
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How can disorders of speech production be distinguished from aphasia
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The content and grammar are normal; written language is often normal; mutism may result from severe aphasia or from motor disorders, but writing may be intact
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Name 3 auditory disorders
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Peripheral hearing loss, pure word deafness, cortical deafness
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How can auditory disorders be distinguished from aphasia
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Reading and other aspects of language are intact
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Name some conditions that result in defects in arousal and attention
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Global confusional state (toxic/metabolic, post-ictal, brainstem ischemia), narcolepsy
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Name a couple of psychiatric conditions that may cause disruption of language
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Schizophrenia, conversion disorder and other somatoform disorders
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What are some aspects of langauge that characterize psychiatric disorders
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Disordered, nonsensical, clanging speech full or neologisms
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What is the most common cause of aphasia
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Cerebral infarction
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List 7 causes of aphasia
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1. Cerebral contusion; SDH, EDH
2. Ischemic or hemorrhagic vascular events 3. Ictal or post-ictal related to focal seizures in dominant hemisphere 4. Mass lesions (brain tumor, abscess, toxoplasmosis) 5. Inflammatory/autoimmune disorder (e.g., MS, vasculitis) 6. Developmental disorder (language delay, autism) 7. Degenerative disorder (primary progressive aphasia, moderately advanced Alzheimer's Disease, Huntington's Disease) |
See neuroexam.com Videos 8-12 for 6-step bedside exam
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What is the most common cause of Broca's aphasia
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Infarct in the territory of the L MCA superior division
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What are other non-language features generally associated with Broca's aphasia (5)
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R hemiparesis affecting the face and UE>LE; dysarthria; frustration; depression; L sided and oral-buccal-lingual structures apraxia
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What is the most common cause of Wernicke's aphasia
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Infarct in the L MCA inferior division territory
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What non-language features are generally associated with Wernicke's aphasia (4)
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Contralateral visual field cut, usually R upper quadrant; apraxia (difficult to tell due to reduced comprehension); anosagnosia (acting as if conversation is normal); angry or paranoid behavior (may appear psychotic)
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What 3 aspects of language determine the type of aphasia
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Fluency, comprehension, repetition
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What are the 8 general types of aphasias
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Global, Mixed transcortical, Broca's, Transcortical Motor, Wernicke's, Transcortical Sensory, Conduction, Anomic
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What are the 4 aphasias related to reduced fluency
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Global, Mixed Transcortical, Broca's, Transcortical Motor
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What are the 4 aphasias related to relatively intact fluency
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Wernicke's, Transcortical Sensory, Conduction, Anomic
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Given reduced fluency, what 2 aphasias are related to reduced comprehension
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Global, Mixed Transcortical
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Given reduced fluency, which 2 aphasias are related to relatively intact comprehension
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Broca's, Transcortical Motor
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Given reduced fluency and comprehension, which aphasia cannot repeat
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Global
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Given reduced fluency and comprehension, which aphasia can repeat
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Mixed Transcortical
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Given reduced fluency and generally intact comprehension, which aphasia cannot repeat
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Broca's
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Given reduced fluency and generally intact comprehension, which aphasia can repeat
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Transcortical Motor
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Given relatively intact fluency, which 2 aphasias demonstrate reduced comprehension
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Wernicke's, Transcortical Sensory
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Given relatively intact fluency, which 2 aphasias demonstrated generally intact comprehension
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Conduction, Anomic
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Given relatively intact fluency and reduced comprehension, which aphasia cannot repeat
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Wernicke's
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Given relatively intact fluency and reduced comprehension, which aphasia can repeat
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Transcortical Sensory
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Given relatively intact fluency and comprehension, which aphasia cannot repeat
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Conduction
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Given relatively intact fluency and comprehension, which aphasia can repeat
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Anomic
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Draw the flow chart of Classification of Language Disorders using a decision tree of fluency, comprehension, and repetition
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See Blumenfeld Figure 19.4, p. 834
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Draw a lateral view of the dominant/L hemisphere and for each disorder (except anomic aphasia) indicate the usual area of infarction and the vascular/watershed territory usually involved
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See Blumenfeld p. 834
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