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{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor={{Rim}} | |QuestionAuthor= {{Rim}} (Reviewed by {{YD}}) | ||
|ExamType=USMLE Step 1 | |ExamType=USMLE Step 1 | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|MainCategory= | |MainCategory=Pathophysiology | ||
|SubCategory=Neurology | |SubCategory=Neurology | ||
|Prompt=A 71 year old | |Prompt=A 71-year-old right-handed man with a past medical history significant for coronary artery disease and hypertension presents to the emergency department for acute-onset right arm weakness and speech difficulty. The patient is not able to speak in full sentences and answers by saying: "Ummm...Ummm..Not move..Ummm arrr...arm". Whenever the physician asks him a question, the patient tries to answer by using hand gestures. Which of the following brain regions is most likely responsible for the patient's speech dysfunction? | ||
|Explanation=The patient's sudden onset | |Explanation=The patient's sudden-onset right side weakness along with speech difficulty is consistent with a [[stroke]] that involves the [[middle cerebral artery]] (MCA). The patient seems to understand what the physician is asking but is finding difficulty articulating the words. The patient's intact comprehension and impaired fluency of speech result from involvement of the Broca's area in the left dominant frontal lobe. Involvement of the left [[frontal lobe]] also explains the contralateral arm weakness. | ||
There are several types of aphasia: | There are several types of aphasia: | ||
* Wernicke's aphasia: impaired comprehension, intact speech fluency and impaired repetition. | * Wernicke's aphasia: impaired comprehension, intact speech fluency, and impaired repetition. | ||
* [[Broca]]'s aphasia: intact comprehension, impaired speech fluency and impaired repetition. | * [[Broca]]'s aphasia: intact comprehension, impaired speech fluency, and impaired repetition. | ||
* Global aphasia: impaired comprehension, impaired speech fluency and impaired repetition. | * Global aphasia: impaired comprehension, impaired speech fluency, and impaired repetition. | ||
* Conduction aphasia: intact comprehension, intact speech fluency and impaired repetition. | * Conduction aphasia: intact comprehension, intact speech fluency, and impaired repetition. | ||
Shown below is an image | Shown below is an image that depicts the different regions involved in aphasias.<br> | ||
[[Image:Aphasia.gif|600px]] | |||
[[Image:Aphasia | |||
|AnswerA=Superior temporal gyrus | |AnswerA=Superior temporal gyrus | ||
|AnswerAExp=Wernicke's aphasia is a speech dysfunction characterized by impaired comprehension, intact speech fluency and impaired repetition. | |AnswerAExp=Wernicke's aphasia is a speech dysfunction characterized by impaired comprehension, intact speech fluency, and impaired repetition. It results from damage to the superior temporal gyrus. Wernicke's aphasia is also known as sensory or receptive aphasia. | ||
|AnswerB=Inferior frontal gyrus | |AnswerB=Inferior frontal gyrus | ||
|AnswerBExp=Broca's aphasia is a speech dysfunction characterized by intact comprehension, impaired speech fluency and impaired repetition. | |AnswerBExp=Broca's aphasia is a speech dysfunction characterized by intact comprehension, impaired speech fluency, and impaired repetition. It results from damage to the inferior frontal gyrus. Broca's aphasia is also known as motor or expressive aphasia. | ||
|AnswerC=Superior temporal and frontal gyri | |AnswerC=Superior temporal and frontal gyri | ||
|AnswerCExp=Global aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency and impaired repetition. | |AnswerCExp=Global aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency, and impaired repetition. It results from damage to a larger area of the brain that involves the superior temporal and inferior frontal gyri. | ||
|AnswerD=Arcuate fasiculus | |AnswerD=Arcuate fasiculus | ||
|AnswerDExp=Conduction aphasia is a speech dysfunction characterized by intact comprehension, intact speech fluency and impaired repetition. | |AnswerDExp=Conduction aphasia is a speech dysfunction characterized by intact comprehension, intact speech fluency, and impaired repetition. It results from damage to the [[arcuate fasciculus]]. | ||
|AnswerE= | |AnswerE=Area between the supplementary motor area and the frontal perisylvian speech zone | ||
|AnswerEExp=Transcortical motor aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency and intact repetition. | |AnswerEExp=Transcortical motor aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency, and intact repetition. It results from damage to the area between the supplementary motor area and the frontal perisylvian speech zone. | ||
|EducationalObjectives=Broca's aphasia is a speech dysfunction characterized by intact comprehension, impaired speech fluency and impaired repetition. | |EducationalObjectives=Broca's aphasia is a speech dysfunction characterized by intact comprehension, impaired speech fluency, and impaired repetition. It results from damage to the inferior frontal gyrus. | ||
|References=First Aid 2014 page 457 | |References=First Aid 2014 page 457 | ||
|RightAnswer=B | |RightAnswer=B |
Latest revision as of 01:01, 28 October 2020
Author | [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Yazan Daaboul, M.D.)]] |
---|---|
Exam Type | ExamType::USMLE Step 1 |
Main Category | MainCategory::Pathophysiology |
Sub Category | SubCategory::Neurology |
Prompt | [[Prompt::A 71-year-old right-handed man with a past medical history significant for coronary artery disease and hypertension presents to the emergency department for acute-onset right arm weakness and speech difficulty. The patient is not able to speak in full sentences and answers by saying: "Ummm...Ummm..Not move..Ummm arrr...arm". Whenever the physician asks him a question, the patient tries to answer by using hand gestures. Which of the following brain regions is most likely responsible for the patient's speech dysfunction?]] |
Answer A | AnswerA::Superior temporal gyrus |
Answer A Explanation | [[AnswerAExp::Wernicke's aphasia is a speech dysfunction characterized by impaired comprehension, intact speech fluency, and impaired repetition. It results from damage to the superior temporal gyrus. Wernicke's aphasia is also known as sensory or receptive aphasia.]] |
Answer B | AnswerB::Inferior frontal gyrus |
Answer B Explanation | [[AnswerBExp::Broca's aphasia is a speech dysfunction characterized by intact comprehension, impaired speech fluency, and impaired repetition. It results from damage to the inferior frontal gyrus. Broca's aphasia is also known as motor or expressive aphasia.]] |
Answer C | AnswerC::Superior temporal and frontal gyri |
Answer C Explanation | [[AnswerCExp::Global aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency, and impaired repetition. It results from damage to a larger area of the brain that involves the superior temporal and inferior frontal gyri.]] |
Answer D | AnswerD::Arcuate fasiculus |
Answer D Explanation | [[AnswerDExp::Conduction aphasia is a speech dysfunction characterized by intact comprehension, intact speech fluency, and impaired repetition. It results from damage to the arcuate fasciculus.]] |
Answer E | AnswerE::Area between the supplementary motor area and the frontal perisylvian speech zone |
Answer E Explanation | [[AnswerEExp::Transcortical motor aphasia is a speech dysfunction characterized by impaired comprehension, impaired speech fluency, and intact repetition. It results from damage to the area between the supplementary motor area and the frontal perisylvian speech zone.]] |
Right Answer | RightAnswer::B |
Explanation | [[Explanation::The patient's sudden-onset right side weakness along with speech difficulty is consistent with a stroke that involves the middle cerebral artery (MCA). The patient seems to understand what the physician is asking but is finding difficulty articulating the words. The patient's intact comprehension and impaired fluency of speech result from involvement of the Broca's area in the left dominant frontal lobe. Involvement of the left frontal lobe also explains the contralateral arm weakness.
There are several types of aphasia:
Shown below is an image that depicts the different regions involved in aphasias. |
Approved | Approved::No |
Keyword | WBRKeyword::Aphasia, WBRKeyword::Broca's aphasia, WBRKeyword::Frontal lobe, WBRKeyword::Stroke |
Linked Question | Linked:: |
Order in Linked Questions | LinkedOrder:: |