APHASIA EXAM #2 2026/2027 | MIDTERM REVIEW GUIDE, KEY CONCEPTS &
PRACTICE QUESTIONS
Nonfluent Aphasias - correct answer ✔✔• May be referred to as: expressive aphasia, motor
aphasia, or anterior aphasia
• Major symptoms characteristic of nonfluent syndromes of aphasia (generalities)
o Decreased rate of speech
o Decreased phrase length
o Decreased prosody
o Decreased initiation of speech
o Decreased talking in general
o Increased effort
o "telegraphic speech"
Nonfluent Aphasia Types: - correct answer ✔✔1.) Broca's
2.) Transcortical Motor
3.) Mixed Transcortical
4.) Global
Broca's Aphasia: - correct answer ✔✔o first described in 1861
o associated with damage to cerebral language areas surrounded sylvian fissure but not
extending to wernickes area
o neuroanatomical bases
♣ posterior inferior frontal gyrus of the left hemisphere is known as brocas area (44 and part of
45)
♣ area known as anterior language cortex
♣ middle cerebral artery bloody supply
,♣ lower part of pre motor cortex
o general characteristics
♣ more easily recognized than Wernicke's pts
♣ typically present with contralateral hemiplegia or hemiparesis
♣ weakness of r side facial muscles
♣ most motor problems improve over time
♣ pts are often very depressed; catastrophic reactions refusing to cooperate or continue testing
Broca's Aphasia: - correct answer ✔✔o language characteristics
♣ nonfluent and effortful speech
⎥ lots of pauses, lots of revisions, prolong syllables, repeat syllables over and over, acquired
apraxia of speech
♣ agrammatic speech
⎥ telegraphic, limited to content words
♣ impaired repetition of words/sentences
⎥ may be unable/have a reduced ability to follow prompts (repeat)
♣ impaired naming
⎥ sometimes cues are helpful (starts with the letter__ (phonemic), word that means
this___(semantic cue))
♣ questionable auditory comprehension
⎥ comp definitely better than production; might have trouble with higher level comprehension
tasks
♣ oral reading
⎥ often mirror their verbal expression
♣ writing problems
⎥ going to write slowly
,Transcortical Motor Aphasia: - correct answer ✔✔-Extrasylvian aphasic syndrome; lies outside
of the perisylvian language zones
-Nonfluent aphasia w/ good repetition skills (almost parrot like)
*Neuroanatomical Bases
-Anterior superior frontal lobe
-Usually above or below Broca's area
-Lesions often impact association pathways
-Impacts supplemental motor area
-Supplied by the anterior cerebral artery
Transcortical Motor Aphasia: - correct answer ✔✔Neuroanatomical Bases
-Anterior superior frontal lobe
-Usually above or below Broca's area
-Lesions often impact association pathways
-Impacts supplemental motor area
-Supplied by the anterior cerebral artery
General Characteristics
-Similar to Broca's aphasia
-Motor disorders: rigidity of UE, akinesia, bradykinesia
-hemiparesis
-pts may demonstrate apathy or behavioral withdrawal
Exhibit little to no interest in using language
Language Characteristics
-muteness, echolalic, reduced spontaneous speech, perseverative
, -agrammatic speech, paraphasic
-Impaired naming w/ intact repetition
-intact serial speech (relatively)
-intact knowledge of grammar/meaningfulness
-limited naming; may use motor prompts (like a clap or tap on the hand)
-better comprehension than production
Mixed Aphasia: - correct answer ✔✔-Rare nonfluent aphasia type
-Combine TMA and TSA
-Language impairment is severe and extensive
-Pts retain repetition skills
-has been labeled isolation aphasia
- "There is an 8th syndrome: Mixed Nonfluent Aphasia: severe nonfluent syndrome In which
auditory comprehension has improved beyond the level of global aphasia but is not good
enough to qualify as relatively preserved as in Broca's aphasia , not as bad as global but not as
good as Broca's"
Mixed Aphasia - correct answer ✔✔*Neuroanatomical Bases:
-Caused by various conditions that decrease blood flow throughout the cerebral arteries
hypoxia of various origins
cardiac arrest
cerebral edema
multiple embolic strokes
-Supplied by the middle cerebral artery, and the anterior/posterior cerebral arteries
-Broca's, Wernicke's and the arcuate fasciculus are spared
*General Characteristics:
PRACTICE QUESTIONS
Nonfluent Aphasias - correct answer ✔✔• May be referred to as: expressive aphasia, motor
aphasia, or anterior aphasia
• Major symptoms characteristic of nonfluent syndromes of aphasia (generalities)
o Decreased rate of speech
o Decreased phrase length
o Decreased prosody
o Decreased initiation of speech
o Decreased talking in general
o Increased effort
o "telegraphic speech"
Nonfluent Aphasia Types: - correct answer ✔✔1.) Broca's
2.) Transcortical Motor
3.) Mixed Transcortical
4.) Global
Broca's Aphasia: - correct answer ✔✔o first described in 1861
o associated with damage to cerebral language areas surrounded sylvian fissure but not
extending to wernickes area
o neuroanatomical bases
♣ posterior inferior frontal gyrus of the left hemisphere is known as brocas area (44 and part of
45)
♣ area known as anterior language cortex
♣ middle cerebral artery bloody supply
,♣ lower part of pre motor cortex
o general characteristics
♣ more easily recognized than Wernicke's pts
♣ typically present with contralateral hemiplegia or hemiparesis
♣ weakness of r side facial muscles
♣ most motor problems improve over time
♣ pts are often very depressed; catastrophic reactions refusing to cooperate or continue testing
Broca's Aphasia: - correct answer ✔✔o language characteristics
♣ nonfluent and effortful speech
⎥ lots of pauses, lots of revisions, prolong syllables, repeat syllables over and over, acquired
apraxia of speech
♣ agrammatic speech
⎥ telegraphic, limited to content words
♣ impaired repetition of words/sentences
⎥ may be unable/have a reduced ability to follow prompts (repeat)
♣ impaired naming
⎥ sometimes cues are helpful (starts with the letter__ (phonemic), word that means
this___(semantic cue))
♣ questionable auditory comprehension
⎥ comp definitely better than production; might have trouble with higher level comprehension
tasks
♣ oral reading
⎥ often mirror their verbal expression
♣ writing problems
⎥ going to write slowly
,Transcortical Motor Aphasia: - correct answer ✔✔-Extrasylvian aphasic syndrome; lies outside
of the perisylvian language zones
-Nonfluent aphasia w/ good repetition skills (almost parrot like)
*Neuroanatomical Bases
-Anterior superior frontal lobe
-Usually above or below Broca's area
-Lesions often impact association pathways
-Impacts supplemental motor area
-Supplied by the anterior cerebral artery
Transcortical Motor Aphasia: - correct answer ✔✔Neuroanatomical Bases
-Anterior superior frontal lobe
-Usually above or below Broca's area
-Lesions often impact association pathways
-Impacts supplemental motor area
-Supplied by the anterior cerebral artery
General Characteristics
-Similar to Broca's aphasia
-Motor disorders: rigidity of UE, akinesia, bradykinesia
-hemiparesis
-pts may demonstrate apathy or behavioral withdrawal
Exhibit little to no interest in using language
Language Characteristics
-muteness, echolalic, reduced spontaneous speech, perseverative
, -agrammatic speech, paraphasic
-Impaired naming w/ intact repetition
-intact serial speech (relatively)
-intact knowledge of grammar/meaningfulness
-limited naming; may use motor prompts (like a clap or tap on the hand)
-better comprehension than production
Mixed Aphasia: - correct answer ✔✔-Rare nonfluent aphasia type
-Combine TMA and TSA
-Language impairment is severe and extensive
-Pts retain repetition skills
-has been labeled isolation aphasia
- "There is an 8th syndrome: Mixed Nonfluent Aphasia: severe nonfluent syndrome In which
auditory comprehension has improved beyond the level of global aphasia but is not good
enough to qualify as relatively preserved as in Broca's aphasia , not as bad as global but not as
good as Broca's"
Mixed Aphasia - correct answer ✔✔*Neuroanatomical Bases:
-Caused by various conditions that decrease blood flow throughout the cerebral arteries
hypoxia of various origins
cardiac arrest
cerebral edema
multiple embolic strokes
-Supplied by the middle cerebral artery, and the anterior/posterior cerebral arteries
-Broca's, Wernicke's and the arcuate fasciculus are spared
*General Characteristics:
