Naming and fluency is impaired in:

Ans. a. Broca's aphasia (Ref: Harrison 19/e p279, 18/e p203, 3286)Naming and fluency is impaired in Broea's aphasia,"Broca's Aphasia: Speech is nonfluent, labored, interrupted by many word-finding pauses, and usually dysarthric. It is impoverished in function words but enriched in meaning-appropriate nouns. Abnormal word order and the inappropriate deployment of bound morphemes (word endings used to denote tenses, possessives, or plurals) lead to a characteristic agrammatism. Speech is telegraphic and pithy but quite informative. Output may be reduced to a grunt or single word ("yes " or "no"), which is emitted with different intonations in an attempt to express approval or disapproval. In addition to fluency, naming and repetition are impaired. '- Harrison 19/e p279 ComprehensionRepetition of spoken languageNamingFluencyWernicke'sImpairedQImpairedQImpairedQPreserved or increasedQBroca'sPreserved (except grammar)QImpairedQImpairedQDecreasedQGlobalImpairedQImpairedQImpairedQDecreasedConductionPreservedQImpairedQimpairedQPreservedQNonfluent (motor) transcorticalPreservedQPreservedQImpairedImpairedFluent (sensory) transcorticalImpairedPreservedQImpairedPreservedIsolationImpairedEcholaliaQImpairedNo purposeful speechAnomicPreservedQPreservedQImpairedPreserved except for wordfinding pausesQPure word deafnessImpaired only for spoken languageimpairedPreservedPreservedPure alexiaImpaired only for readingPreservedPreservedPreservedBroca's AphasiaSpeech is nonfluent, labored, interrupted by many word-finding pauses, and usually dysarthric.It is impoverished in function words but enriched in meaning-appropriate nouns.Abnormal word order and the inappropriate deployment of bound morphemes (word endings used to denote tenses, possessives, or plurals) lead to a characteristic agrammatism.Speech is telegraphic & pithy but quite informativeQ.In the following passage, a patient with Broca's aphasia describes his medical history: "I see ... the dotor, dotor sent me ... Bosson. Go to hospital. Dotor ... kept me beside. Two, tee days, doctor send me home.''Output may be reduced to a grunt or single word ("yes" or "no"), which is emitted with different intonations in an attempt to express approval or disapproval.In addition to fluency, naming & repetition are impairedQ.Comprehension of spoken language is intact except for syntactically difficult sentences with a passive voice structure or embedded clauses, indicating that Broca's aphasia is not just an "expressive" or "motor" disorder and that it also may involve a comprehension deficit in decoding syntax.Even when spontaneous speech is severely dysarthric, the patient may be able to display a relatively normal articulation of words when singing. This dissociation has been used to develop specific therapeutic approaches (melodic intonation therapy) for Broca's aphasiaQ.Causes of Broca's Aphasia:The cause is most often infarction of Broca's area (inferior frontal convolution) & surrounding anterior perisylvian & insular cortex due to occlusion of superior division of middle cerebral arteryQ.Mass lesions, including tumor, intracerebral hemorrhage & abscess, also may be responsible.Associated features:Patients with Broca's aphasia can be tearful, easily frustrated & profoundly depressed.Additional neurologic deficits: Right facial weakness, hemiparesis or hemiplegia & buccofacial apraxia characterized by an inability to carry out motor commands involving orophary ngeal and facial musculature.Insight into their condition is preserved, in contrast to Wernicke's aphasiaQ.Prognosis:When the cause of Broca's aphasia is stroke, recovery of language function generally peaks within 2 to 6 months, after which time further progress is Limited.Speech therapy is more successful than in Wernicke's aphasia