Fairuz Binti Mahamad Rodzi 03008271 The Faculty of Medicine Trisakti Jakarta, 2011

Each of the various characteristics of language (perception, comprehension, production, etc.) is managed by a distinct functional module in the brain, and each of these module is linked to the others by a very specific set of serial connections. The central hypothesis of this model is that language disorders arise from breakdowns in this network of connections between these modules. when you hear a word spoken, this auditory signal is processed first in your brains primary auditory cortex, which then sends it on to the neighbouring Wernickes area. Wernickes area associates the structure of this signal with the representation of a word stored in your memory, thus enabling you to retrieve the meaning of the particular word.

When looking at an individual's ability to process auditory information we take into account several factors. Neurodevelopment of the short term memory The auditory cortex The language centers Word recognition ability Learned listening personality traits

Definition Auditory perception is the ability to perceive and understand sounds, usually with specific organs, such as a human's ears. Sound exists in the form of vibrations that travel through the air or through other substances. Ears detect such vibrations and convert them into nerve impulses, which are then sent to the brain where they can be interpreted.

auditory cortex gray matter of the cerebral cortex whose neurons respond to auditory stimuli divided into three separate parts: the primary the secondary the tertiary auditory cortex. The primary auditory cortex: in between the two others composed of two areas named the Brodmann areas 41 and 42 temporal lobe, right above the ears.

 The

function of the primary auditory cortex is to process sound pitch, volume location of a sound crucial for understanding language

 the

existence of a language centre in the posterior portion of the frontal lobe of this hemisphere. Now known as Brocas area, this was in fact the first area of the brain to be associated with a specific functionin this case, language.

 right-handed

people language understanding area in their left primary auditory cortex. processing speech processes written language. The same area on the right side is typically involved in understanding tone of voice

auditory nerve brainstem synapses in the cochlear nucleus. split into at least two streams, split into motion and form processing. ventral cochlear nucleus synapse on their target cells with giant, hand-like terminals. Something about this tight connection allows the timing of the signal to be preserved to the microsecond (action potentials are on the order of milliseconds, so it is no mean feat). The ventral cochlear nucleus cells project to a collection of nuclei in the medulla called the superior olive. In the superior olive, the minute differences in the timing and loudness of the sound in each ear are compared can determine the direction the sound came from. The superior olive then projects up to the inferior colliculus via a fiber tract called the lateral lemniscus.

Auditory nerve

Brainstem

Ventral cochlear nucleus (timing) or dorsal cochlear nucleus (frequency difference)

Superior olive

Lateral lemniscus

Inferior colliculus

sensory thalamus. medial geniculate nucleus

primary auditory cortex

 Auditory 1. 2. 3.

perception depends upon our alertness A reflex where the arrival of the message causes us to jump or turn our head The auditory cortex where the sound is perceived Other brain areas, which allow the perception to become conscious, recognise the sound by comparing it to those that have previously been memorised and determine an appropriate voluntary response..

When asleep, our ears are still working; sound enters

the auditory pathway (and reflexes can therefore still

occur) up to the auditory brain, but the other brain regions (involved in emotions, motivations, memory,

etc) are inactive: There are therefore no voluntary

responses or conscious perception. Example: speaking to someone who is asleep (or a sound from the street) can make them move without waking them, and without them remembering it when

they wake up.

 The

auditory cortex is the part of the brain that

processes sensory information in the form of sound

it

is essential to processing and understanding

sounds
the

cochlea, have a more direct role in actually

collecting the sound, which is also referred to as auditory information

If

one lacks the ability to process sounds, however,

the sounds seem to be jumbled and meaningless.

The auditory cortex is composed of two different areas

primary

auditory cortex; it is involved in most of

the higher level processing that takes place in

sound processing and is essential for recognizing when sound starts, stops, and changes pitch.
The

peripheral auditory cortex tends to play a

secondary role and is involved in more subtle

processing processes.

Hearing and Listening...What is the difference? Hearing is the ability of the ears to take in sound. The ear's mechanics or structure is capable of responding to sound.

Listening is the result of our auditory cortex processing and interpreting the sounds received from the ear. In other words....our understanding. Listening Style is the learned behavior and how we prefer to listen.
Auditory Processing is the ability to make sense of the sound that comes into the ear and to process or interpret what is heard.

Ten stages of phonemic awareness Pre-phonemic discriminatory listening skills: the ability to distinguish among non-speech environmental sounds (e.g., a beanbag falling on a wooden floor versus a plastic ball falling on a wooden floor), and to identify objects by the sound they make (e.g., a horn, a bell, a helicopter, etc.) Alliteration and rhyme: the ability to identify and produce words that rhyme or that begin with the same phoneme. Phoneme Segmentation: the ability to analyze the syllables and individual phonemes of a word, phrase, or sentence. Phoneme Isolation: the ability to identify the first, middle, or last phonemes in a monosyllabic word.

Phoneme Deletion: the ability to identify how a word would sound if a part of it were omitted. Phoneme Substitution: the ability to replace a phoneme in a word with another phoneme to form a new word. Phoneme Blending: the ability to identify a word when hearing parts of the word presented in isolation. Letter-sound correspondence: the ability to identify the phonemes represented by individual letters and combinations of letters. Phonetic reading: the ability to "sound out" and pronounce unfamiliar or nonsense words based on spelling. Phonetic spelling: the ability to use prior knowledge of spelling rules to write familiar words the student has not learned to spell.

Ascending Central Auditory Pathway

4

to 5 neurons between cochlea and cerebral cortex neuron at the level of spiral ganglian neuron at the level of cochlear nuclei(CN) neuron at the level of Superior olivary

1storder

2ndorder 3rdorder

complex(SOC)
4thor

5thorder neuron at the level of cortex

The following areas are primarily concentrated on the followings Superior temporal gyrus / Heschls gyrus: the areas in the temporal lobes on both sides of the cerebral cortex Areas of auditory perception Temporal area: The frequency characteristics of sound Insular area: The temporal aspects of sound Parietal area: The association of sound with past experiences Auditory stimulus is compared or matched with input from other senses Frontal area: The sounds memory Cortical and sub-cortical areas: auditory discrimination

Causes Of Auditory Nerve Disorders May occur as a result of a Disease, Irritation, Pressure on the nerve trunk Etiologies: Tumor Meningitis Hemorrhage Trauma Auditory nerve lesions may occur in the internal auditory canal or in the cerebellopontine angle

Tumor Of The Auditory Nerve Commonly called: Acoustic Neuroma OR Vestibular Schwannoma Most are benign Variable sizes depending on pt. age and growth characteristics of neoplasm Usually arises from sheaths that cover the vestibular branch of 8thN (Schwann Cells)
Tumor Size Small size if it is within the internal auditory canal Medium size if it extends up to 1cm into CPA Large size if it extends any farther The larger the tumor size within the canal, the greater the probability of pressure causing alteration to the cochlear function The larger the tumor extending into CPA, the greater the likelihood that pressure will involve other cranial N and cerebellum

Other Causes of VIII Nerve HL

Other

conditions can produce identical audiological

symptoms
Acoustic

neuritis:inflammation of vestibular or

cochlear
Multiple Safe

sclerosis (MS)

to assume all unilateral SNHL should be

suspected of being acoustic tumors until proven otherwise

Disorders of First relay station in CANS

Last

point at which entirely IPSI representation is

maintained
Lesions

in this area may produce clinical loss of

hearing sensitivity b/c of tonotopic organization characteristics of this area

Cochlea

nuclei lesions may or may not produce

results specific to retrocochlear disorders on special diagnostic tests

Disorders of the Higher Auditory Pathways

The same disorders affecting CN can affect higher neural

structures Tumors Head injury (major cause of death or serious brain damage among young people in the USA) Audiometric findings influenced by size and location of lesion Lesions in temporal cortex (i.e. CVA or epilepsy) abnormal special tests results in the ear contralateral to the lesion BS lesions are not so predictable

Brainstem Lesions They are not very predictable: If lesion is extra-axial(outside BS) audiometric symptoms appear on the same side of the head Considerable loss of sensitivity for PT especially in HFs If lesion is intra-axial(within BS) central auditory tests may show either contralateral or bilateral effects Hearing sensitivity for PT is normal or near normal at all frequencies

Auditory processing disorder

Decreased

hearing abilities no identifiable

peripheral pathology
Concern

regarding deterioration in their hearing over their difficulties in auditory

Distressed

functioning within social contexts

no

disconcerting unilateral symptoms

 Auditory

Processing Disorder (APD) describes the inability to process the meaning of sound. This condition is often present from early childhood, leading to a number of difficulties as the child becomes older and messages become complex and are given more quickly. APD is also known by the following names: central auditory processing disorder (CAPD), auditory perceptual processing dysfunction, auditory comprehension deficit, central deafness or word deafness.