<prompt> Naming and fluency is impaired in:Brocas aphasiaWernickes aphasiaAnomic aphasiaTranscortical sensory aphasia  <response>: Ans. a. Brocas aphasia Ref: Harrison 19e p279, 18e p203, 3286Naming and fluency is impaired in Broeas aphasia,Brocas 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 19e p279 ComprehensionRepetition of spoken languageNamingFluencyWernickesImpairedQImpairedQImpairedQPreserved or increasedQBrocasPreserved except grammarQImpairedQImpairedQDecreasedQGlobalImpairedQImpairedQImpairedQDecreasedConductionPreservedQImpairedQimpairedQPreservedQNonfluent motor transcorticalPreservedQPreservedQImpairedImpairedFluent sensory transcorticalImpairedPreservedQImpairedPreservedIsolationImpairedEcholaliaQImpairedNo purposeful speechAnomicPreservedQPreservedQImpairedPreserved except for wordfinding pausesQPure word deafnessImpaired only for spoken languageimpairedPreservedPreservedPure alexiaImpaired only for readingPreservedPreservedPreservedBrocas 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 Brocas 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 Brocas 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 Brocas aphasiaQ.Causes of Brocas Aphasia:The cause is most often infarction of Brocas 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 Brocas 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 Wernickes aphasiaQ.Prognosis:When the cause of Brocas 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 Wernickes aphasia 