A lady can’t speak but can tell by writing. Which of the following brain areas is affected?
**Core Concept**
This question tests knowledge of **Broca's aphasia** and the **anatomical localization of speech production**. Broca's area (inferior frontal gyrus, Brodmann area 44/45) is critical for speech articulation. Lesions here cause non-fluent speech with preserved writing, due to disconnection between motor planning and execution.
**Why the Correct Answer is Right**
Broca's area is in the **dominant hemisphere's inferior frontal gyrus**. Damage here disrupts the motor sequencing of speech (via connections to the primary motor cortex) but spares the motor pathways for writing (controlled by separate motor areas). Patients exhibit **Broca's aphasia**: effortful, telegraphic speech, yet intact comprehension and written expression.
**Why Each Wrong Option is Incorrect**
**Option A:** Lesions in the **primary motor cortex (precentral gyrus)** cause contralateral hemiparesis, including slurred speech from facial weakness, but writing would also be impaired.
**Option B:** **Wernicke's area (superior temporal gyrus)** lesions cause fluent **Wernicke's aphasia** with poor comprehension and nonsensical speech, not muteness with preserved writing.
**Option C:** **Angular gyrus** damage impairs reading/writing (alexia/dysgraphia), contradicting the patient’s ability to write.
**Clinical Pearl / High-Yield Fact**
**"Speech is Broca, comprehension is Wernicke."** Broca’s aphasia = **non-fluent speech, intact writing**; Wernicke’s aphasia = **fluent speech, poor comprehension**. Always correlate motor deficits with cortical/motor pathway anatomy.
**Correct Answer: B. Inferior frontal gyrus**