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ECU Motor Speech Disorders > 2.1 - Models of MSDs - Terminology Revisited > Flashcards

2.1 - Models of MSDs - Terminology Revisited Flashcards

1
Q

What are the 3 types of Disease/Injury Localizations?

A

Focal

Multifocal

Diffuse

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2
Q

What is Focal Localization?

A

Single circumscribed area or contiguous group of structures is affected

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3
Q

What is Multifocal Localization?

A

More than one area or more than one group of contiguous structures is affected

(e.g., cerebellar and cerebral hemisphere)

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4
Q

What is Diffuse Localization?

A

Roughly symmetric portions of the nervous system bilaterally is affected

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5
Q

What are the 3 types of Disease/Injury Courses?

A

Acute

Subacute

Chronic

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6
Q

When is a Disease/Injury considered Acute?

A

Within minutes to a few days

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7
Q

When is a Disease/Injury considered Subacute?

A

Within days to 3-4 weeks

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8
Q

When is a Disease/Injury considered Chronic?

A

After 2.5-3 months

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9
Q

What are the 5 types of Disease/Injury Evolution of Courses?

A

Transient

Improving

Progressive

Exacerbating-Remitting

Stationary (Chronic)

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10
Q

What is a Transient Disease/Injury Evolution of Course?

A

Symptoms resolve completely after onset

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11
Q

What is an Improving Disease/Injury Evolution of Course?

A

Severity is reduced but symptoms are not resolved

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12
Q

What is a Progressive Disease/Injury Evolution of Course?

A

Symptoms continue to progress or new symptoms appear

.g., dementia, PPA

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13
Q

What is a Exacerbating-Remitting Disease/Injury Evolution of Course?

A

Symptoms develop, then resolve or improve, then recur and worsen, and so on

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14
Q

What is a Stationary (Chronic) Disease/Injury Evolution of Course?

A

Symptoms remain unchanged for an extended period of time

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15
Q

What 8 conditions do we need to rule out before diagnosing someone with a Motor Speech Disorder?

A

Aphasia

Other cognitive disorder (e.g., dementia)

Sensory (e.g., deafness)

Musculosketel defects (e.g., cleft palate)

Other organic (e.g., laryngeal tumor)

Psychogenic

Normal age-related

Dialect, style

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16
Q

What are the 5 Speech Subsystems?

A

Respiration

Phonation

Resonance

Articulation

Prosody

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17
Q

What is the Respiratory Subsystem in layman’s terms?

A

Breathing

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18
Q

What is the Phonation Subsystem in layman’s terms?

A

Sound/voice quality

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19
Q

What is the Resonance Subsystem in layman’s terms?

A

How air moves after respiration

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20
Q

What is the Articulation Subsystem in layman’s terms?

A

Precision of movement

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21
Q

What is the Prosody Subsystem in layman’s terms?

A

Rhythm of speech

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22
Q

What are 4 observable abnormalities seen in Motor Speech Disorders?

A

VOM (Velocity of Movement)

ROM (Range of Movement)

DOM (Direction of Movement)

Accuracy

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23
Q

What are 4 Physiologic Problems seen in Motor Speech Disorders?

A

Strength

Tone

Timing

Coordination

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24
Q

What are the 6 Salient Features of Motor Speech Disorders?

A

Strength

Speed

Range

Steadiness

Tone

Accuracy

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25
Q

What is Flaccid Dysarthria? (2)

Where does it originate?

A

Flaccid weakness

Reduced muscle tone

//

LMN lesions

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26
Q

What is Spastic Dysarthria? (2)

Where does it originate?

A

Spastic weakness

Excessive muscle tone

//

Bilateral UMN lesions

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27
Q

What is Ataxic Dysarthria? (2)

Where does it originate?

A

Incoordination

Imprecise movements

//

Lesions to the Cerebellum

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28
Q

What is Hypokinetic Dysarthria? (2)

Where does it originate?

A

Rigidity or reduced ROM

Slow movements

//

Lesions to the Basal ganglia

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29
Q

What is Hyperkinetic Dysarthria? (2)

Where does it originate?

A

Involuntary movement

Quick movements

//

Lesions to the Basal ganglia

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30
Q

What is Unilateral upper motor neuron Dysarthria? (2)

Where does it originate?

A

Weakness

Incoordination

//

Unilateral UMN lesions

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31
Q

What is Mixed Dysarthria?

Where does it originate?

A

More than one symptom

More than one location

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32
Q

What is Apraxia of Speech? (2)

Where does it originate?

A

Motor planning

Motor programming

//

Lesions to the Left Hemisphere

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33
Q

What are the 5 Motor System/Sensory System/Motor Speech Programmer involved in speech production?

A

Final common pathway

Direct activation pathway

Indirect activation pathway

Control circuits

Conceptual-programming level

34
Q

What is another name for the Final Common Pathway?

A

LMN System

35
Q

What does the Final Common Pathway include?

2

A

Paired cranial nerves - supply muscles involved in phonation,
resonance, articulation, and prosody

Paired spinal nerves - involved in speech, breathing, and prosody

36
Q

What is the Role of the Final Common Pathway?

A

Conducts messages “written” and controlled elsewhere to the actual muscle

37
Q

What would happen without the Final Common Pathway?

2

A

Muscles could not be activated

Movement would be impossible

38
Q

What occurs when there is damage at LMN level?

A

Flaccid dysarthria

39
Q

What are the two parts of the Upper Motor Neuron System?

2

A

Direct Activation Pathway (Pyramidal)

Indirect Activation Pathway (Extrapyramidal)

40
Q

What is another name for the Direct Activation Pathway?

A

Pyramidal Tract

41
Q

What are the 2 parts of the Direct Activation Pathway of the UMN System (Pyramidal Tract)?

A

Corticospinal Tract

Corticobulbar Tract

42
Q

What does the Corticospinal Tract influence?

A

The activity of the spinal nerves

43
Q

What does the Corticobulbar Tract influence?

A

The activities of many of the cranial nerves

44
Q

What kind of route is the Direct Activation Pathway of the UMN System (Pyramidal Tract)?

A

Express Route to Final Common Pathway (FCP)

45
Q

What is another name for the Indirect Activation Pathway?

A

Extrapyramidal Tract

46
Q

What is contained in the Indirect Activation Pathway of the UMN System (Extrapyramidal Tract)?

Where are these synapses located?

A

Multiple synapses between the cerebral cortex and its destination at the Final Common Pathway (FCP)

Mostly in the brainstem

47
Q

What are the 4 major pathways in the Indirect Activation Pathway of the UMN System (Extrapyramidal Tract)?

A

Corticoreticular

Reticular spinal

Corticorubral

Rubrospinal

48
Q

What is the Corticoreticular Tract?

What does it contain?

A

“Seat of consciousness”

Reticular formation

49
Q

Where is the Corticoreticular Tract located?

3

A

Medulla

Pons

Midbrain

50
Q

What is the Corticorubral Tract?

What does it contain?

A

“Relay to cerebellum”

Red nucleus

51
Q

Where is the Corticorubral Tract located?

A

Midbrain

52
Q

What kind of route is the Indirect Activation Pathway of the UMN System (Extrapyramidal Tract)?

A

Local Route, with Stops en Route to the Final Common Pathway (FCP)

53
Q

What happens when there is Unilateral damage to Trigeminal Nerve (V) alone?

Bilateral damage?

A

Unilateral Lesions = Jaw deviates to side of weakness when jaw opens

Bilateral Lesions = Jaw hangs open

54
Q

What happens when there is damage to the Facial Nerve (VII) alone?

(2)

A

Upper and lower facial weakness,

Isolated articulatory deficit for bilabial consonants

55
Q

What kind of lesions cause single-sided weakness of the LOWER face?

A

Contralateral UMN lesion to Facial Nerve

56
Q

What do Bilateral UMN Lesions cause?

A

Whole body spaticity

57
Q

What kind of lesions cause weakness to one side of the face?

A

Ipsilateral LMN lesion to Facial Nerve

58
Q

What kind of lesions cause weakness of the entire face?

A

Bilateral LMN lesion to Facial Nerve

59
Q

What happens when there is damage to the Glossopharyngeal Nerve (IX)?

(6)

A

Difficulty swallowing

Absent gag reflex

Impaired taste over the posterior one-third of the tongue and palate

Impaired sensation over the posterior one-third of the tongue

Impaired sensation over the palate

Impaired sensation over the pharynx

60
Q

What happens when there is damage to Vagus Nerve (V)?

4

A

Weakness of the soft palate,
pharynx, and larynx.

Droop on weak side of palate

Decreased gag reflex

Palate pulls to strong side when
phonating “ah”

61
Q

What happens when there is UNILATERAL damage to Vagus Nerve (V)? (4)

What changes when the lesion is BILATERAL?

A

Impaired resonance

Impaired voice quality

Impaired swallowing

Impaired phonation (more prominently than resonance)

//

Bilateral lesions more severe

62
Q

What happens when there is damage to Accessory Nerve (XI)?

3

A

Weaker head rotation toward the side opposite the lesion

Reduced ability to elevate or shrug the shoulder on the side of the lesion

Swallowing impairments

63
Q

What happens when there is damage to the Hypoglossal Nerve (XII) or one of its branches?

(2)

A

Isolated tongue weakness

Atrophy, weakness, and fasciculations of the tongue on the side of the lesion

64
Q

What happens when there is UNILATERAL damage to the Hypoglossal Nerve (XII) or one of its branches?

(2)

A

Tongue deviates to the side of the lesion when protruded

Consonant (and vowel) distortion

65
Q

What does the Cerebellum do?

3

A

Receives input from cortex that plans and initiates complex + highly skilled movements

Receives sensory innervations that monitors course of movements

Influences movements by modifying UMN activity patterns (prominent projections to most UMNs)

66
Q

What is the Primary Function of the Cerebellum?

2

A

To detect difference or “motor error” between intended movement and actual movement

To reduce error through its projections to the UMNs

67
Q

What does the Cerebellum corrects?

A

“Motor error” in both real time and over longer periods, as motor learning

68
Q

Each hemisphere of the Cerebellum is involved in controlling movement on the __________ of the body.

A

Ipsilateral side

(E.g. left cerebral hemisphere and right cerebellar hemisphere cooperate in coordinating movement on the right side of the body)

69
Q

What are the Major INPUTS of the Cerebellum from the Cortex?

(3)

A

Parietal

Cingulate

Frontal

70
Q

What are the Major INPUTS of the Cerebellum from Other Locations?

(4)

A

Red nucleus

Superior colliculus

Spinal cord

Reticular formation

71
Q

What are the Major OUTPUTS of the Cerebellum

5

A

Motor Cortex (via relay in VL nuclei of thalamus)

Red nucleus

Vestibular nuclei

Superior colliculus

Reticular formation

72
Q

What do the Basal Ganglia Control Circuits do?

4

A

Posture and tone regulation

Movement scaling

Set switching

Movement selection and learning

73
Q

How does the Basal Ganglia Control Circuits contribute to Posture and Tone Regulation?

(2)

A

Regulating muscle tone

Maintaining normal posture and static muscle contraction needed for voluntary, skilled movements, including speech

74
Q

How does the Basal Ganglia Control Circuits contribute to Movement Scaling?

(3)

A

Scaling force

Scaling amplitude

Scaling duration

75
Q

How does the Basal Ganglia Control Circuits contribute to Set Switching?

(2)

A

Interrupting ongoing behavior to prepare

Facilitating appropriate non routine responses

76
Q

How does the Basal Ganglia Control Circuits contribute to Movement Selection and Learning?

(2)

A

Striatum builds a repertoire of movements

These can be triggered in response to appropriate stimuli

77
Q

What does the Basal Ganglia Control Circuits contribute to?

3

A

Control of movements associated with goal-directed activities (e.g., the arm swing during walking),

Control of automatic activities (e.g., chewing and walking)

Control of movements that must be adjusted as a function of the environment in which they occur (e.g., speaking with restricted jaw movement)

78
Q

What are the 3 Motor Principles for Motor Speech Disorders?

A

Separation of neural control mechanisms

Peripheral dependencies

Voluntary control of the speech musculature

79
Q

What does the Motor Principle: “separation of neural control mechanisms” mean?

A

CNS does not control limb and individual speech systems

80
Q

What does the Motor Principle: “Peripheral Dependencies” mean?

(1+2)

A

Some parameters or subcomponents of speech are dependent on the…

  • Integrity of other parameters
  • Subcomponents of speech
81
Q

What does the Motor Principle: “voluntary control of the speech musculature” mean?

(1+2)

A

There is a common neuromuscular substrate underlying…

  • Control of speech
  • Voluntary speech movements

ECU Motor Speech Disorders (16 decks)

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