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Motor speech final > aos > Flashcards

aos Flashcards

1
Q

What is apraxia

A

it is a neurologic speech disorder that reflects an impaired capacity to plan or program sesnorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech. It can occur in the absence of physiologic disturbances associated with the dysarthrias and in the absence of disturbance in any component of language.

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2
Q

What is apraxia of speech?

A

AOS is a problem with the motor programming of speech movements.

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3
Q

What is dysarthria?

A

problem with muscles/movements

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4
Q

What is aphasia?

A

problem with liunguistic/language problems

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5
Q

T or F. In Apraxia the muscles are ok!

A

True

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6
Q

Does Apraxia involve language problems?

A

No, but it does commonly co-occur with Aphasia

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7
Q

What occurs more likely with aphasia?

A

Apraxia is more common than dys.

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8
Q

Apraxia is almost always caused by

?

A

a left cerebral hemisphere damage

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9
Q

What are the 4 steps in speaking?

A
  1. speaker conceptualizes what is going to be said (where the message is determined)
  2. Speaker formulates the message through selecting semantic, syntactic, morphological, phonological structures for the message.
  3. The motor spch programmer programs/plans the movements necessary to produce the needed phonemes. It activates a plan for the motor execution needed.
  4. This program is sent to the nervous system to produce muscle movement.

Step 2 prob=Aphasia
Step 3=Apraxia
Step 4= Dysarthria

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10
Q

AOS and brocca’s aphasia may have what things in common?

A

their phonological impairments may look alike.

sites of lesion are similar

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11
Q

What is the difference btwn brocas aphasia and AOS?

A

AOS individuals do not have the linguistic problems seen in brocas

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12
Q

Should you evaluate a client who has aphasia for both aphasia and apraxia?

A

YES bc the sites of lesions are so close they commonly co-occur.

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13
Q

What is the MSP (motor speech programmer)?

A

The MSP is considered to be responsible for programming speech.
It transforms abstract phonemes to a neural code from which motor programming can occur. This neural code determines the specific muscle movements neeeded.

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14
Q

What may be some of the specifics of what the programming might possibly include? (6)

A
  • Duration of movement
  • Amplitude of movement
  • acceleration
  • deacceleration
  • Time to peak velocity
  • Timing of speech events
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15
Q

T OR F. It is theorized that the motor speech plans are prepared before the muscle movement begins and that they are held in buffer area. These plans can be modified before movement begins or during movement. This pre-planning is thought to be what allows us to have rapid speech.

A

True

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16
Q

Where is the MSP located?

A

The left cerebral hemisphere

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17
Q

T or F. The MSP is a theoretical system that involves several interacting structures and pathways in the left cerebrum. Thest structures are primarily located in the parietal-frontal and related subcortical circuits.

A

True

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18
Q

Where does the linguistic imput come from>

A

it goes from the perisylvian area in the left cortex to the MSP (this includes the tempoparietal cortex, the insula, and the basal ganglia and thalamus.)

19
Q

What is the insula?

A

it is a cortical brain area that is buried within the lateral (sylvan) cerebral fissure. It is hidden in folds and can’t be seen unless you seperate the temporal and frontal lobes.

20
Q

T OR F. Dr. Robin/Wambaugh may think that the insula might not be involved in apraxia

A

True

21
Q

Dr. Don Robin has found that Brodman’s area 6 is important area in apraxia and that damage in that area is associated with apraxia

A

True

22
Q

What specific areas are thought to be involved with apraxia?

A

Pre-motor area, broca’s, supplemental motor area, basal ganglia and cerebellar circuits.

23
Q

What area of the brain is mostly damaged of the people who have apraxia?

A

Broca’s most common

24
Q

The supplemental area

A

is not a common site of lesion for apraxia but may sometimes be involved

25
Q

The premotor areas are linked to what structures?

A

the basal ganglia and cerebellar circuits for input. They also send connections to the motor area for impulses to be sent on and put into place by the MSP.

26
Q

What 2 areas are important for integrating sensory information that is needed for skilled motor activity.

A

Parietal lobe somatosensory cortex

supramarginal gyrus

27
Q

T or F. The insula is an important area in apraxia that it is a frequent site of lesion for people with apraxia. It can be the only site of lesion but apraxia can occur without it.

A

True (recently being questioned)

28
Q

What lesions of the basal ganglia are common with people with AOS?

A

lesions of the striatum (putamen and caudate nucleus)

29
Q

What are the three most common lesions seen with people with AOS?

A

left posterior frontal lobe (broca), insula (?), basal ganglia

30
Q

What are some non-speech characteristics that may accompany AOS and reflect left hemisphere damage?

A

some right-sided weakness and spasticity
babinski reflec and hyperactive stretch reflex
sometimes limb apraxia

31
Q

Sometimes limb apraxia may be covered up by?

A

hemiparesis or hemiplegia

32
Q

What are the causes of AOS?

A

anything that causes the dominant hemisphere impairment of structures that are involved in motor planning.

  • usually not inflammatory/toxic-metabolic diseases bc they cause diffuse effects and rarely are associated with AOS.
  • demyelinating dz are also not a common cause
  • degenerative dz are rarely associated with AOS
  • Tumors, trauma and stroke are most often the cause
33
Q

What are the most common causes of children with AOS?

A

Tumors, trauma and stroke

34
Q

T or F. Ptnts with Apraxia do not normally complain of dysphagia bc that would implicate a neuromuscular problem that is associated with dysarthria.

A

True

35
Q

What do ptnts complain of with AOS?

A

they cannot pronounce words right they know what they want to say but the words won’t come out right. They may indicate it worsens in stress.

36
Q

what are the clinical findings of the oral mech exam for ptnts with apraxia?

A

if dys does not co-occur, gag reflex, chewing and swallowing should be WNL. similarly there should be no pathological oral reflexes or tongue weakness without dysarthria
-bc motor programming involves sensory involvement as well as motor, note whether or not oral sensation is impaired.

37
Q

What are the clinical findings of oral mech exam for ptnts with apraxia?

A
  • oral mech WNL
  • nonverbal oral apraxia (NVOA): problems with volitional movements of oral structures while the same movements may be performed involuntarily. (always assess for oral and limb apraxia)
  • auditory processing skills are normal with ptnts with AOS but DAF (delayed aud. feed.) can cause more severe breakdowns in speech than normal indiv.
38
Q

what are speech tasks that you would do for ptnts with AOS?

A
  • voluntary speech tasks (convo, narratives, reading)
  • tasks that require sequencing of sounds and syllables (ppl with apraxia have problems with SMR’s pu-tu-ku’s and multisyllabic words Mississippi)
  • hv ptnt read or imitate words that become increasingly complex
  • Imitation tasks reduce the need for word retrieval or other kinds of word formulation which may occur if aphasia co-occurs.
  • ptnt may do ok on those speech tasks which are overlearned (those that have become automatic and nonvolitional)
  • listen for false articulatory starts
  • watch for groping of the articulators
  • ptnts with severe AOS may not be able to do many of these tasks for these ptnts try to elicit any speech response and determine what they can do (repeat cvc syllables)
39
Q

what is the primary articulation error associated with AOS?

A

distortions (but it may be perceived as a substitution but it is actually a distortion.

40
Q

What is the key problem with AOS?

A

articulation

41
Q

T or F. One difference from paraphasias that occur in aphasia is the articulatory distortions that occur in AOS. In paraphasias, there is usually no distortion. Articulatory problems are greater on blends that single consonants

A

True

42
Q

What are the most important diagnostic criteria for AOS:

A

slowed rate of speech (segmentation of syllables)
sound errors- distortions, consistent, predictable
prosodic abnormalities

43
Q

T or F. a person with severe AOS may not initially be able to phonate and may be mute. This typically doesn’t last too long most can phonate after 2 wks. If muteness lasts longer than 2 weeks, consider another diagnosis such as severe aphasia, anarthria or psychogenic mutism

A

True

Motor speech final (5 decks)

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