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Motor Speech Disorders > Ch. 11 Apraxia of Speech > Flashcards

Ch. 11 Apraxia of Speech Flashcards

1
Q

AOS is a problem with what?

A

motor programming of speech movements

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2
Q

dysarthria is a problem with _____

A

muscles/movement

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3
Q

aphasia is a ______ problem

A

linguistic/language

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4
Q

why do apraxia and aphasia often co-occur?

A

the site of lesions

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5
Q

AOS is almost always due to damage where?

A

left cerebral hemisphere

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6
Q

what are the steps in speaking?

A
  1. Speaker conceptualizes what is going to be said. This is where the message is determined.
  2. Speaker formulates the message through selecting semantic, syntactic, morphological, phonological structures for the message.
  3. The Motor Speech Programmer programs/plans the movements necessary to produce the needed phonemes. It activates a plan for the motor execution needed of the muscle movement.
  4. This program is sent through the nervous system to produce muscle movement/motor execution.
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7
Q

What happens if there are difficulties in step 2?

A
  • problems with conceptualization

- aphasia

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8
Q

what happens if there are difficulties in step 3?

A

apraxia

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9
Q

what happens if there are difficulties in step 4?

A

dysarthria

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10
Q

why is AOS often confused with broca’s aphasia?

A

the phonological impairment is similar

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11
Q

What is the motor speech programmer responsible for?

A

programming speech

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12
Q

The MSP transforms the ______ _______ to a ______ _____ from which the motor programming can occur/

A

abstract phonemes/neural code

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13
Q

what does the neural code determine?

A

the specific muscle movements needed

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14
Q

what are the specifics of the programming? (6)

A
  1. duration of movement
  2. amplitude of movement
  3. acceleration
  4. deceleration
  5. time to peak velocity
  6. timing of speech events
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15
Q

where are motor speech plans held before the muscle movement begins?

A

buffer area; can be modified; leads to rapid speech

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16
Q

where is the MSP thought to be located?

A

left cerebral hemisphere

17
Q

where are the structures of the MSP located?

A

parietal-frontal and related subcortical circuits

18
Q

where does the linguistic input to the MSP come from?

A

perisylvian area in the left hemisphere which includes: temporoparietal cortex, insula, basal ganglia, and thalamus

19
Q

what is an important area in apraxia?

A

Broadman’s area 6

20
Q

what areas are thought to be involved with MSP?

A

premotor area, supplemental motor area, parietal lobe somatosensory cortex, supramarginal gyrus, insula, basal ganglia

21
Q

what are the premotor areas linked to?

A

basal ganglia and cerebellar circuits

22
Q

where do people with AOS most often have lesions?

A

broca’s area

23
Q

where do the premotor areas send connections to?

A

motor area for impulses to be sent on and put into place by the motor speech program

24
Q

what structures are important in integrating sensory information that is needed for skilled motor activity

A

parietal lobe somatosensory cortex and supramarginal gyrus

25
Q

lesions in what part of the basal ganglia are common in AOS?

A

striatum (putamen and caudate nucleus)

26
Q

overall, where are the most common sites of lesion?

A

left posterior frontal lobe area (broca’s), insula, and basal ganglia

27
Q

what are nonspeech characteristics?

A

right-sided weakness and spasticity, babinski reflex, hyperactive stretch reflexes, limb apraxia

28
Q

what are the etiologies of AOS?

A
  • anything that causes dominant hemisphere impairment of structures
  • usually NOT inflammatory, toxic-metabolic, degenerative, demyelinating
  • Trauma, tumors, stroke
29
Q

what are pt complaints?

A
  • can’t pronounce words right (know what to say but don’t come out right)
  • no swallowing problems
30
Q

clinical findings?

A
  • if no dysarthria; gag reflex, chewing, swallowing –WNL
  • check oral sensation
  • nonverbal oral apraxia
  • auditory process skills –normal
  • DAF
31
Q

how to assess speech?

A
  • use voluntary speech tasks
  • sequencing of various sounds and syllables (SMRs, multisyllabic words)
  • imitate increasingly complex words
  • voluntary tasks
32
Q

what are things to listen/watch out for?

A

false articulatory starts, groping of articulators

33
Q

what is the primary articulation error?

A

distortion

34
Q

are rate and prosody normal in AOS?

35
Q

Why does fluency become abnormal?

A

pts start and stop repetitively to self-correct

36
Q

what are the most important diagnostic criteria for AOS?

A
  • slowed rate of speech
  • sound errors: distortions, consistent, predictable
  • prosodic abnormalities

Motor Speech Disorders (3 decks)

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