Clinical Examination Flashcards
History taking:
introduction and
basic
onset and
associated
patients ?
consequences of
awareness of
goal setting
demographic data
course of condition
deficits
perception of deficits
condition
diagnosis and prognosis
Speech assessment:
relies heavily on ?
speech tasks include: vowel ... and ... ... speech stress testing and tasks to ?
identification of deviant speech characteristics
prolongation
AMRs and SMRs
contextual speech
challenge or facilitate motor speech planning or programming
Physical examination:
evaluate
assess each
impairment/change in structure and function
speech subsystem
- respiration
- phonation
- articulation
- resonance
Examination of speech mechanism during nonspeech:
observations of the speech mechanism in the absence of speech may
examine the ? particularly?
these observations can be made at
support conclusions drawn about speech
size, strength, symmetry, range, tone, steadiness, speech and accuracy of movements - jaw, face, tongue, palate
rest, sustained phonation, movement, reflexes
Examination of structure:
observe ?
look for ?
size and relative positon of jaw, lips, tongue teeth, hard and soft palates
symmtery at rest
note tissue characteristics
Examination of function: - -speed of -range of - - - response to ? -assess -assess -assess for ? assess ? screen for ?
strength movement movement (ROM) steadiness tone accuracy instructions diadochokineses (AMRs and SMRs) sensation nonverbal apraxia cranial nerves dysphagia
Diadiochokinesis
AMR:
a single syllable ?
patients with many types of dysarthria have
Alternating motion rate
repeated at maximum rate
abnormal AMRs
SMR:
a sequence of
patients with AOS have particular difficulty wwith ? even when
syllables is repeated at maximum rate
SMRs even when AMRs are normal
How many trials for AMR and SMR:
identification of syllables is ? and can be ?
researchers have demonstrated that the maximal rate is contained in the ? and that a ? so the first nine syllables are likely to ?
unimpaired production of 9 syllables requires approx. ? which does not
9
simple/ replicated in clinical setting without difficulty
initial period / deceleration occurs following this/ capture maximum rate
2 sec of correct production
-stress respiratory system of most patients
AMR and SMR trends:
hypothesized to test the ?
lifespan trends:
rates for both tasks ?
rates for both tasks do not ?
maximum rate at which antagonistic muscles of articulation can be stimulated
increases between childhood and adulthood
decreases between adulthood and senescence
rates tend to ? as phoneme moves from anterior to posterior (p to k)
SMRs can be ?
laryngeal DDKs tend to be ?
variability is minimal in normals but ?
slow down
produced as fast as AMRs
slower than consonant based DDKs
high in persons with neurological impairment
ICE: stands for
intelligibility
comprehensibility
efficiency
Intelligibility: the degree to which a listener
comprehensibility: the degree to which a listener understands speech on the basis of ?
efficiency: the rate at which ?
understands auditory signal produced by speaker
auditory signal plus all other information that may contribute to what is being said
intelligible or comprehensible information is conveyed
why measure intelligibility:
reduced intelligibility and speaking rate are nearly ?
measures of intelligibility, combined with measures of ?
intelligibility is closely related to ? such as patient’s self-reports of ?
the results of intelligibility testing are easily ?
universal consequences of dysarthria
rate, provide a useful index of the severity of the overall activity limitation
other measures of speech effectiveness/ comm. effectiveness
communicated to patients
comprehensibility refers to comm. efficiency of a ?
the focus shifts from speech signal of one individual to comm. as it?
considers ?
dyad
develops between two indiv.
comm. strategies
