Final Exam Study Guide Flashcards
hemiplegia
unilateral spastic paresis due to stroke on one cerebral hemisphere
diplegia
spastic paresis occurring especially in lower limbs
spastic cerebral palsy
due to UMN lesion, spasticity, hyper-reflexia, most likely has spastic dysarthria
dyskinetic or athetoid cerebral palsy
due to basal ganglia damage, usually has some involuntary movements, most likely has spastic or hyperkinetic dysarthria
ataxic cerebral palsy
due to cerebellar damage, has gait and balance issues, most likely has ataxic or spastic dysarthria
lingual fasciculations and atrophy can be seen in
CN-XII damage, unilateral or bilateral LMN lesion
when patient displays groping behavior when smiling or protruding the lips or lateralizing the jaw, they most likely have
non-verbal oral apraxi
spastic dysarthria
damage to bilateral UMNs
ataxic dysarthria
damage to cerebellar pathways
UUMN dysarthria
damage to unilateralUMNs
flaccid dysarthria
damage to unilateral or bilateral LMNs
apraxia of speech
a term for a motor speech disorder with phoneme sequencing deficit often associated with damage to the left hemisphere of the braun
dysarthria
a term for a motor speech disorder with speech production deficit resulting from neuromotor damage to PNS or CNS
Diane Sawyer has a right UMN damage. What are some features observed during oral motor examination?
- forehead wrinkles when eyebrows are raised
- tongue deviation to the left side
- paralysis of the left lower face
- both eyes close with a mild weakness
- flat nasiolabal fold on the left side
speech muscle movement deficits of timing, force, range, and direction are seen in _______________ dysarthria
ataxic
5 subsystems of normal speech production
respiration
phonation
prosody
resonance
articulation
myasthenia gravis
neuromuscular junction disease
guillian-barre syndrome
demyelinzation of LMNs
multiple sclerosis
demyelinzation of UMNs
ALS
degeneration of motor tracts, spinal nerves, and cranial nerves
friedrich’s ataxia
inherited progressive condition that damages cerebeullpum, spinal cord, and brainstem
polio
viral infection attacking cervical and thoracic spinal nerves
muscular dystrophy
degeneration of muscle tissue which impacts the respiration, speech, and swallowing
wilson’s disease
hereditary disease with poor metabolism of copper
alternating motion rate
puh, puh, puh
sequential motion rates
puh, tuh, kuh
speech stress testing
counting out loud 1-100 numbers
apraxia of speech testing
counting out loud 1-20 numbers backwards
festinated speech and soft voice
hypokinetic dysarthria
strained-strangled voice, low pitch, and slow rate of speech
spastic dysarthria
involuntary movements impacting the speech production
hyperkinetic dysarthria
hypernasality/audible nasal emissions, breathy voice, and imprecise consonant production
flaccid dysarthria
microglia
acts as scavengers and remove dead cells/other waste
astrocytes
makes up the connective tissue in CNS
ogliodengroglia
from myelin around axons in CNS
glial cells
provide myelin sheath in PNS
french dysarthria assessment-2 evaluates all of the following except onr
oral praxis
three cranial nerve where when one gets damaged, there is a higher possibility that the other two cranial nerves also get damaged
CNs-IX, X, XI
t or f: damage at any level of the motor system can result in a movement disorder. when the damage affects the muscles of speech production, the result can be a motor speech disorder
true
hesitations, revisions, and groping behavior during speech production
apraxia of speech
inability to pucker the lips or protrude the tongue during volitional oral motor tasks
non-verbal oral apraxia
inability to wave good bye or point the finger to the ceiling in response to verbal commands
limb (kinetic) apraxia
lost the concept of planning and sequencing movements to complete tasks such as tooth bushing or dressing
ideational apraxia
axons in CNS
tracts
axons in PNS
nerves
inhibitory action
dopamine
excitatory action
acetylcholine
Lester Holt has a left CN-VII damage. what are some features observed during oral motor examination
- flat nasiolabal fold on left side
- right eye close but left eye does not close
-tongue deviation to the left side - left hemifacial paralysis or paresis
- forehead wrinkles on right but not left side when eyebrows were raised
sucking reflex
stroking the upper lip with tongue blade protrudes the lipspal
momental reflex
stroking the palm leads to chin twitching
jaw jerk reflex
tongue depressor on chin and a gentle tap with a finger elevates the mandible
snout reflex
light tap on philitrium causes protrusion and elevation of lower lip
metronome
rate and rhythm control to improve speech production
PROMPT
combination of proprioception, pressure, and kinesthetic feedbacl
eight-step continuum
to improve the timing and placement of articulatory movements through modeling, positioning of articulators, and repetition
melodic intonation therapy
humming, singing, and tapping the word followed by attempting the target word in response to a question
t or f: dysarthrias or apraxia of speech can be due to abnormal anatomical structures or sensory loss
false
accuracy of movement
speech intelligility during conversational speech
range of motion
extending articulators at different postitions
muscle speed
DDK rates
steadiness of motion
holding the tongue in a protruded position
muscle strength
press tongue against the finger resistance
muscle tone
observing the affected body parts and perpetual analysis of speech
the following 4 statements are true
- vocal quality is best perceived during sustained phonations
- prosodic aspects are best perceived during conversational speech
- articulatory precision, speed, and accuracy are best perceived during DDK rates
- hypernasality is best perceived during connected speech with vowels, stops, and fricatives
external branch of superior laryngeal nerve
motor innervation of CT muscle
recurrent laryneal nerve
motor innervation of PCA, TA, LCA, and IA muscles
CN IX & X
pharyngeal and velar muscles
CN-IX
stylopharyngeous muscle
weakness of skilled movements
pyramidal system damage
spasticity and abnormal reflexes (hyper typically)
extrapyramidal system damage
hyperoreflexia or areflexia
LMN damage
dysmetria, staggered gait, and drunken speech
damage to cerebellar control circuit
which speech tasks are difficult for those with apraxia of speech?
- low frequency words
- sequential motion rates
- counting numbers backwards
- reading words of increasing complexity
_____________ is the most important nerve for respiration
phrenic
t or f: the childhood dysarthria due to a brain dysfunction exhibits the exact same symptom clusters as seen in adults with dysarthria
false
you are an SLP who is seeing identical twin sisters, age 3, both with severe receptive and expressive language impairment. in conversation with their parents, they bring up the question of whether the girl’s difficulty with language could have a genetic cause. you personally have no prior training in genetics. why should you, as an SLP, be interested in learning more about genetics.
the children could have a genetic syndrome, and the language problems are part of the syndrome, SLPs should obtain training in genetics because they have the skills to recognize deficits in communication
you are an SLP who is seeing identical twin sisters, age 3, both with severe receptive and expressive language impairment. in conversation with their parents, they bring up the question of whether the girl’s difficulty with language could have a genetic cause. you personally have no prior training in genetics. which of the following defines the precision medicine initiative?
- the project will involve large numbers of people to provide health information
- the goal is to create a better understanding of the interaction between genetics, lifestyle, and environment
- the project aims to improve health outcomes by making it possible to design targeted and preventative interventions
Jamie, a 6 year old girl is seen by an SLP for a comp speech and language assessment. standardized testing shows expressive and receptive language skills below expectation. her speech sounds hypernasal and breathy, and standard artic testing shows some unusual speech sound substitutions like [m]/p and [n]/t. when jamie walked into the room, a slow labored gait was noted. jamie did an MRI scan at age 2 years and 4 months. what, if any, red flags are there that jamie may have a syndrome of genetic etiology.
finding motor impairments across domains as well as, language impairments in the same child could point to a genetic or chromosomal cause
angelica, 5 years old, is receiving speech therapy to address speech errors related to her repaired cleft palate. none of her biological relatives have a history of cleft palate, not even her twin brother. angelica’s medical history is significant for her surgery as a newborn. the most likely cause of the clefting is:
missing a small piece of chromosome 22
you are an SLP working in an elementary school. on your caseload are three children, a 3 year old, boy, a kindergarten girl, and a boy in 3rd grade. they all have CAS. Jesse and amelia have an older sister who never had any speech or language issues, and marcus has an older brother who also never had any speech or language issues. the affected children have no additional diagnoses. would you classify the speech and language delays as syndromic or nonsyndromic?
nonsyndromic because CAS is occurring without any other diagnoses. the delays in expressive language are often seen in children with CAS
what is the most likely explanation of why some of the children from the same extended family have a similar type of speech disorder?
with several close relatives affected, the best explanation is a genetic change that was inherited
you are an SLP in a private practice and are seeing a 4-year old boy with a severe speech disorder. his mother asks you what her changes are of having another child with the same disorder. your best response is the following:
“if you would like, we can meet to discuss potential red flags and create a referral to a genetics professional for a more in-depth consultation
you are an SLP who is seeing two brothers, one with autism and the other with mostly pragmatic language delays. their parents came to talk to you about the possibility that genetics may explain both boy’s struggles. In your conversation, you discover that there may be a family history for autism. what is your best plan of action?
you ask questions about the family history, draw a three generation diagram, and look for biological relatives who have or who have had any kind of psychiatric or developmental diagnosis
Q3: You are an SLP who is seeing children from two families that caught your attention. In the first family, you are seeing two siblings, Zach and Zoe, with dyslexia and your family interview showed that one cousin and one grandparent but none of the parents have dyslexia. In the second family, Sondra, a girl with hearing impairment, has a mother with hearing impairment, and the mother reports that one of her two brothers and her mother also have hearing impairment. Sondra’s brother does not have hearing impairment.
Which of the following statements are true regarding these two families? (Select two choices)
- the first family could have some genetic risks for dyslexia but if there are several genes involved, plus some other factors, the dyslexia does not always get inherited with a clear pattern
- in the second family, the pattern is clearly genetic, and it is autosomal dominant
you are asked to see a 5 year old child for an evaluation of speech, resonance, and velopharyngeal function. he has no history of cleft palate but has always had “nasal” speech, according to the mother. two year previously, when he lived in another city, he participated in a videofluoroscopy speech study. According to the report, the study showed good velar and lateral pharyngeal wall movement, but incomplete velopharyngeal closure during speech. During swallowing, however, the child was able to achieve complete velopharyngeal closrure consistently. in your assessment, you find that the child has normal articulation placement but that resonance is hypernasal
referral to craniofacial surgeon for consideration of surgical intervention
a child presents to you with a history of cerebral palsy. in your assessment, you find that he has very hypernasal speech but essentially normal articulation placement. based on his history and the characteristics of his speech, what would be an appropriate diagnosis?
velopharyngeal incompetence
you are evaluating a child with abnormal resonance. in your assessment, you note that there are often m/b and n/d substitutions. you also note that, in connected speech, the /n/ sound is frequently used as a substitution for siblants. what diagnosis does this suggest?
hypernasality
you are asked to see a 12-year-old boy for an evaluation. his mother reports that he is “lazy with his speech” and that he mumbles all the tome. she thinks it is because he is going through puberty. in your assessment, you note abnormal resonance and low volume. an intraoral examination reveals very large tonsils that almost touch in the midline. based on this history and your examination, what type of resonance disorder does this child demonstrate?
pharyngeal cul-de-sac resonance
your patient has a history of cleft lip and palate. he is 17 years old and has significant maxillary retrusion with midface deficiency. as a result, he has a class III maloclusion with anterior crossbite. what type of abnormal resonance is common due to midface retrusion.
hyponasality
your patient has a history of cleft palate. a recent nasopharyngoscopy evaluation showed a very large velopharyngeal opening during speech. what type of nasal emission would you expect with a large opening?
inaudible nasal emission
you are working with a patient who has had a pharyngeal flap for correction of velopharyngeal insufficiency. although resonance is now normal, he still uses some compensatory productions. In particular, you notice that he coarticulates a compensatory production with oral plosives. which of the following compensatory productions would he most likely coarticulate with oral plosives?
glottal stop
