INFO TO KNOW Flashcards
list the cranial nerves in order from 1-12
I - OLFACTORY II - OPTIC III - OCULOMOTOR IV - TROCHLEAR V - TRIGEMINAL VI - ABDUCENS VII - FACIAL VIII - VESTIBULOCOCHLEAR IX - GLOSSOPHARYNGEAL X - VAGUS XI - SPINAL ACCESSORY XII - HYPOGLOSSAL
list whether each cranial nerve is sensory, motor, or both
I - OLFACTORY - S II - OPTIC - S III - OCULOMOTOR - M IV - TROCHLEAR - M V - TRIGEMINAL - B VI - ABDUCENS - M VII - FACIAL - B VIII - VESTIBULOCOCHLEAR - S IX - GLOSSOPHARYNGEAL - B X - VAGUS - B XI - SPINAL ACCESSORY - M XII - HYPOGLOSSAL - M
function of CN I, Olfactory nerve
smell sensation
function of CN II, Optic nerve
vision
function of CN III, Oculomotor
eye movement, upper eyelid elevation, pupil constriction
function of CN IV, Trochlear
downward and lateral (midline) eye movement
function of CN V, Trigeminal
- sensory: face sensation
- motor: muscles of mastication & tensor tympani
function of CV VI, Abducens
lateral (away from midline) eye movement
function of CN VII, Facial
- sensory: taste (anterior 2/3 tongue)
- motor: muscles of facial expression, lacrimation, salivation
function of CN VIII, Vestibulocochlear
- hearing and vestibular sensation
function of CN IX, Glossopharyngeal
- sensory: taste (posterior 1/3 tongue), upper px, middle ear
- motor: stylopharyngeus, elevation of px & lx, pharyngeal dilation, salivation
function of CN X, Vagus
- sensory: lower px, lx, base of tongue, epiglottis
- motor: palatal elevation & depression, laryngeal movement (vocal fold tension, adduction, abduction), pharyngeal constriction, cricopharyngeal function
function of CN XI, Spinal Accessory
- motor innervation of sternocleidomastoid and trapezius muscles = head turning, shoulder elevation
function of CN XII, Hypoglossal
- motor innervation of intrinsic tongue muscles = bolus manipulation and propulsion
list the intrinsic muscles of the larynx
1) thyroaryntenoids
2) cricothyroids
3) lateral cricoaryntenoids
4) posterior cricoarytenoids
5) transverse and oblique interarytenoids
6) vocalis muscles
action, function, CN innervation of vocalis muscle
- action: form vibrational mass of VFs
- function: change thickness/tense of VFs, change vocal tone
- CN X - RLN
action, function, CN innervation of thyroarytenoid muscles
- action: draw arytenoid cartilages forward
- function: tense, shorten VFs
- CN X - RLN
action, function, CN innervation of cricothyroids
- action: tilt thyroid cartilage down, stretching VFs
- function: work w/ TA muscles to raise pitch
- CN X - SLN
action, function, CN innervation of LCAs
- action: medially rotate arytenoid cartilages
- function: adduct VFs
- CN X - RLN
action, function, CN innervation of PCAs
- action: externally rotate arytenoid cartilages
- function: abduct VFs
- CN X - RLN
action, function, CN innervation of transverse and oblique interarytenoids
- action: draw arytenoids together
- function: adduct VFs
- CN X - RLN
so which intrinsic muscles of larynx are ADDUCTORS?
LCA, TRANSVERS & OBLIQUE INTERARYNTENOIDS
so which intrinsic muscles of larynx are ABDUCTORS?
PCA
primary muscles of inspiration?
diaphragm, external intercostals
is regular, non-speech expiration active or passive?
passive
primary muscles that can induce forced expiration?
abdominal muscles, internal intercostals
tidal volume
average volume of air exchanged in a cycle of passive breathing
inspiratory reserve volume
the max volume of air that can be inspired above the level of tidal inspiration
expiratory reserve volume
the max volume of air that can be expired below relaxation volume
residual volume
the volume of air that remains in the lungs after a max exhalation
vital capacity
volume of air exchanged between a maximum inspiration and a maximum expiration
what is approximate normal vital capacity for women and men?
- women = 4 L
- men = 5 L
functional residual capacity
volume of air in the lungs at the end of the expiratory phase of tidal breathing
inspiratory capacity
maximum volume of air that can be expired
total lung capacity formula
IRV + TV + ERV + RV
list the suprahyoid extrinsic muscles of the larynx w/ their functions
- mylohyoid: elevates hyoid, tenses floor of mouth
- geniohyoid: elevates and advances hyoid widening px during swallow, shortens floor of mouth
- stylohyoid: elevates and retracts hyoid bone, lengthens floor of mouth
- digastric: elevates hyoid, supports hyoid during swallow, depresses mandible
list the infrahyoid extrinsic muscles of the larynx
- sternohyoid: depresses hyoid, helps steady hyoid
- omohyoid: depresses, retracts, and steadies hyoid during speaking and swallowing
- thyrohyoid: depresses hyoid or elevates lx toward hyoid bone for airway protection during swallow
- sternothyroid: depresses hyoid bone and lx
list the intrinsic muscles of the tongue
- superior longitudinal, inferior longitudinal, transverse, vertical
list the extrinsic muscles of the tongue
- genioglossus, hyoglossus, styloglossus, palatoglossus
see p. 44 for functions of tongue muscles
review p. 44
what is a typical cycle of voicing, as described by the myoelastic aerodynamic theory?
1) the VFs are adducted, closing glottis
2) subglottal air pressure builds up
3) air pressure blows open VFs
- inferior portions before superior portions, producing wavelike motion from bottom to top = mucosal wave
4) as explained by the Bernoulli principle, as air rushes through the glottis, pressure decreases
5) the decrease in pressure, paired with the pliable nature of the VFs, closes the VFs
6) with the VFs closed, pressure once again builds up, leading to another cycle of vibration
the majority of GENETIC syndromes cause language disorders b/c of?
effects on the AUDITORY system
examples of autosomal chromosomal disorders
- down syndrome (trisomy 21)
- cri du chat
sex-linked chromosomal disorders
- turner syndrome
- klinefelter syndrome
- fragile x
- cornelia de lange
- neurofibromatosis
- prader-willi
- williams
metabolic disorders
- phenylketonuria
- mucopolysaccharidoses
- hurler syndrome
- enzyme deficiency
down syndrome associated language difficulties
- expressive worse than receptive
- syntax worse than semantics
* *vocab and syntax growth is asynchronous = uneven development
most common inherited form of intellectual handicap
fragile x
general symptoms of fragile x
moderate intellectual handicap, language-learning difficulties beyond what would be predicted by cog deficits, hyperactivity, attn deficits
language characteristics of fragile x
- weaknesses: delayed expressive syntax, organization, auditory memory, pragmatic (fluency, prosody)
- strengths: receptive language, vocab, visual
most prevalent mental health diagnosis made in childhood
ADHD
most common neural tube deficit
spina bifida
general characteristics of neural tube deficits (spina bifida)
- 25% have intellectual disability, perceptual deficits, difficulties in organization, attention, and academic fluency
list the 4 subcortical aphasia syndromes
1) anterior capsular-putaminal aphasia
2) posterior capsular-putanimal aphasia
3) global capsular-putanimal aphasia
4) thalamic aphasia
list the SOL and language features of anterior capsular-putanimal aphasia
- SOL: anterior part of internal capsule and putanem
- Some features of Broca’s and TSM: sparse output, reduced phrase lengths, reduced articulation
- NOT agrammatic though!!! = good syntax
- repetition good
- AC good
- frequently hemiplegia
list the SOL and language features of poterior capsular-putanimal aphasia
- SOL: posterior part of internal capsule and putanem
- features of both ant and post aphasia b/c some pathways from Wernicke’s and motor pathways are interrupted
- FLUENT
- poor repetition
- poor AC
- good articulatory ability
- **frequently hemiplegia
So, if a PWA comes in w/ a fluent type of aphasia and yet they are hemiplegic in a wheelchair, you might suspect a subcortical lesion where?
in the posterior internal capsule/putanem
list the SOL and language features of global capsular-putanimal aphasia
- SOL: lesion in both anterior and posterior portions of internal capsule and putanem
- GLOBAL type of aphasie w/ severe impairments in ALL language modalities
- little or no verbal output
- poor AC
- often hemiplegia
list the SOL and language features of thalamic aphasia
- SOL: thalamus, likely a hemorrhage as opposed to an occlusive infarct
- features of TSA or Wernicke’s
- FLUENT
- good repetition
- semantic paraphasias
- jargonistic paraphasias
- poor word-finding
- perseveration
- typically better AC than Wernicke’s or TCS
list the major muscles of the velopharyngeal valve with their functions
1) levator veli palatini (main muscle mass of velum): velar ELEVATION
2) superior constrictors: moves lateral pharynx medially to narrow the velopharyngeal port to close around velum
3) palatopharyngeus: moves lateral pharyngeal walls medially
4) palatoglossus: DEPRESSES velum for production of nasals
5) musculus uvulae (only intrinsic velar muscle): additional stiffness to nasal side of velum during VP closure
6) tensor veli palatini: opens EUSTACHIAN TUBE during swallowing & yawning, enhances middle ear aeration & drainage
list the ages and language associated with the “locutionary” stages
1) perlocutionary: birth to 8 mo, no communicative intent (adults infer)
2) ilocutionary: 8-12 mo, gestures & vocalizations to communicate, no words
3) locutionary stage: 12 mo-lifespan, words to communicate
list the ages, MLU avg, and MLU range for Brown’s stages
- Stage I: 15-30 mo, 1.75, 1.5-2.0
- Stage II: 28-36 mo, 2.25, 2.0-2.5
- Stage III: 36-42 mo, 2.75, 2.5-3.0
- Stage IV: 40-46 mo, 3.5, 3.0-3.7
- Stage V: 42-52+, 4.0, 3.7-4.5
morphological structures that emerge at Brown’s 5 stages
- I: combine basic words
- II: present progressive (-ing), regular plurals (-s), in, on
- III: -s possessives, irreular past tense, uncontractible copula (“to be” when only verb in sentence)
- IV: articles, regular past tense, 3rd person regular present tense
- V: 3rd person irregular, uncontractible auxiliary (“to be” as auxiliary verb - Are they swimming? Is she going?), contractible copula (She’s ready, I’m here), contractible auxiliary (They’re coming, He’s gone)
list 4 common neurodegenerative syndromes and any subtypes under each
1) Alzheimer’s Dementia
- 3 stages: mild/early, mod-mid, severe/late
2) Vascular Dementia
3) Frontotemporal Dementias
- Frontal dementia
- Semantic dementia (primary progressive aphasia, fluent)
- Nonfluent progressive aphasia
- Phonologic/Logopenic progressive aphasia
4) Dementia w/ Lewy Bodies (Parkinson’s)
Alzheimer’s Dementia
- what causes it?
- how many yrs till death?
- area of brain 1st impacted?
- associated deficits
- amyloid-beta protein deposits that cause neuron death
- 8-15 on avg
- medial temporal lobe
- memory declines 1st, followed by language and cognition as neuron death spreads laterally
Vascular dementia
- what causes it?
- typical onset and life expectancy
- associated deficits
- can it co-occur w/ other dementias?
- is it progressive?
- cerebrovascular disease: lacunar stroke (multiple small subcortical infarcts), multiple cortical infarcts, Binswanger’s disease (subcortical white matter infracts d/t HTN), CADASIL (inherited VaD)
- 60-75 yrs, shorter than AD d/t vascular disease and its association w/ other deficits
- HIGHLY variable depending on SOL - confusion, probs w/ recent memory, wandering/getting lost, loss of continence, pseudobulbar effect, difficulty following instructions, probs handling money. If cortex is affected, then aphasia, apraxia, dysarthria, agnosia, hemipariesis, sensory deficits are all possible too).
* **EF deficits - yes, can co-occur w/ AD
- not necessarily progressive
Frontotemporal dementia
- what causes it?
- onset and progression
- general symptoms and differentiation from AD
- extensive brain atrophy visible in frontal and temporal lobes
- onset is younger than AD (55 yrs avg), progression more rapid (6-8 yrs)
- symptoms/differentiation from AD:
~decrease in spontaneous output and mutism earlier
~communication deficits more pronounced than memory
~parietal lobe fnxs often preserved (visuospatial, R-L orientation, calculations)
FRONTAL Dementia
- characteristics
- disinhibition, impulsivity, apathy, antisocial behavior.
- EF deficits in planning/organization
- ***memory relatively spared
- reduced spontaneous output, but language may be unimpaired on naming tests
- stereotypical behavior, catch phrase, liking sweet foods
Semantic Dementia
- SOL
- characteristics of OE/AC
- Lt anterior temporal lobe
- OE similar to TSA/Wernicke’s: fluent yet anomia w/ empty, vague words, poor naming, poor rep, syntax/phonology, visual/cog relatively intact
- AC poor for words
Primary Nonfluent Aphasia
- SOL
- characteristics of OE/AC
- Broca’s
- OE similar to Broca’s, gradually gets worse
- AC fair, eventually gets worse
Logopenic/Phonologic Primary Progressive Aphasia
- SOL
- characteristics
- L poterior language zone, inferior parietal
- can’t retain and organize phonological sequences = poor word retrieval
- poor repetition
- poor AC
