L1: Intro Flashcards
dysarthria is a neurogenic motor speech impairment which is characterized by…
alterations in the speed, force, range, accuracy, or coordination of movements of the speech musculature
in dysarthria the speech mechanism may also demonstrate involuntary… and also some abnormalities in….
movements or alterations in muscle tone
also some abnormalities in reflexes
apraxia of speech is an
articulatory disorder resulting from impairment, as a result of brain damage, of the capacity to program the positioning of the speech musculature and the sequencing of muscle movements for the volitional production of phonemes
apraxia of speech involves NO …
sig weakness, slowness, or incoordination of the speech musculature
how would you look at dysarthria from a neurological perspective?
- where is the site of lesion/neuromuscular deficit
- are the patients characs consistent w the proposed neuro diagnosis
- how severe are the speech symps and are they changing over time
how would you look at dysarthria from a speech physiology perspective?
- which speech structures/processes are impaired
- which measures can be used to assess the speech production deficits
- is there a physiological explanation for the intelligibility deficit?
how would you look at dysarthria from a rehab perspective?
- what is the extent of the comm deficit?
- are there procedures to improve the deficit
- how will the outcome of intervention be measured
what are the 8 components of neuromotor testing?
strength
asymmetry
speed of movement
range of movement
accuracy of movement
steadiness testing and evaluation of involuntary movements
tone
reflexes
what are the 3 parameters you would test for strength in neuromotor testing?
maximum strength
stability of sustained contractions
accuracy of force
what are the 2 methods you would use for strength in neuromotor testing?
examiner applies force against pts resistance
instruments - grip strength, tongue strength etc
what are you trying to differentiate between during an asymmetry assessment in neuromotor testing? (3 things)
focus vs generalized
left versus right deficits (in both oral facial and limb sys)
LMN (ipsilateral) vs UMN (contralateral)
what are 5 parameters of speed of movement you would assess in a neuromotor testing?
initiation (delayed/immediate)
trajectory of movement (rapid vs slow)
relaxation and return to rest (abnormally sustained or slow)
pausing during movement
rate of repetition
what are 3 methods to assess speed of movement in a neuromotor testing?
single movement to a target (nose-finger)
repetition of movement (finger tapping)
clinical ratings, rep rate (#/sec)
what are 3 parameters of range of movement you would assess in a neuromotor testing?
max size of movement (not as important)
size of movement during repeated or sequential movements
consistency in size of repeated or sequential movements (variable, telescoping)
what methods can be used to assess range of movement in a neuromotor testing?
observation and rating of max and repeated movements
what are 2 parameters of accuracy of movement you would assess in a neuromotor testing?
distance from a spatial target (achieved target, undershoot, overshoot)
single vs multiple movements to a spatial target (groping, self-correct, multiple attempts)
what methods can be used to assess accuracy of movement in a neuromotor testing?
move a structure bw two points as rapidly as possible
instrumental analysis of movement patterns
what are 2 parameters of steadiness/involuntary movements would you assess in a neuromotor testing?
regular, repetitive, involuntary movements
irregular involuntary movements
what are 3 methods would you use to assess steadiness/involuntary movements in a neuromotor testing?
observe structures at rest, during sustained postures, and during movements
analysis of pts writing and drawings
instrumental procedures of tremor freqs and movements
what are 2 parameters of tone would you assess in a neuromotor testing?
inc (hypertonia) vs dec (hypotonia)
constant vs irregular tone
what method would you use to assess tone in a neuromotor testing?
examiner observes or feels the resistance to passive movements
what are 2 parameters of reflexes would you assess in a neuromotor testing?
presence of abnormal reflexes (ex. babinski, sucking)
reduced, absent, or hyperactive stretch reflex
what 2 methods would you use to assess reflexes in a neuromotor testing?
tap tendon and observe movement (rate strength of reflex)
use of electromyography to stimulate and record muscles
