L2/3: Assessment Flashcards

1
Q

5 components of assessment

A

history and interview

motor speech exam (non speech tasks)

motor speech exam (speech tasks)

assess of intelligibility

acoustic and physiological analysis (not essential)

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2
Q

why is history/interview of onset and course important? what are the main ideas of the questions you would ask?

A

useful for neurological diagnosis, prognosis, and management decisions

also reveals the patient’s perception of the prob

main ideas: was it sudden/gradual, other difficulties, did it change, other factors (ex. medication)

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3
Q

why is history/interview of associated problems important?

A

may provide confirmatory info

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4
Q

why is history/interview of the patient’s perception of the problem important?

A

can provide useful confirmatory info

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5
Q

why is history/interview of the consequences of the disorder important?

A

address functional consequences of MSDs

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6
Q

why is history/interview of the management of the disorder important?

A

gain info about what the pt and others (including other professionals) have done to manage the speech disorder

useful for determining prognosis and future management recommendations

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7
Q

why is examination of speech mechanism during non-speech activities informative?

A

they provide info about orofacial movements - particularly of the jaw, face, tongue, and palate

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8
Q

how is the examination of speech mechanism during non-speech activities completed? (4 types of observations)

A

observations are primarily visual and tactile but also auditory

the observations can be made:
- at rest
- during sustained postures
- during movement
- reflexes

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9
Q

what do observations of the speech mechanism during non-speech activities tell us?

A

may support conclusions drawn about speech

even if not confirmatory of a speech diagnosis they may nonetheless be important

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10
Q

assessment of mandibular musculature during non-speech activities tests…

A

V - trigeminal

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11
Q

assessment of lip and facial musculature during non-speech activities tests…

A

VII facial and III oculomotor

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12
Q

assessment of palatopharyngeal musculature during non-speech activities tests…

A

IX - Glossopharyngeal, X - vagus

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13
Q

assessment of laryngeal musculature during non-speech activities tests…

A

X-Vagus

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14
Q

assessment of tongue musculature during non-speech activities tests…

A

XII - hypoglossal

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15
Q

assessment of respiratory musculature can be done during non-speech activities tests by…

A

strong sniffs/gasps (inhalatory) etc

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16
Q

palmomental reflex

A

in response to brisk stroking of right and left palms leads to contraction of R/L mentalis or lower lip (ex. in ALS pts)

17
Q

fasciculations

A

a spontaneous, involuntary muscle contraction and relaxation, involving groups of muscle fibers

18
Q

vocal flutter is associated w

A

laryngeal weakness

19
Q

what are the 5 ways the speech mechanism is examined in speech activities?

A

vowel prolongation

prolongation of /s/ and /z/

alternating movement rates (AMRs or DDKs)

stress counting: counting from 1-200 (ex. important in MG)

contextual speech (reading aloud, picture description, conversation)

20
Q

norm of max phonation time for adult female 13-65

A

21 seconds

21
Q

norm of max phonation time for adult male 13-65

A

25.89 seconds

22
Q

norm of max phonation time for geriatric female 65+

A

13.55 seconds

23
Q

norm of max phonation time for geriatric male 65+

A

14.68 seconds (SD=6.25)

24
Q

what is the general rule for s/z ratios?

A

ratio of 1.4 considered upper limit for normal, expect 1.0 in adults

25
s/z ratio above 1.4 suggests
ratio above 1.4 suggests inadequate/inefficient laryngeal valving (/s/ longer than /z/)
26
sedate geriatrics s/z ratio norm
0.76
27
activate geriatrics s/z ratio norm
0.82
28
norm of rate of repetition for /pΛ/ for adults (syllables per sec)
4.5 - 7.5 syllables/second
29
what are the three measures of intelligibility in dysarthria?
rating scores severity scores phonetic intell testing
30
what is the sentence intelligibility test (SIT) at single word?
50 words, patient reads, naive listener picks from 10 possible words for each word number of correct/total = % intell
31
what is the sentence intelligibility test (SIT) at sentence level?
22 sentences, patient reads sentences, naive listener transcribes them number of words correct/total = % intell
32
sentence intell test (SIT) provides what type of score? what does it not provide?
severity score does not provide a phonetic explanation for the intell deficit
33
describe the phonetic intelligibility test... what can it be used for?
70 word test attempts to provide a phonetic explanation for the patient's intell deficit examines 19 phonetic errors that commonly occur in dysarthria provides a phonetic error profile that shows the proportion off error for each phonetic error profile can be used to determine which phonetic errors are contributing the most to the intell deficit
34
why is rate important to consider for intellgibility?
rate is an important component of intell we may want to tweak a patient's rate to see if it changes their intell patients dont often find the optimum rate on their own - need help to find it