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Neuromuscular > Lecture 1 - Overview > Flashcards

Lecture 1 - Overview Flashcards

1
Q

Dementia Definition

A

A gradual deterioration of previously intact cognitive functions secondary to diffuse brain diseases.
An acquired persistent impairment of intellectual functions with compromise in at least 3 of the following areas of mental activity: memory, language, visuospatial functioning, emotion or personality, and cognition.

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2
Q

Aphasia Definition

A

An acquired disorder of language processing secondary to brain damage

Common clinical characteristics of aphasia are:
reduced comprehension, limited auditory span, impaired word finding, impaired language formulation, speech problems, and disorders of reading and writing.

Not included:
developmental/cognitive disorders and thought/mental illness problems

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3
Q

Motor Planning

A

Mapping of linguistic units into phonology incorporating strength, speed, range, direction, and muscular.

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4
Q

Apraxia

A

A disorder in the voluntary execution of learned movements not caused by paralysis, incoordination, sensory deficits, or a lack of understanding of the desired movement

An inability to carry out skilled motor acts on command, when it can be demonstrated that they person understands the command and can perform the same motor act in a different context

Volitional action

No SM involvement

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5
Q

Apraxia of Speech

A

Impair articulatory capacity

AoS distinguishes from the movement disorders represented by the dysarthria as well as speech disorders associated with aphasia. The clinical manifestation of AoS are believed to reflect a disturbance in the planning and programming of movements of speech.

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6
Q

Motor Externalization - Execution of communicative content

A 
Respiration
Phonation
Articulation
Prosody
Resonance
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7
Q

Dysarthria - Definition

A

A collective name for a group of neurogenic speech disorders resulting from abnormalities in strength, speed, range, steadiness, tone or accuracy of movements required for breathing, phonatory respiratory, articulatory or prosodic aspects of speech production.

The responsible pathophysiology disturbances are due to the CNS/PNS abnormalities…

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8
Q

Dysarthria - Implications

A 
Dysarthria is:
-Neurogenic
-Movement control
-Auditory perceptual characteristics
- Different underlying pathophysiologies
- Dysarthria types differ with lesion localization
- Exclusion of normal speech variations
    age
    gender
    style specific
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9
Q

Dysarthria - Characteristics

A

Age of Onset

  • Congenital
  • Acquired

Natural Course

  • Developmental to stable
  • Recovering
  • Stable
  • Degenerative
  • Exacerbating-remitting

Etiologies

  • TBI
  • CVA
  • Infectious
  • Neoplastic (tumor)
  • Metabolic
  • Neurological conditions
    • CP
    • Parkinson’s
    • MS
    • ALS
  • Communicative Disturbances
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10
Q

Dysarthria - Perceptual Characteristics

A 
Pitch characteristics
Loudness
Voice Quality
Respiration
Prosody
Articulation
Overall Intelligibility
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11
Q

Exclusion from Dysarthria

A 
Developmental Speech Disorders 
   - Dyslalia (articulator abnormality)
   - Palilalia (rapid word and phrase repetitions)
Musculoskeletal defects (clefts)
Stuttering
Voice change at puberty
Psychogenic aphonia
Malocclusion
Foreign and regional accents
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12
Q

Dyslalia

A

Articulator abnormality

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13
Q

Palilalia

A

Rapid word and phrase repetitions

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14
Q

Motor Speech Processes

A 
Respiration
Phonation
Articulation
Resonance
Prosody
Motor Symptoms
   - Weakness
   - Imprecise action
   - Slowness
   - Incoordination
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15
Q

Musculoskeletal Valves

A 
Abdominal, diaphragm, & chest muscles
Laryngeal structures
Pharynx & posterior tongue
Lower Palato-pharynx
Muscles of tongue
Mandible muscles
Facial muscles
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16
Q

Articulatory Complexity

A 
There are: 
100 controlled muscles
100 motor units
14 phonemes a second
100x100x14 = 140,000 neuromotor events
17
Q

Dysarthria - Medical View

A 
Medical View
 - disease model
 - disruption of normal processes
     - signs and symptoms
     - severity comparable to   
       disease stages
 - diagnosis 
     - history, neuro exam, imaging, 
       lab tests
18
Q

Dysarthria - SLP View

A

SLP View

  • Functional impairment
  • Differential diagnosis
  • For understanding syndromes
  • Consistency with proposed syndrome
  • Monitoring the disease process
  • Life quality
19
Q

Methods of Studying MotorSpeechDisorders

A

Perceptual Methods

  • Auditory attributes
  • Gold standard (for clinical differential diagnosis)

Instrumental - Acoustic Methods
- confirmation of observed perception

Physiological Methods

  • Movements and articulation
  • Relationship of pathophysiology with acoustic and perceptual aspects
20
Q

International Classification of Impairments, Disabilities, and Handicaps (WHO, 1980)

A

A standard terminology for describing human functioning and disability

Limitation:
Medical consequences - consequences of diseases were predictable and unidirectional, using a medical vs. social orientation toward disability “handicap”

21
Q

International Classification of Impairments, Disabilities, and Handicaps - Impairment

A

Impairment:
Structural/functional abnormality

Dysarthria - dysfunctional speech 
     - deviance of speech motor 
        processes due to altered 
        strength motion rate, 
        precision, and incoordination
22
Q

International Classification of Impairments, Disabilities, and Handicaps - Disability

A
  • Effect on skills/abilities
  • Any lack of ability to perform an activity in the manner considered normal for a human being

Dysarthria - reduced speech intelligibility and abnormal prosodic patterns

23
Q

International Classification of Impairments, Disabilities, and Handicaps - Handicap

A

Effect on the functional performance or activity that involves the whole person.

Dysarthria - a disadvantage for a given to fulfill the role that is normal for that individual

Cultural factors, society attitudes, and the environments
- what may be a disability in one person may be a handicap in others

24
Q

International Classification of Impairments, Disabilities, and Health (WHO, 2001)

A

Provide a standard language and framework for the description of functioning and health

Shift from the disease model

Goal is the enhancement of person’s functional capacity through the modification of the environments and structural behaviors

25
Q

International Classification of Impairments, Disabilities, and Health (WHO, 2001) - Two Components

A 
Health Conditions
 - Body Functions and Structures
     - Anatomy and physiology of 
       the human body. Ex. 
       craniofacial anomaly and 
       language impairments
 - Activity and Participation
     - Activity refers to the 
      execution of a task or action. 
      Participation is the involvment 
      in a life situation. Ex. 
      difficulties with swallowing 
      safely for independent 
      feeding and accessing the 
      general education and social 
      curriculum. 
Contextual Factors
 - Environmental Factors
     - make up the physical, social, 
      and attitudinal environments. 
      Ex. the impact of 
      environments on individuals' 
      ability to safely maintain 
      nutrition and communication.
 - Personal Factors
     - Internal influences on an individual's functioning and disability and are not part of the health condition: 
             - Age, gender, ethnicity, 
             educational level, social 
             background, and  
             profession 
              - PF not coded in the ICF 
              because of a variability 
              among cultures, but 
              included because of 
              likelihood of impact on 
              functioning. 
              - Ex. a person's 
              background or culture 
              that influences the 
              reaction to a 
              communication disorder.
26
Q

Coding

A

The qualifiers - restriction level

0: within normal limits
1: mild deficit
2: moderate deficit
3: severe
4: complete loss

27
Q

ICF - Prevention

A

Primary prevention
- preventing the onset of impairments

Secondary Prevention
- Preventing impairment from negative physical, psychological and social consequences

28
Q

ICF - Rehabilitation

A

Teaching goal - oriented skills to reach an optimum functioning level

Providing with tools to change the life by compensating for a loss of function

Counseling to facilitate social adjustment.

Oriented skills to reach an optimum mental, physical, and/or level of functioning.

29
Q

ICF - Equalization of Opportunity

A

Accessibility of Social Opportunities:

  • Cultural environment
  • Housing
  • Transportation
  • Social and health services
  • Educational and word opportunities
  • Social activities
  • Recreational facilities
30
Q

Functional Communication

A

Standardized test batteries:

  • info. about impairments
  • no info about active restriction or participation limitation

The ICF

  • Assessment of functional communication
  • Functional Assessment of Communication Skills for Adults
31
Q

Mayo Study of Speech Deviance

A 
Neurological approach
Perceptual Approach 
 - auditory attributes of speech
 - gold standard for clinical identification
 - subjectivity of judgment
32
Q

Tremor

A

4-6 Hz vocal fluctuation

33
Q

Flutter

A

10-12 Hz vocal fluctuation

34
Q

Wow

A

1-3 Hz vocal fluctuation

35
Q

Falsetto

A

Higher than normal pitch range

36
Q

Vocal Fry

A

Lower than normal pitch range

Neuromuscular (2 decks)

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