LECTURE #12 - neurogenic communication disorders 1 Flashcards
what are the two parts of the nervous system ?
central nervous system AND the peripheral nervous system
what makes up the central nervous system :
brain and spinal cord
what makes up the peripheral nervous system :
all the other nerves that connect the body
to brain and spinal cord
what does the CNS do ?
It’s like the main control center for your body
how does the CNS function ?
The brain processes information, makes decisions, and sends commands. The spinal cord acts as a highway, carrying messages between the brain and the rest of the body.
what does the PNS do ?
It connects the CNS to the rest of your body and sends signals to and from it.
how does the PNS function ?
It’s like a network of wires that links your limbs, organs, and muscles to the CNS.
between the CNS and PNS, which is the main hub for decision-making and control ?
CNS
between the CNS and PNS, which acts as the communication network that relays information between the brain and your body
PNS
what does the CNS enable ?
high level functions
what can damage to the central nervous system lead to ?
damage can lead to many types of communication disorder
what do the brainstem and spinal cords provide ?
sensory and motor pathways
between body and brain
what can damage to the sensory and motor pathways between body and brain disrupt ?
biological support for speech
what are the main parts of the brain ?
- cerebrum
- cerebellum
- brainstem
give a description of the cerebrum ?
The largest part of the brain, divided into two halves called hemispheres (left and right)
what is the function of the cerebrum ?
Controls thinking, memory, emotions, problem-solving, voluntary movement, and sensory processing.
how many regions of the cerebrum are there ?
- frontal
- parietal
- occipital
- temporal
what part of the brain is “majority of the brain” ?
cerebrum
the cerebrum is divided into what ?
2 hemispheres (the right and the left)
what does the left hemisphere control ?
- controls right side of the body
- tasks linked to language and logic
what does the right hemisphere control ?
- controls left side of the body
- tasks linked to creativity, cognition
where do we find the cerebellum ?
below the cerebrum, behind the brainstem, back of the brain
what is the cerebrum responsible for ?
- Helps coordinate and regulate neural impulses
- Regulates balance, posture, and fine motor movements
describe the frontal lobe :
- Primary motor cortex
- Executive functions
describe the parietal lobe :
- Primary sensory
- Cognitive functions
describe the occipital lobe ?
- visual processing
describe the temporal lobe ?
- Primary auditory cortex
- Language comprehension
where do we locate the frontal lobe ?
Front part of the brain, behind your forehead.
where do we locate the parietal lobe ?
Top middle part of the brain, behind the frontal lobe.
where do we locate the occipital lobe ?
Back part of the brain.
where do we locate the temporal lobe ?
On the sides of the brain, near your ears.
which lobe is responsible for “Handles hearing and memory.” ?
temporal lobe
which lobe is responsible for the following “Responsible for thinking, planning, decision-making, and voluntary movement.” ?
Frontal Lobe
which lobe is responsiblensible for “Processes sensation (touch, temperature, and pain) and spatial awareness.” ?
parietal lobe
which lobe is responsible for the following “Primarily responsible for vision.” ?
Occipital Lobe
how many cortical regions of intrest are there of the CNS ?
- Primary auditory cortex
- Primary motor cortex
- Broca’s area
- Wernicke’s area
where do we find the primary auditory cortex ?
temporal lobe
is the primary auditory cortex unilateral, bilateral, etc ?
bilateral
what does bilateral mean ?
both sides
what does the primary auditory cortex include ?
Heschl’s gyrus ?
what is “heschl’s gyrus” ?
It’s where the brain first processes sounds you hear, making it important for hearing and understanding sounds. (awareness of perception of sound)
where do we find “heschl’s gyrus” ?
small area in the temporal lobe of the brain
what is the first area of cortex to process auditory information ?
heschl’s gyrus
what is the primary motor cortex ?
controls muscles (including for speech)
where is the primary motor cortex located ?
in frontal lobe along precentral gyrus
is the primary motor cortex unilateral, bilateral, etc ?
bilateral
where is the broca’s area located ?
in frontal lobe
what is the broca’s area responsible for ?
Involved in speech
production and expressive
language & speech comprehension
is the Broca’s area unilateral, bilateral, etc ?
unilatral
broca’s area is unilatral in what hemisphere ?
in the left hemisphere for most poeple
what does the left hemisphere control ?
right side of body
what does the right hemisphere control ?
left side of body
what is the left hemisphere responsible for ?
language, logic, math, and analytical thinking.
what is the right hemisphere responsible for ?
creativity, art, music, and spatial awareness
what is the left hemisphere usually called ?
the “logical” or “verbal” side
what is the right hemisphere usually called ?
the “creative” or “visual” side
what is wernicke’s area ?
Involved in language
comprehension & plays a role in language production
where is the wernicke’s area located ?
Temporal lobe, beside
primary auditory cortex
is the wernicke’s area unilateral, bilateral, etc ?
unilateral
wernicke’s area is unilatral in what hemisphere ?
in left hemisphere in most people
what are the two subcortical regions of intrest of the CNS ?
basal ganglia and thalamus
what is the basal ganglia ?
- Involved in movement
- Connected to cerebellum and cortex
what is the thalamus ?
- Relay area between parts of cortex
- Many functions, including motor and sensory
what helps CNS communicate with body ?
peripheral nervous system
what are the main parts of the PNS ?
cranial nerves & spinal nerves
how do the cranial nerves work :
enter/exit brain and brainstem
how many pairs of cranial nerves are there ?
12
how many pairs of spinal nerves are there ?
31
how do the spinal nerves work :
enter/exit sinal cord
what are some examples of high-level functions that the brain enables in the CNS ?
thinking, learning, speech, language
which hemisphere is “creativity” side ?
right hemisphere
which hemisphere is the “logical” side ?
left hemisphere
what lobe of the cerebrum are responsile for growth/fine motor movement and pragmatics/understanding ?
frontal lobe
what lobe of the cerebrum is the houses the region of brain that hearing goes to first ?
temporal
in the primary motor cortex, which parts of the body require more precise and fine motor control have more space dedicated to them, therefore more space designated to them ?
- Hands and Fingers: Have a large area because of the need for precise, complex movements.
- Face and Mouth: Also take up significant space to control facial expressions and speech.
in contrast to the hands/fingers and face/mouth what parts of the body take up less space on the primary motor cortex ?
areas like the torso or legs take up less space because they involve larger, less detailed movements
what is the motor homunculus ?
is like a funny map of the human body that shows how much space each body part takes up in the primary motor cortex of the brain, which controls movement
most expressive language/primary role is in what area ?
predominantly the broca’s aphasia
what is the main role of the basal ganglia ?
to support movements ans sequence fuctioning
what is the main role of the thalamus ?
central moditor and coordinator of tasks related to speech and language
how many cranial nerves are there ?
12
what are the cranial nerves we focus on in class ?
- cranial nerve 5
- cranial nerve 7
- cranial nerve 8
- cranial nerve 9
- cranial nerve 10
- cranial nerve 11
- cranial nerve 12
what is cranial nerve 5 ?
trigeminal - facial sensation and chewing (face and jaw movements)
what is cranial nerve 7 ?
facial - facial expression and taste
what is cranial nerve 8 ?
auditory - balance and hearing
what is cranial nerve 9 ?
glossopharyngeal - taste and salvations (speech production and feed)
what is cranial nerve 10 ?
vagus - swallowing and talking & taste and respiration (diagram and breathing)
what is cranial nerve 11 ?
accessory - pharynx/larynx muscles & neck and shoulder movement (muscles for swallowing)
which cranial nerve is responsible for taste, salivation, speech production and feed) ?
glossopharyngeal nerve 9
which cranial nerve is responsible for facial sensation, chewing, face and jaw movement ?
trigeminal nerve 5
which cranial nerve is responsible for balance and hearing ?
auditory nerve 8
which cranial nerve is responsible for facial expression and taste ?
facial nerve 7
which cranial nerve is responsible for pharynx/larynx muscles, neck and shoulder movement ?
accessory nerve 11
which cranial nerve is responsible for swallowing, taste, talking and respiration ?
vagus nerve 10
which cranial nerve is responsible for tongue moevement ?
hypoglossal nerve 12
“sensory” is ascending or descending nerve tract ?
ascending
“motor” is ascending or descending nerve tract ?
descending
within the spinal nerves what are the two nerve tracts ?
ascending and descending nerve tracts
what is the ascending nerve tract ?
Carry sensory information from the body up to the brain.
what is the descending nerve tract ?
Carry motor commands from the brain down to the body.
describe the parts of the body of the “sensory” of the ascending nerve tract ?
from glands, tissues, joints, etc.
describe the parts of the body of the “motor” of the descending nerve tract ?
innervate muscles of chest, abdomen, limbs
what plain of the body is the ascending nerve tract ?
posterior (exit back portion of spinal cord)
what plain of the body is the descending nerve tract ?
anterior (exit back portion of spinal cord)
neurogenic communication disorders are usually brain-based, acquired disorders, what are the 3 types ?
- Acquired motor speech disorders
– Dysarthria
– Apraxia - Acquired language disorders
– Aphasia - Cognitive-communication disorders
in the Distribution of Neurogenic
Communication Disorders; what is the biggest percentage ?
dysarthria
in the Distribution of Neurogenic
Communication Disorders; what is the second biggest percentage ?
28%
in the Distribution of Neurogenic
Communication Disorders; what is the smallest percentage ?
apraxia
which neurogenic communication disorders are neurogenic language ?
cognitive-communication, aphasia and other
which neurogenic communication disorders are neurogenic speech ?
dysarthria and aphraxia
what type of neurogenic communication disorder is dysarthria ?
acquired motor speech disorder
what type of neurogenic communication disorder is apraxia ?
acquired motor speech disorder
what is dysarthria ?
is when the muscles used for speaking are weak or not controlled well, causing slurred or slow speech
what is dysarthria caused by ?
weakness, paralysis, slowness, or incoordination of muscles responsible for speech
TRUE OR FALSE
dysarthria may also have involuntary movements or alterations in muscle tone
TRUE
what is the impairment caused with dysarthria ?
impairment in speed, force, range, direction, or timing of motor control for speech
what are some common causes of dysarthria ?
stroke, Parkinson’s Huntington’s,
ALS, cerebellar disease
different types of dysarthria are based on what ?
based on lesion location within
CNS/PNS
how many major types of dysarthria ?
6
what are the 6 major types of dysarthria ?
1) hyperkinetic
2) hypokinetic (parkinson’s)
3) spastic
4) flaccid
5) ataxic
6) mixed
what neural system is involved with “hyperkinetic” ?
basal ganglia
what neural system is involved with “hypokinetic (parkinson’s) ?
basal ganglia (substantia nigra)
what neural system is involved with “spastic” ?
brain/brainstem motor neurons
what neural system is involved with “flaccid” ?
cranial nerves
what neural system is involved with “ataxic”?
cerebellum
what neural system is involved with “mixed” ?
≥ 2 nervous system components
what are the two types of hyperkinetic dysarthrias ?
chorea and oromandibular dystonia
what is chorea ?
is when the body makes sudden, unpredictable, arrhythmic involuntary movements that you can’t control.
what are some common causes of hyperkinetic dysarthria ?
Huntington’s disease, stroke,
HIV infection
what are some disyinctive speech characteristics of hyperkinetic dysarthria ?
variable speech rate, excess loudness variation, rapid and unpredictable consonant and vowel distortions
TRUE OR FALSE
hyperkinetic dysarthria has several subtypes ?
TRUE
hyperkinetic is wat type of movements ?
involuntary movements
what is oromandibular dystonia ?
is when the muscles in the face, mouth, or jaw tighten or spasm, slow, systained involuntary movements and spams of face, lips, tongue, and velum, making it hard to speak or chew
what are some common causes of oromandibular dystonia ?
unknown (idiopathic), drugs,
head trauma
what are some distinctive speech characteristics of oromandibular dystonia ?
voice stoppages, voice tremor, prolonged consonant and vowel distortion
what are some subtypes of hyperkinetic dysarthrias ?
- Spasmodic Dysphonia
- Essential Voice Tremor
what is Essential Voice Tremor ?
Rhythmic tremor in voice intensity or voice pitch, regular voice stoppages
what causes Essential Voice Tremor ?
Unknown, 30% have family history
what is Spasmodic Dysphonia ?
Strained, effortful phonation or irregular voice stoppage due to hyperadduction or hyperabduction of vocal folds
what causes spasmodic dysphonia ?
unknown
what is hypokinetic dysarthria ?
reduced movement in the muscles needed for speech. This causes speech to sound quiet, mumbled, or monotone, and the person may speak very slowly or quickly with rushed speech. (reduced ability to move, rigidity, reduced range of motion and slowness)
what is the most common cause of hypokinetic dysarthria ?
Parkinson’s disease and
related Parkinson-like disorders
what is a type of speech disorder often linked to Parkinson’s disease ?
Hypokinetic Dysarthria
what are distinctive speech characteristics of hypkinetic dysarthria ?
- Hypophonia (soft speech)
- Imprecise consonant articulation
- Short rushes and rapid rate of speech
- Monotone pitch and monoloudness
what is Spastic Dysarthria ?
is a speech disorder caused by increased tone (stiffness, tightness) in muscles with reduced fine motor control, weakness and slowness of movement due to damage in the brain. This makes speech sound slow, strained, and effortful, with a harsh or hoarse voice
what are some common causes of spastic dysarthria ?
stroke, ALS, TBI, MS
what are distinctive speech characteristics ?
- Slow rate
- Low pitch
- Harsh and strained-strangled vocal quality
- Imprecise production and distortion of consonants and vowels
what is flaccid dysarthria ?
is a speech disorder caused by weak or floppy muscles due to damage to the nerves that control them. This weakness can make speech sound slurred, breathy, or soft, and it may affect pronunciation and voice quality. (muscle weakness, reduced muscle tone)
what are some common causes of flaccid dysarthria ?
trauma, neurosurgery,
ALS, muscular dystrophy, tumour, stroke
what are some distinctive speech characteristics of flaccid dysarthria ?
- Hypernasality
- Breathiness
- Nasal emission
- Audible inspiration
what is ataxic dysarthria ?
Impaired coordination of movement
what are some common causes of ataxic dysarthria ?
stroke, TBI, MS, brain, tumours
what are some distinctive speech characteristics of ataxic dysarthria ?
– Sounds “slurred,” “intoxicated”
– Imprecise consonant and vowel production
– Irregular breakdown in articulation accuracy
– Excess and equal stress (metering out syllables)
what is mixed dysarthria ?
is a speech disorder that involves a combination of two or more types of dysarthria. It occurs when damage affects multiple parts of the nervous system, leading to different muscle problems like weakness, stiffness, or uncoordinated movement
how can mixed dysarthria make speech sound ?
varied, with characteristics such as slurred, strained, or breathy speech, depending on which types are combined
what is the most common dysarthria type ?
mixed dysarthria
in simplest way, what is mixed dysarthria ?
two or more pure dysarthria types
how many types of dysarthria are there ?
6
what are the causes of mixed dysarthria ?
– More diffuse damage than other dysarthrias
– Commonly associated with degenerative disorders (e.g., ALS, MS)
* E.g., ALS commonly presents with spastic-flaccid
dysarthria
what are the 6 types of dysarthria ?
1) Hyperkinetic
2) Hypokinetic
3) Spastic
4) Flaccid
5) Ataxic
6) Mixed
hyperkinetic dysarthria means damage to the …
basil ganglia
spastic dysarthria means damage to the …
motor neurons
hypokinetic dysarthria means damage to the …
basal ganglia
flaccid dysarthria means damage to the …
cranial nerves
ataxic dysarthria means damage to the …
cerebellum
mixed dysarthria means damage to the …
combination of structures
what are the motor difficulties linked to hyperkinetic dysarthria?
Involuntary movements (e.g.,
tics, chorea), variable prosody,
voice breaks
what are the motor difficulties linked to hypokinetic dysarthria ?
Reduced range of motion, rigidity, slowness
what are the motor difficulties linked to spastic dysarthria ?
Muscle stiffness (spasticity), reduced range of motion, slow speech
what are the motor difficulties linked to flaccid dysarthria ?
Muscle weakness, reduced tone, nasal speech, reduced volume
what are the motor difficulties linked to ataxic dysarthria ?
Lack of coordination, irregular rhythm and rate, errors in timin
what are the motor difficulties linked to mixed dysarthria ?
Varies based on the specific combination of damaged areas
what are some speech characteristics linked to hyperkinetic dysarthria ?
Irregular bursts of speech, variable loudness, tremor-like voice
what are some speech characteristics linked to hypokinetic dysarthria ?
Monotone, fast rate, reduced volume, imprecise articulation
what are some speech characteristics linked to spastic dysarthria?
Harsh, strained, and slow speech; tight voice
what are some speech characteristics linked to flaccid dysarthria?
Breathy, weak, hypernasal speech with slow rate
what are some speech characteristics linked to ataxic dysarthria ?
Irregular and imprecise articulation, drunken-sounding speech
what are some speech characteristics linked to mixed dysarthria ?
combination of features
what is apraxia ?
Acquired neurological impairment in motor speech planning and programming that leads to the inability to voluntarily select and program skilled motor movements for speech
what is apraxia unrelated to ?
weakness, slowness, paralysis
what are some speech characteristic s of apraxia ?
- Groping attempts and great variability
- Repeated attempts to correct errors
- Complex, long words are difficult
in regards to distribution of acquired motor speech disorders, which type has the largest percentage ?
mixed 27%
in regards to distribution of acquired motor speech disorders, which type has the least percentage ?
anarthria 2%
