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Cognitive Communication Disorders & Motor Speech Disorders > Motor: exam 1 > Flashcards

Motor: exam 1 Flashcards

1
Q

What is a motor speech disorder according to Dr. Fleck?

A

different diagnosis that have to do with neuro muscle control

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2
Q

What is a motor speech disorder according to the book?

A

Speech disorders resulting from neurologic impairments affecting: planning, programming, control, or execution of speech.

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3
Q

Speech disorder resulting from neurological impairments affect: __________, __________, ________, or _______ _________

A

planning, programming, control, or execution of speech

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4
Q

Motor speech disorders include what?

A

Dysarthiras and apraxia of speech

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5
Q

What is a group of neurologic speech disorders that reflect abnormalities in: strength, speed, range, steadiness, tone or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production?

A

Dysarthrias

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6
Q

Dysarthrias is a group of speech disorders that reflect abnormalities in what?

A

strength, speed, range, steadiness, tone or accuracy of movements

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7
Q

What is the definition of dysarthria (according to Mayo clinic)?

A

occurs when the muscles you use for speech are weak or you have difficulty controlling them.

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8
Q

Name three things that describes dysarthria

  1. Dysarthria is:
  2. Dysarthria is:
  3. Dysarthria is:
A
  1. neurologic in nature
  2. a disorder of movement
  3. categorized into different types
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9
Q

What is a neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that results in phonetically and prosodically normal speech?

A

apraxia of speech

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10
Q

T/F: Apraxia of speech is when the brain struggles to develop plans for speech movements. Muscles are NOT weak, but DO NOT perform normally normally-the brain has difficulty coordinating the movements. (Mayo Clinic)

A

True

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11
Q

T/F: Apraxia is well researched outside of speech pathology.

A

False, it is ignored outside speech pathology literature and is often buried within categories of aphasia or the generic heading dysarthria.

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12
Q

Motor speech exam, description: The description characterizes the features of _______ and _______ related to speech.

A

structures; functions

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13
Q

T/F: Motor speech exam: the description is obtained from the patient’s history and description of the problem, oral mechanism examination, perceptual characteristics of speech , and results of standard clinical and instrumental tests?

A

True

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14
Q

Motor speech exam: Once the speech has been described the clinician decides if speech is _______ or __________.

A

normal; abnormal

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15
Q

What is the first step in a differential diagnosis?

A

The description

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16
Q

What part of the motor speech exam asks the following questions:

  • Is the problem neurologic?
  • If the problem is NOT neurologic, is it organic?
  • If the problem IS or is NOT neurologic, is it recently acquired or long standing?
  • If the problem is neurolgic, is it an MSD or some other neurologic communication disorder? If an MDS is present, it is dysarthria or apraxia of speech?
  • If dysarthria is present, what type is it?
A

Establishing diagnostic possibilities

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17
Q

When establishing a diagnosis, as diagnosis can be confirmed or eliminated based on the __________________. (three words)

A

site of lesion

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18
Q

Establishing diagnosis: What happens once reasonable diagnostic possibilities have been recognized?

A

A single diagnosis may emerge or at least a list of possibilities from most likely to least likely.

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19
Q

When establishing implications of localization and disease diagnosis, what should SLPs do?

A

SLPs should address explicitly the implications for localization.

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20
Q

Establishing implications of localization and disease diagnosis:

SLPs need to address the compatibility of the speech diagnosis with the neurologic diagnosis.

  1. If spastic dysarthria is the diagnosis, is it appropriate to say it is usually associated with bilateral upper motor neuron (UMN) involvement?
  2. If the diagnosis is Parkinson’s disease but the patient has mixed spastic-ataxia dysarthra, is it appropriate to say mixed dysarthria is compatible with Parkinson’s disease?
A
  1. yes

2. no, mixed dysarthria is NOT compatible with Parkinson’s disease.

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21
Q

T/F: When specifying severity of an MSD the severity should be exact.

A

False: the severity of the MSD should be estimated.

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22
Q

Cranial Nerve (CN) V is called ________

a. Trigeminal
b. Facial
c. Glossopharyngeal
d. Vagus

A

a. Trigeminal

* hint Trigeminal =(T) 5 =(V) -> TV

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23
Q

Cranial Nerve (CN) VII is called ________

a. Trigeminal
b. Facial
c. Glossopharyngeal
d. Vagus

A

b. Facial

* hint Seven (VII) facial features… 2 eyes, 2 ears, 2 nostrils, 1 mouth=7

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24
Q

Cranial Nerve (CN) IX is called ________

a. Trigeminal
b. Vagus
c. Glossopharyngeal
d. Facial

A

c. Glossopharyngeal

* hint

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25
Q

Cranial Nerve (CN) X is called ________

a. Facial
b. Trigeminal
c. Glossopharyngeal
d. Vagus

A

d. Vagus

* hint people think Vegas is 10/10

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26
Q

Examination:

What are the 6 features of neuromuscular activity that influences speech production? (Hint: *****)

A 
STARS:
S trength
T one
A ccuracy
R ange of motion 
S peed of movement
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27
Q

Cranial Nerve (CN) XII is called ________

a. Facial
b. Vagus
c. Trigeminal
d. Hypoglossal

A

d. Hypoglossal

* hint 11 (letters) + 1= XII

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28
Q

Trigeminal is which Cranial Nerve?

A

V

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29
Q

Facial is which is which Cranial Nerve?

A

VII

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30
Q

Glossopharyngeal is which Cranial Nerve?

A

IX

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31
Q

Vagus is which Cranial Nerve?

A

X

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32
Q

Accessory is which Cranial Nerve?

A

XI

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33
Q

Hypoglossal is which Cranial Nerve?

A

XII

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34
Q

lower motor neuron (final common pathway, motor unit) describes the localization of which type of dysarthria?

A

flaccid

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35
Q

bilateral upper motor neuron (direct and indirect activation pathway) describes the localization of which type of dysarthria?

A

spastic

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36
Q

Describe the localization of ataxic dysarthria.

A

cerebellum (cerebellar control circuit)

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37
Q

The basal ganglia control circuit (extrapyramidal) describes the localization for which (2) types of dysarthria?

A

Hypokinetic and hyperkinetic

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38
Q

If an individual has lesions in the cerebellum and in the lower motor neuron, what type of dysarthria does that describe?

A

Mixed dysarthria

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39
Q

Trigeminal nerve: LMN (or FCP) lesions of the masticatory nucleus or is axons lead to paresis or ____ and eventual atrophy of masticatory muscles on the paralyzed side.

A

Paralysis

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40
Q

T/F: The unilateral upper motor neuron is lateralized in the unilateral lower motor neuron.

A

False; unilateral upper neuron

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41
Q

Which type(s) of dysarthria have an execution neuromotor base?

A

Flaccid, spastic

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42
Q

Which type(s) of dysarthria have a control neuromotor base?

A

Ataxic, hypokinetic, hyperkinetic

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43
Q

The unilateral upper motor neuron has what type of neuromotor base?

A

execution/control

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44
Q

A mixed dysarthria has what type of neuromotor base?

A

execution and/or control

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45
Q

Glossopharyngeal nerve: Speech related motor supply to the stylopharyngeus and upper constrictor muscles of the ____, tongue, and eustachian tube.

A

Pharynx

*hint: glossoPHARYNGEAL - pharynx

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46
Q

What is the neurologic (specific) for flaccid dysarthria?

A

weakness

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47
Q

What is the neurologic (specific) for spastic dysarthria?

A

spasticity

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48
Q

What is the neurologic (specific) for ataxic dysarthria?

A

incoordination

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49
Q

What is the neurologic (specific) for hypokinetic dysarthria?

A

rigidity; reduced range of movement; scaling problems

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50
Q

What is the neurologic (specific) for hyperkinetic dysarthria?

A

involuntary movements

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51
Q

What is the neurologic (specific) for unilateral upper motor neuron?

A

Upper motor neuron weakness incoordination, or spasticity

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52
Q

What is the neurologic (specific) for Apraxia of Speech?

A

planning/programming errors

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53
Q

T/F: The manifestations of an undetermined dysarthria is typical, precise, and easy to diagnose.

A

False; they can be sufficiently subtle, complicated or unusual

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54
Q

The paired trigeminal nerve is the ____ (size) of the cranial nerves.

A

Largest

*hint CN V - smallest number (V/5), largest nerve

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55
Q

The trigeminal nerve sensory functions include transmission of ___.

A

Pain

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56
Q

Trigeminal nerve motor components are responsible for innervating the ____ of mastication and the mylohyoid, anterior belly of the digastric, tensor tympani, and tensor veli palatini muscles.

A

Muscles

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57
Q

The trigeminal nerve is divided into ophthalmic, maxillary, and ____ branches

A

Mandibular

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58
Q

Final Common Pathway (FCP) is also commonly referred to as ____.

A

LMN

*hint FCP, LMNop

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59
Q

LMN (or FCP) lesions of the masticatory nucleus or is axons lead to paresis or ____ and eventual atrophy of masticatory muscles on the paralyzed side.

A

Paralysis

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60
Q

The paired facial nerve is a mixed ___ and ____ nerve.

A

Motor and sensory

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61
Q

Facial nerve: Its motor component supplies the muscles of ____ expression and stapedius muscle.

A

Facial

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62
Q

Facial nerve: Its sensory components innervate the submandibular, sublingual, and lacrimal glands, as well as ____ receptors on the anterior two-thirds of the tongue and nasopharynx.

A

Taste

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63
Q

Facial nerve: LMN lesions can ____ or paralyze muscles on the entire ipsilateral side of the face.

A

Weaken

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64
Q

Glossopharyngeal nerve is a mixed motor and ____ nerve.

A

Sensory

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65
Q

Glossopharyngeal nerve: Speech related motor supply to the stylopharyngeus and upper constrictor muscles of the ____, tongue, and eustachian tube.

A

Pharynx

*hint: glossoPHARYNGEAL - pharynx

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66
Q

EXAMINATION:

Three Essential procedural components of a examination

A

H istory
I dentification of salient speech features (ID’S)
I identification of confirmatory signs (IDCS)

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67
Q

EXAMINATION:

History of Formal Examination confirms?

A

Documentation, Refines, and sometimes revises the diagnosis

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68
Q 
EXAMINATION:
What does the history reveal of an examination?
a) time course of complaints
b) neuromuscular activity 
c) observations about disorders
d) Contextual speech displayed or observed
e) all above
f) A, C, D
A

F) time course of complanints, observation about disorders, contextual speech displayed or obsered

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69
Q

EXAMINATION:

Salient features contribute most ______ and ________ to a _________

A

directly, influentially, diagnosis

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70
Q

Examination:

What are the 6 features of neuromuscular activity that influences speech production? (Hint: ***)

A 
STARS:
S trength
T one
A ccuracy
R ange of motion 
S peed of movement
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71
Q

Confirmatory Signs: What diagnosis does NOT require confirmatory signs?

A

MSD

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72
Q

Confirmatory Signs: T/F they are signs other than deviant speech characteristics?

A

TRUE

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73
Q

Confirmatory Signs: They are additonal clues about___________ or _____ factors.

A

lesion locus OR underlying neurophathophysiologic factors

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74
Q

Confirmatory Signs:

Signs may ____ have ____ causal or _____ relationships with _______

A

NOT, DIRECT, EXPLANATORY with MSD

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75
Q 
Confirmatory Signs:
Confirmatory speech system signs does NOT include:
gait
atrophy
Reduced tone
Fasciculations
poor inhibited laughter or crying
presence of pahtologic oral reflexes
A

GAIT (this is NONSPEECH motory system signs

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76
Q 
Confimatory Signs
IF rooting reflexes comes back, there may be\_\_\_\_
a) nothing wrong
b) neurological condition
c) functional disorder 
d) b and c
A

B) Neurological condition

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77
Q

Name the top 5 common neurological conditions

A

headache, stroke, seizure, Parkinsons, and dementia

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78
Q

Confirmatory Signs:

What is Limb atrophy?

A

muscles waste away

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79
Q

Confirmatory Signs:
Gait, muscles stretch reflex, superficial and pathological reflexes, hyperactive limb reflexes, limb atrophy, and difficulty initiating limbs movements = ________

A

Confimatory NONSPEECH motor system signs

80
Q

Confimatory Signs include two signs; name them

A

SPEECH SYSTEMS SIGNS

NONSPEECH MOTOR SYSTEM SIGNS

81
Q

Confirmatory Signs:

Name 3 nonspeech motory system sign

A

Gait, muscles stretch reflex, superficial and pathological reflexes, hyperactive limb reflexes, limb atrophy, and difficulty initiating limbs movements

82
Q

EXAMINATION: Why would you review the case history with client and/or caretakers?

A

confirm or varify information is correct or if anything else needs to be added.

83
Q

Confirmatory signs can be manifest in ?

A

speech or nonspeech muscles

84
Q

Glossopharyngeal nerve: Effects of lesions are ______ to isolate because such lesions usually also damage the vagus nerve.

85
Q

Glossopharyngeal nerve: Damage to the nerve is most predictably associated with reduced pharyngeal sensation, gag reflex, and reduced pharyngeal elevation during _____.

A

Swallowing

86
Q

Glossopharyngeal nerve lesion may lead to: Glossopharyngeal neuralgia, paroxysmal radiating ____ pain of unknown cause, triggered by swallowing or tongue protrusion.

87
Q

Vagus Nerve: Complex and lengthy ____ motor and sensory nerve.

88
Q

Vagus Nerve branches include: Pharyngeal branch, Superior Laryngeal nerve branch, and recurrent _____ branch.

89
Q

Vagus Nerve: Effects of vagus nerve lesions depend on the particular _____ of the nerve that has been damaged.

90
Q

Vagus Nerve: Damage to all of its branches produces _____ of the soft palate, pharynx, and larynx.

91
Q

Vagus Nerve: Unilateral LMN lesions can affect resonance, voice quality, and _____ but usually affect _____ more prominently than resonance.

A

Swallowing; Phonantion

92
Q

Accessory Nerve: Can also be called the ____ accessory nerve

93
Q

Accessory Nerve: Lesions in the region of the foramen magnum or in the region of the jugular foramen can weaken ____ rotation toward the side ____ the lesion.

A

Head; Opposite

94
Q

Accessory Nerve: Lesions in the region of the foramen magnum or in the region of the jugular foramen can also reduce the ability to ____ (or shrug) the shoulder on the ___ of the lesion

A

Elevate; Side

95
Q

Hypoglossal Nerve: Is a ____ nerve.

96
Q

Hypoglossal Nerve: The hypoglossal muscle receives ___ and tactile information.

97
Q

Hypoglossal Nerve: Damage to the hypoglossal nucleus or its axons can lead to ____, weakness, and fasciculations of the _____ to deviate to the side of the lesion when protruded.

A

Atrophy; Tongue

98
Q

Lower Motor Neuron
Origin: ______ and spinal cord

Destination:
______

A

Brainstem; Muscle

99
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function: Produce _____ actions for ____ and muscle tone

A

Muscle; Reflexes

100
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out ____ _____ _____ (UMN) commands for _____ movements and postural adjustments

A

Upper Motor Neuron; Voluntary

101
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out upper motor neuron (UMN) commands for voluntary movements and postural adjustments

Distinctive Signs of Lesions:
______ of all movements (voluntary and ____)

A

Weakness; Automatic

102
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out upper motor neuron (UMN) commands for voluntary movements and postural adjustments

Distinctive Signs of Lesions:
Weakness of all movements (voluntary and automatic)
Diminished ______
_____ muscle tone

A

Reflexes; Decreased

103
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out upper motor neuron (UMN) commands for voluntary movements and postural adjustments

Distinctive Signs of Lesions:
Weakness of all movements (voluntary and automatic)
Diminished reflexes
Decreased muscle tone
\_\_\_\_\_\_
104
Q

Lower Motor Neuron
Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out upper motor neuron (UMN) commands for voluntary movements and postural adjustments

Distinctive Signs of Lesions:
Weakness of all movements (voluntary and automatic)
Diminished reflexes
Decreased muscle tone
Atrophy
\_\_\_\_\_\_\_\_\_
A

Fasciculations

105
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
______ ______

A

Cerebral Cortex

106
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
____ and ____ nerve nuclei

A

Cranial; Spinal

107
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct _____, skilled movements

108
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
_____ and loss of skilled movement/dexterity

109
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
Weakness and loss of skilled movement/dexterity
Hypore____

A

HyporeFLEXIA

110
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
Weakness and loss of skilled movement/dexterity
Hyporeflexia
Decreased ______ tone

111
Q

Upper Motor Neuron
DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
Weakness and loss of skilled movement/dexterity
Hyporeflexia
Decreased muscle tone
\_\_\_\_\_ sign
112
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
______ ______

A

Cerebral Cortex

113
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
______ and _____ nerve nuclei

A

Cranial; Spinal

114
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control ____, tone, and movements supportive of ______ movement

A

Posture; Voluntary

115
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
______ (and weakness)

A

Spasticity

116
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
______

117
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
Clonus
_______ stretch reflexes

A

Hyperactive

118
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
Clonus
Hyperactive stretch reflexes
\_\_\_\_\_ muscle tone
119
Q

Upper Motor Neuron
INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
Clonus
Hyperactive stretch reflexes
Increased muscle tone
Decorticate or decerebrate \_\_\_\_\_
120
Q

->Lower Motor Neuron or Upper Motor Neuron?

Origin:
Brainstem and spinal cord

Destination:
Muscle

Function:
Produce muscle actions for reflexes and muscle tone
Carry out upper motor neuron (UMN) commands for voluntary movements and postural adjustments

Distinctive Signs of Lesions:
Weakness of all movements (voluntary and automatic)
Diminished reflexes
Decreased muscle tone
Atrophy
Fasciculations
A

Lower Motor Neuron

121
Q

->Lower Motor Neuron or Upper Motor Neuron?

DIRECT Activation Pathway
Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
Weakness and loss of skilled movement/dexterity
Hyporeflexia
Decreased muscle tone
Babinski sign
A

Upper Motor Neuron

122
Q

->Lower Motor Neuron or Upper Motor Neuron?

INdirect Activation Pathway
Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
Clonus
Hyperactive stretch reflexes
Increased muscle tone
Decorticate or decerebrate posture
A

Upper Motor Neuron

123
Q

Upper Motor Neuron
-> Direct or Indirect Activation Pathway?

Origin:
Cerebral cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Direct voluntary, skilled movements

Distinctive Signs of Lesions:
Weakness and loss of skilled movement/dexterity
Hyporeflexia
Decreased muscle tone
Babinski sign
124
Q

Upper Motor Neuron
-> Direct or Indirect Activation Pathway?

Origin:
Cerebral Cortex

Destination:
Cranial and spinal nerve nuclei

Function:
Control posture, tone, and movements supportive of voluntary movement

Distinctive Signs of Lesions:
Spasticity (and weakness)
Clonus
Hyperactive stretch reflexes
Increased muscle tone
Decorticate or decerebrate posture
125
Q

The basic functions of the final common pathway are to:

A

Stimulate muscle contraction and movement. Other motor divisions must act through it to influence movement

126
Q

The basic functions of the direct activation pathway are to:

A

Influence consciously controlled, skilled voluntary movement

127
Q

The basic functions of the indirect activation pathway are to:

A

Mediate subconscious, automatic muscle activities including posture, muscle tone, and movements that support and accompany voluntary movement

128
Q

The basic functions of the control circuits are:

A

Integration or coordination of sensory information and activities of direct and indirect activation pathways to control movement

129
Q

The basic functions of the Basal ganglia are to:

A

Plan and program postural and supportive components of motor activity

130
Q

The basic functions of the Cerebellar are to:

A

Integrate and coordinate execution of smooth, directed movements

131
Q

What does the cerebellar control circuit consist of?

A

cerebellum and its connections.

132
Q

What are the two components of the cerebellum?

A

flocculonodular lobe and the body of the cerebellum

133
Q

What connections does the flocculonodular lobe have?

A

primary connections to the vestibular mechanism

134
Q

What does the flocculonodular do?

A

modulates equilibrium and the orientation of the head and eyes. Primary function is control of eye movement.

135
Q

The body of the cerebellum includes what?

A

midportion or vermis

lateral cerebellar hemispheres (subdevided into anterior and posterior lobes)

136
Q

______ lobe is a projection area for spinocerebellar proprioceptive information. It regulates posture, gait, and truncal tone

137
Q

The ______ cerebellar hemispheres in the posterior lobe are particularly important for coordinating skilled, sequential voluntary muscle activity.

138
Q

_________ organization , including speech structures, is evident in portions of the anterior and posterior lobes

A

Somatotopic

139
Q

Each _____ hemisphere is connected to the contralateral thalamus and _____ hemisphere, and each helps control movements on the ipsilateral side of the body

A

cerebellar

cerebral

140
Q

The fiber tracts enter or leave the cerebellum through what three structures?

A

inferior, middle, and superior cerebellar peduncles

141
Q

What are the output neurons of the cerebellar cortex?

A

Purkinje cells

142
Q

Where do the purkinje cell axons synapse?

A

In the deep cerebellar nuclei,

143
Q

Why are the dentate nucleus important for speech control?

A

seems to be active in initiating movement, executing preplanned motor tasks, and regulating posture.

144
Q

Damage to dentate nucleus has been associated with what dysarthria?

A

persisting dysarthria

145
Q

When focal lesions produce dysarthria what areas are often implicated?

A

lateral hemispheres and paravermal or posteromedial areas

146
Q

Functional neuroimaging during covert speech tasks demonstrates activation of the ____ portions of the ____ cerebellar hemisphere.

A

superior

right

147
Q

Overt speech production is associated with _____, inferior cerebellar hemisphere activation and connections with the motor cortex, ____, and ________.

A

bilateria
basal ganglia
thalamus

148
Q

cerebellar pathways for speech include:

A

reciprocal connections with cerebral cortex;
reciprocal connections with brainstem ;
cooperative activity with the basal ganglia control circuit;
auditory and proprioceptive feedback from speech muscles, tendons, and joints

149
Q

What is the function of the cerebellar control circuit?

A

help coordinate timing among components of movement, scale the magnitude of muscle action, and coordinate the sequence of agonist and antagonistic muscle activity

150
Q

What is the cerebellum’s probable general role in speech?

A

receives advance notice about the syllabic content of an utterance from the cortex so that it refines the temporal and prosodic properties of its physical expression and be prepared to check the adequacy of the outcome based on auditory and other feedback from speech muscles, tendons, and joints.

151
Q

Flocculonodular lesions are associated with:

A

truncal ataxia, gait disturbances, nystagmus, and ocular movement abnormalities

152
Q

Lesion of the _______ ______ are associated with gait ataxia

A

caudal vermis

153
Q

Lesions in the _____ and ______ cerebellar hemispheres are associated with intention tremor and incoordination of voluntary movements.

A

lateral

paravermal

154
Q

Incoordination of voluntary movements is reflected in: _____, _______, _______. These lesions affect limb movements and can lead to dysarthria.

A

dysmetria, dyssynergy, dysdiodokinesia.

155
Q

The effects on speech of cerebellar or cerebellar pathway lesions can be attributed to incoordination and, possibly, hypotonia. They are classified as ______ dysarthria.

156
Q

The core gray matter structures of the basal ganglia include the _____ and ____

A

striatum

GPi

157
Q

What is lentiform nucleus?

A

putamen and GPi

158
Q

What does the basal ganglia circuitry include?

A

gray matter structures, bidirectional inhibitory and excitatory connecting pathways, several crucial neurotransmitters

159
Q

What is the primary receptive portion of the basal ganglia and what does it receive?

A

striatum (putamen), receives major excitatory input

160
Q

What are the functions of the basal ganglia circuitry?

A

opening the gates to intended movements, closing the gates to competing or unwanted movements, preventing “locking up” of movement.

In addition, posture and tone regulation, movement scaling, set switching, movement selection and learning.

161
Q

basal ganglia control circuit dysfunction on movement can be manifested in what two general ways?

A
  1. reduced mobility or (hypokinesia)

2. Involuntary movements (hyperkinesia)

162
Q

______ is often associated with disease of the SN

A

Hypokinesia

163
Q

What results in a deficiency of dopamine in the basal ganglia; resulting in rigidity?

A

hypokinesia

164
Q

Hypokinetic-rigid syndromes result from what?

A

loss of dopaminergic neurons in the SN, drugs that block dopamine receptors, and certain toxins

165
Q

Hyperkinesia results from what?

A

excessive activity in dopaminergic nerve fibers. results in involuntary movements

166
Q

Lesions of the motor components of the basal ganglia generally produce _____ profound dysarthria than lesions of the cortical components of the control circuit

167
Q

The supratentorial consists of what?

A

Hemispheres, lobes, basal ganglia, thalamus, cranial nerves I & II

168
Q

What is the posterior Fossa?

A

Brainstem (Pons, medulla, midbrain, cerebelllum)

169
Q

Peripheral consists of what?

A

Cranial and Spinal nerves

170
Q

Spinal Column has what sections?

A

Cervical (7), Thoracic(12), Lumbar(5) (CTL)

171
Q

The visceral system is also called _________.

A

The internal regulation system. It contains afferent and efferent components to maintain homeostasis in the body.

172
Q

Cerebrospinal Fluid System (ventricular System)

A

acts as a cushion to trauma in the CNS and maintain a stable environment for neural activity.

173
Q

The Vascular System provides

A

oxygen and other nutrients to neural structures and removes metabolic waste. - Major locus of abnormalities that can lead to a MSD.

174
Q

Vascular disturbances in the left or right carotid/ left, right, or middle cerebral arteries can produce

A

Dyarthrias

175
Q

Left middle cerebral artery disturbances can cause

A

Apraxia and Aphasia

176
Q

Know the localization of neurologic dieases:

A

1) focal- single area (e.g. left frontal lobe)
2) multifocal- involving more than one area or more than one group of structures (e.g. cerebellar and cerebral hemisphere plaques associated with MS)
3) Diffuse- Roughly symmetric portions (e.g. cerebral atrophy associated with dementia)

177
Q

What are the development of symptoms?

A

acute- within minutes
subacute- within days
chronic-within months

178
Q

Evolution or course of a disease

A

Transient- symptoms completely resolve after onset
Improving- Severity is reduced, but symptoms are not involved
Progressive- Symptoms continue to progress or new symptoms appear
Exacerbating-remitting- Symptoms develop, improve, reoccur, and worsen
Stationary (Chronic)- Symptoms remain unchanged
To Improve Properly Eat Seaweed

179
Q

Inflammatory Diseases

A

Infectious Processes- (e.g. meningitis, encephalitis)

180
Q

Toxic Metabolic Diseases

A

Vitamin deficiencies, thyroid Hormone deficiency, hypoxia, hypoglycemia, and drug toxicity

181
Q

Neoplastic Disease

182
Q

Trauma

A

Gunshot wound, fall, auto injury, blast

183
Q

What is the most common cause of neurologic deficits?

A

Vascular Disease

184
Q

Most common cerebrovascular disease is

A

Stroke aka Infarct aka Cerebrovascular Accident (CVA)

185
Q

Neurons deprived of oxygen and interruption of blood supply

186
Q

What are the two types of onset for MSDs?

A

Congenital/developmental and Acquired

187
Q

A MSD can take one of 5 courses: congenital, _____, _____, improving, and _____-_____.

A

chronic, progressive/degenerative, and exacerbating-remitting

188
Q

Determining the site of a lesion can _____.

A

Predict certain speech deficits

189
Q

7 locations for MSD lesions are:

A
  • neuromuscular junction
  • peripheral & cranial nerves
  • brainstem
  • cerebellum
  • basal ganglia
  • pyramidal or extrapyramidal pathways
  • cerebral cortex
190
Q

There are 6 different categories for neurological diagnosis: degenerative, inflammatory, traumatic, _____-_____, _____, and _____.

A

Toxic-metabolic, neoplastic, and vascular causes

191
Q

T/F: By itself, MSD is usually diagnostic of a particular neurologic cause or disease?

192
Q

What determines the distinctive pattern of speech deficits associated with MSD?

A

Pathophysiology

193
Q

Pathophysiology variable:

Speech components involved …

A

categorized by speech subsystems affected (i.e. breathing, phonation, articulation, or resonance)

194
Q

T/F: Pathophysiology variable:

Severity does Not differentiate among MSDs.

195
Q

Pathophysiology variable: Severity …

A

relevant for treatment/management decisions

196
Q

Pathophysiology variable:

Perceptual characteristics ….

A

crucial to differential diagnosis and management

Cognitive Communication Disorders & Motor Speech Disorders (6 decks)

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