Motor Speech Flashcards
What are the three things that the Neurological process of speech involves?
1) Cognitive- Linguistic Process
2) Motor Speech Programming
3) Neuromuscular Execution
What are the two types of Motor speech disorders?
Dysarthria & Apraxia
What is dysarthria?
Motor speech d/o caused by disturbances of muscular control due to damage in CNS or PNS.
What are the three things that can happen to the speech musculature with Dysarthria?
1) Paralysis
2) Weakness
3) Incoordination
What are the 5 speech subsystems?
1) Respiration
2) Resonance
3) Phonation
4) Prosody
5) Articulation
**RRPPA
What are the 6 types of dysarthria?
1) Flaccid
2) Spastic
3) Ataxic
4) Hypokinetic
5) Hyperkinetic
6) Mixed
What is Apraxia?
Impaired ability to program sensorimotor commands for the positioning & mvmt of muscles for volitional production of speech.
T/F It is more likely for Dysarthria to co-occur with Aphasia than Apraxia.
False- Apraxia is more likely to co-occur w/ Aphasia.
What are the two subsystems of speech that are affected in Apraxia?
1) Articulation
2) Prosody
What articulation errors are present in Apraxia?
1) Inconsistency of errors
2) Difficulty initiating speech.
T/F Prosody is not affected in Apraxia of Speech.
False- Prosody is affected due to starting/stopping when self-correcting.
List the 5 stages in the course of a given dz?
1) Transient
2) Improving
3) Progressive
4) Exacerbating-Remitting
5) Stationary
TIPES
What does it mean when a dz is considered transient?
It means that the symptoms come and go. Ex: Bell’s Palsy.
What is Exacerbating - Remitting?
When symptoms occur, then get better, then occur again, gets worse, then better, etc. Unpredictable.
What is the course of dz for ALS considered?
Progressive aka degenerative.
T/F Tx for dysarthria always depends on the severity and course of dz.
True.
Development of symptoms can be ______, _________, or _________.
Acute (minutes), Subacute (days), or Chronic (months).
T/F Acute means that symptoms appear within the course of days or weeks.
False- comes on quickly within minutes.
What does it mean when the development of symptoms are chronic?
It means it comes on within months.
Most motor speech disorders are associated with which of the following?
a) Acute d/o
b) Subacute d/o
c) Chronic d/o
C) Chronic d/o
The course of motor speech d/o’s depends on __________.
Etiology.
The brain and spinal cord make up the ________.
Central Nervous System (CNS).
What are the three parts of the brain?
Cerebrum, brainstem, cerebellum.
What are the three lobes of the cerebellum?
Anterior, Posterior, Flocculonodular.
The midportion of the cerebellum is also known as what?
Vernis
Which part of the brainstem controls respiration?
a) midbrain
b) pons
c) medulla
c) medulla
What are the four anatomic levels of the CNS?
1) Supratentorial
2) Posterior
3) Spinal
4) Peripheral
SPSP
T/F The nucleus of the Cranial Nerves are inside of the brainstem then exit into axons.
True.
What are fossae?
3 cavities in the base of the skull.
“fossa” = “ditch”
What are foramina?
Holes in fossae where cranial nerves exit the skull.
What makes up the supratentorial level of the CNS?
Anterior & Middle Fossae,
All of the lobes of the Cerebrum,
BG, Thalamus, & Hypothalamus,
CN I & II.
What makes up the posterior level of the CNS?
Posterior Fossa,
Brainstem & Cerebellum,
CN III-XII (3-12 aka all the rest).
Why are the cranial nerves paired and why is that important for speech purposes?
It is protected, one is on the left and one is on the right.
The three layers of meninges that surround the CNS are_________, __________, _________.
1) Dura mater
2) Arachnoid Mater
3) Pia mater
What are the three spaces that surround the meninges?
1) Epidural- b/w skull and dura
2) Subdural- below dura (prone to infection)
3) Subarachnoid- below arachnoidmater (contains CSF)
The ________ space is filled with CSF and is connected to the inner part of the brain via the ventricular system.
Subarachnoid.
What is a nerve?
a group of nerve fibers (axons).
What are the 6 Neurologic Systems?
1) Ventricular system
2) Vascular system
3) Neurochemical system
4) Consciousness system
5) Motor system
6) Sensory System
What is another name for the ventricular system and what does it mainly consist of?
Cerebrospinal system.
Consists of Paired lateral ventricles (in each hemisphere), third ventricle (b/w the 2 thalami), & 4th ventricle.
What structure produces CSF? Where is it found?
Choroid plexus; within the ventricles.
What is the function of the vascular system of the brain?
Provides O2 and nutrients to structures and removes waste.
What structures does the vascular system involve?
Blood vessels, arterial systems (2= aka carotid and vertebral basilar systems). Join into COW @ base of brain.
What does the neurochemical system involve?
Amino acids, ACH, neuropeptides, etc. influences all anatomic levels of nervous system.
What does a motor unit consist of?
An Axon & the muscle fiber that it innervates.
Structures found in the Supratentorial levels and the posterior fossa level are involved in which neurologic system?
Consciousness system- this system is important for maintaining consciousness, awareness, & attention in the environment.
What structures are involved in the Motor system?
BG, cerebellum, CNS/PNS pathways, efferent (exit) connection to the cortex.
The Sensory system includes which structures?
The peripheral receptor organs.
In the PNS, groups of fibers are called ______, whereas in the CNS groups of fibers are called _________.
Nerves; Pathways or Tracts.
Name 3 supporting glial cells & describe them.
1) Oligdendroglia cells- form myelin in CNS.
2) Schwann cells- form myelin in PNS
3) Astrocytes- found in CNS; moves substances b/w blood & neurons. Blood-Brain Barrier (BBB). Keeps toxins out of brain.
The spaces b/w the myelin are called _____________.
Nodes of Ranvier.
Name 2 dz’s that cause demyelination.
Guillian Barre dz & Multiple Sclerosis (MS).
If LMN innervation is lost, what will happen to the muscle?
It will atrophy. May also cause fasciculations if not properly innervated.
What is ischemia?
Lack of O2 caused by disruption in the blood supply.
Multifocal damage means that the damage is ___________.
In more than 1 area.
T/F The thalamus helps to mediate speech, languages, and cognitive function.
True.
The BG consists of _________, ___________, and ____________.
Globus pallidus, putamen, caudate nucleus. Striatum= putamen and caudate nucleus.
The Lentiform nucleus in the BG consists of which two structures?
Globus pallidus & putamen.
Which two structures work w/ the BG that are important for motor control.
Subthalamic nuclei & Substantia Nigra
What is the Substantia Nigra?
It works w/ the BG. Located primarily in the midbrain. Sometimes considered part of the BG.
Function = Imp. in motor control.
T/F The reticular formation is part of the brain stem and is important in motor control.
True.
Localizations of damage (lesions) can be _________, ____________, or _____________.
Focal, multifocal, or diffused (typically bilateral) ex: dementia= generalized cerebral atrophy.
What are the broad categories (6) of etiologies for Motor Speech Disorders (MSD)?
1) Degenerative- ALS
2) Inflammatory- meningitis
3) Toxic- drugs, etc.
4) Neoplastic dz- tumors
5) Traumatic injuries- gunshot
6) Vascular dz - CVA/Stroke
DITNTV
LMNs are involved in motor mvmt. Where do they originate and which nerves do they consist of?
Originate in the brainstem or spinal cord. Consist of CNs (12 pairs) and Spinal Nerves (31 pairs).
Where do UMNs originate?
Motor Cortex and they project down (axons) and synapse with the LMNs (cranial and spinal neurons).
T/F LMNs only move when UMNs send an impulse for it to do so.
True.
What are the FOUR main parts of the Speech Motor System?
1) Final Common Pathway- also LMNs or PNS.
2) Direct Activation Pathway
3) Indirect Activation Pathway
4) Control Circuits
Why is it called the “Final Common Pathway” ?
B/c it is the last link in the sequence of events that leads to motor movement.
