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Motor Speech Exam 1 > Motor Speech DO > Flashcards

Motor Speech DO Flashcards

0
Q

Define Motor Speech Disorders

A

Disorders of speech resulting from neurologic impairment affecting the motor programming or neuromuscular execution of speech.

Apraxia and Dysarthrias

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1
Q

What are the three processes that work together to produce speech?

A

Cognitive linguistic process- “decide what you want to say”intention to communicate
Motor speech programing- “motor speech planning”
Neuromuscular execution-“ execution” cns and pns innervate muscles

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2
Q

How can you identify facciculations?

A

Tiching

Means nerve is dying

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3
Q

What is dysarthria?

A 
Group of motor speech disorders resulting from disturbances in muscular control over the speech mechanism due to damage of the CNS or PNS. 
Can result in:
Paralysis
Incoordination of speech musculature
Weakness
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4
Q

What subsystems of speech can dysarthria affect?

A 
Respiration
Phonation
Resonation
Articulation
Prosody
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5
Q

T or F

Both apraxia and dysarthria can occur with aphasia.

A

True

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6
Q

T or F

Apraxia co-occurs more commonly with aphasia

A

True

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7
Q

What are the subsystems that apraxia can affect?

A

Articulation and prosody

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8
Q

T or F

Transient course of disease means symptoms don’t last, they disappear completely

A

True

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9
Q

Fill in the blank:

____________ means things are improving but some symptoms are still there- but not as severe

A

Improving

Course of disease

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10
Q

MC

When symptoms don’t get better, they continue to get worse or new symptoms appear is called:

A. Stationary
B. Exacerbating- remitting
C. Progressive

A

C. Progressive

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11
Q

T or F

When symptoms occur, then get better, them occur again, then better, then worse is called exacerbating- remitting.

A

True

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12
Q

______ symptoms remain unchanged after they have reached maximum severity

A

Stationary

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13
Q

Match

A. Chronic
B. Acute
C. Subacute

  1. Comes on within months
  2. Comes on quickly within minutes.
  3. Comes on within days.
A

A 1
B 2
C 3

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14
Q

What is the main job of the Medulla?

A

Controls respiration

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15
Q

4 main anatomic level of CNS

What constitutes the Supratentorial?

A 
Ant and middle fossae 
Paired frontal, temporal, parietal, & occipital 
Basal ganglia 
Thalamus 
Hypothalamus
CN I & II
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16
Q

4 main anatomic level of CNS

What contains the posterior part of CNS?

A

Posterior fossa
Brainstem
Cerebellum
CN III-XII

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17
Q

Where do 10 of the 12 pairs of CNs originate?

A

Brain stem- at the posterior fossa level

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18
Q

Refresher

What are the 3 Meninges?

A

Dura mater
Arachnoid mater
Pia mater

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19
Q

What are the neurologic systems?

A
  • Ventricular system (where the ventricles are filled with CSF)
  • Vascular system (blood vessels )
  • Neurochemical system (amino acids, ACH, neuropeptides)
  • Consciousness system (maintaining consciousness, attention, etc)
  • Motor system (motor activity… Some areas or cortex, basal ganglia, cerebellum, CNS/PNS)
  • Sensory system (peripheral receptor organs)
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20
Q

What does a motor unit contain?

A

Axon muscle fiber it innervates

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21
Q

Fill in the blank

Supporting Glial Cells

_________ form myelin in CNS
_________ form myelin in PNS
_________ help move substances between blood and neurons of CNS, part of blood brain barrier

A

Oligdendroglia cells
Schwann cells
Astrocytes

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22
Q

Refresher

This is the relay station of the brain

A

Thalamus

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23
Q

Refresher

Contains globus palladus, putamen, caudate nucleus, lentiform nucleus

A

Basal ganglia

Initiation?

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24
Q

______ damage found in single area

A

Focal

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25
Q

_______ damage found in more than one area

A

Multifocal

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26
Q

_______ damage involve bilateral symmetric parts of the nervous system

A

Diffuse

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27
Q

What are some of the etiologies that can produce MSD

A 
Degenerative diseases- ALS
Inflammatory diseases- meningitis
Toxic
Neoplastic dz- tumors 
Traumatic Injuries 
Vascular diseases- CVA neurons deprived from oxygen
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28
Q

If damage to UMN

A

Spastic

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29
Q

If damage to LMN

A

Facciculations
Atrophy
Weakness

30
Q

From book:

Final common pathway- LMN
Direct Activation pathway- UMN
Indirect Activation pathway-UMN
Control Circuits- like the basal ganglia and cerebellum

A

…

31
Q

Match

  1. Direct =
  2. Indirect =

A. Extrapyramidal
B. Pyramidal

A 
Direct= pyramidal
Indirect= extrapyramidal
32
Q

Explain, concisely, the innavation for CN VII

A

Bilateral innervation for upper face

Contralateral innervation for lower face

33
Q

T or F

CN XII has bilateral innervation to most tongue muscles but CONTRALATERAL innervation for genioglossus

A

True

34
Q

Deviation always goes to the

A. Strong side
B. Weak side
C. Neither

A

B. Weak side

35
Q

What is the largest CN?

A

Trigeminal CN V

36
Q 
The CN V is sensory and motor. Sensory from:
A. Face
B. Mouth
C. Jaw
D. Tongue
E. All
A

E. All

37
Q 
CN V is sensory and motor. Motor for:
A. Eyes
B. Muscles of mastication 
C. Tensor palatini, tensor veli palatini mylohyoid, 
D. B & C
A

D

38
Q

T or F

CN V has unilateral innervation

A

False. It has bilateral innervation

39
Q

T or F

CN V:
If bilateral lesion then jaw hangs at rest– profound affect to speech
If unilateral lesion jaw deviates to weak side– not as much

A

True

40
Q

What does the Glossopharyngeal CN IX innervate?

A
  • Stylopharyngeus which elevates pharynx in speech and swallowing
  • bilateral innervation… If lesion then may reduce gag reflex and pharyngeal sensation
41
Q

How many branches does the Vagus CN X have? And which ones are they?

A

3 branches. They are:
Pharyngeal branch
Superior laryngeal branch
Recurrent laryngeal branch

Has bilateral innervation for all branches

42
Q

What is the job of CN XI Accessory?

A

Hean and neck mvmnt

Bilateral innervation

43
Q

What does the Hypoglossal CN XII innervate?

A

All intrinsic and extrinsic (except palatoglossus which is innervated by Xth )tongue muscles.

All muscles have bilateral innervation but the genioglossus (receives contralateral input)

44
Q

Refresh

What are the two tracts that make up the UMN system and Direct Pathways?

A

Corticobulbar

Corticospinal

45
Q

Why is the dierect activation pathway important?

A

Bc it controlls skilled, discrete, and rapid voluntary movements like speech

46
Q

What is more damage UMN lesion or LMN lesion?

A

Depends on innervations.

If there is bilateral innervations then LMN lesion are more severe than UMN lesions.

47
Q

Where do messages originate?

A

Motor strip of the cortex

48
Q

What type of lesion can cause flaccid dysarthria?

A

LMN system

49
Q

What does flaccid mean?

A

Weak

50
Q

If a patient has hypernasality, what can it mean?

A

Weakness of the muscle

51
Q

What are some other characteristics of flaccid dysarthria?

A

Hypotonia
Weak reflexes
Atrophy
Fasciculations (visible) and fibrillation (not visible)

52
Q

T or F

Atrophy and Fasciculations are only seen in LMN

A

True

53
Q

Name the etiologies of flaccid dysarthria

A 
Neuromuscular Junction DZ- 
     Myasthenia Gravis
Vascular Disorder
Infectious DZ
Demyelinating DZ
Muscle diseases
Degenerarive DZ
Anatomic anomalies
radiation treatment
**REMEMBER: ALL SYMPTOMS OF DAMAGE IN FLACCID DYSARTHRIA ARE DUE TO LESIONS IN THE LMN SYSTEM.**
54
Q

What is Myasthenia Gravis?

A

is a chronic neuromuscular junction dz characterized by rapid weakness of voluntary movement of muscles & improvement with rest is seen.

55
Q

what are the e branches of trigeminal nerve V?

A

Sensory opthalmic branch
Sensory Maxillary branch
Motor & Sensory Mandibular branch

56
Q

What do the three branches of the trigeminal nerve V innervate?

A

Sensory opthalmic branch- upper face
Sensory Maxillary branch- midface
Motor & Sensory Mandibular branch- jaw muscles, tensor tympani, tensor veli palatini

57
Q

T or F

Trigeminal Nerve V is sensory to jaw, face, lip, and tomgue and motor to jaw

A

True

58
Q

What is more damage to speech,

a unilateral lesion to trigeminal nerve V or a bilateral lesion to Nerve V? explain

A

Bilateral lision…. Jaw hangs down. Pt. may not be able to close the jaw

59
Q

If patient complaints of drooling and difficulty chewing and decrease sensation from the face, cheeks, tongue, teeth and palate, what nerve may be damage?

A

Trigeminal nerve V

60
Q

What assessments can you do to assess the effects on speech if CN V is damage?

A

Pt. closes eyes and touch face
Listen to speech
Do AMR’s puh tuh kuh, if imprecise or slow on puh then problem is present

61
Q

What does CN VII innervate?

A

Face
lip muscles
sensory information from anterior 2/3 tongue

62
Q

If unilateral damage occurs in CN VII Facial nerve, what are some pt characteristics that we may see?

A

side sagging
hypotonic
forehead may be unwrinkled
eyebrow dropped

63
Q

If bilateral damage occurs in CN VII Facial nerve, what are some pt characteristics that we may see?

A

rare
facial symmetry
pt may not be able to retract lips or puff out cheeks (bilabials and labiodental may not be done)
drooling
pt may complain of not being able to move lips well in speech and while eating
synkinesis- abnormal contraction of muscle next to muscle that is normally moving.

64
Q

What is synkinesis?

A

abnormal contraction of muscle next to muscle that is normally moving.

65
Q

How can we assess CN VII Facial nerve?

A 
Stress testing
conversation
reading
AMRs
may see "flutter cheek" due to less resistance of intraoral pressure
66
Q

T or F

If pt. has a bilateral lesion to CN VII they may substitute lingual alveolar sounds for bilabial t/p

A

True

67
Q

T or F

If pt. has a unilateral lesion to CN VII they may exaggerate jaw closure to make bilabials

A

True

68
Q

What does Glossopharyngeal Nerve IX innervate?

A

stylopharyngus muscle which raises pharynx in speech and swallowing
Sensory from pharynx and posterior 1/3 of tongue
responsible for some gag reflex

69
Q

T or F

If Glossopharyngeal nerve IX damage, Vagus is usually affected as well

A

True

70
Q

T or F

Hypoglossal Nerve XII is reponsible for some gag reflex

A

False

CN IX Glossopharyngeal is in charge

71
Q

What can you do to assess CN IX?

A

Elicit gag reflex (not always reliable)

Pt. may have pain in throat- to trigger pain ask to swallow or stick out tongue

72
Q

T or F

Speech tasks are a good way to assess function of Glossopharyngeal Nerve IX

A

False

this nerve cannot be assessed directly through speech tasks

Motor Speech Exam 1 (1 decks)

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