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MSD practice questions > MSD Exam 1 > Flashcards

MSD Exam 1 Flashcards

1
Q

The primary function of the skull is…
a. Protection
b. Vascular flow
c. Growth
d. Motor stability

A

a. protection

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2
Q

The final common pathway for speech is also called the…
a. Direct activation pathway
b. Lower motor neuron system
c. Upper motor neuron system
d. Basal ganglia direct pathway

A

b. Lower motor neuron system

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3
Q

A dysphonia from vocal abuse is a…
a. Normal variation in speech production
b. Nonneurologic speech disturbance
c. Neurological speech disorder
d. Motor speech disorder

A

b. Nonneurologic speech disturbance

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4
Q

What might contribute to your diagnosis of spastic dysarthria?
What speech characteristics will be present?
What confirmatory signs would you see in your assessment?

A

Speech characteristics: slowness, reduced ROM, reduced force of movement, excessive tone could all lead to imprecise consonants, harsh, strained-strangled vocal quality, hypernasality, monopitch, monoloudness
Confirmatory signs: pseudobulbar affect, impairment in fine, skilled movements, hypertonia, hyperreflexia,
Babinski reflex present

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5
Q

Define differential diagnosis.

A

The process of narrowing diagnostic possibilities and arriving at a specific diagnosis.

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6
Q

The following cranial nerves originate in the medulla except…
a. Glossopharyngeal
b. Hypoglossal
c. Vagus
d. Facial

A

d. Facial

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7
Q

Flaccid dysarthrias are due to an impairment of this system.
a. Lower motor neuron
b. Basal ganglia direct pathway
c. Direct activation pathway
d. Upper motor neuron

A

a. Lower motor neuron

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8
Q

What is one assessment task that could determine at what level the motor system is involved for a facial nerve paralysis? Describe the innervation of cranial nerve VII to explain this task.

A

One assessment task to determine the motor system level involvement for a facial nerve paralysis would be raising eyebrows, squinting. The facial nerve (cranial nerve VII) is connected to the motor strip via UMNs. If the UMNs are damaged, the contralateral lower face will be affected, because they are bilaterally innervated for the upper face and contralaterally innervated for the lower face. If the facial nerve itself is damaged (lower motor neuron level), the ipsilateral full face will be affected.

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9
Q

A good history is important to the motor speech evaluation process. Please list 8 questions that are relevant and necessary to ask.

A
  1. What brings you in today?
  2. Do you have any history of childhood speech issues?
  3. Do you have history of a stroke or TBI?
  4. Will you tell me about your medical history?
  5. What is your highest form of education?
  6. Do you have difficulty swallowing solids/liquids?
  7. Do you have concerns regarding your speech? If so, what are they?
  8. Do you have any other concerns or information you would like to share with me?
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10
Q

Clinical characteristics of flaccid dysarthria may consist of impairment movement relating to all of the following except…
a. Range
b. Accuracy
c. Coordination
d. Speed

A

c. Coordination

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11
Q

Auditory perceptual analysis can identify salient features through all of the following except…
a. Visual observations
b. Instrumental observations
c. Tactile observations
d. Auditory observations

A

b. Instrumental observations

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12
Q

Etiologies matching…
Vascular disease
Toxic metabolic syndrome
Trauma
Inflammatory disease
Degenerative disease
Neuroplastic disease

A

Etiologies matching…
Vascular disease = stroke
Toxic metabolic syndrome = hypoglycemia
Trauma = fall
Inflammatory disease = encephalitis
Degenerative disease = dementia
Neuroplastic disease = CNS tumor

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13
Q

Outline the specific pathway of the direct activation pathway (AKA pyramidal tract).

brainstem and spinal cord
primary motor cortex
through internal capsule
descend in the corona radiata
through cerebral peduncle

A
  1. primary motor cortex
  2. descend in the corona radiata
  3. through internal capsule
  4. through cerebral peduncle
  5. brainstem and spinal cord
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14
Q

The term flaccid dysarthrias is plural because a patient that has 1 flaccid dysarthria is likely to gain another in the course of their lifetime.
a. True
b. False

A

b. False

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15
Q

Hyperkinesia results from damage to the indirect pathway of the basal ganglia control circuit.
True
False

A

True

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16
Q

Spastic dysarthria may present in a patient that has a diagnosis of multiple sclerosis.
True
False

A

True

17
Q

Motor speech disorders can occur due to damage in the meninges and in the meningeal spaces.
True
False

A

True

18
Q

Ballismus can be produced by effects of hypokinesia.
True
False

A

False

19
Q

Fasciculations are jerky, flinging movements of the extremities.
True
False

A

False

20
Q

The flocculonodular lobe of the cerebellum modulates equilibrium and orientation of the head and eyes.
True
False

A

True

21
Q

The indirect activation pathway is also called the extrapyramidal tract.
True
False

A

True

22
Q

Describe the role of the basal ganglia control circuit? What would damage to the direct and indirect pathways affect?

A

Role: helps to move muscles (when needed) and not move muscles (when needed). Need balance between direct pathway and indirect pathway.
Damage to direct pathway- hypokinesia, bradykinesia, akinesia, possible resting tremor, hypokinetic dysarthria
Damage to indirect pathway- hyperkinesia, dyskinesias, ballismus, hemiballismus, chorea, athetosis, hyperkinetic dysarthria

23
Q

The primary motor cortex has a
organization.
horizontal
topographic
functional
hierarchical

A

topographic

24
Q

Dopamine is a neurotransmitter that influences the sensitivity of neurons to excitatory and inhibitory input.
True
False

A

True

25
Q

Bilateral damage to the trigeminal nerve could result in lingual fasciculations.
True
False

A

False

26
Q

Lesions to the indirect activation pathway at the level of the reticular formation most often lead to death.
True
False

A

True

27
Q

Describe the cerebellar control circuit’s function in speech. Provide some general effects of damage.
Function in speech: Function in speech would be articulation and breathing.

A

Function in speech: Refines the temporal and prosodic properties after receiving advance notice from the cortex; Checks the adequacy of the outcome based on auditory and other feedback from speech muscles, tendons, and joints
General effects of damage: dysmetria, nystagmus, dysdiadochokinesis, intention tremor, hypotonia, speech incoordination: ataxic dysarthria

28
Q

The anterior lobes of the cerebellum help regulate
posture, gait, and truncal tone
balance
fine motor coordination
none of the above

A

posture, gait, and truncal tone

29
Q

The oral mechanism examination task of asking the patient to move their tongue from side to side as fast as they can is primarily assessing…
Symmetry
Rate and coordination
Sensitivity
Strength

A

Rate and coordination

30
Q

Pallilalia is a…
Normal variation in speech production
Neurological speech disorder
Motor speech disorder
Nonneurologic speech disturbance

A

Neurological speech disorder

31
Q

Flaccid dysarthria is due to lower motor neuron damage.
Effects on respiration?
Effects on phonation?
Effects on resonance?
Effects on articulation?
Effects on prosody?

A
  • Respiration: spinal nerve damage could cause diaphragm weakness which would lead to reduced breath support/vital capacity–›short phrase length
  • Phonation: vagus nerve damage could cause vocal fold paresis/paralysis–> dysphonia, aphonia
  • Resonance: vagus nerve damage could cause velopharyngeal insufficiency–›hypernasality
  • Articulation: hypoglossal nerve damage could cause lingual weakness–> imprecise articulation
  • Prosody: vagus nerve damage could cause vocal fold paresis/paralysis–> monopitch, monoloudness.
32
Q

Describe the cerebellar control circuit’s function in speech. Provide some general effects of damage.

A
33
Q

Damage to the spinal anatomic level could result in
dysarthria.
Unilateral upper motor neuron
Ataxic
Spastic
Flaccid

A

Flaccid

34
Q

By having the patient relax and open their mouth slightly while swiping a tongue depressor from the corner of their mouth along and to the middle of their top lip, I can assess the patient’s
reflex.
Suck
Babinski
Mouth
Gag

A

Suck

35
Q

Normal aging can cause changes in all of the following except…
Pitch
Fluency
Speech breathing patterns
Non-verbal communication

A

Non-verbal communication

36
Q

Taking into account the 5 speech subsystems, describe how a flaccid dysarthria might present for each. In other words, where would the specific damage be within that motor system and what speech characteristics would be present with that subsystem being affected?

A

Respiration: Specific damage to the phrenic nerve would cause issues with respiration. Signficant damage to the phrenic nerve results in issues with the diaphgram, resulting in speech characteristics like short/simple sentences and shallow breathing.
Phonation: Specfic damage to CN IX and X can result in issues with phonation.
Resonance: Specific damage to CN IX and X can result in issues with resonance. These nerves intervate the larynx/pharynx/velum, resulting in a change in resonance like hypernasality.
Articulation: Specific damage to CN V, VII, XII can result in articulation distortion. A bilateral lesion to CN V would result in imprecise consonant production due to the opening/hanging of the jaw. A unilateral lesion to CN VII would cause slight deficits in labial and labiodental consonats, while a bilateral lesion would cause more severe deficits of the labial and labialdental consonats. A unilateral lesion to CN XII would cause slight articulation issues as there is lingual paresis/paralysis on one side resulting in deviation, while a bilateral lesion causes imprecise and poor articulation due to full lingual paralysis.
Prosody: Specific damage to CN IX and CN X would result in effects of prosody, like monopitch and monoloudness.

37
Q

Instrumental analysis using visual imaging techniques for MSDs can include…
Nasometry
Videofluoroscopy
Spirometry
Electromyography

A

Videofluoroscopy

38
Q

Vascular interruption to the branches of the internal carotid artery will cause damage to most of the cerebral hemispheres. This could result in all of the following except…
Flaccid dysarthria
Spastic dysarthria
Apraxia of speech
Aphasia

A

Flaccid dysarthria

39
Q

The function of the indirect activation pathway is to…
plan voluntary movements
initiate skilled, voluntary movements
help maintain balance and govern posture
encode movements

A

help maintain balance and govern posture

MSD practice questions (8 decks)

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