MSD quiz Flashcards
True/false: Vowel prolongation is affected by one’s respiratory and phonatory abilities.
True
Stress testing would help detect which disorder?
Myasthenia gravis
The location of the lesion in the basal ganglia control circuit is likely to lead to which type of dysarthria?
Hypokinetic & Hyperkinetic
Which of the subsystems are examined in evaluation of spontaneous speech production? (choose all that apply)
Respiration, Phonation, Resonance, Articulation, Prosody
The type of motor speech disorder that may show excessive speech rate would be:
Hypokinetic dysarthria
Issues that may interfere with an ideal evaluation include the following (choose all that apply):
Time constraints, Lack of client cooperation, Language barrier
The following information does not belong in a case history section of your evaluation (choose all that apply):
The client presented with mild apraxia of speech. The client coughed on thin liquids during the evaluation. The client showed reduced articulatory precision for consonant sounds when reading the Grandfather Passage
True/false: In order to perform a valid motor speech exam, a person must use a complete formal test, such as the Frenchay Dysarthria Assessment (FDA).
False
True/false: For diadochokinetic rate, it is within normal limits for a person to have slower repetition of velar sounds than of bilabial sounds.
True
True/false: Comprehensibility assessment examines how much the person with the motor speech disorder understands his non-impaired communication partner in conversation.
False
Someone with a diagnosis of AOS will show difficulty with the following areas (choose all that apply):
Sequential motion rates for speech production, Articulation of multisyllabic utterances.
True/false: When addressing speech sound production for someone with AOS, work on speed and then on accuracy.
False
The most sensitive test within the motor speech exam from the options listed below to test for AOS is the following:
AMR/SMR testing
When choosing sounds to address in treatment for AOS, the order to consider would involve which considerations? Choose all that apply:
Oral/nasal distinctions before voicing distinctions, Bilabial sounds before velar sounds, Singletons before consonant clusters, High frequency words before low frequency words, Single syllable words before multisyllabic words, Stressed words before unstressed words
The following are some strategies to improve praxis for the person with moderate apraxia of speech (choose all that apply):
Repetition of the target, Phonetic placement, Minimal contrast practice, Use finger tapping to control rate, Use automatic speech tasks such as counting or singing, Tactile cues, Melodic intonation therapy
A person with AOS who also presents with aphasia is likely to present with which classification of aphasia?
Broca’s aphasia
A person with AOS from CVA may also present with dysarthria. The type of dysarthria likely to present with AOS is the following:
Unilateral upper motor neuron dysarthria
The reason for the presentation of AOS with aphasia and dysarthria is:
proximity of the location of the lesion to the areas that contribute to motor planning, language, and execution of movement
True/false: If a person presents with severe expressive aphasia, it will be difficult to determine the presence/severity of AOS in that individual.
True
List in order of amount of difficulty a person with AOS would struggle with the following:
1 Vocalizing in imitation
2 Counting to 10
3 Reading a simple passage
4 Conversing about previous work history
True/false: The PROMPT technique is an example for articulatory-kinematic (A-K) approaches.
True
True/false: A metronome, pacing board, hand/finger tapping or counting, and other intersytemic gestural rate control strategies can provide a temporal basis for organizing sequences of speech movements.
True
True/false: In AOS there are phonemic paraphasias.
False
True/false: Medications are often helpful to treat individuals with AOS.
False
Which of the following is NOT a rate and/or rhythm approaches? Contrastive stress tasks, Metronome, Metrical Pacing Therapy (MPT), Eight-step (integral stimulation) approach, Melodic intonation therapy
Eight-step (integral stimulation) approach
True/false: The control circuits have contact with the LMN?
false
True/false: Do direct activation pathway and indirect activation pathway have direct contact with the LMN?
True the indirect motor pathway however has multiple synapses with the cortical and the LMN nuclei.
When the lesion is in the UMN on the right side, the tongue will deviate to the _______.
Left side - Gets the signal but the weakness there is on the LMN lesion, weakness to the left side.
True or False: Left UMN damage to the facial nerve causes upper and lower right facial paralysis?
False – only lower face.
Lesion on the left LMN or facial nerve cause weakness on the ___________.
a) left upper and lower face b) right upper and lower face
a)left upper and lower face
True/false: Flaccid dysarthria is caused by peripheral nerve damage.
True
True/false: Myasthenia gravis test positive for stress testing.
true
True/false: People with UM lesions test positive for stress testing.
False
True/false: Typically the mirror will get foggy during the production of /m/, /n/, and /ng/.
true
True/false: If the mirror gets foggy with non-nasal sounds this could be inadequate closure of the velopharyngeal port?
true
Neurons in the direct and indirect activation pathway are: a) LMN b) UMN
b) UMN
You see a clinician assessing a patient’s gag reflex. This would give info about the function of the _________ nerve? a) V b) VII c) IX d) XII
c) IX – glossopharyngeal
True/false: Basal ganglia control circuit is also regarded as part of the extrapyramidal system?
True
True or false: LMN’s are part of the extrapyramidal pathways?
false LMNS are part of the final common pathway.
True/false: Cerebellar control circuit plays a role in coordination of speech movements?
True
The_________ branch of the Vagus nerve mediates few pharyngeal function? a) pharyngeal b) superior c) recurrent
a) pharyngeal
What is the name of the CN V?
Trigeminal, CN VII – facial, CN XII - hypoglossal
You see a clinician assessing the duration of sustained vowel production. This is ____? a) AMR b) SMR c) MPT/MPD d) none of the above
c) MPT/MPD
Which of the types of aphasia co-occur with apraxia of speech? a) Broca’s b) global c) conduction d) anomic e) A and B
e) A and B - Broca’s and global
Damage to which of the following sections of Vagus nerve results in hypernasality?_______
Pharyngeal branch
Which of the following is a confirmatory sign for a motor speech disorder diagnosis?______
a. Breathy voice
b. Lingual fasciculations
c. Imprecise articulation
d. None of these
d. None of these
Which of the following types of dysarthria is associated with basal ganglia dysfunction?_____
a. Flaccid
b. Spastic
c. Hyperkinetic
d. Hypokinetic
e. Both a and b
f. Both c and d
f. Both c and d
If you are assessing vocal quality, which of the following subsystems of speech are you mainly assessing?________
a. Phonatory system
b. Articulatory system
c. Resonatory system
d. Respiratory system
a. Phonatory system
In motor speech disorder assessment, AMR stands for ______
a. Alternating Motion Rate
b. Alternative Motor Response
c. Alert Motor Reflex
a. Alternating Motion Rate
If the clinician is stroking the back of the tongue during assessment, s/he is assessing____
a. Snout reflex
b. Sucking reflex
c. Palmomental reflex
d. Gag reflex
d. Gag reflex
“_______________ are visible, arrhythmic, isolated twitches in resting muscle that result from spontaneous motor unit discharges in response to nerve degeneration or irritation.” (Duffy, 2020)
a. Atrophy
b. Fibrillations
c. Fasciculations
d. Tremors
c. Fasciculations
In facial nerve lesion, atrophy can lead to facial asymmetry.____
a. True
b. False
True
It is a red flag if a 50-year-old male patient’s maximum phonation duration is 7 seconds (hint: refer to the table from your textbook)
a. True
b. False
False
A 40-year old man, following traumatic brain injury, shows spastic dysarthria. Also, he exhibits laughing and crying disproportionate to the situation and at times without apparent reason. He is exhibiting____
a. Reduced facial tone
b. Emotional lability
c. Facial apraxia
B - Emotional lability
In Motor Speech Disorders, FDA stands for
a. Frenchay Dysarthria Assessment
b. Functional Disability Assessment
c. Fixed Dynamic Analysis
a. Frenchay Dysarthria Assessment
________________refers “The degree to which a listener understands the acoustic signal produced by a speaker (Duffy, 2020)”
a. Efficiency
b. Comprehensibility
c. Intelligibility
c. Intelligibility
Corticospinal and corticobulbar tracts are part of _____________
a. Direct activation system
b. Indirect activation system
a. Direct activation system
Mr. A, an SLP, asks Mr. C, a client with ALS, to puff his cheeks and hold it tight. Mr. A is assessing
a. CN V
b. CN VII
c. CN IX
d. CN X
b. CN VII
Apraxia of speech (AOS) is a language disorder.
a. True
b. False
False
Dysarthria is a type of motor speech disorder.
a. True
b. False
True
MSD treatment: Palatal lift is an example of prosthetic management.
a. True
b. False
True
The recurrent laryngeal nerve branch of the Vagus nerve is important for vocal fold opening and closing.
a. True
b. False
True
The ABA is a test used for AOS assessment.
a. True
b. False
True
MSD treatment: Dopaminergic drugs are often recommended for patients with Parkinson’s disease.
a) True
b) False
True
True/false: The leading cause for spastic and flaccid dysarthria is neurodegenerative disease
True
True/false: HYPERACTIVE gag reflex is more common in flaccid than other dysarthria types.
False
Hypernasality can result from damage to the ________ cranial nerve.
X
The dysarthria caused by Myasthenia gravis is considered
a) Spastic dysarthria
b) Flaccid dysarthria
c) Ataxic dysarthria
d) Hypokinetic dysarthria
b) Flaccid dysarthria
True/false: Facial nerve paralysis can result in perioral fasciculations.
True
Vocal fold adduction paralysis can be caused by damage to which of the following branches of the Vagus nerve.
a) Superior
b) Recurrent
c) Pharyngeal
b) Recurrent
True/false: Diplophonia can manifest in cases of unilateral paralysis of the recurrent branch of the Vagus nerve.
True
Damage to the peripheral facial nerve causes upper and lower facial weakness on the ___________side of the lesion
a) Same
b) Opposite
a) Same
Lingual atrophy can result from damage to
a) V cranial nerve
b) VII cranial nerve
c) X cranial nerve
d) IX cranial nerve
e) XII cranial nerve
e) XII cranial nerve
True/false: In case of Trigeminal nerve paralysis, palpation of masseter or temporalis muscle may be decreased for weak side when biting down.
True
You are assessing a client who had a TBI that damaged several cranial nerves. He reports difficulty moving his jaw. What CN damage do you suspect?
a) V
b) VII
c) IX
d) X
e) XII
a) V
Which of the following statements is FALSE?
a) Tourette’s syndrome is the prototypic tic disorder
b) In adductor spasmodic dysphonia there is spasming of the vocal folds during adduction
c) Mycolonus is a fast hyperkinesia
d) Dystonia is a slow hyperkinesia
e) Sensory tricks could be an option to reduce the interference of adventitious movements on speech in individuals with ataxic dysarthria
e) Sensory tricks could be an option to reduce the interference of adventitious movements on speech in individuals with ataxic dysarthria
True/false: For individuals with severely impaired intelligibility due to spastic dysarthria, alphabet board could be an option if they would like to still continue to use their speech.
True
True/false: Bilateral UMN damage causes spastic dysarthria
True
___ is characterized by increased resistance to sudden movement (active or passive), increased resistance to faster movement and more resistance at the beginning of the movement.
Rigidity
__________ activation pathway is responsible for quick, skilled, discrete movements, like speech.
a) Direct
b) Indirect
a) Direct
True/false: Psuedobulbar affect can interfere with quality of life of affected individuals as it affects their social interaction.
True
True/false: In case of spastic dysarthria, pushing/pulling exercises should be recommended.
False
True/false: Central weakness and reduced range of movement of the articulators, slow rate of speech, strained-strangled voice quality and hypernasality can be seen in individuals with spastic dysarthria.
True
True/false: There is a lot of scientific evidence that non-speech oral-motor exercises facilitate speech movements.
False
Multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are considered ____ parkinsonism.
a) typical
b) atypical
b) atypical
True/false: Essential tremors tend to be worse during movement than when at rest.
True
True/false: Currently, the diagnosis of “corticobasal DEGENERATION” can only be confirmed after a brain autopsy.
True
True/false: Normal Pressure Hydrocephalus (NPH) is a medical condition characterized by enlarged ventricles.
True
True/false: Every patient with vascular parkinsonism is responsive to dopaminergic medications.
False
Visual hallucinations are typically seen in which of the following conditions?
a) PD
b) PSP
c) Lewy body dementia
d) MSA
c) Lewy body dementia
TRAP is an acronym for 4 cardinal symptoms of PD. What does A stand for?
a) Aphasia
b) Akinesia/bradykinesia
c) Aphonia
d) Alexia
e) Agraphia
b) Akinesia/bradykinesia
In ________spasmodic dysphonia there is spasming of the vocal folds during adduction?
a) Adductor
b) Abductor
a) Adductor
True/false: Irregular articulatory breakdown is often the distinguishing feature of ataxic dysarthria.
True
True/false: Pseudobulbar affect is not a motor speech characteristic, but it can interfere with social communication.
True
True/false: Lee Silverman Voice Treatment (LSVT) shows efficacy only for treatment of hypokinetic dysarthria.
False
Symptoms of Parkinson’s disease include which of the following (choose all that apply):
Postural deficits
Difficulty initiating movement
Weakness
Rigidity
Tremor (at rest)
Spasticity
Reduced coordination
Slow movement
Small handwriting
Cognitive changes
Postural deficits
Difficulty initiating movement
Rigidity
Tremor (at rest)
Slow movement
Small handwriting
Cognitive changes
The principles of Lee Silverman Voice Treatment include the following (choose all that apply):
a) Use of intensive treatment
b) Focus on articulatory precision
c) High level of physical effort
d) Treatment addresses primarily pitch variation
e) Limit focus to 1-2 subsystems
f) Increase sensory awareness
g) Use of yawn-sign to reduce muscle tension
a) Use of intensive treatment
c) High level of physical effort
e) Limit focus to 1-2 subsystems
f) Increase sensory awareness
A common complaint from a person with Parkinson’s disease would be:
a) Having a hard time understanding other people
b) Other people complaining of his unclear speech
c) Hearing loss
d) Reduced episodic memory
b) Other people complaining of his unclear speech
True/false: Someone with Parkinson’s disease with deep brain stimulation may present with primarily spastic dysarthria.
True
A person with a diagnosis of progressive supranuclear palsy can present similarly to someone with Parkinson’s disease, but the motor speech disorder will likely also include which of the following (choose all that apply):
Spastic dysarthria
Flaccid dysarthria
Ataxic dysarthria
Hyperkinetic dysarthria
UUMN dysarthria
Spastic dysarthria
Ataxic dysarthria
True/false: A relative increase of dopamine or relative decrease in acetylcholine in the basal ganglia control circuit is likely to manifest in a hyperkinetic disorder.
True
True/false: Involuntary movements are only associated with lesions in the basal ganglia control circuit.
False
True/false: Hyperkinesias are never under volitional control.
False
Which of the following symptoms of hyperkinetic dysarthria of chorea are you likely to encounter during the task for vowel prolongation?
Hypernasality
Monopitch
Strained-harsh vocal quality
Articulatory distortions
Irregular articulatory breakdowns
Loudness variations
Sudden forced inspiration/expiration
Monoloudness
Hypernasality
Strained-harsh vocal quality
Loudness variations
Sudden forced inspiration/expiration
True/false: Behavioral treatment for spasmodic dysphonia is only effective after medical intervention.
True
True/false: Action tremor is associated with Parkinson’s disease.
False
Some behavioral treatments for abductor spasmodic dysphonia include the following (choose all that apply):
Hard glottal onset of phonation
Easy onset speech
Making voiceless sounds voiced
Making voiced sounds voiceless
Hard glottal onset of phonation
Making voiceless sounds voiced
True/false: A lot of behavioral treatments for hyperkinetic disorders involve compensating for the interference imposed by the extraneous movements.
True
Which of the following is not a common symptom of unilateral upper motor neuron dysarthria?
Reduced coordination
Muscle resistance to movement
Symmetrical weakness of the lips
None of the above
Symmetrical weakness of the lips
The presence of fasciculations or atrophy point to a lesion in which area?
Cortex
Basal ganglia
Lower motor neuron
Cerebellum
Lower motor neuron
A person with ataxic dysarthria presents with:
a) Reduced coordination and muscle tone
b) Reduced coordination and increased muscle tone
c) Normal coordination and impaired vocal volume
d) Reduced pitch variation and normal articulation
Reduced coordination and muscle tone
True/false: AMRs for a person with ataxic dysarthria are slow and regular.
False
Mixed dysarthria can result from which of the following:
a. Presence of more than one neurological diagnosis/disorder
b. Presence of multiple lesions or events within the same cause
c. Degenerative disease that affects more than one part of the nervous system
d. All of the above
d. All of the above
True/false: Rate control exercises are generally used to increase speed of speech production.
False
The type of motor speech disorder that multiple sclerosis and amyotrophic lateral sclerosis share within the diagnosis of mixed dysarthria is the following:
Flaccid dysarthria
Spastic dysarthria
Ataxic dysarthria
Hypokinetic dysarthria
Hyperkinetic dysarthria
UUMN dysarthria
Apraxia of speech
Spastic dysarthria
True/false: ALS, PD, HD, PSP, and MS all impact cognition in addition to motor speech ability.
True
True/false: The time to introduce the concept of AAC to someone with ALS is the same time that you begin the AAC assessment for him.
False
True/false: An appropriate time to begin the assessment for AAC for someone who presents with ALS is when the person’s speech rate has deteriorated to 200 words per minute for reading sentences.
False
True/false: Assessment of comprehensibility includes both the person’s intelligibility and any other means the person uses to convey his message.
True
True/false: Giving a cue regarding the topic for the utterance is a better comprehensibility strategy for milder dysarthria, rather than more severe dysarthria.
True
The most common cause of neurologic deficits and, probably, MSDs, is:
a. Progressive, degenerative neuronal atrophy
b. Neoplasm
c. Vascular disease
d. None of the above
c. Vascular disease
A branch of this cranial nerve innervates the tensor veli palatini, tensor tympani, jaw opening and lateralizing muscles (lateral pterygoids), and jaw closing muscles (temporalis, masseter, medial pterygoids).
a. CN 5
b. CN 7
c. CN 9
d. CN10
CN 5
Recognizing and understanding predictable patterns of speech disturbance and their underlying neurophysiologic bases are valuable for:
a. Understanding nervous system organization for speech motor control
b. Differential diagnosis and localization of neurologic disease
c. management of motor speech disorders
d. all of the above
d. all of the above
Fasciculations are generally seen with disorder at which part of the neurological system?
a. UMN
b. LMN
c. Basal ganglia control control circuit
d. Cerebellar control circuit
LMN
True or False: Though most of the cranial nerves originate in the brainstem, the nerve nuclei are considered part of the peripheral nervous system and lesions at their level are therefore classified differently from lesions in the supratentorial level regarding dysarthria type.
True
When a single dysarthria type leads to anarthria, the most likely type of dysarthria present is the following:
Hyperkinetic
Flaccid
Ataxic
Spastic
Spastic
True or False: Of the arteries that lead to the brain, the left posterior cerebral artery is most likely to be related to apraxia of speech when there is vascular etiology.
False
Neurologic signs and symptoms generally reflect:
a. the location of a lesion and not necessarily its specific cause.
b. The cause of the symptoms but not the location of the lesion
c. Both the location and the cause
d. Neither the location nor the cause
a. the location of a lesion and not necessarily its specific cause.
The major distinction between PNS nerves and CNS tracts is that:
a. CNS tracts have myelination and PNS nerves do not.
b. CNS tracts transmit impulses to other neurons, whereas PNS nerves transmit impulses from nerves to end organs, such as muscle.
c. For CNS tracts, functionally significant regeneration of axons does occurs after cell bodies die or when axons are separated from their cell bodies by injury or disease. For PNS nerves, regeneration of the nerve is not possible, even if the cell body survives.
b. CNS tracts transmit impulses to other neurons, whereas PNS nerves transmit impulses from nerves to end organs, such as muscle.
true or false: The evaluation of anyone with a suspected MSD begins with a perceptually based speech assessment.
True
Electromyography, kinematic measures, and aerodynamic measures are all forms of what type of method for studying motor speech disorders?
physiological
perceptupal
acoustic
all of the above
physiological
True or false: all the cranial nerves originate in the brainstem.
False
True/false: The location of the lesion will impact the type and nature of neuromuscular deficit seen and can affect the severity level of the deficit.
True
which of the following would not fall into the category of motor speech disorders (choose all that apply)?
dysarthria
apraxia of speech
aphasia
anarthria
cleft palate
aphasia
cleft palate
True or false: sensory deficits may be implicated in some motor speech disorders.
True
True/false: Bilateral UMN lesions can cause spastic dysarthria.
True
Hypokinetic dysarthria results from damage to:
FCP
Pyramidal tract
Basal ganglia control circuit
Basal ganglia control circuit
Disruption of the left UMN innervation for facial nerve causes weakness on ___________lower face.
Left
Right
Right
t or f: Although not in every individual, the tongue predominantly receives contralateral UMN innervation.
true
Corticobulbar tracts are:
Direct activation pathways
Extrapyramidal pathways
Direct activation pathways
The client presents with a lesion at the left cranial nerve nucleus of the seventh cranial nerve. He presents with facial droop - on which side and which part of the face?
a. Full left side of the face
b. Full right side of the face
c. Lower half of the left side of the face
d. Lower half of the right side of the face
Full left side of the face
The client presents with a cortical lesion to the right frontal lobe. The client presents with facial droop - which side of the face and which part of the face?
a. Full left side of the face
b. Full right side of the face
c. Lower half of the left side of the face
d. Lower half of the right side of the face
Lower half of the left side of the face
A lesion at the cranial nerve nucleus is likely to show more severe weakness of the impacted muscles than a cortical lesion that affects the same muscles.
True
False
True
The cranial nerve nuclei for the trigeminal and facial nerves receive different levels of contribution from each hemisphere of the cortex than the other cranial nerve nuclei.
True
False
False
The client presents with a lesion to the right cranial nerve nucleus to the 12th cranial nerve. The speech sounds that the client is likely to have trouble with include which of the following?
a. All bilabial sounds
b. All velar sounds
c. All voiced sounds
d. All nasal sounds
b. All velar sounds
Treatment for spastic dysarthria would include the following - choose all that apply:
a. Pushing/pulling exercises
b. Rate modification to increase speech rate
c. Relaxation exercises
d. Rate modification to slow rate
e. Easy onset phonation
f. Respiratory compensation exercises for breath support
c. Relaxation exercises
d. Rate modification to slow rate
e. Easy onset phonation
f. Respiratory compensation exercises for breath support
True/false: Pseudobulbar affect can be successfully treated surgically.
False
True/false: Nonspeech oromotor exercises may be used to treat flaccid or spastic dysarthria.
True
The decision to address respiration in treatment would depend on:
a. How much air pressure the person can currently sustain on exhalation
b. How well the person can support phonation with his current respiration
c. How many words the person can say on one breath
d. All of the above
d. All of the above
Key characteristics of spastic dysarthria are the following: (choose all that apply)
a. Slow but regular AMRs
b. Slow speech rate
c. Extraneous movements during speech production
d. Hypernasality
e. Strained-strangled vocal quality
f. Reduced coordination for speech sound production
g. Tremor
a. Slow but regular AMRs
b. Slow speech rate
d. Hypernasality
e. Strained-strangled vocal quality
