Neuro & motor speech Flashcards
What is thrombosis?
A collection of blood material that blocks the flow of blood
What is embolus?
Traveling mass of arterial debris or a clump of tissue from tumor that gets lodged in a smaller artery and blocks the flow of blood
What are hemorrhagic strokes?
Caused by bleeding in the brain due to ruptured blood vessels.
What’s the definition of aphasia?
Neurologically based language disorder
What aphasia a are no fluent?
Global
Broca’s
Transcortical motor aphasia
What are the fluent aphasias?
Wernicke’s
Transcortical sensory aphasia
Conductive
Anomia
Characteristics of broca’s aphasia?
No fluent, effortfull, slow, halting, and uneven speech
Limited word output, short phrases and sentences
Misarticulated or distorted speech sounds
A grammatical error telegraphic speech
Poor repetition
Inspired naming
Poor oral reading and comprehension
Monotonous speech
Aware of deficits
Characteristics of transcortical motor aphasia?
Absent or reduced spontaneous speech
Nonfluent, paraphasic, agrammatic, and telegraphic speech
Echolalia
Limited word fluency
Good comprehension
Slow and difficult reading aloud
Inspired writing
What is akinesia?
Decreased sense of movement
What is bradykinesia?
Slowness of movement
Characteristics of Wernicke’s?
Press of speech (logarrehea)
Rate of speech with normal and good articulation
Severe word finding problems
Neologisms
Circumlocutions
Empty speech (this, that, stuff & thing)
Impaired conversational turn taking
Impaired repetition skills
What is ischemic?
Blocked or interrupted blood supply to the brain.
Characteristics of global
Profound anomia
Virtually no speech output
Very poor auditory comp
Stereotypical utterances
Lesion site for Broca’s
Anterior MCA
Frontal lobe (posterior)
Lesion site for Wernicke’s
Posterior temporal gyrus
Posterior section of middle and inferior temporal gyrus
Lesion site for global
Impacts frontal, parietal and temporal lobes
Often caused by occlusion of MCA prior to branching in LH
Lesion site for transcortical motor aphasia
Sub cortical anterior to frontal horn of lateral ventricle (left frontal lobe)
Characteristics of transcortical motor
Non fluent
Good repetition
Good auditory comp
Impaired imitation
Phrase length ~ 5
Agrammatic
Telegraphic
Characteristics of conduction aphasia
Fluent
Good auditory comp
Poor repetitions
Self corrections
Phrase length WNL
Site of lesion for conduction aphasia
Arcuate fasciculus
Characteristics of anomic aphasia
Good comprehension
Good repetition
Fluent
Circumlocutions
Semantic paraphasias
Phrase length- WNL
Lesion sit for anomic aphasia
Inferotemporal gyrus
Characteristics for transcortical sensory aphasia
Poor comprehension
Good repetition
Severe anomia
Fluent
Artic, prosody, grammar= good
Empty content
Perseveration
Lesion site for transcortical sensory aphasia
Angular gyrus
Post middle temporal gyrus
Lateral part of occipital
Treatment for AOS
Articulatory accuracy
Slower rate
Systematic practice
Gradual increase in the rate
Normal prosody
Self monitoring and self correction
Treatment for aphasia
Auditory comprehension
single words
spoken sentences
yes/no & following directions
Verbal expression- naming
use functional words
use modeling to evoke
incomplete sentences
phonetic cues
syllabic cues
Verbal expression- expanded utterances
Reading skills
survival reading skills
reading newspapers
reading and comprehending words, phrases, sentences and paragraphs
Writing skills
egocentric
functional words
Types of dysarthria
flaccid
spastic dysarthria
hypokinetic dysarthria
hyperkinetic dysarthria
ataxia
UUMN
Describe flaccid dysarthria
hyper nasality
deficits in automatic (reading, swallowing), reflexive (coughing), and voluntary (speech) movements
imprecise consonant productions
breathiness of voice
decreased loudness
monotone and slow rate of speech
common etiology: myasthenia graves, guillain-barre, ALS
describe spastic dysarthria
Harsh
Strain-strangled
Low pitch
Slow rate
Pitch breaks
Slow and regular AMRs
describe ataxia dysarthria
Irregular articulatory breakdowns (inconsistent)
Irregular AMRs
Excess and equal stress
Slow and inaccurate
Distorted vowels
“Drunken speech”
Poorly coordinate movement pattern
Scanning or staccato pattern of speech
Ataxic Gait
Friedrich’s Ataxia
describe hypo kinetic dysarthria
Decreased ROM
Affects aspects of motor control (preparation, maintenance, switching of motor programs)
Increased rate of speech with reduced intelligibility
Monopitch and monoloudness
Palilalia
Associated with basal ganglia pathology (Parkinson’s)
What is AOS?
Apraxia of speech. A motor planning disorder, that primarily affects prosody and articulation
Where is the site of lesions for AOS?
Left hemisphere, motor strip and Broca’s area. Frequently co-exists with Broca’s aphasia
Characteristics of apraxia of speech
Slow rate
Excess and equal stress
Groping
Inconsistent errors
Assessment for AOS
Imitative speech tasks, phonemes, syllables, and progressively longer words
DDK (they won’t be able to do these)
Automatic speech tasks
Picture descriptions
Limb movement to rule out limb apraxia
WAB or apraxia battery for adults
Tx for AOS
Repetition
Articulating accuracy
slower rate
Modification of prosody
Encourage client to communicate in whichever mode is best for them (writing, a communication book, gestures, or speech)
What is Dysarthria
It is a neurological speech disorder
What is the hallmark for dysarthria?
Impaired muscle control
In addition, it may impact all systems of language
Characteristics of ataxic dysarthria and the systems of speech
Phonation: mono pitch, monoloud, harsh quality
Articulation:imprecise consonants, distorted vowels. Drunken speech
Prosody: prolonged phonemes and word junction, slow rate of speech, excess and even stress
Other: gait disturbances and uncoordinated, slow, halting movements
Characteristics of spastic dysarthria and the systems of speech
Results from bilateral damage to the UMN
Respiration: short phrases, reduced AMEs/DDK
Phonation: mono pitch, monoloud, harsh, strained-strangled
Articulation: imprecise consonants, distorted vowels
Prosody: reduced stress, slow rate
Other: muscle spasticity and weakness, hyperactive gag reflex, reduced range and slowness of movement
Characteristics of flaccid dysarthria and the systems of speech
Damage to CN that I control LMN
Respiration: weakness linked to CN weakness, short phrases
Phonation: breathy quality, audible inspiration, monoloudness
Articulation: imprecise consonants
Resonance: hypernasality
Other: muscle twitches and other muscular disorders
Characteristics of hyperkinetic dysarthria and the systems of speech
Huntington’s
Basal ganglia
Respiration: audible inspiration and forced or sudden inspiration or expedition
Phonation: voice tremor, intermittent strained voice, harsh voice, voice stopping, dystonia
Articulation: imprecise consonants, distorted vowels
Prosody: slower rate, excess loudness, equal stress
Resonance: hypernasality
Other: trimmers and ticks, movement disorders including facial and in movements, involuntary movements, abrupt and the severe contractions of extremities, and neck spasms.
Characteristics of hypokinetic dysarthria and the systems of speech
Basil ganglia
Respiration: irregular, rapid rate of breathing, reduced to vital capacity
Phonation: mono pitch mono loud, breathy or harsh quality
Articulation: imprecise confidence, “stuttering like” repetitions
Prosody: reduced stress, short bursts, inappropriate silences
Other: “masked” face, resting tremor, rigidity and increased muscle tone, micrographic writing, decreased swelling
Assessment for dysarthria
Obtain medical history
Obtain a conversational speech sample and a reading sample to evaluate connected speech
Assess DDKs
OME
Determine the speech intelligibility rating
Frenchay dysarthria assessment
Intervention for dysarthria
Dysarthria is very unique, intervention varies
Postural adjustments for adequate respiration
Slow rate
Over articulation
AAC
biofeedback fur resonance and phonation
SLOP
5 parameters of dysarthria
Respiration, phonation, resonance, articulation and prosody
Lesion site for AOS
Left hemisphere, frontal lobe
More cortical than sub cortical
What two types of blockages are there?
Thrombosis and embolism
