Neurogenic Voice Disorders Flashcards
The CNS contains?
- motor cortex, primary motor strip, midbrain, brainstem
- Broca’s area
- Insula
- Precentral gyrus
- Basal Ganglia/Thalamus
- Temporal Lobes (Heschyl’s gyrus)
Motor cortex, primary motor strip, midbrain, and brainstem do what?
provide motor control of the larynx
What role does Broca’s area play in voice?
Voice Response (preplanning)
What role do the insula play in voice?
Motor Planning for voice
What role does the precentral gyrus play in voice?
Voice Production
What role does the Basal Ganglia play in voice?
Sensory info. for vocalizing (motor)
What is the Temporal Lobe (Heschyl’s Gyrus) in charge of?
Audition
What Cranial Nerves of the PNS are involved in phonation/voice?
- Glossopharyngeal (IX)
- Vagus (X)
- Spinal Accessory (XI)
- Hypoglossal (XII)
The Glossopharyngeal Nerve (IX) does what?
innervates Motor to the Stylopharyngeus (elevates the larynx)
The Spinal Accessory Nerve (XI) does what?
- Innervates neck accessory m. (SCM & strap)
- Innervates Levator Veli Palatini
- Innervates Uvula
The Hypoglossal Nerve (XII) does what?
- Depression/elevation of larynx (via tongue m.)
2. Neck strap m.
What are the branches of the Vagus Nerve (X)?
- Pharyngeal Branch
- Superior Laryngeal Nerve (SLN)
- Recurrent Laryngeal Nerve (RLN)
The Superior Laryngeal Nerve does what?
- SENSORY (internal branch): mucous membrane & supraglottal larynx
- MOTOR (external branch): CT-Cricothyroid m.
- ->PITCH!!!
The Recurrent Laryngeal Nerve does what?
- RIGHT - loops behind Right Carotid & Right Subclavian
- LEFT - loops around the aortic arch
- MOTOR - Thyroarytenoids (TA) of the VF Posterior Cricoarytenoid (PCA)-abductor, Lateral Cricoarytenoid (LCA)-adductor, Transverse Arytenoids-adductors, Oblique Arytenoids (adduction)
Recurrent Laryngeal Nerve can be damaged during?
surgery-can be nicked (causing voice loss, paresis/paralysis; which can be temporary…or not), RLN can also be stretched (causing sluggishness)
What are the Neurogenic Etiologies?
- Congenital (Huntington’s)
- Lesion/Tumor/Disease (Dysarthria, Stroke, Cancer)
- Trauma (TBI, n. trauma)
What are the Neurogenic Disorders?
- Lower Motor Neuron (LMN)
- Upper Motor Neuron (UMN)
- Mixed
What are the LMN Neurogenic Disorders?
- Vocal Fold Paralysis
2 Myasthenia Gravis - Guillaine-Barre
- Flaccid Dysarthria
What are the UMN Neurogenic Disorders?
- Spastic Dysarthria
- Hypokinetic Dysarthria (Parkinson’s Disease)
- Hyperkinetic Dysarthria (SD-Spastic Dysphonia, essential tremor)
- Ataxic Dysarthria
What are the Mixed Neurogenic Disorders?
- Amyotrophic Lateral Sclerosis (ALS)
- Traumatic Brain Injury (TBI)
- Multiple Sclerosis (MS)
What is the LMN involvement of neurogenic disorders?
Flaccidity, weakness, reduced m. contraction, reduced range of motion (ROM)
- Flaccid Dysarthria
- VF Paralysis
- Myasthenia Gravis (MG)
- Guillaine Barre
What is the UMN involvement in neurogenic dysarthrias; specifically Spastic Dysarthria?
Spasticity/hypertonicity, strain/strangle, short phonation time, monopitch (CTM controlled by SLN), (uncontrolled mvmt. spasims)
-Spastic Dysarthria
What is the UMN involvement in Hypokinetic Dysarthria?
Rigidity, Bradykinesia (moving slower), Limited ROM (effecting all m. of the body), Resting Tremor (unintentional)
What is the UMN involvement in Hyperkinetic Dysarthria?
Uncontrolled Movements & Strain/Strangle (voice quality)
