neurogenic voice disorders Flashcards
what is broca’s area responsible for?
voice response (preplanning)
what is the insula responsible for?
motor planning for voice
what provides motor control for the larynx
motor cortex, primary motor strip, midbrain, brainstem
precentral gyrus is responsible for?
voice production
Basal ganglia and the thalamus are responsible for?
sensory info for vocalizing
temporal lobes (heschyl’s gyrus)
audition
What are the cranial nerves of phonation/voice?
glossopharyngeal, vagus, spinal accessory, hypoglossal
the glossopharyngeal innervates
it innervates the stylopharyngeus muscle that elevates the alrynx
the vagus innervates?
SLN/RLN: sensory and motor to laynx and motor to thorax
The spinal accessory cranial nerve innervates?
neck accessory muscles (sternocleidomastoid) and the trapezius muscles) also the levator veli palatine and uvula
The hypoglossal innervates?
it innervates the depression/elevation of the larynx via the tongue muscles also inn. the neck strap muscles
SLN innervates?
sensory: internal branch the mucous membrane
motor: CT which controls pitch
RLN: where do the R and L branches loop around?
Right branch: loops behind carotid and Right subclavian arteries
Left branch: loops around the aortic arch
What is the motor innervation provided by the RLN?
motor to the TA of VF and the PCA (abductor) LCA (adductor) transverse arytenoids (Adduction), oblique arytenoids (adduction)
It innervates every intrinsic muscle of the larynx except the CT (SLN)
What are some neurogenic etiologies that can cause voice problems?
congenital (Huntington’s), lesion/tumor/disease (dysarthiria’s, strokes, cancer) (ALS)
Trauma (TBI) (any neurological trauma)
lower motor neuron damage can cause?
vf paralysis/paresis, Myosthenia gravis (MG), guilaine-Barre, Flaccid dysarthria
Upper motor neuron damage can cause?
Spastic dys, hypo/hyperkinetic dys, ataxic
what are some types of disorders that cause mixed dysarthria?
ALS, TBI Multiple sclerosis
Myosthenia gravis normally happens in males or females?
females
what is guillane-barre?
if you don’t treat can cause respiratory distress syndrome. they have high protein in CSF/blood..must take out the ptnts blood and put it back in.
It is acute and its a virus that attacks the immune system
What is disorder that goes with or causes hypokinetic dysarthria
Parkinson’s disease
Hyperkinetic dysarthria can be caused by what disorders?
spasmodic dysphonia, essential tremor (Huntington’s disease/chorea)
Ataxic dysarthria is caused by damage to what?
cerebellum
what is the most frequent type of mixed dysarthria?
spastic/flaccid
what can LMN involvement cause?
flaccidity, weakness, reduced muscle contraction, reduced ROM (vf. paralysis)
What are signs and symptoms of spastic dysarthria?
spasticity/hypertonicity, strain/strangle, short phonation time, monopitch (problems with CT)
what are some signs of hypokinetic dysarthria?
rigidity, bradykinesia (slow movements), limited ROM (can really see this in their gate (shuffle)), resting tremor, akinesia (not moving)
What are some signs of hyperkinetic dysarthria?
uncontrolled movements, strain strangled voice
Huntington’s
What is ataxic dys and what are some symptoms/signs?
cerebellar lesion, prosodic slowdown, resonance changes, inarticulation, may sound intoxicated (balance and coordination issue)
Mixed dysarthria:
usually spastic and flaccid
ALS: UMN and LMN involvement (can kill the muscles do not exercise speeds up the process)
death comes between 2-5 years of a diagnosis
progressive neurodegenerative dx
MS: myelin sheath degeneration
TBI: variable
