Overview Flashcards
What is dysarthria?
A group of neurogenic speech disorders that reflect abnormalities in various parameters of the speech mechanism.
What is apraxia of speech?
A neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands for speech.
Motor speech disorders are NOT
cognitive linguistic impairments sensory deficits musculoskeletal defects voice disorders normal changes in speech
What is the site of lesion for flaccid dysarthria?
brainstem motor neurons or nerves to muscles
What is the site of lesion for ataxic dysarthria?
Cerebellum, or tracts leading to and from cerebellum
What is the site of lesion for hypokinetic dysarthria?
Basal ganglia (specifically substantia nigra)
What is the site of lesion for hyperkinetic dysarthria?
basal ganglia
What is the site of lesion for spastic dysarthria?
fiber tracts connecting cortex with brainstem motor neurons
What are the cortical production components of speech, from first to last?
Plan, program, control/monitor, execute
Corticospinal tracts are responsible for what?
connecting cortex to spinal nerves
Corticobulbar tracts are responsible for what?
connecting cortex to cranial nerves
Corticoreticular tracts do what?
indirect pathways, responsible for reflexes, posture, and tone. subconscious
What are the effects of damage to the FCP?
weakness, paralysis (if all LMN damaged), fasciculations, fibrillation
What is a neuromuscular juncture?
synapse in the PNS; axon terminals, motor endplates, shwann cell sheathes
What is a motor end plate?
specialized post synaptic area in neuromuscular junction of PNS
What is the function of groups of fibers in the CNS?
tracts; designed to synapse with other neurons
What is the function of groups of fibers in the PNS?
nerves; transmitting primarily to muscle or from sensory end organs
What is a disease of the cell body associated with dysarthria?
ALS (CNS and/or PNS)
What are two diseases of the axons associated with dysarthria?
MS (CNS) Guillain Barre (PNS)
What is a disease of the synapse between nerve and muscle (PNS) (Neuromuscular junction) associated with dysarthria?
Myasthenia gravis
Which cortical motor areas are associated with dysarthria?
primary motor cortex
premotor area
supplementary motor area
Which cortical motor areas are associated with stuttering?
right frontal operculum (broca’s)
right insula
Which cortical motor areas are associated with apraxia of speech?
Broca’s area
left insula
What are are the cortical sensory areas we need to know/
primary sensory cortex (temperature, pain, pressure)
primary visual cortex
primary auditory cortex
What are the functions of the cerebellum?
muscle tone
movement sequencing and scaling (timing and force)
motor learning or repeated adjustments in force and movement sequencing
role in attention and language
What are the effects of cerebellar damage (associated with dysarthria)?
hypotonia intention tremor dysmetria decomposition of movement ataxia
What are the functions of the basal ganglia?
integrator of motor information for complex movements
postural support needed for skilled, voluntary movements
regulates amplitude, velocity, initiation of movements
What are the effects of damage of the BG?
Hypokinesia (PD) muscle rigidity resting tremor slowness of movement (bradykinesia) reduced movement amplitude (hypokinesia) ??
What is the function of the thalamus?
relay all sensory info but smell
relay motor signals from BG and cerebellum
What is voluntary motor control?
Ability to perform an action on command
depends on control signals originating in motor cortical areas that are sent to PNS
What is the pyramidal system?
direct pathways – skilled movement, input to alpha motor neurons
What is the extrapyramidal system?
indirect pathways – support skilled movement, input to gamma motor neurons
What are the symptoms of UMN damage?
spasticity
weakness or paresis (limited atrophy)
hyper-reflexia
What are the symptoms of LMN damage?
hypotonicity atrophy hyporeflexia weakness muscle fasciculations in acute state
What is unusual about CN VII in terms of innervation?
upper face receives bilateral UMN/corticobulbar tract input
lower face muscles receive contralateral UMN input
What is unusual about the innervation of CN XII?
receives primarily contralateral corticobulbar input
What are the parts of the pyramidal system?
corticobulbar, corticospinal, corticopontine tracts
What are the parts of the extrapyramidal system?
rubrospinal, reticulospinal, olivospinal, vestibulo spinal tracts
What is an AMR? SMR?
both part of DDK
AMR: repetition of single syllable
SMR: repetition of syllable sequence
is AMR or SMR better in people with AOS?
AMR
Can we use DDK rate to make inferences about speed or regularity of tongue movement for connected speech?
NO
What are impairments of respiratory-laryngeal integrity that could be present in dysarthria?
decreased respiratory support
decreased respiratory-phonatory coordination/control
reduced phonatory function (hypoadduction, hyperadduction)
What are some indications of impairments of respiratory-laryngeal integrity?
tired/fatigued when talking and at rest run out of breath when talking have to push words out (effortful talking) poor loudness control weak cough
What are some ways of evaluating respiratory-laryngeal functions?
straw thing
cough
grunt/glottal coup
