Overview of MSD Ch1 Flashcards
apraxia is related to…
groping
dysarthria is related to…
weakness
motor speech disorders
- results from damage to the nervous system, motor control system, or both
- includes cranial nerves
MSDs results from damage to the underlying system involved with…
- planning
- programming and executing speech
- producing fluent, intelligible speech
MSDs do not result from disorders of language or phonology
- may accompany language disorders or phonological disorders
- person may have a language disorder + motor speech disorder (2 distinct disorders) or phonological disorder + motor speech disorder
neurology of speech, cognitive linguistic processes
- intent to communicate is coded into words
- involves cognition and language
- must be coded into speech, the actual production
neuromuscular execution
- selection, sequencing, regulation of sensori-motor programs
- programs activate speech muscles and neurons at appropriate times, durations, and intensities
- allows for motor speech planning, programming, and control
- central and peripheral nervous system must combine
these executive motor speech programs by innervating
- breathing muscles
- phonatory muscles
- resonatory muscles
- articulatory muscles
respiration
- the foundation for speech
- inhalation/exhalation
- disorders of breathing impact speech
we speak during which phase of respiration?
exhalation
phonation
- actual production of speech sound
- sound at its source, vocal folds and air puff from lungs
resonance
- change in speech signal as it travels through
- pharynx, oral cavity, nasal cavity
- size and shape of each structure impacts quality of sound
articulation
movement of articulators to produce the smooth coordinates movements needed fro speech sound production
speech motor control
- requires rapid coordination across a wide range of muscle groups
- brain programs the sequence of movements as a single unit
- articulation highly coordinated and overlapping movements
MSDs can occur if
- brain cannot group and sequence relevant muscles to plan or program a movement
- brain may be sending the wrong plan or program
- deficits or inefficiencies in basic phonological or movement characteristics of muscles
- brain damage can impact planning, coordination, timing, and/or execution
MSDs can be seen in children or adults
- CAS or AOS
- childhood dysarthria
- anoxia, cerebral palsy
- strokes
- TBI
- neurological disorders
apraxia of speech and acquired apraxia of speech
disturbance to brain circuits devoted to the programming or articulatory movements are impaired
dysarthria and dysarthria in adults
disturbances in motor control due to damage to the central or peripheral nervous system (e.g., some degree of weakness, slowness, incoordination, or altered muscle tone)
categorizing MSDs
- age of onset
- can be congenital or acquired
- if acquired, usually clear onset, not always with progressive neurological problems
- course of the disorder
- congenital (e.g., anoxia or cerebral palsy)
- chronic or stationary (stroke patient plateus or adult with cerebral palsy)
- improving (e.g., following stroke or TBI)
- progressive or degenerative (ALS or Parkinson’s)
- exacerbating-remitting (e.g., MS)
site of lesions for MSDs could be
- neuromuscular junction
- peripheral or cranial nerves
- brainstem
- cerebellum
- basal ganglia
- pyramidal or extrapyramidal pathways
- cortex
the motor system, purpose of knowing site of lesion
- neurological diagnosis
- gives you an idea of what to expect with speech
- if site of lesion does not jive with diagnosis, take careful notes and let neurologist know
neurological diagnosis
- degenerative
- inflammatory
- toxic-metabolic
- neoplastic (abnormal cells)
- traumatic
- vascular
type of MSD can help confirm
neurologic diagnosis
Parkinson’s disease generally results in
hypokinetic dysarthria
myasthenia gravis results in
flaccid dysarthria
if not typical type for etiology
suspect incomplete or inaccurate diagnosis
apraxia comes from damage to which hemisphere?
left hemisphere
what percent of MSDs are apraxia?
8%
flaccid dysarthria
- lower motor neuron
- problems with executing the movement
- caused by weakness
spastic dysarthria
- bilateral upper motor neuron problems
- issues with execution of the movement
- spasticity is the neuromotor basis
ataxic dysarthria
- problems originate in the cerebellum
- causes issues with “control”
- difficulty modulating motor programming activities
- movement is uncoordinated
hypokinetic dysarthria
- problem arises in the basal ganglia (extrapyramidal)
- issues with “control”
- resultant problems are from rigidity, reduced range of movement
hyperkinetic dysarthria
- problem arises in basal ganglia (extrapyramidal)
- issues with “control”
- involuntary movements occur
unilateral upper motor neuron
- site of lesion is the upper motor neurons on 1 side
- problems with execution/control
- causes upper motor neuron weakness, incoordination, or spasticity
mixed dysarthria
- more than 1 site of lesion
- more than 1 type
