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Motor Speech > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Cranial Nerves receive impulses from the cortex from the __________ tract

A

Corticobulbar

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2
Q

For the cranial nerves I-IV are at the _____ level of the brainstem

A

Midbrain

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3
Q

For the cranial nerves, V-VIII are at the _______ level of the brainstem

A

Pons

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4
Q

For cranial nerves, IX-XII are at the level of the ________

A

Medulla

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5
Q

Are cranial nerves UMN’s or LMNs?

A

LMNs

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6
Q

Cranial nerves innervate muscles of which structures?

A

jaw, face, pharynx, larynx, soft palate, tongue and neck

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7
Q

The cranial nerves of speech production are….

A

Trigeminal, facial, glossopharyngeal, vagus, spinal accessory, and hypoglossal

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8
Q

When would you test the olfactory nerve?

A

If a frontal lobe tumor is suspected

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9
Q

What are some conditions that might cause a damaged olfactory nerve?

A

Closed head injuries, nasal obstruction, viral infections, Parkinson’s, MS, Alzheimer’s

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10
Q

How do you test the olfactory nerve?

A

Ask if patient can smell vanilla or cinnamon in each nostril

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11
Q

How to test visual field

A

Card at patient’s bedside

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12
Q

What three nerves control eye movement and pupil diameter?

A

III- Oculomotor
IV- Trochlear
VI- Abducens

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13
Q

How to test these oculomotor, trochlear, and abducens

A

Hold up a finger in front of your partner. Tell them to keep their head still and follow your finger up and down, right and left. Do their eyes follow your finger?

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14
Q

What does the Trigeminal Nerve (V) control

A

Facial muscles and muscles of mastication

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15
Q

How to test the trigeminal nerve

A

Palpate the masseter muscle as the patient bites down hard.
Open mouth and resist examiner’s attempt to close the mouth.
Jaw jerk reflex

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16
Q

What are the three branches of the trigeminal nerve?

A

Opthalmic, Mandibular, Maxillary

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17
Q

What does the mandibular branch of the trigeminal nerve do?

A

Innervates muscles of the jaw and velum for elevation and lowering

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18
Q

What function is the Abducens (VI) nerve responsible for?

A

Eye movement

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19
Q

How to examine the facial nerve generally?

A

Examine facial symmetry. Check taste.

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20
Q

How to examine the motor portion of the facial nerve?

A 
Have the patient wrinkle their forehead
Puff out cheeks
Close eyes tight 
Show their teeth
Purse their lips or blow a kiss (orbicularis iris)
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21
Q

How to examine the sensory portion of the facial nerve?

A

Dip a cotton tip in sweet, salty, sour, or bitter. Apply to one side then the other side of the extended tongue.

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22
Q

The portion of the facial nerve that serves the muscles of the lower face receives unilateral innervation from the ______ side of the brain

A

contralateral

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23
Q

The portion of the facial nerve that serves the muscles of the upper face receives bilateral innervation from the _________

A

right and left corticobulbar tracts

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24
Q

Upper motor neuron lesions such as stroke cause _____________

A

Contralateral facial weakness, sparing the forehead

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25
Q

Lower motor neuron lesions such as facial nerve injury cause ___________

A

Weakness involving the whole ipsilateral face

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26
Q

What are the roles of the glossopharyngeal nerve?

A

Innervates the stylopharyngeus muscle which assists in the elevation of the pharynx and larynx.
Plays a role in resonance and phonation by shaping the pharynx
Contributes to the gag reflex, an important component of swallowing.

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27
Q

What are some of the structures served by the Vagus nerve (CN X)?

A

Heart, velum, larynx, intestines

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28
Q

What are three branches of CN X that have special importance to speech production?

A

Pharyngeal nerve branch,
Exterior superior laryngeal nerve branch
Recurrent nerve branch

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29
Q

Which CNs are tested together?

A

CN IX and X

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30
Q

How are they tested?

A

Symmetrical palate elevation while saying “ah”

Does the patient gag when the posterior pharynx is brushed?

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31
Q

What is the main function of the spinal accessory nerve?

A

Help turn, tilt, and thrust the head forward

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32
Q

What muscles does the spinal accessory nerve innervate?

A

Trapezius, sternocleidomastoid- related to posture for speech and feeding

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33
Q

How do you test the spinal accessory?

A

To test the strength of the muscles used in head movement, put your hands on the sides of the patient’s head. Tell the patient to move his or her head from side to side. Apply only light pressure when the head is moved.

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34
Q

What does the hypoglossal nerve innervate?

A

Intrinsic muscles of the tongue and most extrinsic muscles

Supplies muscles of the tongue and muscles surrounding the hyoid bone.

35
Q

How do you test the hypoglossal nerve?

A

Have patient stick out tongue and move it from side to side.

Strength can be tested by having the patient push the tongue against a tongue blade.

DDK

Note any atrophy or fasiculations of the tongue while it is resting on the floor of the mouth

Ask patient to stick out tongue and note whether it curves to one side or not

Ask patient to move tongue from side to side and push it forcefully against the inside cheeks

36
Q

Tongue fasiculations and atrophy are indicative of…

A

LMN lesions

37
Q

Unilateral tongue weakness can cause the tongue to deviate toward the _____ side

A

Weak

38
Q

Abnormal articulation can be the result of lesions in…

A

Muscles of articulation, neuromuscular junction, peripheral or central portions of cranial nerves V, VII, IX, and XII

39
Q

What are the two branches of the auditory nerve

A

Vestibular, cochlear

40
Q

Vestibular branch carries impulses for….

A

balance

41
Q

Cochlear branch carries impulses for…

A

hearing

42
Q

The Glossopharyngeal nerve innervates the ______ muscle which assists in the elevation of the pharynx and larynx

A

Stylopharyngeus

43
Q

The major role of the spinal accessory nerve (XI) is to….

A

help turn, tilt, and thrust the head forward, posture for speech and feeding

44
Q

Name two muscles that the spinal accessory nerve innervates

A

Sternocleidomastoid, trapezius

45
Q

How to test the spinal accessory nerve

A

Put your hands on the sides of the patient’s head. Tell the patient to move their head from side to side. Apply only light pressure when the head is moved.

46
Q

What is the neuromuscular junction?

A

Point at which axons of the PMN make synaptic connections with muscle cells; .

47
Q

What is an action potential?

A

A neural impulse, a brief electrical charge that travels down an axon

Generated by the movement of positively charged atoms in and out of channels in the axon’s membrane

48
Q

What is a threshold?

A

The level of stimulation required to trigger a neural impulse

49
Q

What is a synapse?

A

Junction between the axon tip of the sending neuron and the dendrite or cell body of the receiving neuron.
A tiny gap at this junction is called a synaptic gap or cleft.

50
Q

What are neurotransmitters?

A

Chemical messengers that transverse the synaptic gap between neurons.

When released by the sending neuron, neurotransmitters travel across the synapse and bind to receptor sites on the receiving neuron, thereby influencing whether it will generate a neural impulse.

51
Q

What are the components of the cortical level of motor speech function?

A

Primary motor cortex, premotor cortex, supplementary motor area, Broca’s area

52
Q

What are the components of the direct motor system (pyramidal system)

A

Corticobulbar tract, corticospinal tract

53
Q

What are the components of the indirect motor system (extrapyramidal system)

A

Subcortical level- basal nuclei

Descending pathways

54
Q

What kind of movement does the Direct Motor System (pyramidal system) control?

A

Muscle tone
Conscious fine, skilled movements
In the face and distal limbs
Operates at a conscious level

55
Q

What do descending motor pathways do in general?

A

Deliver impulses from the brain to the spinal cord.

56
Q

What do indirect (extrapyramidal) pathways control?

A

Subconscious motor programs (arm swing)

Help maintain appropriate level of skeletal muscle tone

57
Q

What is the general path that the corticobulbar tract takes?

A

Descend through the sub cortex and brainstem to connect with cranial nerves that control the oral mechanism.

Courses through the internal capsule, then the cerebral peduncles, then mixes up with other fibers in the pons, then on the ventral surface of the medulla in the medullary pyramids.

58
Q

The path of the corticospinal tract

A

Arise from various sensory motor areas of the brain
System descends and enters the diencephelon where its fibers are concentrated in a small area called the internal capsule
Fibers enter the brainstem and descend through the peduncles of the midbrain, pons, and pyramids of the medulla
At the lower margins of the medulla, the fibers decussate to the opposite side

59
Q

Damage to the corticospinal tract can cause

A

Loss of muscle strength, reduced dexterity of the hands and fingers

60
Q

What kinds of muscles does the corticospinal tract regulate?

A

Muscles that maintain balance and posture, muscles controlling coarse movements of the proximal portions of the limbs, muscles that control head neck, and eye movement.

61
Q

What is the rubrospinal tract responsible for?

A

Large muscle movement as well as fine motor control
Terminates primarily in the cervical spinal cord
Facilitates flexion in the upper extremities
Upper limb, but not lower limb control

62
Q

What is the pathway of the reticulospinal system and what kinds of muscles/movements does it control?

A

The reticulospinal system is an extrapyramidal motor tract that descends from the reticular formation in two tracts to act on the motor neurons supplying the trunk and proximal limb muscles. Mainly involved in locomotion and postural control.

63
Q

List deficits that involve too little movement

A

Rigidity (resistance to movement, stiffness/tightness, slowness)
Bradykinesia (reduced speed of muscle activation; delays and false starts, slowness)
Reduced range of motion (hypokinesia)
Tremor (static or resting)
Breaking and Freezing problems (starting and stopping; e.g. stopping at the foot of the stairs)

64
Q

To what other major structures do the basal ganglia have fibers connected to?

A

Cerebral cortex
Thalamus and hypothalamus
Descending fibers to the spinal cord

65
Q

What is chorea?

A

An involuntary movement disorder, one of a group of neurological disorders called dyskinesias

66
Q

What is athetosis

A

Symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases arms, legs, neck, and tongue

67
Q

List some upper motor neuron symptoms

A 
Spastic hemiplegia
Increased muscle tone
\+ Babinski sign
Hyperreflexias
Loss of abdominal reflexes
68
Q

List some clinical signs of a pyramidal syndrome

A

Spasticity, involuntary movement is absent, Positive Babinski sign, increased muscle stretch reflex

69
Q

List some clinical signs of an extrapyramidal indirect motor system syndrome

A

Rigidity, involuntary movement is present, absent babinski sign, decreased stretch reflex

70
Q

Cerebellar control circuit lesions can result in what kind of dysarthria?

A

Ataxic

71
Q

Ataxic dysarthria is characterized by….

A

Incoordination, hypotonicity

72
Q

What are confirmatory signs of cerebellar control circuit lesions?

A 
Slow voluntary movements
Jerkiness of movements
Wide based gait
Intention or terminal tremor
Essential tremor
73
Q

What is the PNS also known as

A

The final common pathway

74
Q

What does the final common pathway refer to?

A

Cranial nerves that attach to the brainstem and spinal nerves that attach to the spinal cord

75
Q

The final common pathway implies that the…

A

PNS serves as the last route of the nervous system

76
Q

What is the role of the lower motor neuron system in speech?

A

To carry out the commands delivered by UMNs as delivered by the cerebral cortex and as influenced by the basal ganglia and cerebellar control circuit

77
Q

Name symptoms of damage to LMN system

A

Eliminate function of motor unit
Weakness of muscles and reduce tendon reflexes
Muscle tone is flaccid
Absent or greatly reduced babinski

78
Q

LMN lesion symptoms can be seen in which disorders?

A

Myasthenia gravis and muscular dystrophy

79
Q

UMNs originate in the ________ and synapse onto cranial nerve nuclei in the _________ or onto cells in the __________

A

motor cortex
brainstem (corticobulbar)
spinal cord (corticospinal)

80
Q

If UMNs are damaged, there will be…

A

Spasticity, reduction in the ability to initiate skilled motor movements, babinski sign

81
Q

What is spasticity

A

Increased muscle tone, reflexes are exaggerated

82
Q

If LMNs are damaged, the result is

A

Flaccid paralysis

83
Q

UMN pathways are

A

Direct/pyramidal system, basal nuclei and cerebellar control circuit

Motor Speech (3 decks)

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