Study Guide: Know that... (w/ Elaborations) Flashcards
know where the primary motor cortex is
precentral gyrus (BA 4)
extra credit: source for descending motor pathways; voluntary movements; somatotopically organized
know where the primary somatosensory cortex is
postcentral gyrus (BA 1, 2, 3)
extra credit: primary sensation receptor; somatotopically organized
know what the subcortical structures are (4)
diencephalon (thalamus, hypothalamus, epithalamus, subthalamus), basal ganglia, substantia nigra, subthalamic nucleus
know where the cerebellum and the brainstem are located
cerebellum : rear of brain, below cerebrum :: brainstem : between subcortical structures and the spinal cord
extra credit: the brainstem consists of the midbrain, pons, and medulla - origin of the cranial nerves
know where, in general, upper and lower motor neurons originate and terminate
UMNs originate in the cortex and terminate on LMNs (in either the spinal cord or the brainstem); LMNs originate in either the spinal cord or the brainstem and terminate on the muscles they innervate
extra credit: all UMNs decussate to the opposite side before synapsing on LMNs
know what motor planning is
to formulate a strategy of action by specifying motor goals (which are spatial-temporal targets rather than explicit commands re: which muscles should contract)
extra credit: premotor cortex (BA 6) and supplementary motor areas
know the difference between motor planning and motor programming
motor planning : sequential motor goals (articulator specific and not muscle specific) :: motor programming : sets of muscle specific commands
know the difference between motor planning and motor programming according to van der merwe (see lecture 4 also)
motor planning : transformation of phonemes into a code that is handled by the motor system :: motor programming : a set of muscle commands updated via sensory feedback
know motor planning according to van der merwe (see lecture 4 also) (5)
highest level of motor hierarchy; speech context is anticipated with and w/o sensory feedback; core motor plans are recalled from sensorimotor memory; phoneme is the smallest unit - they each have a different motor plan; articulator specific and NOT muscle specific
know motor programming according to van der merwe (see lecture 4 also) (3)
sensory feedback monitors interface between preplanned programs and real time updating; specific movement parameters are computed; timing and amount of muscle contraction is specific before movement onset
know where the corticospinal tracts originates, where it crosses over and where it terminates (i.e. in the spinal cord at the level of the individual spinal nerves)
originates : cerebral cortex at different levels of the spinal cord (mostly primary motor cortex: BA 4) :: terminates : spinal cord at the level of the individual spinal nerves
extra credit: decussates at the pyramids in the lower medulla; innervates muscles of the limbs
know where the the corticobulbar tract originates, where it crosses, and terminates
originates : cerebral cortex :: terminates : different cranial nerve nuclei located at different levels of the brainstem
extra credit: decussates at the level of the cranial nerve nuclei they innervate; innervates all muscles of speech and swallowing EXCEPT respiration
know the terms paralysis / paresis
paralysis : gross limitation of movement :: paresis : incomplete paralysis
know the signs of UMN damage (2)
hypertonia-spasticity; hyperreflexia
know the signs of LMN damage (3)
hypotonia; paralysis / paresis; atrophy (fasciculations fibrillations)
know the subdivisions of the extrapyramidal system (2)
indirect activation pathway; control circuits: basal ganglia and cerebellum (basal ganglia system and cerebellar control circuit)
know the general pathways for the indirect activation pathways
originate in the cortex, synapse on nuclei of the brainstem, and the synapse on the cranial nerve nuclei
extra credit: helps to regulate reflexes and maintain posture and tone
know some of the effects of spasticity on speech (e.g. slowness, hypernasality)
in general, spasticity results in slow movements and reduced range of motion
know the structures that make up the basal ganglia (BG) system (5)
BG : caudate nucleus, putamen, globus pallidus :: BG functional network : subthalamic nucleus, substantia nigra
know the function of BG (2)
dampens cortical discharges; helps to initiate movement
know the results of damage to BG (2)
reduced movement OR excess involuntary movement
know the term dyskinesia
describes movement disorders usually associated with extrapyramidal damage
know the role of the feedforward and sensory feedback mechanisms in coordination of muscle activity
feedforward mechanism contains information concerning volitional movement from the muscles, tendons, and joints; the efferent copy is compared to the actual sensory feedback and error corrections are made if necessary
know what ataxia is
lack of coordination of voluntary motor acts; affects rate, range, timing, direction, and force of movement
be able to write out a simple definition of dysarthria
“a collective name for a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for breathing, phonatory, resonator, articulatory, or prosodic aspects of speech production” (duffy, 2013)
be able to write out a simple definition of apraxia of speech
“a neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech”
know the general lesion locus for each of the dysarthria types, e.g. flaccid = LMN lesion, ataxic = cerebellum (cerebellar control circuit) etc.
flaccid = LMN; spastic = (B)UMN; ataxic = cerebellum; hypokinetic / hyperkinetic = basal ganglia; UUMN = UUMNs
be able to list the components of a MSD exam (4)
hx; ID of salient movement characteristics and their production of normal / deviant speech characteristics; ID of confirmatory signs; Assessment of Intelligibility, Comprehensibility & Efficiency
know what the salient motor characteristics are (e.g. symmetry, strength, etc) (6)
symmetry, strength, speed of movement, range of motion, steadiness, accuracy
know the difference between AMRs and SMRs
AMR : alternating motion rates :: SMR : sequential motion rates
know the difference between intelligibility, comprehensibility, and naturalness
intelligibility : the degree to which a listener understands the acoustic signal produced by a speaker (duffy, 2005) :: comprehensibility : the degree to which a listener understands speech on the basis of the acoustic signal plus all other information that may contribute to understanding what has been said (duffy, 2005) :: naturalness : refers to the normality of speech
be able to list the 5 discreet stages of van der merwe’s model of speech production
intention, linguistic-symbolic planning, motor planning, motor programming, neuromotor execution
know the relationship between the cranial nerves damaged and the speech subsystem affected, e.g. damage to CN X results in impaired phonation and resonance, CN XII in articulation, etc.
CN V : reduced jaw movement-closure (only if bilateral :: CN VII : impaired articulation of sounds involving facial movements (paralysis-paresis)
CN X : impaired phonation and resonance :: CN XII : impaired articulation involving lingual movements
know the confirmatory signs of flaccid dysarthria (6)
paresis / paralysis; atrophy; fasciculations; fibrillations; reduced / absent reflexes; hypotonia
also know that the signs of cranial nerve damage are ___ to the damage, e.g. a left recurrent laryngeal nerve lesion would result in a true ___ vocal cord paralysis / paresis
ipsilateral; left
define apraxia of speech
a neurological speech disorder that impairs the ability to plan sensorimotor commands for movements; causes abnormal articulatory and prosodic speech
define dysarthria
a group of neurological speech dx that affect strength, speed, symmetry, steadiness, ROM, or accuracy of movements required for (1) phonation (2) articulation (3) resonance (4) respiration of speech production
