The Neurology of Speech

Question 1

Conceptual level

Answer 1

• involves thoughts, feelings, ideas
• prefrontal cortex & limbic system
• encoding must take place in upcoming levels

Question 2

Linguistic planning level

Answer 2

2 parts:
- linguistic planning (language content, form, use)
- motor planning (plans, arrangements of phonemes)

pre-motor cortex important area (FRONTAL LOBE)

Question 3

Motor planning

Answer 3

plans and arrangements of phonemes

Question 4

motor programs

Answer 4

involves:
- execution of specific phonemes in time and space
- discrete movements of tongue, lips

Question 5

motor movements make up

Answer 5

a motor plan

Question 6

Apraxia of speech

Answer 6

motor planning and programming disorder

Question 7

characteristic of AOS

Answer 7

searching/groping for articulatory placement, random substitutions, errors in placement

Question 8

Neurological damage leading to AOS

Answer 8

• Brocas area
• supplementary motor area
• insula
• basal ganglia

Question 9

AOS - Broca’s area

Answer 9

• critical role in speech production
• works with motor cortex to control ability to speak words

Question 10

AOS - Supplementary motor area (SMA)

Answer 10

• involved planning & initiating complex movements
• connects Broadman area 6 in frontal lobe (anterior to primary motor)
• associate planning speech production

Question 11

SMA syndrome

Answer 11

• recovery weeks to months starting leg, arm, and lastly speech

cause: direct damage SMA or surgery

Question 12

AOS - insula (insular cortex)

Answer 12

• coordinates complex articulatory movements
• studies suggest role pre-artic planning
• connects with Broca’s area

Question 13

AOS - basal ganglia

Answer 13

• role as gate keeper to allow/inhibit actions
• when damaged, can floor system competing options

Question 14

the basal ganglia includes

Answer 14

caudate nucleus
putamen
globus paddius
substantia nigra
subthalamic nuclei

Question 15

Basal ganglia

Answer 15

regulates motor functioning, especially tone and posture so that we have smooth/precise motor movements

Question 16

damage to basal ganglia

Answer 16

dyskinesias results

Question 17

cerebellum

Answer 17

coordinates muscle movements so they are skilled and sequential

Question 18

damage to cerebellum circuit

Answer 18

speech can become uncoordinated – ataxic dysarthria

Question 19

Upper Motor Neuron damage

Answer 19

SPASTIC MUSCLES
- hypertonia
- hyperflexia

Clonus
Babinski sign
No atrophy
No fasciculations

Question 20

Lower Motor Neuron damage

Answer 20

FLACCID MUSCLES
- hypotonia
- hyporefelxia

No clonus
No babinski sign
Marked atrophy
Fasciculations

Question 21

Indirect motor system

Answer 21

AKA extrapyramidal system
medial motor systems:
- anterior corticospinal
- vestibulospinal
- reticulospinal
- tectospinal

Question 22

Final common pathway (FCP)

Answer 22

Last leg go motor signal journey
Part of the lower motor neurons

Question 23

the FCP involves

Answer 23

• cranial nerves in the case of speech
• alpha motor neurons (innervate extrafusal muscle fibers involved in muscle contraction)
• gamma motor neurons (innervate intrafusal muscle fibers involved in proprioception)

Question 24

Cranial nerves can be affected when there is LMN damage

Answer 24

V trigeminal
VII facial
IX glossopharyngeal
X vagus
XI accessory
XII hypoglossal
Spinal nerves c3-c5, t2-t11

Question 25

damage to multiple motor pathways can lead to

Answer 25

mixed dysarthria (ALS)

Question 26

ascending sensory tracts

Answer 26

dorsal column
spinothalamic
spinocerebellar

Question 27

sensory tracts

Answer 27

provide proprioception for speech

Question 28

proprioception

Answer 28

body’s eyes for itself or the body’s knowledge of where its parts are in space

Question 29

proprioception is made up of

Answer 29

1. Kinesthesia (brain awareness of position and structure movement)
2. Joint position sense