The Neurology of Speech Flashcards
Conceptual level
- involves thoughts, feelings, ideas
- prefrontal cortex & limbic system
- encoding must take place in upcoming levels
Linguistic planning level
2 parts:
- linguistic planning (language content, form, use)
- motor planning (plans, arrangements of phonemes)
pre-motor cortex important area (FRONTAL LOBE)
Motor planning
plans and arrangements of phonemes
motor programs
involves:
- execution of specific phonemes in time and space
- discrete movements of tongue, lips
motor movements make up
a motor plan
Apraxia of speech
motor planning and programming disorder
characteristic of AOS
searching/groping for articulatory placement, random substitutions, errors in placement
Neurological damage leading to AOS
- Brocas area
- supplementary motor area
- insula
- basal ganglia
AOS - Broca’s area
- critical role in speech production
- works with motor cortex to control ability to speak words
AOS - Supplementary motor area (SMA)
- involved planning & initiating complex movements
- connects Broadman area 6 in frontal lobe (anterior to primary motor)
- associate planning speech production
SMA syndrome
- recovery weeks to months starting leg, arm, and lastly speech
cause: direct damage SMA or surgery
AOS - insula (insular cortex)
- coordinates complex articulatory movements
- studies suggest role pre-artic planning
- connects with Broca’s area
AOS - basal ganglia
- role as gate keeper to allow/inhibit actions
- when damaged, can floor system competing options
the basal ganglia includes
caudate nucleus
putamen
globus paddius
substantia nigra
subthalamic nuclei
Basal ganglia
regulates motor functioning, especially tone and posture so that we have smooth/precise motor movements
damage to basal ganglia
dyskinesias results
cerebellum
coordinates muscle movements so they are skilled and sequential
damage to cerebellum circuit
speech can become uncoordinated – ataxic dysarthria
Upper Motor Neuron damage
SPASTIC MUSCLES
- hypertonia
- hyperflexia
Clonus
Babinski sign
No atrophy
No fasciculations
Lower Motor Neuron damage
FLACCID MUSCLES
- hypotonia
- hyporefelxia
No clonus
No babinski sign
Marked atrophy
Fasciculations
Indirect motor system
AKA extrapyramidal system
medial motor systems:
- anterior corticospinal
- vestibulospinal
- reticulospinal
- tectospinal
Final common pathway (FCP)
Last leg go motor signal journey
Part of the lower motor neurons
the FCP involves
- 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)
Cranial nerves can be affected when there is LMN damage
V trigeminal
VII facial
IX glossopharyngeal
X vagus
XI accessory
XII hypoglossal
Spinal nerves c3-c5, t2-t11
damage to multiple motor pathways can lead to
mixed dysarthria (ALS)
ascending sensory tracts
dorsal column
spinothalamic
spinocerebellar
sensory tracts
provide proprioception for speech
proprioception
body’s eyes for itself or the body’s knowledge of where its parts are in space
proprioception is made up of
- Kinesthesia (brain awareness of position and structure movement)
- Joint position sense
