Week 1/quiz 1 Flashcards
Motor Speech Processes
speech motor planning, programming, control, and execution
cognitive linguistic processes
all the processes converting our verbal/emotional messages into a code
neuromuscular execution
speech articulators in charge of executing those commands
1st step of why MSD is important
the study of MSD helps us understand the organization of the sensorimotor system
2nd step of why MSD is important
changes in speech can be the initial or oNLY sign of neurologic disease
3rd step of why MSD is important
an increase in prevalence can be anticipated as people live longer
4th step of why MSD is important
proper identification of deficits in speech and neuropwthphysiology helps with management
dysarthria
disorders presenting with abnormal strength, speed, range, steadiness, tone, or accuracy of movement (execution phase)
apraxia
impaired capacity to plan or program the motor commands necessary for directing phonetically and prosodically normal speech
planning phase
formulation of the strategy of action by defining motor goals
-motor goals can be found in spatial and temporal movements of speech sounds
programming phase
muscle tone, movement velocity, force, and range are specified
control phase
modulatory muscle adjustment occurs before or during execution of speech tasks
dysarthrias
-neurologic in origin (must be)
-disorder of movement
-impairment of upper and lower motor neurons resulting in disordered strength, range, tone, etc.
-not a single disorder, but rather a group of disorders that can be categorized
-overused by other professionals
apraxia
neurologic in origin (can be pure apraxia or mixed with dysarthria)
-can be congenital or acquired
other neurologic disorders
acquired neurogenic stuttering, palilalia, echolalia, mutism, foreign accent syndrome
-cognitive-lingusitc disturbances: aphasia, akinetic mutism
-sensory deficits: congenital deafness
nonneurologic disturbances
musculoskeletal defects (laryngectomy, cleft lip and palate
-nonneurologic or nonpsychogenic voice disorders (dysphonia with head and neck neoplasms, vocal abuse, hormonal disturbances
-psychogenic: schizophrenia, depression, conversion disorder
normal variations in speech production
age, gender, variations in style
the neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution
neuromuscular execution
changes in speech can be the initial or ONLY sign of
neurologic disease
all statements regarding dysarthria are correct EXCEPT
-neurologic in origin
-a disorder of movement
-a group of disorders that can be categorized based on perceptual characteristics
-impairment of planning and programming
-impairment of planning and programming
methods we will use for Dx and Tx of MSDs
perceptual methods and instrumental methods
perceptual methods
the GOLD standard for clinical differential diagnosis
-auditory modality is the focus of investigations of perceptual characteristics of the dysarthrias (70-75%) and rest is from visual and tactile observations
instrumental methods
-not widely used
acoustic instrumental method
quantify and display frequency, intensity, and temporal components of the speech signal
physiologic instrumental method
measure the sources of activity the generate and control speech
-common methods are movement of air and peripheral structures
visual imaging methods
video fluoroscopy, nasoendoscopy, laryngoscopy, and videostroboscopy (used to see vocal folds and soft palate)
reasons we use perceptual methods
-identification, referral, and evaluation of anyone suspected of having an MSD
-the usefulness of perceptually based differential diagnosis
-standard for judging the functional outcome of treatment is mostly based on perceptual judgements
flaccid dysarthria (localization)
lower motor neuron
flaccid dysarthria (neuromotor bases-general)
execution
flaccid dysarthria (neuromotor bases-specific)
weakness
spastic dysarthria (localization)
bilateral upper motor neuron
spastic dysarthria (neuromotor bases-general)
execution
spastic dysarthria (neuromotor bases-specific)
spasticity
ataxic (neuromotor bases-general)
control
ataxic dysarthria-localization
cerebellum
ataxic (neuromotor bases-specific)
incoordination
hypo kinetic dysarthria-localization
basal ganglia control circuit
hypo kinetic- neuromotor bases-general
control
hypo kinetic-neuromotor bases- specific
rigidity; reduced range of movement
hyperkinetic- localization
basal ganglia control circuit
hyperkinetic- neuromotor bases- general
control
hyperkinetic- neuromotor bases- specific
involuntary movement
unilateral upper motor neuron
same as for localization
unilateral upper motor neuron- neuromotor bases-general
execution/control
unilateral upper motor neuron- neuromotor bases-specific
upper motor neuron weakness, incoordination, or spasticity
apraxia of speech-localization
left (dominant) hemisphere
apraxia of speech- neuromotor bases-general
motor programming/planning
apraxia of speech- neuromotor bases-specific
planning/programming errors
most common dysarthria
mixed
in a patient who is in the acute phase of stroke, the course of motor speech disorder is
improving
