PRAXIS 2 23-24 Flashcards
A 65-year-old patient is transferred from another facility with a diagnosis of aphasia. The patient’s symptoms, however, appear more consistent with apraxia. Which of the following tasks for the patient is most appropriate when assessing verbal apraxia of speech?
A.Repeating words of increasing length
B.Recalling three common items
C.Performing voluntary oral movements
D.Following two-step commands
A.Repeating words of increasing length -Inability to repeat two-syllable words is a clear indicator of apraxia of speech.
Oropharyngeal dysphagia in a child with Down syndrome is most likely caused by which of the following factors?
A.Hypotonia
B.Digestive problems
C.Pneumonia
D.Aversive feeding behaviors
A.Hypotonia
Which of the following recommendations to a parent of an infant with cleft lip and palate should an SLP make to best optimize feeding for adequate nutrition and appropriate growth?
A.Providing a bottle rather than breast-feeding the infant
B.Positioning the infant in a supine position during feeding times
C.Allowing the infant to take as much time as needed to feed
D.Using a bottle with a modified nipple during feedings
D.Using a bottle with a modified nipple during feedings
The head lift exercise published by Shaker et al. (2002) was designed to produce which of the following changes in swallow biomechanics?
A.Increase in laryngeal closure duration
B.Strengthening of the base of the tongue
C.Increase in diameter and duration of the upper esophageal sphincter (UES) opening
D.Prolonged relaxation of the cricopharyngeal portion of the inferior constrictor muscle
C.Increase in diameter and duration of the upper esophageal sphincter (UESU E S) opening
Trigeminal fxn and damage
SENSORY: 3 branches
sensation for oral muscoa/teeth (both top&bottom)/gums, face sensation, position bolus in mouth
MOTOR: muscles of mastication, elevation of Hyoid & larynx
Damage: inability to close mouth and chew.
Facial fxn and damage
SENSORY: anterior 2/3 of tongue taste, face, salivary gland stimulation, soft palate
MOTOR: facial expression, lip shape/seal/motion, movt of cheeks
Damage: mask like appearance.
Vestibulocochlear fxn and damage
SENSORY: 2 branches - vestibular & acoustic. Provides sensory information hearing & balance
Damage: hearing loss / balance issues / both
Glossopharyngeal fxn and damage
SENSORY: posterior 1/3 of tongue taste, gag reflex, produce saliva
MOTOR: stylopharyngeus, pharyngeal constriction/shortening, larynx/pharynx elevation
Damage: loss of taste, difficulty swallowing, impaired gag reflex.
Vagus fxn and damage
SENSORY: sensation of food/residue in larynx, pharynx, sensations of larynx, pharynx, ext ear
MOTOR: intrinsic muscles of larynx, VP (velum) closure, constriction of pharynx, peristalsis, digestion/HR/breathing
Damage: swallowing issues, velum paralysis and voice problems
Spinal accessory fxn and damage
MOTOR: sternocleidomastoid, temporalis muscles, head turn/shoulder shrug, some soft palate (velum)
Damage: neck weakness, inability to turn head, shrug or raise arms
Hypoglossal fxn and damage
MOTOR: all intrinsic and some extrinsic tongue muscles, tongue motion
Damage: tongue paralysis, unintelligible speech and swallowing issues
Form consists of:
Phonology, syntax (word order), and morphology (word endings)
Content consists of:
Semantics (word meaning), vocab,
Use consists of:
Pragmatics (social rules of language)
Brown’s Stage I
AGE: 12-26mos, 50 words in vocab, basic phrases with communicative intent (“my doll”)
Brown’s Stage II
AGE: 27-30mos, present progressive -ing, regular plural -s
Brown’s Stage III
AGE: 31-34mos, irregular past tense, possessive ‘s,
Brown’s Stage IV
AGE: 35-40mos, articles (A, The), regular past tense, third person regular present tense
Brown’s Stage V
third person irregular (doggy does tricks), contractible copula (she’s happy), contractible auxiliary (she’s dancing)
Syndrome
multiple anomalies having a single pathological cause (chromosomal or genetic based)
Sequence
single malformation during embryological devlpment causing a pattern or sequence of anomalies
Association
multiple anomalies that co-occur together by chance (without a specific etiology or sequence of events)
Tympanogram type A indicates
normal, tissue moving back and forth
Tympanogram type B indicates
pressure in, eardrum no movt – blocked or infected (fluid/wax/etc), some degree of conductive HL
Tympanogram type C indicates
negative pressure, shifted, pressure in head is different than atmosphere pressure, NOT hearing loss, transitional phase, middle ear is equalizing
How to define if HL is sensorineural?
complete bone conduction test
Sensorineural HL
due to INNER ear damage – age, loud noise exposure, genetic factors,
conductive HL
due to OUTER/MIDDLE ear damage – ear infxns,
Flaccid dysarthria
local: LMN
hypernasality, nasal emissions, weakness, breathy/wet voice, atrophy, imprecise consonants, tongue fasciculations
etiology: stroke, myasthenia gravis,
Spastic dysarthria
local: bilateral UMN
lmtd ROM, slow & effortful speech, increased tone, low pitch, weakness
etiology: stroke, infxn, tumor, CP, TBI, encephalitis
Ataxic dysarthria
local: cerebellar system
slurred speech, poor coordination, inaccurate movts, distorted vowels, prolonged phonemes, slow ‘drunk’ looking
etiology: damage to cerebellum (stroke) or atrophy of cerebellum
HYPOkinetic dysarthria
local: Basal Ganglia
mono pitch/mono loudness, short rushes of speech, rigidity, robotic quality of speech, fast & imprecise DDK
etiology: PD
HYPERkinetic dysarthria
local: Basal Ganglia (++ dopamine)
quick, involuntary movts, variable tone and speech
etiology: Huntington’s Disease
Unilateral Upper Motor Neuron Dysarthria
local: Unilateral upper motor neuron
weakness, unilateral facial weakness, harsh voice, imprecise articulation
etiology: unilateral stroke
The neurons that transmit information away from the brain are called
Efferent
When a person is producing voiced and voiceless /th/, the muscle that is most involved is the
genioglossus
Which muscles are the most involved in adducting the vocal folds?
lateral cricioarytenoids and transverse arytenoids
The lowest frequency of a periodic wave is also known as
Fundamental frequency (F0)
Steven’s & House Rules:
tongue height & F1 inversely related, tongue advancement & F2 positively related, lip rounding increase = all F0 down
Which of the following might be included in a treatment plan for a child with cleft palate?
A.) targeting posterior sounds
B.) targeting increased oral awareness
C.) targeting use of nasal sounds
D.) targeting marked sounds
B.) targeting increased oral awareness
which of the following i the major physical or organic factor underlying impairment in the speech of people with cleft palate?
A.) congenital hearing loss from otitis media
B.) broad irregular maxillary arch
C.) palatopharyngeal insufficiency
D.) irregular vocal fold abduction
C, palatopharyngeal insufficiency is VP insufficiency