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Hagge MSD Exam 2 > Study Guide > Flashcards

Study Guide Flashcards

0
Q

Name the pathways and their tracts

A
  • Final common pathway
  • Direct activation pathway- corticobulbar and corticospinal
  • Indirect activation pathway- corticoreticular and corticorubral
  • Control circuits- cerebellar and basal ganglia
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1
Q

What are tracts and pathways?

A

groups of fibers that travel together in the CNS that transmit impulses to other neurons

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2
Q

What is the Romberg test?

A

Romberg test: a test of balance that rules out loss of proprioception, vestibular problems, or hysteria (exaggerated/uncontrollable emotion). Need 2/3 things to maintain balance while standing: proprioception, vestibular function (head position in space), and vision. Patient asked to close eyes, if loose balance, may indicate a positive Romberg associated with cerebellar ataxia.
Test: stand with feet together and eyes open versus feet together and eyes closed.

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3
Q

what are the 4 parts of the motor speech disorder examination?

A
  1. history
  2. examination of the oral mechanism at rest or during non-speech activities
  3. perceptual assessment of speech characteristics
  4. assessment of intelligibility, comprehensibility, and efficiency
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4
Q

which nerves are involved with speech production?

A

CN V: trigeminal- Sensory from face and mouth; motor to muscles of chewing
CN VII- Facial: Facial movement, hyoid elevation, stapedius reflex, salivation, lacrimation, and taste.
CN IX: glossopharyngeal- Pharynx for swallowing, posterior 1/3 of tongue
CN X: vagus- All intrinsic muscles of larynx; swallowing, phonation, involuntary muscle and gland control; taste; skin/organ sensitivity
CN XI: accessory- Muscles that move the head, neck, and shoulders
CN XII: hypoglossal- Movement of the tongue

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5
Q

what are the 5 systems that we assess with dysarthria?

A

phonation, prosody, articulation, resonance, respiration

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6
Q

what are the published tests for dysarthria and apraxia that Duffy describes?

A

Dysarthria- Frenchay Dysarthria Assessment (FDA-2)

Apraxia- Apraxia Battery for Adults- Second Edition (ABA-2)

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7
Q

describe intelligibility, comprehensibility and efficiency

A

Intelligibility: the degree to which a listener understands the acoustic signal produced by a speaker.
Comprehensibility: the degree to which a listener understands speech on the basis of the auditory signal plus all other info. that may contribute to understanding what has been said.
Efficiency: rate at which intelligible or comprehensible info. is conveyed. (may be intelligible but very inefficient because rate is slow).

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8
Q

define palilalia

A

compulsive repetition of words/phrases, usually in context of accelerating rate and decreasing loudness.

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9
Q

define diplophonia

A

simultaneous perception of two different pitches

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10
Q

define coprolalia

A

involuntary, compulsive, repetitive obscene language or swearing, uttered loudly, softly, or incompletely

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11
Q

define vocal flutter

A

rapid, relatively low-amplitude voice tremor, usually most apparent during vowel prolongation

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12
Q

what are pitch breaks?

A

pitch shows sudden and uncontrolled variation

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13
Q

Grandfather passage importance

A
  • batters its reader with syntactic and semantic complexity
  • offers an ideal mode of eliciting speech and reading errors
  • may be used for a quick survey of the student’s ability to produce correct speech sounds
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14
Q

at what level are the problems located for flaccid dysarthria?

A

final common pathway

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15
Q

what type of lesions would result in flaccid dysarthria?

A

lesions to LMN

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16
Q

what is the most prominent feature of flaccid dysarthria?

A

muscle weakness

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17
Q

what are the hallmarks of flaccid dysarthria?

A
  • hypernasality
  • nasal air emission
  • audible inspiration or stridor on inhalation
  • often speaks in short phrases
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18
Q

if all LMN is lost, what is the result?

A

paralysis

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19
Q

if some of LMN is lost, what is the result?

A

paresis

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20
Q

what are fasciculations?

A

muscle twitches– a small, involuntary muscle contraction and relaxation

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21
Q

what is SLOP?

A

Slow
Loud
Overaticulate
Pause

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22
Q

Spastic dysarthria is a result from what kind of neuron damage?

A

bilateral UMN: direct and indirect activation pathways of CNS

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23
Q

T/F speech deficits will present at rest with spastic dysarthria

A

false; will present in movement

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24
Q

which areas of speech are affected in spastic dysarthria?

A

all of them

25
Q

What kind of lesions is ataxic dysarthria associated with?

A

cerebellar

26
Q

what does ataxic dysarthria affect?

A

standing, walking, speech

-movements halting, imprecise, jerky, poorly coordinated, lack of fluidity/smoothness

27
Q

name the terms that accompany cerebellar lesions

A 
Nystagmus
Hypotonia
Dysmetria
Dysdiadokokinesis
Intention or kinetic tremors
28
Q

Define nystagmus

A

Rapid back and forth jerky movements of the eyes at rest or with lateral or upward gaze

29
Q

define hypotonia

A

absence of tone; decrease in resistance to passive

30
Q

define dysmetria

A

An inability or impaired ability to accurately control the range of movement in muscular acts
Overestimating or underestimating the range of motion needed to place the limbs correctly during voluntary movement

31
Q

define dysdiadokokinesis

A

movement, errors in the sequence and speed of component parts of a movement, with a resultant lack of coordination

32
Q

T/F ataxic dysarthria is poorly coordinate movement pattern rather than weakness

A

true

33
Q

where are the breakdowns for ataxic dysarthria?

A

motor organization and control

34
Q

T/F breakdowns for ataxic dysarthria are consistent

A

false; they are inconsistent– breakdowns for flaccid dysarthria are consistent

35
Q

what is the Romberg test?

A

test of balance that rules out loss of proprioception, vestibular problems, or hysteria

36
Q

What is Unilateral UMN dysarthria associated with?

A

damage to UMN

37
Q

T/F UUMN dysarthria results in bilateral UMN weakness in face/tongue

A

false; it results in unilateral UMN weakness in face/tongue (bilateral = spastic dysarthria)

38
Q

list some clinical characteristics of UUMN dysarthria

A
  • Babinski reflex on affected side
  • combo of weakness and spasticity, affected limbs
  • corticobulbar involvement- contralateral lower facial weakness
39
Q

what are some etiologies for UUMN dysarthria? which is the most common?

A
  • tumors
  • trauma– especially surgical trauma
  • unilateral stroke (most common)
40
Q

what component of speech is mostly affected for UUMN dysarthria?

A

articulation

41
Q

T/F weakness is on the contralateral side for UUMN

A

true

42
Q

T/F tongue protrusion will deviate to the stronger side

A

false; weaker side

43
Q

how does UUMN and flaccid dysarthrias differ in terms of weakness?

A

UUMN is weakness on lower half of one side

flaccid is total paresis on one side

44
Q

Apraxia or Dysarthria?

An impaired ability to generate the motor programs for speech movements

A

Apraxia; Apraxia is a planning/programming problem, not a movement problem like dysarthria

45
Q

Apraxia or Dysarthria?

Errors are inconsistent and unpredictable

A

Apraxia

46
Q

Apraxia or Dysarthria?

Errors are consistent and predictable

A

Dysarthria

47
Q

Apraxia or Dysarthria?

Errors are mainly distortions and omissions

A

Dysarthria

48
Q

Apraxia or Dysarthria?

Different errors occur in spontaneous speech versus repetition

A

Apraxia

49
Q

Apraxia or Dysarthria?

Patient’s spontaneous speech contains fewer errors than does his/her speech in repetition tasks

A

Apraxia

50
Q

Apraxia or Dysarthria?

Distortions are the most common type of error

A

Dysarthria

51
Q

Apraxia or Dysarthria?

“Slurred speech”

A

Dysarthria

52
Q

Apraxia or Dysarthria?

Speaking softly or barely able to whisper

A

Dysarthria

53
Q

Apraxia or Dysarthria?

There are islands of clear speech; when producing over-learned material or material that has become automatic, the patient will speak clearly

A

Apraxia

54
Q

Apraxia or Dysarthria?

Slow rate of speech

A

Dysarthria

55
Q

Apraxia or Dysarthria?

Substitutions are the most common type of error

A

Apraxia

56
Q

Apraxia or Dysarthria?

Anticipation of errors cause dysfluent speech

A

Apraxia

57
Q

Apraxia or Dysarthria?

Hoarseness

A

Dysarthria

58
Q

Apraxia or Dysarthria?

Breathiness

A

Dysarthria

59
Q

Apraxia or Dysarthria?

Groping, trial and error types of articulatory movements

A

Apraxia

60
Q

Apraxia or Dysarthria?

Changes in vocal quality

A

Dysarthria

61
Q

Apraxia or Dysarthria?

The muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all after a stroke or other brain injury

A

Dysarthria

Hagge MSD Exam 2 (4 decks)

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