558: Relevant Material

Question 1

name of the process of specifying spatial and temporal (sequencing) motor goals when formulating an action

Answer 1

motor planning

Question 2

premotor cortex (BA 6) : motor planning of the limbs influenced by external triggers :: ___ motor area : motor planning of the limbs influenced by intentions

Answer 2

supplementary

Question 3

name of the inability to execute skilled, learned motor acts NOT due to neurological or cerebellar damage; also referred to as an impairment of motor planning

Answer 3

apraxia

Question 4

motor planning : articulator specific motor goals :: motor ___ : muscle specific commands

Answer 4

programming

Question 5

according to ___, motor planning occurs first and is articulator specific as opposed to muscle specific

Answer 5

van der mewre

Question 6

regions responsible for motor ___ include: premotor cortex, supplementary motor cortex, Broca’s area, parietal association cortex, portions of insula, portions of basal ganglia

Answer 6

planning

Question 7

regions responsible for motor ___ include: basal ganglia, cerebellum, premotor and supplementary motor cortex

Answer 7

programming

Question 8

the corticospinal and corticobulbar tracts make up the ___ system and are responsible for the execution of ___ movements

Answer 8

pyramidal, voluntary

Question 9

name of the tract that originates in the cortex and descends toward lower motor neurons of the spinal cord; innervates muscles of the limbs

Answer 9

corticospinal

Question 10

name of the tract that originates in the cortex and descends toward lower motor neurons of the brainstem; innervates muscles of the head and neck including those involving speech and swallowing - except muscles of respiration

Answer 10

corticobulbar

Question 11

corticospinal : decussates at the pyramids of lower ___ :: corticobulbar : decussates at the level of the cranial nerve to be innervated

Answer 11

medulla

Question 12

choose: if the corticospinal pathway is damaged above the level of the crossing over in the lower medulla, you will see paresis / paralysis on the ( contralateral / ipsilateral ) side

Answer 12

contralateral

Question 13

choose: if the corticospinal pathway is damaged below the level of the crossing over in the lower medulla, you will see paresis / paralysis on the ( contralateral / ipsilateral ) side

Answer 13

ipsilateral, because the pathways have already crossed over

Question 14

___ levels of the pyramidal pathways used to describe levels of descending white matter pathways include: corona radiata, internal capsule, and crus cerebri

Answer 14

subcortical

Question 15

choose: lesions in the internal capsule have a ( greater / smaller ) chance of creating widespread impairments because fiber pathways are closely packed at this level

Answer 15

greater

Question 16

name of the system whose pathways communicate directly with lower motor neurons to directly transmit the final message (final common pathway) to the muscles

Answer 16

direct motor system

upper motor neurons : central nervous system :: lower motor neurons : spinal nerves and cranial nerves

Question 17

the motor unit consists of (1) the ___ motor neuron cell body in the spinal cord or brainstem (2) the ___ of nerve cell bodies becoming spinal nerves and cranial nerves (3) the point of ___ between the nerve and the muscle (4) individual ___ innervated by this nerve

Answer 17

(1) lower
(2) axon
(3) synapse
(4) muscle fibers

Question 18

paresis : partial paralysis :: paralysis : ___ paralysis

Answer 18

complete

Question 19

signs of ___ motor neuron damage include: hypertonia (spasticity), hyperreflexia, weakened and slowed speech, reduced range of motion in speech

Answer 19

upper

Question 20

signs of ___ motor neuron damage include: hypotonia, paralysis / paresis, atrophy, hyporeflexia

Answer 20

lower

Question 21

name of the system composed of two subsystems, including: the indirect activation pathway and control circuits (basal ganglia, cerebellum)

Answer 21

extrapyramidal system

Question 22

name of the two-stage pathway that begins in the cortex, synapses on select nuclei in the brainstem, and then synapse on the cranial nerve nuclei (i.e. the lower motor neurons)

Answer 22

indirect activation pathway

Question 23

the indirect activation pathways helps to regulate ___ and maintain posture and tone

Answer 23

reflexes

Question 24

damage to the indirect activation pathways results in hyperreflexia and ___ - which results in slowness and hyper adduction of the vocal folds and sometimes, spastic dysarthria or unilateral UMN dysarthria

Answer 24

spasticity

Question 25

name of the first stage pathway (of the indirect activation pathways) that begins in the motor, premotor, and sensory cortex and terminates in the reticular formation of the brainstem

Answer 25

corticoreticular

Question 26

name of the first stage pathway (of the indirect activation pathways) that begins in the cortex and terminates in the red nucleus of the midbrain

Answer 26

corticorublar

Question 27

choose: the ( first / second ) stage pathways (of the indirect activation pathways) run from the reticular formation, vestibular nuclei, and red nucleus to the cranial nerve nuclei

Answer 27

second

Question 28

true or false: the control circuits of the basal ganglia and cerebellum directly synapse on the lower motor neurons

Answer 28

false, the control circuits of the basal ganglia and cerebellum DO NOT directly synapse on the lower motor neurons

Question 29

name of the group of subcortical nuclei involved in motor and cognitive behaviors, whose main nuclei include the striatum (caudate nucleus and putamen) and globus pallidus

Answer 29

basal ganglia

Question 30

the function of the basal ganglia includes: motor and cognitive function, dampening cortical discharges and initiating ___

Answer 30

movement

Question 31

damage to the basal ganglia may result in reduced movement or excess ___ movement

Answer 31

involuntary

Question 32

Parkinson's : reduced movement and trouble initiating movement :: ___ : excessive involuntary movements

Answer 32

Huntington's

Question 33

name of the disease caused by degeneration of the dopamine-producing neurons in the substantia nigra; results in ( increased / reduced ) drive / excitation of motor regions of the cortex

Answer 33

Parkinson's, reduced

Question 34

name of the genetic disease caused by damage to the striatum and cerebral cortex; results in ( increased / reduced ) excitation of the motor regions of the cortex

Answer 34

Huntington's, increased

Question 35

symptoms of ___ disease include: rigidity, akinesia, bradykinesia, hypokinesia, and resting tremor

Answer 35

Parkinson's *note: increased tone (rigidity), difficulty initiating (a-), slow movement (brady-), fewer movement (hypo-)

Question 36

tremor, chorea, athetosis, dystonia, and myonucleus are all types of ___

Answer 36

dyskinesias

Question 37

the term "dyskinesia" is associated with ___ damage; it is also used to describe ___ disorders

Answer 37

extrapyramidal, movement

Question 38

this lobular structure has significantly more afferent pathways than efferent pathways

Answer 38

cerebellum

Question 39

the main function of the cerebellum is coordination of different muscle groups and ___; it also plays a role in motor programming, maintenance of muscle tone, and motor learning

Answer 39

balance

Question 40

the cerebellum helps to coordinate motor activity using feedforward and sensory feedback systems, which compares the ___ copy and actual sensory feedback to make error corrections as necessary

Answer 40

efference

Question 41

name of the term referring to the lack of coordination of ___ motor acts - affects rate, range, timing, direction, and force of movement

Answer 41

ataxia, voluntary

Question 42

name of the term referring to the inability to gauge the distance, speed, and power of movement

Answer 42

dysmetria

Question 43

undershooting : hypometria :: overshooting : ___

Answer 43

hypermetria

Question 44

true or false: hypertonia is a symptom of cerebellar damage

Answer 44

false, hypotonia is a symptom of cerebellar damage

Question 45

name of the category of motor speech syndromes characterized by abnormalities in strength, speed, range, steadiness, tone, or accuracy of movements required for control of respiratory, phonatory, resonator, articulatory, and prosodic aspects of speech production

Answer 45

dysarthria

Question 46

name of the category of motor speech syndromes whose central or PNS abnormalities most often reflect weakness, spasticity, incoordination, involuntary movements, slowness of speech, or excessive, reduced, or variable muscle tone

Answer 46

dysarthria

Question 47

UMN lesions : UUMN dysarthria and spastic dysarthria :: LMN lesions : ___ dysarthria *note: UUMN (unilateral upper motor motor neuron)

Answer 47

flaccid

Question 48

name of the type of lesions responsible for both hypokinetic and hyperkinetic dysarthria

Answer 48

basal ganglia lesions

Question 49

name of the type of lesions responsible for ataxic dysarthria

Answer 49

cerebellar and cerebellar pathway lesions

Question 50

true or false: mixed lesions lead to mixed dysarthrias

Answer 50

true

Question 51

name of the type of dysarthria characterized by the following symptoms: very mild, relative mildness of speech impairment, usually due to stroke, imprecise articulation (harshness, reduced loudness, hyper nasality, slow rate of speech)

Answer 51

UUMN (unilateral upper motor neuron) dysarthria

Question 52

re: UUMN dysarthria where do these lesions occur?

Answer 52

unilateral upper motor neuron dysarthria; lesions in: cerebral hemisphere (usually motor cortex), descending white matter pathways, internal capsule, brainstem

Question 53

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: unilateral lower facial weakness, unilateral tongue weakness

Answer 53

UUMN (unilateral upper motor neuron) dysarthria

Question 54

name of the type of dysarthria characterized by the following symptoms: strained-harsh voice quality, monopitch, monoloudness, slow rate of speech (slow AMRs)

Answer 54

spastic dysarthria

Question 55

name of the measurement of rate, rhythm, precision, and range of motion of rapid movements of the lips, jaw, and tongue; patient is asked to breathe and repeat: /p p p/ /t t t/ and /k k k/

Answer 55

alternate motion rate (AMR)

Question 56

what is the AMR for normal adults?

Answer 56

5 - 6 syllables per second

Question 57

name of the type of lesions responsible for spastic dysarthria

Answer 57

central nervous system lesions and lesions affecting the upper motor neuron pathways

Question 58

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: slow rate of orofacial movements, reduced range of motion, hyperactive gag reflex, pseudo bulbar effect, pathologic laughter and crying, drooling, dysphagia

Answer 58

spastic dysarthria

Question 59

name of the type of dysarthria whose symptoms vary depending on the location of LMN damage, potentially affecting: respiration, phonation, resonance, and articulation

Answer 59

flaccid dysarthria

Question 60

damage to which cranial nerve results in the following flaccid dysarthria symptoms: bilateral trigeminal weakness (reduced jaw movements, weakened closure, articulatory contacts between the tongue, lips, and teeth)

Answer 60

CN V

Question 61

damage to which cranial nerve results in the following flaccid dysarthria symptoms: imprecise articulation of sounds requiring facial movements, paresis or bilateral weakness resulting in distortion of sounds, prevented production of bilabials and labiodentals if paralysis occurs bilaterally

Answer 61

CN VII

Question 62

damage to which cranial nerve results in the following flaccid dysarthria symptoms: voice and resonance changes

Answer 62

CN X *note: occurs because this cranial nerve innervates both the muscles of the larynx and soft palate

Question 63

damage to which cranial nerve results in the following flaccid dysarthria symptoms: vocal cord paralysis, hoarseness, breathiness, diplophonia

Answer 63

CN X *note: diplophonia is when two pitches are perceived rather than one because the two vocal cords are vibrating at different rates

Question 64

damage to which cranial nerve results in the following flaccid dysarthria symptoms: vocal breathiness and / or inhalators stridor

Answer 64

CN X

Question 65

damage to which cranial nerve results in the following flaccid dysarthria symptoms: restricted control of vocal pitch

Answer 65

CN X

Question 66

true or false: unilateral lesions of the superior laryngeal nerve produce significant dysphonia

Answer 66

false; they do not produce significant dysphonia

Question 67

damage to which cranial nerve results in the following flaccid dysarthria symptoms: nasality, audible nasal emission, significant weakness of sounds requiring intramural pressure

Answer 67

CN X

Question 68

damage to which cranial nerve results in the following flaccid dysarthria symptoms: articulatory tongue imprecisions (weakness, atrophy, and fasciculations)

Answer 68

CN XII *note: unilateral hypoglossal lesions : mild articulatory imprecision :: bilateral lesions : severe articulatory imprecisions

Question 69

lesions in which areas often lead to flaccid dysarthria?

Answer 69

cell bodies, axons, or neuromuscular junction of the LMNs, CN V, VII, X, XII, cervical and thoracic spinal nerves

Question 70

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: damage expressed as weakness and loss of muscle tone, oral reflexes reduced or absent, atrophy of affected muscles, fasciculations

Answer 70

flaccid dysarthria

Question 71

name of the type of dysarthria characterized by the following speech symptoms: "drunken" speech, slow speech rate, unsteady vowel prolongations, slow and irregular AMRs

Answer 71

ataxic dysarthria

Question 72

lesions in which areas often lead to ataxic dysarthria?

Answer 72

cerebellum or cerebellar control circuits / pathways

Question 73

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: normal size, strength, symmetry, and reflexes; slow, irregular jaw, face, and tongue movements during non-speech AMR tasks

Answer 73

ataxic dysarthria

Question 74

name of the type of dysarthria characterized by the following speech symptoms: accelerated speech, hypophonia, arctic errors due to reduced range of motion, rapid (and "blurred") speech AMRs

Answer 74

hypokinetic dysarthria

Question 75

lesions in which areas often lead to hypokinetic dysarthria?

Answer 75

basal ganglia control circuit (when diseased); frequent in persons with Parkinson's disease

Question 76

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: expressionless face even during social interaction; tremors in the jaw, face, or tongue at rest; reduced range of motion of the jaw, face, and tongue during speech AMRs

Answer 76

hypokinetic dysarthria

Question 77

the following are two subtypes of which kind of dysarthria? 1. quick or slow, rhythmic or arrhythmic, involuntary movements that interrupt, distort, or slow speech movements 2. affect respiration, phonation, resonance, and articulation - often, prominent affects on prosody

Answer 77

hyperkinetic dysarthria

Question 78

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: rhythmic, quavering waxing, and waning vocal character; possibly abrupt voice arrests and slowed speech rates

Answer 78

tremor

Question 79

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: quick, unsustained, and unpredictable movements where abnormal speech characteristics depend on the structures (jaw, face, tongue, palate, larynx, respiratory system) affected

Answer 79

chorea

Question 80

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: quick, involuntary adductor or abductor movements; voice arrests with strained quality or transient breathiness; hyper nasality and nasal emissions; irregular articulatory breakdowns; prosodic abnormalities; irregular AMRs

Answer 80

chorea

Question 81

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: slow and sustained speech movements; slow, adventitious movements of lips, tongue, or jaw; can be confined to muscles for speed hand swallowing and triggered only by the act of speaking

Answer 81

dystonia

Question 82

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: __ductor spasmodic dysphonia : waxing / waning strained-harsh voice quality :: __ductor spasmodic dysphonia: breathy / aphonic segments of speech

Answer 82

layngeal dystonia; [fill-ins] ad, ab

Question 83

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms: hypernasality, significantly impaired articulation, abnormalities of prosody

Answer 83

dystonia

Question 84

lesions in which area often lead to hypokinetic dysarthria?

Answer 84

basal ganglia control circuits

Question 85

name of the type of dysarthria characterized by the following non-speech oral mechanism findings: normal size, strength, and symmetry; no hyper or hyporeflexia; involuntary movements only observed during the oral motor exam

Answer 85

hyperkinetic dysarthria

Question 86

name of the category of motor speech syndromes characterized by disorders in motor planning

Answer 86

apraxia

Question 87

a disorder of learned movement

Answer 87

apraxia

Question 88

true or false: apraxia is caused by paralysis, weakness, or incoordination and is accounted for by sensory loss, comprehension deficits, or inattention to commands

Answer 88

false; "disorder of learned movement, NOT caused by paralysis, weakness, or incoordination and CANNOT be accounted for by sensory loss, comprehension deficits, or inattention to commands"

Question 89

name of the kind of apraxia characterized by the following speech symptoms: difficulty carrying out volitional, oral non-speech movements (not due to weakness, incoordination, sensory, or cognitive-linguistis impairment)

Answer 89

oral apraxia; also called nonverbal oral apraxia (NVOA)

Question 90

name of the kind of apraxia characterized by the following speech symptoms: imprecise / distorted articulation (SODA); slow speech rate; prolonged consonants and vowels; syllabic production of speech

Answer 90

apraxia of speech (AOS)

Question 91

lesions in which areas often lead to apraxia of speech (AOS)?

Answer 91

middle cerebral artery, posterior portions of the frontal lobe (Broca's area), parietal lobe, sometimes basal ganglia *note: rarely seen in isolation; usually paired with aphasia and / or a unilateral UMN dysarthria

Question 92

___ is a function of the dominant hemisphere, and apraxia of speech is associated with left (___) hemisphere damage

Answer 92

praxis, dominant

Question 93

name of the type of apraxia characterized by the following non-speech oral mechanism findings: right lower facial and tongue weakness due to involvement of the nearby corticobulbar pathway; co-occurance of nonverbal oral apraxia (but may also occur independently)

Answer 93

apraxia of speech (AOS)

Question 94

given that a patient has basal ganglia lesions, they will likely have a ___ hypokinetic : little excitation :: hyperkinetic : excess excitation

Answer 94

dysarthria

Question 95

UUMN (unilateral upper motor neuron) dysarthria is often ___ with lesions in the ___

Answer 95

mild; internal capsule

Question 96

dysarthrias due to UMN lesions include (2)

Answer 96

unilateral UMN dysarthria, spastic dysarthria

Question 97

dysarthrias due to LMN lesions include (1)

Answer 97

flaccid dysarthria

Question 98

dysarthrias due to cerebellar damage include (1)

Answer 98

ataxic dysarthria

Question 99

dysarthrias due to basal ganglia damage include (4)

Answer 99

hyperkinetic dysarthria, hypokinetic dysarthria (tremor, chorea, dystonia)

Question 100

in flaccid dysarthria, damage to this CN is expressed by reduced jaw movement and jaw closure; affected articulatory contacts between the tongue, lips, and teeth

Answer 100

trigeminal V

Question 101

in flaccid dysarthria, damage to this CN is expressed by imprecise articulation of sounds requiring facial movement, such as bilabials and labiodentals

Answer 101

facial VII

Question 102

in flaccid dysarthria, damage to this CN is expressed by vocal cord paralysis, hoarseness, breathiness, diplophonia, restricted vocal pitch, hypernasality

Answer 102

vagus X

Question 103

in flaccid dysarthria, damage to this CN is expressed by weakness, atrophy, fasciculations of the tongue; articulatory imprecisions of all lingual consonants

Answer 103

hypoglossal XII