Exam 1 Flashcards
(104 cards)
0
Q
Sound
A
Waves transmitted through a medium
1
Q
Communication
A
Exchange of information with a sender and a receiver
2
Q
Speech
A
Acoustic signal, coding, or representation of language
3
Q
Language
A
Abstract, agreed upon set of symbols that represent meaning
Rule based
4
Q
Motor Speech Processes: Message Planning
A
What do I want to say?
5
Q
Motor Speech Processes: Message Coding
A
How do I say it (what words do I use)
6
Q
Motor Speech Processes: Motor Planning
A
Choose the movement strategies, taking into account the intended goal
7
Q
Motor Speech Processes: Motor Programming
A
What muscles, how much, when, how long
8
Q
Motor Speech Processes: Execution
A
Activation of motor neurons, activation of respiratory, resonatory, phonatory, and articulatory systems
9
Q
Motor Speech Disorders
A
Acquired neuromotor speech disorders
Neurogenic speech disorders
Due to damage, disease, developmental differences of neural centers and pathways of speech production in the CNS and/or PNS
11
Q
Disorders of motor programming/planning
A
Apraxia or dyspraxia
No motor weakness
12
Q
Disorders of neuromotor execution
A
Dysarthria
Must be differentiated from other disorders like psychogenic disorders, normal aging, structural differences
Result of disturbance in execution of speech movements
Language generally uneffected
Related to movement
13
Q
Limb apraxia
A
Cant perform actions with body on demand
14
Q
Orofacial apraxia
A
Cant complete gestures with articulators such as sticking out tongue on demand
15
Q
Flaccid Dysarthria
A
Lower Motor Neuron
16
Q
Spastic Dysarthria
A
Bilateral upper motor neuron
17
Q
Ataxic Dysarthria
A
Cerebellum/cerebellar control circuits
18
Q
Hypokinetic Dysarthria
A
Basal Ganglia (substantia nigra) PD
19
Q
Hyperkinetic Dysarthria
A
Basal Ganglia
20
Q
Methods of Studying Motor Speech Disorders
A
Perceptual (gold standard)
Instrumental
Acoustic
Visual imaging
21
Q
Dimensions of Motor Speech Disorder: Age of Onset
A
congenital or acquired acute/subacute/chronic) Acute: Symptoms within minutes Subacute: Happens over days Chronic: Happens over months
22
Q
Dimensions of Motor Speech Disorder: Cause or Etiology
A
Genetic, infection, unknown, etc
23
Q
Dimensions of Motor Speech Disorder: Natural course
A
Transient: symptoms will resolve
Stationary: remain unchanged after reaching maximum severity
Improving: symptoms reduced in severity but have not resolved
Progressive/degenerative: symptoms continue to get worse over time
Exacerbating/remitting: symptoms may improve or resolve then become exacerbated and possibly worsen, like MS
24
Q
Dimensions of Motor Speech Disorders
A
Age of onset Cause/etiology Natural course Site of lesion Neurologic diagnosis Pathopysiology Subsystems involved Severity Perceptual characteristics
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Dimensions of Motor Speech Disorder: Pathopysiology
Changes caused by the disorder such as weakness or spacticity
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Etiology
```
Vascular
Inflammatory
Traumatic/Toxic
Anoxic or autoimmune
Metabolic
Idiopathic (unknown cause) or latrogenic (treatment induced)
Neoplastic (tumor)
Altered brain morphology
Degenerative
```
27
Treatment Approaches
AAC
Normalizing pysiological support (reduce nasality, normalize loudness)
Teach Compensatory behaviors
Medical Approaches (surgery, drug, prosthetic)
Eliminate maladaptive behaviors
Interaction enhancement strategies (communication strategies)
Maintain communication skills (encourage continued communication and social interaction)
Strategies to alter negative attitudes of others (educate others)
28
ICF: Body Function
Physiological functions of body systems
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ICF: Body Structures
Anatomical parts of the body, limbs, organs, and their components
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ICF: Impairments
Problems in body function or structure such as significant deviation or loss
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ICF: Activity
Execution of a task or action by an individual
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ICF: Participation
Involvement in life situation
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ICF: Activity Limitation
Difficulties an individual may have in executing activities
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ICF: Participation Restrictions
Problems an individual may experience in involvement in life situations
35
ICF: Environmental Factors
Make up physical, social, attitudinal, and environment in which people live and conduct their lives
36
Source-Filter Theory
Source is what generates sound (VF, stops and fricatives are also a source at the point of closure)
Filter modifies the sound (rest of the vocal tract, can lengthen vocal tract by rounding lips)
37
Ten Functional Components of Speech
```
Abdominal muscles
Diaphragm
Rib Cage
Larynx
Tongue/pharynx
Posterior Tongue
Velopharynx
Jaw
Lips
```
38
Four Major Subsystems of Speech
Respiratory (most common issue in motor speech disorders)
Phonatory
Velopharyngeal
Articulatory
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Respiratory/Pulmonary System
Breathing
Speech
Three functional components: diaphragm, rib cage, abdominal muscles, needed for subglottal pressure
40
Major muscles of inspiration
Diaphragm and external intercostals
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Tidal volume
Amount inhaled and exhaled during a normal breath cycle
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Inspiratory reserve volume
Amount of air that can be inhaled beyond the tidal volume
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Expiratory reserve volume
Amount of air that can be exhaled beyond the tidal volume
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Residual volume
Amount remaining in lungs after maximum exhale (keeps lungs from collapsing)
45
Total lung capacity
Tidal volume, inspiratory reserve, expiratory reserve, residual volume
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Inspiratory capacity
Maximum volume of air that can be inhaled from the resting expiratory level
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Expiratory capacity
Maximum volume of air that can be exhaled from the resting inspiratory position
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Vital capacity
Inspiratory reserve, expiratory reserve and tidal volume (maximum amount of air that can be fully exhaled after as deep an inhalation as possible)
49
Functional residual capacity
Amount of air remaining in lungs after a normal tidal expiration
50
Rest breathing
40% inhalation 60% exhalation
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Speech breathing
10% inhalation 90% exhalation
52
Subglottal pressure needed for phonation
3-5cm H2O
53
What is the only bone in the larynx?
Hyoid (all others are cartilage)
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Extrinsic laryngeal muscles
Elevate and depress the larynx
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Intrinsic laryngeal muscles
Connect cartilages
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Posterior cricoarytenoids
Open (abduct) vocal folds
57
Cricothyroids
Elongate VFs to change pitch
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Velopharyngeal mechanism involves....
Velum (soft palate) and nasopharynx
59
Velopharyngeal closure: Coronal
Velum raises up to meet the back of the pharynx
60
Velopharyngeal closure: Sagittal
Most movement is in lateral pharyngeal wall, sides close in to meet velum
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Velopharyngeal closure: Circular
Equal movement of the velum and lateral pharyngeal wall
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Velopharyngeal closure: Circular with Passavant's ridge
Equal movement of lateral and posterior pharyngeal wall and velum
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Intrinsic Muscles of the Tongue
Muscles used to move the tongue
64
Extrinsic Muscles of the Tongue
Stabilize the tongue
65
Sensory innervation for anterior 2/3 of tongue
General sensation CNV
| Taste CNVII
66
Posterior innervation for posterior 1/3 of tongue
Taste and temperature CNIX
67
Necrosis
Cell death
68
Lesion
Area of damage
69
Infarct
Area of necrosis due to vascular disturbance, later replaced by scar tissue
70
Ischemia
Deficiency of blood flow due to obstruction or constriction
71
Focal
Involving a single area
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Multifocal
Involving more than one area
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Diffuse
Involving roughly symmetric portions of the nervous system bilaterally
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Primary Motor Cortex
Execute movement
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Supplementary Motor Cortex
Plan and coordinate complex movement
76
Premotor Cortex
Integrates sensory information and prepares primary motor cortex for execution
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Lower Motor Neurons
Neurons of brainstem and spinal cord whose axons terminate on muscles
78
Damage to Lower Motor Neurons results in....
Flaccid dysarthria
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All motor CNs are....
LMNs
80
Efferent pathways
Leaving CNS
81
Afferent pathways
Sensory, returning to CNS
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CN V
Trigeminal (Mixed)
Muscles of mastication, sensation to head jaw and forehead
Tactile sensation for anterior 2/3 of tongue
83
CN VII
Facial nerve (mixed)
Muscles for facial expression
Taste for anterior 2/3 of tongue
Upper part of face is bilaterally innervated
Lower part is contralaterally innervated
Lesion in UMN would affect lower contralateral side
Lesion in LMN would affect upper and lower face
84
CN IX
Glossopharyngeal (mixed)
Gag reflex
Sensory input from posterior 1/3 of tongue
85
CN X
Vagus (mixed)
Innervates muscles of larynx, respiration
Raises the velum
86
CN XI
```
Spinal Accessory (motor)
Levator and uvula
```
87
CN XII
```
Hypoglossal (motor)
Innervates Tongue
Innervated contralaterally
Will deveate toward weaker side
LMN damage will lead to fasciculations and atrophy
```
88
Pyramidal System
Direct activation pathway
Skilled voluntary movements
Conscious higher level control
Lesions result in: hypotonia, weakness, babinski reflex
89
Corticobulbar tract
Pyramidal system
| Cortex to brainstem/cranial motor systems
90
Corticospinal Tract
Pyramidal system
| Controls distal muscles of limbs
91
Extrapyramidal System
```
Indirect Activation Pathway
Coordinate basic movements
Suppress undesired movements
Posture and tone
Hypertonia, hyper-reflexia, hyperactive gag
```
92
Basal Ganglia
Influences movement generated by primary motor cortex
Contributes to cognitive and affective deficits
Pass signals for intentional movement and inhibit undesired movement
Abnormalities can lead to over or under filtering (PD is over filtering, HC is under filtering)
93
Cerebellum
Balance, coordination
Compares intended signal to actual movement
Dysdiadochokinesia and dysmetria
94
TBI
Non Progressive MSD
Ataxia in cerebellar damage
Tremors, dystonic movements
Noisy, disinhibited, confused and disorientation
Post Traumatic Amnesia
60% acutely Dx with dysarthria, 10% chronic dysarthria
95
Cortical CVAs
Aphasia
Apraxia
Dysarthria
Unilateral lesions most effects articulation, may produce contralateral weakness or transient mild dysarthria
Bilateral lesions: bulbar palsy, locked in syndrome
96
ALS
Bulbar signs effect speech first, progresses quickly
Spinal/limb is harder to notice at first
Often progress to mixed
Effects CNS and PNS
UMN: Weakness, increased tone, hyper reflexia
LMN: weakness, flaccidity, atrophy
Implement AAC when speaking at 100-125 wpm
97
Guillan Barre
Similar to MS but myelin in PNS destroyed
| Most recover
98
Parkinson's Disease
Hypokinetic dysarthria
Substantia nigra of basal ganglia
Hypokinetic, bradykinesia, rigidity, resting tremor
Implement LSVT at stage 2 to recalibrate loudness
99
Huntington's Chorea
Excessive movement
Hyperkinetic
Debilitating movement disorders (chorea is hallmark), personality and cognitive changes
Dementia is also a hallmark
100
MS
Myelin destroyed in the CNS
| Impairments vary based on site of lesion
101
Duchenne Muscular Distrophy
Loss or malfunction of dystrophin protein
Disturbance in gait
Eventually in a wheelchair
High risk of respiratory impairment
102
Lupus
Inflammation of joints, organs, and tissues
Fever and fatigue
Butterfly rash on face
Memory loss
Chorea, ataxia, dystonia, facial weakness, vocal fold paresis
Not terminal, but chronic, waxes and wanes
103
Sydenham's Chorea (St. Vitus' Dance)
Results from childhood infections
Jerky, explosive speech
Transient breathiness
Harsh or strained-strangled vocal quality
Involuntary movements of mouth and larynx
Infection destroys cells in striatum of basal ganglia
Many acute symptoms spontaneously resolve
104
Tardive Dyskinesia
May appear similar to PD, HC, CP, Tourettes, stroke
Sudden uncontrollable movements
Tic-like movements in facial muscles
Sometimes symptoms diminish but some are permanent
