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Motor Speech > Intro to Motor Speech > Flashcards

Intro to Motor Speech Flashcards

1
Q

What does the CNS include?

A

Brain

Cerebral Cortex (outer surface)

Subcortical structures
-Thalamus, basal ganglia

Brainstem
-Midbrain, Pons, Medulla

Cerebellum

Spinal Cord

**Main highway of signal transmission

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2
Q

What does the PNS include?

A

12 pairs of cranial nerves
31 pairs of spinal nerves

**Transmit signals between the CNS & rest of the body. Has to go here to get to the musculature system

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3
Q

What is a Motor Speech Disorder?

A

“Speech disorders resulting from neurologic impairments affecting the planning, programming, control or execution of speech.” (Duffy)

**Any interruption in that pathway results in a motor speech disorder.

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4
Q

Dysarthria

A

Impaired production of speech due to disturbances in the muscular control of the speech mechanism.

**Issues that affect control and EXECUTION of speech. Plan is good but getting plan to the muscle is disrupted. Can affect ALL systems of speech.

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5
Q

Dysarthria can include impaired….

A

Articulation, resonance, phonation, and respiration.

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6
Q

What are the six subtypes of Dysarthria?

A

Flaccid, Spastic, Ataxic, Hypokinetic, Hyperkinetic, and Unilateral Upper Motor Neuron, plus a combo of these subtypes.

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7
Q

What is Apraxia of Speech?

A

A deficit in the ability to smoothly sequence the speech-producing movements of the tongue, lips, jaw, etc.

**PLAN & PROGRAM, getting the right sequence of commands.

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8
Q

Apraxia primarily affects…

A

Articulation and prosody

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9
Q

Areas of the Frontal Lobe

A

Dorsolateral Prefrontal Cortex

Orbitofrontal Cortex

Motor Areas

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10
Q

Dorsolateral Prefrontal Cortex

A
  • Planning
  • Reasoning
  • Working memory
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11
Q

Orbitofrontal Cortex

A
  • Emotions
  • Reward
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12
Q

Motor Areas

A
  • Planning & programming of movements (contralateral)
  • Organized into homunculus
  • Broca’s area involved in speech plan (also contributes to syntax, grammar, and phonological processing)

**Motor strip and somatosensory area- somatotopically organized

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13
Q

Motor and Sensory Homunculus

A

FATAL (Face, Arms, Torso, Legs)

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14
Q

Areas of the Parietal Lobe

A

Primary Somatosensory Area
- Sense of touch, pain, and temp (contralateral)
- Organized into homunculus

Superior Parietal Lobule
- Body awareness / proprioception
- Attention

Inferior Parietal
- reading processing & language
- spatial attention

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15
Q

Areas of the Temporal Lobe

A

Hippocampus
Herschel’s Gyrus
Wernickes Area
Visual Word Form Area

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16
Q

Hippocampus

A
  • Inside temporal lobe
  • Memory processing
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17
Q

Herschel’s Gyrus

A

Auditory Cortex

** Can cause issues with speech but NOT motor speech. Can lead to planning and programming issues that are not motor in nature but linguistic

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18
Q

Wernicke’s Area

A

Language Comprehension

**Can test with rainbow passage or grandfather, test Alexia or phonological errors (not motor).

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19
Q

Visual Word Form Area

A

Deciphers letters and words during reading

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20
Q

Areas of the Occipital Lobe

A

Primary Visual Cortex
Association Cortices
Dorsal Pathway
Ventral Pathway

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21
Q

Primary Visual Cortex

A

Organized like retina

** The retina is organized into three primary layers, the photoreceptive layer, the bipolar cell layer, and the ganglion cell layer.

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22
Q

Association Cortices

A

Process color, and shape

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23
Q

Dorsal Pathway

A

Understanding location and movement

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24
Q

Ventral Pathway

A

Identifying objects

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25
Q

Cerebellum (CNS)

A

Modify motor programs initiated elsewhere (cortex)
- Guides/coordinates the speech, timing, force, range, and direction of movement

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26
Q

The Cerebellum receives input from:

A
  • Cerebral Cortex
  • Peripheral sensory systems (e.g., vestibular)

**Cerebellum is not cerebral. Helps coordinate different muscles together, speech planning/ execution, motor learning.

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27
Q

Thalamus

A
  • Relay system for afferent and efferent CNS
  • Control and gaits where info goes in and out of the brain
  • Involved in alertness, sleep, consciousness and learning
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28
Q

The Basal Ganglia is involved in:

A
  • Voluntary motor control
  • Motor and procedural learning, cognition, emotion
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29
Q

What does the Brainstem consist of?

A

Midbrain
Pons
Medulla

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30
Q

Midbrain

A
  • Pathways for hearing, vision, eye movement
  • Sleep/wake cycle
  • Eye movement
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31
Q

Pons

A
  • Respiration control
  • Pathways for face and eye movement, swallow, and taste
  • Co2 levels in blood, determining rate of breathing
  • Here we start seeing cranial nerves
32
Q

Medulla

A
  • Reflexes for coughing, sneezing, vomiting, and swallowing
  • Parts of autonomic nervous system
  • Pathways for throat, tongue, and neck movements
  • Heart rate
  • Muscle control for throat, tongue, neck
33
Q

Brainstem Pathways

A
  • These pathways (tracts) connect the cortical motor and sensory areas to the peripheral nervous system (nerves)
  • Corticobulbar- Cranial Nerves
  • Corticospinal- Spinal Nerves

** Information for/from each cranial nerve branches at different areas of the brainstem

** Information for/from the rest of the body continues down into spinal cord

34
Q

Bulbar Tract

A
  • Motor info to the cranial nerves
  • Everything from level of injury and down is affected
35
Q

Types of sides

A
  • Ipsilateral= same side
  • Bilateral= both sides
  • Contralateral= opposite sides
36
Q

Cranial Nerves

A

Name Mnemonic- Oh Oh Oh, To Touch And Feel Very Good Vagina, Such Heaven

Function Mnemonic- Some Say Marry Money, But My Brother Says Big Boobs Matter More

Olfactory –CN I- S
Optic –CN II- S-
Oculomotor –CN III- M
Trochlear –CN IV- M
Trigeminal –CN V- B
Abducens –CN VI- M
Facial –CN VII- B
Vestibulocochlear –CN VIII- S
Glossopharyngeal –CN IX- B
Vagus –CN X- B
Spinal Accessory –CN XI- M
Hypoglossal –CN XII-M

** Important for this class: CN V, CN VII, CN X, CN IX, CN XII (5,7,9,10,12)

37
Q

Olfactory

A

CN I- S

38
Q

Optic

A

CN II- S

39
Q

Oculomotor

A

CN III- M

40
Q

Trochlear

A

CN IV- M

41
Q

Trigeminal

A

CN V- B

42
Q

Abducens

A

CN VI- M

43
Q

Facial

A

CN VII- B

44
Q

Vestibulocochlear

A

CN VIII- S

45
Q

Glossopharyngeal

A

CN IX- B

46
Q

Vagus

A

CN X- B

47
Q

Spinal Accessory

A

CN XI- M

48
Q

Hypoglossal

A

CN XII- M

49
Q

What CN’s are located in the Cerebrum?

A

CN I- Olfactory
CN II- Optic

50
Q

What CN’s are located in the Midbrain?

A

CN III- Oculomotor
CN IV- Trochlear

51
Q

What CN’s are located in the Pons?

A

CN V- Trigeminal
CN VI- Abducens
CN VII- Facial
CN VIII- Vestibulocochlear

52
Q

What CN’s are located in the Medulla?

A

CN IX- Glossopharyngeal
CN X- Vagus
CN XI- Spinal Accessory
CN XII- Hypoglossal

53
Q

What are the 6 CN for Speech Production?

A

CN V- Trigeminal- B
CN VII- Facial- B
CN IX- Glossopharyngeal B
CN X- Vagus- B
CN XI- Spinal Accessory- M
CN XII- Hypoglossal

54
Q

What is the SENSORY function for CN V- Trigeminal?

A

SENSORY: Three branches of sensory information across the face, eyes, forehead and anterior 2/3 of tongue

55
Q

What is the MOTOR function for CN V- Trigeminal?

A

MOTOR: Muscles of mastication (chewing) in the mandibular branch
- Masseter, pterygoid, mylohyoid, and digastric muscles
- Also motor for tensor tympani (dampens chewing sounds) and tensor veli palatini (help raise soft palate)

56
Q

What is the function of the CN VII- Facial Nerve?

A
  • Muscles of facial expression
  • Stapedius muscles/reflex
  • Taste from anterior 2/3 of the tongue
  • Salivary glands and lacrimal gland

** Bell’s palsy

57
Q

What is the function of the CN IX- Glossopharyngeal Nerve?

A
  • Taste and touch for rear 1/3 of tongue, external ear canal, and parts of pharynx
  • Includes sensory part of the gag reflex
  • Saliva response for parotid gland
  • Stylopharyngeus muscle elevates pharynx during swallow and speech
58
Q

What is the function of the CN X- Vagus Nerve?

A
  • Motor and sensory information for the larynx (phonation)
  • Pharyngeal plexus with CN IX- Glossopharyngeal
    - Sensory and motor
  • Muscles of the soft palate and base of tongue
  • Parasympathetic branches to many internal organs
59
Q

What are the MOTOR branches of CN X- Vagus Nerve?

A

Pharyngeal Branches
- Levator Veli Palatini
- Palatoglossus

Superior laryngeal branches
- Cricothyroid

Recurrent laryngeal branches
- All other intrinsic laryngeal muscles

60
Q

What is the function of CN XII- Hypoglossal Nerve?

A
  • Transmits motor information to the muscles of the tongue
  • Needed for articulation of all vowels and non labial and/or dental consonants
61
Q

What are the Spinal Nerves for Speech?

A

C3-C5 Phrenic Nerve
- Motor supply to the diaphram

Thoracic Nerves
- Intercostal muscles
- Abdominal muscles

62
Q

What are the 4 major functional divisions of the Speech Motor System?

A

Final Common Pathway
Direct Activation Pathway
Indirect Activation Pathway
Control Circuits

63
Q

Final Common Pathway

A

Lower motor neuron system (nerves)

64
Q

Direct Activation Pathway

A

Upper motor neuron system a.k.a pyramidal tract

65
Q

Indirect Activation Pathway

A

Extrapyramidal tract

66
Q

Control Circuits

A

Basal ganglia & Cerebellum

67
Q

Final Common Pathway

A
  • Involves pairs of cranial nerves which communicate with the muscles of phonation, resonance, articulation and prosody
    CN V- Trigeminal, CN VII- Facial, CN IX- Glossopharyngeal, CN X- Vagus, and CN XII- Hypoglossal
  • Also includes spinal nerves involved in respiration
    Primarily C3-5 form the phrenic nerve, which is controlled by nuclei in the pons and medulla
  • Lower motor neurons originate in the brainstem at the cranial nerve nuclei and terminate in the musculature
  • Damage to the final common pathway results in FLACCID DYSARTHRIA
68
Q

Direct Activation Pathway

A
  • Includes the primary motor cortex, premotor cortex, supplementary motor area as well as some somatosensory fibers
  • Upper motor neurons from the pyramidal tracts
    Corticobulbar Tract - Neurons connect from motor cortex to brainstem nuclei of CN V, VII, IX, X, and XII
    Corticospinal Tract - Neurons project to spinal nerves affecting respiratory muscles
  • Cross the midline (decussate) in the medulla to connect to the contralateral final common pathway
  • Damage to upper motor neurons on one side only results in Unilateral Upper Motor Neuron Dysarthria
  • Bilateral damage to UMNs results in SPASTIC DYSARTHRIA
69
Q

Indirect Activation Pathway

A

Also known as the extrapyramidal tract

Includes pathways between the cortex and:

  • Reticular formation (Corticoreticular tract) – assists with sensorimotor integration and with muscle tone regulation
  • Red nucleus (Corticorubral tract) – assists with muscle tone regulation
70
Q

What are the Control Circuits?

A

Cerebellar
Basal Ganglia

71
Q

Cerebellar

A
  • Coordinate timing between adjacent steps in movements
  • Scales the size of movements by coordinating agonists and antagonists
  • Damage results in ATAXIC DYSARTHRIA
72
Q

Basal Ganglia

A
  • Posture and tone regulation
  • Movement scaling
  • Inhibition of excess movement
  • Damage results in HYPERKINETIC or HYPOKINETIC DYSARTHRIA
73
Q

What is Motor Planning and Programming?

A

Motor Planning: is goal oriented and general

Motor Programming: converts the plan to fine details of what to move and when

A very complex array of circuits are involved including motor areas, sensory areas, limbic system, Insula, Broca’s area, thalamus, etc.

Impairment of this process results in APRAXIA OF SPEECH

74
Q

Damage to which cranial nerve would result in impaired laryngeal function?

A

CN X- Vagus

75
Q

What is phonation?

A

The production or utterance of speech sounds

76
Q

What is resonance?

A

The quality in a sound being deep, full, and reverberating

Motor Speech (9 decks)

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