Lecture 1 and 2 Flashcards Preview

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Flashcards in Lecture 1 and 2 Deck (57):
1

Where is the primary motor cortex located?

Precentral gyrus in the frontal lobe.

2

How is the primary motor cortex organized?

Somototopically

3

Explain somototopic organization - think homunculus.

The bottom of the frontal lobe sends signals to the head and neck, and the upper portion sends signals to the lower body. More frontal lobe real estate is dedicated to our lips, tongue, and hands.

4

Where is the somotosensory cortex located?
What is the function?

Postcentral gyrus
Primary receptor of general body sensations

5

Name the 4 subcortical structures.

1) Diencephalon
2) Basal Ganglia
3) Substantia Nigra
4) Subthalamic Nucleus

6

Subcortical Structures:
What 4 structures does the Diencephalon include?

1) Thalamus
2) Hypothalamus
3) Epithalamus
4) Subthalamus

7

Where is the cerebellum located?

Rear of the brain, below the cerebrum

8

With what is the cerebellum involved?

Coordination

9

Where is the brainstem located?

Between the subcortical structures and the spinal cord

10

What does the brainstem consist of?

Midbrain, pons, and medulla

11

Where do upper motor neurons originate and terminate?

They originate in the cortex and terminate/synapse on lower motor neurons in either the brainstem (corticobulbar tract) or spinal cord (corticospinal tract)

12

Where do lower motor neurons originate and terminate?

Originate in the brainstem or spinal cord and terminate on the muscles they innervate

13

Muscles of the limbs only receive what type of innervation?

Unilateral, contralateral

14

Most muscles of the head and neck receive what type of innervation?

Bilateral

15

1)There are two pathways that a nerve signal must travel to reach a muscle - what are they?

1) The first is the lower motor neuron pathway and the 2nd is the upper motor neuron
2)

16

What makes up the pyramidal system and for what is the pyramidal system responsible?

- Corticospinal and corticobulbar tracts
- Responsible for voluntary movement

17

Where does the corticospinal tract originate?
Where does it cross over?
Where does it terminate?

- Begins in the cerebral cortex at different levels of the spinal cord. (Most axons originate in the primary motor cortex.)
- decussates at the pyramids of the lower medulla
- Terminates in the spinal cord at the level of the individual spinal nerves.

18

Where does the corticobulbar tract originate?
Where does it cross over?
Where does it terminate?

- Begins in the cerebral cortex
- decussates at the level of the cranial nerve nuclei they innervate
- Terminates at the cranial nerve nuclei located at different levels of the brainstem

19

For what is the frontal lobe responsible?

Motor planning

20

What is motor planning?
What area is involved in motor planning?

-Formulating a plan by specifying motor goals. Not muscle specific.
- Supplementary motor areas

21

Do the control circuits synapse directly on the lower motor neurons?

No

22

Control circuits have what function?
Do they project to the LMN?

Integrate or help control diverse activities of the structures and pathways involved in motor performance.
No

23

What are the 5 types of dyskonesias?

1) Tremor
2) Chorea
3) Athetosis
4) Dystonia
5) Myoclonus

24

The term _____ is usually associated with extrapyramidal damage but may be used to describe movement disorders from other causes

Dyskinesia

25

Name the lobes of the cerebellum.

Anterior, posterior, and flocculondular.

26

The cerebellum has significantly more efferent or afferent pathways?

Afferent

27

What is the main function of the cerebellum?

-Coordination of different muscle groups and balance.
-Also plays a role in motor programming, maintenance of muscle tone, and motor learning.

28

Explain the cerebellum's use of feedforward and sensory feedback.

Feedforward - a motor plan is made regarding volitional movement from the muscles, tendons and joints. That plan is sent to motor programming.
Sensory feedback - The motor program makes its muscle plan based on sensory feedback and sends an efferent copy back to the motor plan. The motor plan then makes adjustments.

29

Cerebellar damage can cause _____ which is a lack of coordination of volunteer motor acts; the rate, range, timing, direction, and force of movement may be affected.

Ataxia

30

Define dysarthria.

A collective name for a group of neurologic speech disorders. Abnormalities include strength, speed, range, steadiness, tone or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production.

31

Define apraxia.

A neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech..

32

True or false?
Motor Speech Disorders (MSDs) don't tend to be closely associated with damage to specific regions/systems within the nervous system.

False

33

Name the lesion locus for the following dysarthrias:
a. Flaccid
b. Spastic
c. Ataxic
d. Hypokinetic
e. Hyperkinetic
f. Unilateral Upper Motor Damage
g. Mixed

a. LMN
b. UMN (bilateral)
c. Cerebellum (control circuit)
d. Basal ganglia
e. Basal ganglia
f. UMN (unilateral)
g. Two or more of the above

34

The current classification system for MSDs comes from studies done at the ____ clinic in the 1960s and are based on _____-______ analysis.

Mayo
Auditory-perceptual

35

Parkinson's always results in what type of MSD?

hypokinetic dysarthria

36

True or false?
Degenerative disease can cause any type of dysarthria.

true

37

True or false?
TBI can cause any type of dysarthria.

true

38

Diseases of the neuromuscular junction can result only in which condition?

flaccid dysarthria

39

During an OME, if a patient exhibits atrophy and fasciculations, to which MSD might this point? Hypotonia and are observed as well.

Flaccid dysarthria

40

During an OME, if a patient exhibits pathologic oral reflexes, hyperactive gag, and psuedobulbar affect (uncontrollable laughter or crying but don't feel happy or sad), to which MSD might this point?

Spastic dysarthria

41

During an OME, if a patient has normal findings, nothing uncommon, but the jaw, face, and lingual movements are dysmetric (undershooting or overshooting their target) - which MSD would this indicate?

Ataxic dysarthria

42

During an OME, if a patient has masked like face, orofacial tremulousness and reduced ROM on nonspeech AMRs would indicate which MSD?

Hypokinetic dysarthria

43

During an OME, if a patient has quick or slow, patterned or unpatterned involuntary movements at rest, during sustained postures, AMRs would indicate which MSD?

Hyperkinetic dysarthria

44

During an OME, if a patient has unilateral facial weakness or unilateral lingual weakness without atrophy or fasciculation would indicate which MSD?

UUMN dysarthria

45

A patient's speech is characterized by phonatory and resonatory abnormalities. Also exhibits continuous breathiness, diplophonia, audible inspiration, short phrases. Possible hypernasality. Which MSD?

Flaccid dysarthria

46

A patient's speech is characterized by slow speech rate and steady AMRs and strained vocal quality. Which MSD?

Spastic dysarthria

47

A patient's speech is characterized by irregular artic breakdowns during connected speech, irregular AMRs and dysprosody.

Ataxic dysarthria

48

A patient's speech is characterized by monopitch, monoloudness, reduced loudness and stress, a tendency towards a rapid rate and rapid and blurred AMRs are characteristic.

Hypokinetic dysarthria

49

A patient's speech is characterized by mildness and somewhat nebulous abnormalities. Tendency for speech AMRs to be regular while some irregularity during connected speech

UUMN

50

Compensatory or restorative approach?
Trying to improve the physiology supporting speech

Restorative

51

Compensatory or restorative approach?
Use of internal strategies such as speaking louder, or external strategies like AAC.

Compensatory

52

When deciding whether or not someone is a candidate for a type of therapy include (6)?

1) medical prognosis
2) impairment and disability
3) environment and communication partners
4) motivation and needs
5) co-occurring 6) impairments/conditions
healthcare system

53

What does treatment focus on?

intelligibility, efficiency, naturalness of speech, or any combination of these.

54

True or false?
Treatment should first focuses on what is quickest to fix and what will be most meaningful.

True

55

Approaches that use speech tasks or indirect non-speech like strengthening exercises or posture would be a compensatory or restorative approach?

Restorative

56

Making maximum use of residual physiological support would be a compensatory or restorative approach?

compensatory

57

true or false?
most treatment is focused on compensated intelligibility.

true