motor speech disorders Flashcards
(195 cards)
1
Q
where is the primary motor cortex found?
A
frontal lobe
2
Q
what are the 3 motor processes to produce speech?
A
planning
programming
execution
3
Q
what happens in the “planning” process when producing speech?
A
sequencing of articulatory goals
4
Q
what happens in the “programming” to produce speech?
A
preparing the flow of motor info across muscle, control timing, and force of movement.
5
Q
what happens during the “execution” to produce speech?
A
activating the relevant muscles.
6
Q
what are two major speech disorders?
A
apraxia
dysarthria
7
Q
do people with apraxia and dysarthria have problems with writing?
A
no. these are only issues with motor processes.
8
Q
What is the cause of motor speech disorders?
A
Neuromuscular and /or motor control system.
9
Q
Where is the issue for apraxia ?
A
Planning and sequencing
10
Q
Where is the issue for dysarthria?
A
Execution
11
Q
Where is the disconnect for dysarthria?
A
Damage is on nervous system pathways. Disconnect between cerebellum and muscles
12
Q
What can be affected from dysarthria?
A
Respiration
Phonation
Resonance
Articulation.
13
Q
What is the cause of motor speech disorders?
A
Stroke
Head trauma
Progressive diseases
14
Q
How is the hearing abilities of motor speech disorders?
A
Fine
15
Q
Spastic:
Damage where?
Major symptom:
Other signs:
A
Upper motor neurons
Spasticity
Weakness, increases muscle tone, gagging, drooling, involuntary crying
16
Q
Ataxic:
Damage where?
Major symptom:
Other signs:
A
Cerebellum
In coordination
Reduced muscle tone, “intoxicated speech”, wide based gait, tremors
17
Q
Difficulty with properly planning, programming, and executing motor movements for speech
A
motor speech disorders.
18
Q
what are the stages of word production (4)
A
concept/message
lexical-concept
phonological encoding
articulation
19
Q
broca’s aphasia does not have writing impairments. t/f
A
false!
their writing matches their speech.
20
Q
MSD has writing impairments. t/f
A
false. Their writing is fine.
21
Q
MSD have deficits that result from impairment of ___________ and/or motor control system.
A
neuromuscular
22
Q
MSD may co-occur with other language impairments, t/f
A
t
23
Q
other oral movements (besides speech) may be impaired, including chewing and smiling. t/f
A
t
24
Q
is MSD/s common among adults or children? what type?
A
adults.
46% dysarthria
25
What are the impaired mechanisms in MSDs?
planning/programming
| execution
26
Apraxics have issues with what motor processes?
planning and programming
27
dysarthrics have issues with what motor processes?
execution
28
in general what does dysarthria impact? (4)
respiration
phonation
resonance
articulation
29
Speech disorder due to dysfunctional motor execution resulting in incoordinated, weak, and slow articulatory movements
dysarthria
30
what is the cause of dysarthria?
Damage to nervous system pathways results in inability to send proper message from brain to the muscles involved in speech
31
Typically occurs because of a progressive disease, stroke, or trauma
acquired dysarthria
32
what imposes control on movement initiated in primary motor cortex?
cerebellum
33
Group of cell nuclei in the medial part of the brain
Basal Ganglia
34
where do upper motor neurons originate?
primary motor cortex
35
where do lower motor neurons originate?
brainstem and spinal cord.
36
what receives information from upper motor neurons?
lower motor neurons
37
what part of the body is responsible for phonation?
vocal cords
38
```
what type of dysarthria;
LMN damage
weakness
reduced muscle tone
reduced reflexes
atrophy
fasiculations
```
flaccid
39
```
what type of dysarthria:
UMN damage
spasticity
weakness
reduced range of movement
increased muscle tone
hypertonia
```
spastic
40
```
what type of dysarthria:
Non-speech deficits:
Paresis/spasticity of other body parts
Hyperactive reflexes (e.g., gag)
Dysphagia, drooling
Pseudobulbar affect
(involuntary crying)
```
spastic
41
```
what type of dysarthria:
Cerebellum damage
Errors in force, speed, timing, range, & direction of movements
i.e., incoordination
Reduced muscle tone
“intoxicated speech”
```
ataxic
42
what are the primary deficits of basal ganglia dysarthrias?
hypokinetic (parkinsons)
| hyperkinetic (huntingtons)
43
symptoms associated with ?:
Chorea
Dystonias
Tremor
Palatopharyngolaryngeal myoclonustics (muscles spasms of vocal folds)
hyperkinetic
44
Relatively slow waxing/waning involuntary postures resulting from excessive muscles contracting
dystonia
45
Area of damage: primary motor cortex, white matter in frontal lobe, or brainstem
```
Major symptoms:
Weakness
Incoordination
Spasticity
central face weakness
hemiparesis/plegia
```
unilateral upper motor neuron dysarthria
46
upper motor neuron damage will lead to :
spastic dysarthria
47
what are three ways to measure Dysarthria symptoms?
perceptual
acoustic
physiological (measuring muscle strength)
48
problems with apraxia deal mainly with?
sequencing
49
the main problem with dysarthria is?
execution
50
do apraxics have writing impairments?
no
51
what does an apraxic person sound similar to?
broca's
52
```
dysarthria or apraxia?
Speech distortions
Consistent errors
Little/no groping for sounds
All speech affected
Muscle weakness/rigidity
```
dysarthria
53
```
dysarthria or apraxia?
Speech substitutions
Inconsistent errors
groping for sounds
“Island of fluency”
Automatic speech = ok
No muscle weakness/rigidity
```
apraxia
54
Speech disorder or neurological origin characterized by inability to program or sequence articulatory movements for speech production
apraxia
55
what is the cause of apraxia?
Can be developmental or acquired
| No known cause for developmental
56
acquired AOS means there is damage where?
only to Broca's area. (left frontal corex)
57
Acquired AOS is due to :
stroke, brain injuries, illness, infections
58
Inability to transform an intact linguistic representation(idea in their head) into coordinated movements of the articulators(words)
acquired AOS
59
what does speech sound like for acquired AOS?
```
sound substitutions
sound distortions
prolonged durations of sounds
reduced prosody
difficulties initiating speech
groping of articulators
```
60
what is the most common error type for AOS?
anticipation
61
what are three common error in AOS?
anticipations:(felephone)
perseverations (gave the goy)
exchanges (with this wing I do red)
62
if someone could not stick out their tongue or puff their cheeks they may have?
acquired AOS
63
2 non language symptoms of acquired AOS are:
oral motor apraxia
| impaired oral sensation
64
treatment of apraxia includes?
```
speech therapy (awareness of articulators/exercises)
AAC
```
65
what disorder involves deficits with processing and using language? including reading, writing, speaking, auditory.
aphasia
66
what disorder involves inability to execute speech movements, sequencing, disconnect between brain and articulators?
apraxia
67
inability to activate volitional movements for speech
apraxia
68
if a client has difficulty moving their tongue when given directions, this is an example of
apraxia
69
someone who drools or has poor speech due to facial weakness
dysarthria
70
someone that may have other weakness' other than just speak may be
ataxic dysarthria
71
errors are consistent and predictable
dysarthria
72
errors are inconsistent and unpredicatable
apraxia
73
errors are many distortions and omissions
dysarthria
74
substitutions are most common type of error
apraxia
75
all aspects of speech are affected
dysarthria
76
mainly an articulation issue
apraxia
77
apraxia and dysarthria both may have swallowing issues. t/f
t
78
what is always a result from damage to the broca's area?
apraxia
79
what is the result of damage to either the CNS or PNS?
dysarthria
80
dysarthria or apraxia?
| speech substitutions
apraxia
81
dysarthria or apraxia?
| speech distortions
dysarthria
82
dysarthria or apraxia?Little/no groping for sounds
dysarthria
83
dysarthria or apraxia?
| Automatic speech = ok
apraxia
84
dysarthria or apraxia?All speech affected
dysarthria
85
dysarthria or apraxia?“Island of fluency”
apraxia
86
treatment for apraxia includes? (2)
speech therapy
| aac
87
the patient has subcortical damage. What is most likely the outcome?
dysarthria
| if cortical damage, it will be bilateral
88
the patients speech behavior has sound level distortions.
dysartharia
89
The patient's speech has abnormal prosody.
aos
90
this patient has problems initiating speech and has phoneme substitutions.
aos
91
the patient has phoneme substitutions.
aos
92
the patient has infrequent metathetic errors.
aos
93
presence of paralysis, paresis, ataxia, involuntary movements. apraxia or dysarthria?
dysarthria
94
the longer the utterance the more errors are made. apraxia or dysarthria?
aos
95
prolonged durations of sound is typical for apraxia or dysarthria?
aos
96
where is the damage for flaccid?
lower motor neurons
97
where is the damage for spastic?
upper motor neurons
98
where is the damage for ataxic?
cerebellum
99
where is the damage for hypokinetic/hyperkinetic?
basal ganglia
100
what are the 2 control circuits relating to the motor system?
basal ganglia
| cerebellar
101
what are the 2 execution pathways relating to the motor system?
upper
| lower motor neurons.
102
what control circuit imposes control on movement initiated in primary motor cortex?
cerebellum
103
what part of the brain plays a major role in error correction based feedback?
cerebellum
104
group of cell nuclei in the medial part of the brain is the?
basal ganglia
105
where do upper motor neuron axons synapse?
cell bodies of lower motor neurons in the brainstem and spinal cord.
106
where do lower motor neurons originate where?
brain stem and spinal cord.
107
lower motor neuron axons synapse where?
muscle fibers
108
a patients primary deficit is weakness. what type of dysarthria and where is damage?
flaccid
| lower motor
109
a patients primary deficit is spasticity. what type of dysarthria and where is damage?
spastic
| upper motor
110
a patients primary deficit is incoordination. what type of dysarthria and where is damage?
ataxic
111
a patients primary deficit is involuntary movements. what type of dysarthria and where is damage?
basal ganglia
| hyperkinetic
112
a patients primary deficit is rigidity. what type of dysarthria and where is damage?
hypokinetic
| basal ganglia
113
a patient has weakness; incoordination; spasticity. what type of dysarthria and where is damage?
unilateral UMN
| UMN
114
```
major deficit is: weakness other signs of this type of dysarthria:
reduced muscle tone
reduced reflexes
atrophy
fasciculations
```
flaccid
115
people with conduction aphasia make what type of errors with their speech?
phonological paraphasias
116
where is brain damage when the result is conduction aphasia?
cortex in the posterior superior temporal lobe.
117
why do conduction aphasics have a hard time repeating non-words?
this would require intact phonological processing; which they do not have.
118
harry has a large amount of right hemisphere damage. What would be a difficult task for him?
summarizing a paragraph that he read or summarizing a conversation he heard.
also, paying attention to information in their left visual field.
119
paying attention to information in the left visual field would be difficult for someone with ...?
right hemisphere damage
120
t/f people with apraxia and dysarthria make the same errors consistently.
false
| dysarthria makes consistent, but not apraxia
121
why does someone with apraxia have difficulty with saying fairly long words but does not have difficulty with simple sounds, such as "tatatata"?
because apraxia is a deficit in the planning and sequencing of motor sequences.
122
would an apraxic have difficulty with "tatatata" or "ta ba ka da"?
ta ba ka da
| this requires motor sequencing which is impaired.
123
apraxia is a deficit in the processing that occurs before the motor movements are made. t/f
t
124
if the basal ganglia is not active enough, the patient might have....
hypokinetic dysarthria
125
what is an example of hypokinetic dysarthria?
parkinson
126
what is an example of hyperkinetic dysarthria
huntingtons
127
what is the one thing that all types of aphasia have in common ?
anomia
128
main symptom of hyperkinetic dysarthria.
involuntary movements
129
main symptom of hypokinetic dysarthria
rigidity, stiffness, and tightness
130
main symptom of spastic dysarthria
increased muscle tone, lack of inhibitory signals
131
main symptom of flaccid dysarthria
weakness
132
main symptom of ataxic dysarthria
"druken speech", due to cerebellum damage
133
how is transcortical motor aphasia's speech comprehension
good, no major deficits
134
how is broca's aphasia speech comprehension?
good ,but difficulties with some complex syntactic constructions
135
how is wernickes aphasia speech comprehension?
very poor
136
how is global aphasia speech comprehension?
very poor
137
how is anomic aphasia speech comprehension?
good, no major deficits
138
Transcortical motor and Broca's aphasias are mainly problems of speech production, not comprehension. One exception to this though is that Broca's aphasics' comprehension is ____________
agrammatic, meaning that they have difficulty understanding phrases or sentences in which the grammatical structure is needed to understand the sentence
139
which neurons are the neurons that have synapses with the muscles?
lower motor
140
where do UMN and LMN connect?
brain stem and spinal cord
141
do conduction aphasics have speech comprehension problems?
no
142
what is alexia?
ACQUIRED (dyslexia) inability to comprehend written language
143
what are the 3 routes used in reading?
1. Grapheme to phoneme conversion (sound it out)
2. whole word to phonology conversion (words activate the appropriate sound based representation, which then activates meaning)
3. whole word meaning route (familiar words activate appropriate visual word form, which activates meaning)
144
Can you use the grapheme to phoneme conversion for irregular words?
no, only works for regular words.
145
why is grapheme to phoneme conversion not a route to depend on?
1. it would take forever to read!
| 2. doesn't work for irregular words.
146
which word route takes care of irregular word issues?
whole word to phonology conversion.
147
whole words activate the appropriate sound representation, which then activates meaning. However, what type of words still present a problem?
him vs. hymn
write vs. right
homophones
148
how would someone use the whole word to meaning route?
Words activate the appropriate visual representation which in turn activates meaning
POODLE-->dog, fluffy, smart
149
why do people not use the whole word to meaning route all the time?
the words must be familiar!
150
what are the 3 routes needed in order to read normally?
1. grapheme to phoneme
2. whole word to phonology
3. whole word to meaning
151
when reading is disrupted, what is it called?
acquired alexia
152
what are two ways to describe deficits with reading?
1. neurological model
| 2. cognitive model
153
which model is used to explain the different types of alexia with agraphia a clinician might see?
cognitive model
154
when using the neurological model for pure alexia, what is the diagnosis?
a 'disconnection' syndrome, from left hemisphere word-recognition system
155
according to the neurological model, alexia with agraphia, has what deficits?
pure reading and writing
156
according to the neurological model, aphasic alexia, has what type of deficits?
reading deficits mirror language deficits
157
A patient with pure alexia would be able to do what?
write
| read letter-by-letter
158
can a person with pure alexia read individual words?
sometimes, however when combining words they cannot access meaning.
159
what type of alexia is a disconnection of visual information from left hemisphere word-recognition system?
pure alexia
160
A patient is able to write normally, however they cannot read what they just wrote. This is an example of what type of alexia?
Pure alexia.
161
a patient is able to tell you what you spelled out. for example, "C-A-T". they can tell you it says 'cat". this is an example of what type of alexia?
pure alexia
162
other symptoms of pure alexia are: (3)
1. impaired ability to copy words.
2. acalculia
3. hemianopsia (blind in one visual field; usually the right)
163
what type of speech comprehension and production does a person with pure alexia have?
normal
164
what two parts of the brain must be damaged to cause Pure Alexia?
1. left primary visual cortex
| 2. splenium
165
part of the corpus callosum that connects the right visual cortex to the left hemisphere.
splenium
166
where is the calcarine sulcus?
primary visual cortex
167
what is the etiology of pure alexia?
blocked splenium
168
why does a blocked splenium cause pure alexia?
Because visual information cannot get to the regions in the left hemisphere that process word forms
169
where is the splenium?
posterior part of the corpus callosum
170
which type of alexia is not affected by orthographical regularity?
pure alexia
171
what type of alexia has relatively pure reading/writing deficits, with no aphasia?
alexia with agraphia
172
a patient has a brain lesion on the angular gyrus in the left hemisphere. What type of alexia would they most likely suffer from?
alexia with agraphia
173
according to the neurological model, what two types of alexia do not have aphasia?
pure alexia
| alexia with agraphia
174
the cognitive model, describes what 3 types of reading deficits?
surface dyslexia
phonological dyslexia
deep dyslexia
175
when the only route left is to "sound it out", it is known as what type of dyslexia?
surface (visual form)
176
what patients typically exhibit surface dyslexia?
dementia
| alzheimer
177
a patient cannot read non-words or new words and is unable to "sound it out". what type of dyslexia?
phonological dyslexia (sound form)
178
where is there brain lesions when the result is phonological dyslexia?
superior temporal lobe, angular gyrus, and other nearby areas.
179
A patient is making semantic errors, has difficulty with abstract and function words. What type of dyslexia?
deep dyslexia
180
where is damage when the result is deep dyslexia?
large left hemisphere perisylvian lesion.
181
what type of patients typically have surface dyslexia?
dementia
182
what part of the brain is thought to be the central area involved in the processing of orthographic word forms?
angular gyrus
183
lesions to what part of the brain will result in alexia with agraphia?
angular gyrus
184
a patient is able to read and comprehend words, however cannot read pseudowords. What type of alexia?
phonological
185
a patient with phonological alexia might have damage to what areas of the brain?
temporal lobe and surrounding areas, as well as angular and supramarginal gyri
186
a patient is able to read words and pseudowords but has profound impairments with comprehension. What type of alexia?
semanti
187
a patient is supposed to read the word "soft" but verbalizes the word "hard". The next word is "vegetable" and their response is "broccoli". This is an example of what type of alexia?
deep
188
the disconnection between orthographical units and phonological units is representative of what type of alexia?
phonological
189
is the reading and comprehension preserved with phonological alexia?
yes
190
which type of alexia has problems with pseudo words?
phonological
191
a patient is a not able to use visual input to activate the orthographic unit therefore unable to read, although can recognize individual letters. What type of alexia?
pure
192
"groping" is a common characteristic for what type of patient?
apraxic
193
a patient is making inconsistent errors, such as substitutions, additions, repetitions and prolongation. What is the deficit?
apraxia
194
inability to transform graphemes into phonemes, and thus non-words are often read as real words they resemble.
phonological alexia
195
This type of dyslexia is similar to phonological dyslexia but in addition makes numerous semantic errors.
deep
