Speech

Question 1

What does slow, effortful, harsh speech indicate?

Answer 1

Pseudobulbar dysarthria (UMN)

This type of dysarthria is associated with upper motor neuron lesions.

Question 2

For right-handed individuals, where is language typically located in the brain?

Answer 2

Left hemisphere

Approximately 95% of right-handed people have language functions localized in the left hemisphere.

Question 3

What cognitive functions are assessed during a speech examination?

Answer 3

Place, time of day, and job

These questions help evaluate the cognitive aspect of speech.

Question 4

Which are aof the brain is resonsible for expressive aphasia?

Answer 4

Broca’s

This condition affects the ability to express language while comprehension may remain intact.

Question 5

Which area of the brain is responspibe for Conduction aphasia

Answer 5

Arcuate fasciculus

It connects Broca’s area and Wernicke’s area, facilitating language processing.

Question 6

What characterizes Wernicke’s aphasia?

Answer 6

Receptive aphasia

Individuals with this condition have difficulty understanding language.

Question 7

What are some potential causes of expressive, receptive, or conduction aphasia?

Answer 7

Middle cerebral artery occlusion, space-occupying lesions, neurodegenerative disorders, thalamic stroke

These conditions can disrupt language processing areas in the brain.

Question 8

What is pseudobulbar dysarthria caused by?

Answer 8

Bilateral damage to the corticobulbar tracts

This leads to impaired control of cranial nerve nuclei affecting speech and swallowing.

Question 9

What are some other signs you may find with pseudobulbar dysarthria?

Answer 9

Forehead sparing facial weakness, brisk jaw jerk, emotional lability

These signs indicate upper motor neuron involvement.

Question 10

What conditions can lead to bulbar dysarthria?

Answer 10

Myasthenia gravis, Guillain–Barré syndrome, motor neuron disease, poliomyelitis, brainstem infarction

These conditions affect lower motor neurons and can cause weakness in speech production.

Question 11

What are signs of ataxic dysarthria?

Answer 11

Slurred speech, scanning speech, excessive stress on syllables

Ataxic dysarthria is associated with cerebellar dysfunction.

Question 12

What are common causes of ataxic dysarthria?

Answer 12

Cerebellar disorders, posterior circulation infarction, cerebellar hemorrhage

These affect coordination and timing of speech production.

Question 13

What are the signs of Parkinsonian dysarthria?

Answer 13

Soft and monotonous speech, slow rate, lack of facial expression

This condition is linked to extrapyramidal symptoms.

Question 14

What can cause dysphonia?

Answer 14

Laryngitis, local pathology, inhaled steroids, recurrent laryngeal nerve palsy

These factors can impair sound production in the larynx.

Question 15

Speech examination

Answer 15

1. I’ll be assessing your speech; I’ll be asking a few questions; might sound strange so please bear with
2. Full name and full address – listen for dysarthria (word articulation) and dysphonia (sound articulation)
   a. Slow, effortful, harsh – Pseudobulbar (UMN)
3. Right handed or left handed? – for 95% of right handed people language lives in the left; for 50% of left hand people, language lives in the left
4. Cognitive function: place, time of day, my job
5. Broca’s: Expressive or nominal aphasia > three parts of an object
6. Integrity of lips, tongue, vocal folds > pa, la, ka, cough
7. Arcuate fasciculus: Conduction aphasia and dysarthria > 1,2,3 syllables, baby hippo, British constitution, no ifs and or buts
8. Wernicke’s: Receptive aphasia > pointing