Study Guide

Question 0

Name the pathways and their tracts

Answer 0

• Final common pathway
• Direct activation pathway- corticobulbar and corticospinal
• Indirect activation pathway- corticoreticular and corticorubral
• Control circuits- cerebellar and basal ganglia

Question 1

What are tracts and pathways?

Answer 1

groups of fibers that travel together in the CNS that transmit impulses to other neurons

Question 2

What is the Romberg test?

Answer 2

Romberg test: a test of balance that rules out loss of proprioception, vestibular problems, or hysteria (exaggerated/uncontrollable emotion). Need 2/3 things to maintain balance while standing: proprioception, vestibular function (head position in space), and vision. Patient asked to close eyes, if loose balance, may indicate a positive Romberg associated with cerebellar ataxia.
Test: stand with feet together and eyes open versus feet together and eyes closed.

Question 3

what are the 4 parts of the motor speech disorder examination?

Answer 3

1. history
2. examination of the oral mechanism at rest or during non-speech activities
3. perceptual assessment of speech characteristics
4. assessment of intelligibility, comprehensibility, and efficiency

Question 4

which nerves are involved with speech production?

Answer 4

CN V: trigeminal- Sensory from face and mouth; motor to muscles of chewing
CN VII- Facial: Facial movement, hyoid elevation, stapedius reflex, salivation, lacrimation, and taste.
CN IX: glossopharyngeal- Pharynx for swallowing, posterior 1/3 of tongue
CN X: vagus- All intrinsic muscles of larynx; swallowing, phonation, involuntary muscle and gland control; taste; skin/organ sensitivity
CN XI: accessory- Muscles that move the head, neck, and shoulders
CN XII: hypoglossal- Movement of the tongue

Question 5

what are the 5 systems that we assess with dysarthria?

Answer 5

phonation, prosody, articulation, resonance, respiration

Question 6

what are the published tests for dysarthria and apraxia that Duffy describes?

Answer 6

Dysarthria- Frenchay Dysarthria Assessment (FDA-2)

Apraxia- Apraxia Battery for Adults- Second Edition (ABA-2)

Question 7

describe intelligibility, comprehensibility and efficiency

Answer 7

Intelligibility: the degree to which a listener understands the acoustic signal produced by a speaker.
Comprehensibility: the degree to which a listener understands speech on the basis of the auditory signal plus all other info. that may contribute to understanding what has been said.
Efficiency: rate at which intelligible or comprehensible info. is conveyed. (may be intelligible but very inefficient because rate is slow).

Question 8

define palilalia

Answer 8

compulsive repetition of words/phrases, usually in context of accelerating rate and decreasing loudness.

Question 9

define diplophonia

Answer 9

simultaneous perception of two different pitches

Question 10

define coprolalia

Answer 10

involuntary, compulsive, repetitive obscene language or swearing, uttered loudly, softly, or incompletely

Question 11

define vocal flutter

Answer 11

rapid, relatively low-amplitude voice tremor, usually most apparent during vowel prolongation

Question 12

what are pitch breaks?

Answer 12

pitch shows sudden and uncontrolled variation

Question 13

Grandfather passage importance

Answer 13

• batters its reader with syntactic and semantic complexity
• offers an ideal mode of eliciting speech and reading errors
• may be used for a quick survey of the student’s ability to produce correct speech sounds

Question 14

at what level are the problems located for flaccid dysarthria?

Answer 14

final common pathway

Question 15

what type of lesions would result in flaccid dysarthria?

Answer 15

lesions to LMN

Question 16

what is the most prominent feature of flaccid dysarthria?

Answer 16

muscle weakness

Question 17

what are the hallmarks of flaccid dysarthria?

Answer 17

• hypernasality
• nasal air emission
• audible inspiration or stridor on inhalation
• often speaks in short phrases

Question 18

if all LMN is lost, what is the result?

Answer 18

paralysis

Question 19

if some of LMN is lost, what is the result?

Answer 19

paresis

Question 20

what are fasciculations?

Answer 20

muscle twitches– a small, involuntary muscle contraction and relaxation

Question 21

what is SLOP?

Answer 21

Slow
Loud
Overaticulate
Pause

Question 22

Spastic dysarthria is a result from what kind of neuron damage?

Answer 22

bilateral UMN: direct and indirect activation pathways of CNS

Question 23

T/F speech deficits will present at rest with spastic dysarthria

Answer 23

false; will present in movement

Question 24

which areas of speech are affected in spastic dysarthria?

Answer 24

all of them

Question 25

What kind of lesions is ataxic dysarthria associated with?

Answer 25

cerebellar

Question 26

what does ataxic dysarthria affect?

Answer 26

standing, walking, speech | -movements halting, imprecise, jerky, poorly coordinated, lack of fluidity/smoothness

Question 27

name the terms that accompany cerebellar lesions

Answer 27

``` Nystagmus Hypotonia Dysmetria Dysdiadokokinesis Intention or kinetic tremors ```

Question 28

Define nystagmus

Answer 28

Rapid back and forth jerky movements of the eyes at rest or with lateral or upward gaze

Question 29

define hypotonia

Answer 29

absence of tone; decrease in resistance to passive

Question 30

define dysmetria

Answer 30

An inability or impaired ability to accurately control the range of movement in muscular acts Overestimating or underestimating the range of motion needed to place the limbs correctly during voluntary movement

Question 31

define dysdiadokokinesis

Answer 31

movement, errors in the sequence and speed of component parts of a movement, with a resultant lack of coordination

Question 32

T/F ataxic dysarthria is poorly coordinate movement pattern rather than weakness

Answer 32

true

Question 33

where are the breakdowns for ataxic dysarthria?

Answer 33

motor organization and control

Question 34

T/F breakdowns for ataxic dysarthria are consistent

Answer 34

false; they are inconsistent-- breakdowns for flaccid dysarthria are consistent

Question 35

what is the Romberg test?

Answer 35

test of balance that rules out loss of proprioception, vestibular problems, or hysteria

Question 36

What is Unilateral UMN dysarthria associated with?

Answer 36

damage to UMN

Question 37

T/F UUMN dysarthria results in bilateral UMN weakness in face/tongue

Answer 37

false; it results in unilateral UMN weakness in face/tongue (bilateral = spastic dysarthria)

Question 38

list some clinical characteristics of UUMN dysarthria

Answer 38

- Babinski reflex on affected side - combo of weakness and spasticity, affected limbs - corticobulbar involvement- contralateral lower facial weakness

Question 39

what are some etiologies for UUMN dysarthria? which is the most common?

Answer 39

- tumors - trauma-- especially surgical trauma - unilateral stroke (most common)

Question 40

what component of speech is mostly affected for UUMN dysarthria?

Answer 40

articulation

Question 41

T/F weakness is on the contralateral side for UUMN

Answer 41

true

Question 42

T/F tongue protrusion will deviate to the stronger side

Answer 42

false; weaker side

Question 43

how does UUMN and flaccid dysarthrias differ in terms of weakness?

Answer 43

UUMN is weakness on lower half of one side | flaccid is total paresis on one side

Question 44

Apraxia or Dysarthria? An impaired ability to generate the motor programs for speech movements

Answer 44

Apraxia; Apraxia is a planning/programming problem, not a movement problem like dysarthria

Question 45

Apraxia or Dysarthria? Errors are inconsistent and unpredictable

Answer 45

Apraxia

Question 46

Apraxia or Dysarthria? Errors are consistent and predictable

Answer 46

Dysarthria

Question 47

Apraxia or Dysarthria? Errors are mainly distortions and omissions

Answer 47

Dysarthria

Question 48

Apraxia or Dysarthria? Different errors occur in spontaneous speech versus repetition

Answer 48

Apraxia

Question 49

Apraxia or Dysarthria? Patient’s spontaneous speech contains fewer errors than does his/her speech in repetition tasks

Answer 49

Apraxia

Question 50

Apraxia or Dysarthria? Distortions are the most common type of error

Answer 50

Dysarthria

Question 51

Apraxia or Dysarthria? “Slurred speech”

Answer 51

Dysarthria

Question 52

Apraxia or Dysarthria? Speaking softly or barely able to whisper

Answer 52

Dysarthria

Question 53

Apraxia or Dysarthria? There are islands of clear speech; when producing over-learned material or material that has become automatic, the patient will speak clearly

Answer 53

Apraxia

Question 54

Apraxia or Dysarthria? Slow rate of speech

Answer 54

Dysarthria

Question 55

Apraxia or Dysarthria? Substitutions are the most common type of error

Answer 55

Apraxia

Question 56

Apraxia or Dysarthria? Anticipation of errors cause dysfluent speech

Answer 56

Apraxia

Question 57

Apraxia or Dysarthria? Hoarseness

Answer 57

Dysarthria

Question 58

Apraxia or Dysarthria? Breathiness

Answer 58

Dysarthria

Question 59

Apraxia or Dysarthria? Groping, trial and error types of articulatory movements

Answer 59

Apraxia

Question 60

Apraxia or Dysarthria? Changes in vocal quality

Answer 60

Dysarthria

Question 61

Apraxia or Dysarthria? The muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all after a stroke or other brain injury

Answer 61

Dysarthria