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Motor Speech > Test #1 > Flashcards

Test #1 Flashcards

0
Q

What are the two main tracts that UMNs run?

A

corticobulbar and corticospinal tracts

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1
Q

Where do UMN run?

A

entirely within the central nervous system

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2
Q

What type of neurons are corticobulbar neurons?

A

anything having to do with speech

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3
Q

Is the UMN like the parent of child?

A

parent (instructs the LMN)

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4
Q

What starts the process of initiating movement?

A

UMNs

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5
Q

What does a lesion to the UMN cause?

A

spasticity and hypertonicity

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6
Q

What are the two types of UMNs?

A

pyramidal and extra pyramidal

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7
Q

explain the pyramidal UMN

A
  • direct pathway

- goes directly from the motor strip to the LMN

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8
Q

what would a lesion to the pyramidal tract cause?

A

weakness/inability to do skilled movement

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9
Q

Explain the extrapyramidal UMN

A

indirect pathway

  • goes from the motor strip and makes stops along the way
  • gets a lot of feedback
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10
Q

What would a lesion to the extrapyramidal tract cause?

A

spasticity

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11
Q

What does UMN lesions almost always cause?

A

spasticity and weakness

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12
Q

Where are LMNs?

A

the peripheral nervous system

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13
Q

What is the LMNs job?

A

make the muscle contract

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14
Q

What does a lesion to the LMN cause?

A

weakness

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15
Q

Where is the lesion for flaccid dysarthria?

A

LMN

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16
Q

For flaccid dysarthria, what does every symptom lead back to?

A

weakness

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17
Q

What are the hallmark symptoms of flaccid dysarthria?

A

hypernasality and phonatory incompetence

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18
Q

Explain hypernasality

A

weakness of the velopharyngeal mechanism

-palate can’t lift to the pharynx and/or can’t close around it

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19
Q

What kind of nerve lesions cause flaccid dysarthria?

A

lesions to the cranial nerves

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20
Q

Are all cranial nerves paired or unpaired?

A

paired

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21
Q

Do cranial nerves innervate contralateraly or ipsilaterally?

A

ipsilaterally

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22
Q

What is cranial nerve V?

A

trigeminal

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23
Q

What is the trigeminal nerve responsible for?

A

jaw movement

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24
Q

How many branches does the trigeminal nerve have?

A

3

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25
Q

What is the only branch of the trigeminal that is important for speech?

A

the mandibular branch

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26
Q

What muscles does the mandibular branch innervate?

A

muscles used for mastication and the tensor veli palatini (assists with VP closure and tenses out the palate)

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27
Q

What would a lesion to the mandibular branch of the trigeminal nerve cause?

A

the jaw to hang open and hypernasality

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28
Q

What would happen if there were a unilateral lesion to the mandibular branch of the trigeminal nerve?

A

ipsilateral weakness of the jaw and velum (the other side can often compensate)

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29
Q

If there is a lesion to the trigeminal nerve would the patient open their jaw toward the good side of the affected side?

A

affected side

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30
Q

What does the VII cranial nerve do?

A

innervates muscles for facial expression

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31
Q

What is the main facial muscle that aids in speech?

A

the circular muscle that helps control lip movements

-obicularis oris

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32
Q

if there is facial droop, will it be on the affected side or the good side?

A

the affected side

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33
Q

How many branches of the facial nerve are there?

A

two

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34
Q

Explain the branches of the facial nerve?

A
  • the upper branch is for the upper face; gets bilateral innervation from the UMN
  • the lower branch is for the lower face; only gets contralateral innervation
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35
Q

What is the IX cranial nerve?

A

the glossopharyngeal

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36
Q

What does the glossopharyngeal do?

A

helps with VP closure and creating more space in the pharynx

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37
Q

What muscle does the glossopharyngeal nerve innervate?

A

the stylopharyngeus (changes the shape of the throat when making sound-produces different resonance quality)

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38
Q

What is the X cranial nerve?

A

vagus

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39
Q

What does the vagus nerve do?

A

allows adduction, abduction and tension of the voice

-also helps with VP closure

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40
Q

What are the three branches of the vagus nerve?

A
  • pharyngeal
  • superior laryngeal
  • recurrent laryngeal
41
Q

What does the pharyngeal branch of the vagus do?

A

innervates most of the muscles of the soft palate (important for VP closure)

42
Q

Which branch should be thought of if there is hypernasality?

A

the pharyngeal branch

43
Q

What does the superior branch of the vagus nerve do?

A

important for tensing the VFs for pitch change

-innervates the cricothyroid

44
Q

What does the recurrent laryngeal branch of the vagus nerve do?

A

innervates all other intrinsic muscles laryngeal muscles (posterior cricoid, thryoarytenoid complex, lateral cricoarytenoid)
-muscles for tensing, relaxing, abducting, and adducting

45
Q

What would damage to the recurrent laryngeal branch cause?

A

adductor paralysis

-breathiness or hoarseness

46
Q

What is cranial nerve XII?

A

hypoglossal nerve

47
Q

Does the hypoglossal get ipsilateral or contralateral information?

A

contralateral information

48
Q

What will you see if there is weakness of the tongue?

A

fasiculations (happen during the process of atrophy)

49
Q

Will the tongue point toward or away from the site of lesion if there is a lesion to the hypoglossal?

A

toward the site of lesion?** check!

50
Q

What are some etiologies for flaccid dysarthria?

A
  • brainstem CVA
  • myasthenia gravis
  • Guillain Barre Syndrome
  • Polio
  • muscular dystrophy
  • progressive bulbar palsy
51
Q

What are some characteristics of flaccid dysarthria?

A
  • hypernasality
  • phonatory incompetence
  • shortened phrase length
  • pressure incompetence
  • if the vagus nerve is affected
    • hypernasality and nasal emission
  • imprecise consonants
  • inspiratory stridor
  • monopitch/monoloudness
  • reduced glottal coup
  • reduced or absent reflexes
52
Q

What does AMR stand for?

A

alternating motion rates

“pu pu pu pu”

53
Q

What are SMRs?

A

sequential motion rates

“putiku putiku putiku”

54
Q

Where is the site of lesion for spastic dysarthria?

A

UMN

55
Q

What does spastic dysarthria cause?

A

weakness and spasticity

56
Q

What does spasticity cause?

A

increased muscle tone (hypertonicity)

57
Q

Why is there often weakness AND spasticity?

A

because the extrapyramidal and pyramidal routes often follow each other so a lesion to one will often means a lesion to the other
-extrapyramidal lesion causes spasticity and pyramidal causes weakness

58
Q

Where is the spasticity for spastic dysarthria?

A

often in the phonatory system

59
Q

What causes the harsh, tight, and strained sounded of the voice the spastic dysarthria?

A

spasticity in the phonatory system

60
Q

What kind of damage MUST there be to get spastic dysarthria?

A

bilateral damage to the UMN

61
Q

What are some etiologies of spastic dysarthria?

A
  • TBI
  • degenerative diseases
  • cumulative affects of UMN damage (stoke, or tumors)
  • brainstem CVA
  • infections
  • meningitis
  • ALS
  • multiple sclerosis
  • cerebral anoxia
62
Q

What are the symptoms of spastic dysarthria?

A
  • imprecise consonants (may be because of reduced or short voice onset time)
  • tight, strangled sounding voice
  • reduced ROM, which leads to imprecise contact of the articulators
  • harsh voice, caused by hypertonicity
  • low pitch
  • monopitch (caused by ROM of the cricothyroid)
  • hypernasality
63
Q

What are the two hallmark symptoms of spastic dysarthria?

A

harsh voice and reduced rate of speech

64
Q

What do all the symptoms of spastic dysarthria lead back to?

A

spasticity

65
Q

What are some comorbid symptoms of spastic dysarthria?

A
  • drooling

- pseudobulbar affect (emotional lability)

66
Q

How do you differentiate flaccid from spastic dysarthria?

A

flaccid: LMN lesion; leads to overall weakness, muscles are hypotonic
* *hallmark symptoms are phonatory incompetence and hypernasality
spastic: bilateral UMN lesion; causes spasticity and weakness, muscles are hypertonic
* *hallmark symptoms are are harsh voice and slow rate of speech

67
Q

Does severe hypernasality point to flaccid or spastic dysarthria?

A

flaccid

68
Q

Does a harsh or strangled voice point to spastic or flaccid dysarthria?

A

spastic

69
Q

Is emotional lability a sign of spastic or flaccid dysarthria?

A

spastic dysarthria

70
Q

are slower AMRs and SMRs a sign of spastic or flaccid dysarthria?

A

spastic

71
Q

Explain unilateral UMN dysarthria?

A

very mild; mild articulation problems are most common

-contralateral weakness

72
Q

Where does most of the weakness occur with unilateral UMN dysarthria?

A

the contralateral tongue or the contralateral lower face

73
Q

What are the cranial nerves that get contralateral innervation and will be affected with unilateral UMN dysarthria?

A

the facial and hypoglossal nerves

74
Q

What are you likely to see with unilateral UMN dysarthria?

A

lower facial droop and tongue weakness

-slightly slowed movements and reduced ROM to the tongue and the articulators

75
Q

What may co-occur with dysarthria if there is a unilateral lesion to the left hemisphere?

A

apraxia or aphasia

76
Q

What may co-occur with dysarthria if there is a unilateral lesion to the right hemisphere?

A

cognitive deficits and vision problems

77
Q

What are some etiologies for unilateral UMN dysarthria?

A
  • stoke (about 95% of cases)

- focal lesion (GWS, tumor)

78
Q

What are the symptoms of unilateral UMN dysarthria?

A
  • main=mild imprecise articulation
  • weakness
  • reduced ROM
  • decreased fine motor control of the tongue and lower face
  • irregular articulatory breakdown
79
Q

Where is the lesion for unilateral UMN dysarthria?

A

the unilateral UMN

80
Q

What do all symptoms of unilateral UMN dysarthria relate back to?

A

mild face and lower tongue weakness

81
Q

Where is the site of lesion for ataxic dysarthria?

A

cerebellum

82
Q

What are the main changes in ataxic dysarthria?

A

articulation and prosody

83
Q

What is the main speech symptoms of ataxic dysarthria?

A

slurred or unsteady speech

84
Q

What is the cerebellum’s job?

A

to coordinate the timing and force of muscle movements

-gages appropriate force and coordination with a lot of sensory information

85
Q

How does the cerebellum communicate with the rest of the central nervous system?

A

the three cerebellar peduncles

86
Q

what are the names of the three cerebellar peduncles?

A
  • superior
  • middle
  • inferior
87
Q

What is the job of the superior peduncle?

A

send corrections to coordinate the task

88
Q

What is the job of the middle peduncle of the cerebellum?

A

brings the motor request into the cerebellum from the motor strip

89
Q

What is the job of the inferior peduncle of the cerebellum?

A

brings in proprioceptive information about the body

90
Q

What does the cerebellum do with the information from the middle and inferior peduncles?

A

refines the movements

91
Q

What are some non speech signs of ataxia?

A
  • decreased balance or equillibrium
  • intention/action tremor
  • muscles are hypotonic
  • difficulty with motor learning
  • truncal instability
  • nystagmus
  • pendulousness
92
Q

What is an intention/action tremor?

A

only see the tremor when the person goes to do something

93
Q

What is nystagmus?

A

darting of the eyes

94
Q

What is pendulousness?

A

swaying back and forth

95
Q

What are some etiologies of ataxia?

A
  • stroke to the cerebellum
  • degenerative diseases
  • lead poisoning
  • mercury poisoning
  • alcoholism
  • exposure to cyanide
  • dilantin toxicity
  • TBI
  • hypothyroidism
96
Q

What is Friedreich’s ataxia?

A

a hereditary degenerative disease that affects the cerebellum and spinal cord
-may affect gait, dexterity, speech, and vision

97
Q

What does ETOH mean on a medical chart?

A

ethonal abuse

98
Q

What is Dilantin toxicity?

A
  • Dilantin is a drug used for seizure control

- if it gets overloaded in the system it will cause irreversible ataxia

99
Q

What is especially prone to twisting during a TBI?

A

the cerebellar peduncles

100
Q

What are the hallmark symptoms of ataxia?

A
  • scanning speech (robotic speech)
  • irregular articulatory breakdown
  • irregular AMRs and SMRs
101
Q

What do all signs of ataxia relate back to?

A

incoordination

Motor Speech (2 decks)

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