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Neural Bases Exam II
Motor Speech Disorders (Lecture 5)
| Question | Answer |
|---|---|
| Cognitive-Linguistic Processes | Generate intent,Generate verbal symbols,Organize verbal symbols, Remember it all! |
| Sensorimotor Planning/Programming | Translate verbal symbols into sensorimotor score, Designate muscle activation patterns, Store expected feedback |
| Neuromuscular Execution | Direct activation of motoneurons,Muscle contraction, Movement, SPEECH!!!! |
| Cognitive-Linguistic Stage Disorders | Aphasia: Defect of Language Generation, Word-finding problems, Agrammatism, Neologisms, Auditory comprehension deficits, Reading and writing deficits |
| Sensorimotor Planning/Programming Defects | Apraxia of speech, Difficulty sequencing syllables, Articulatory groping, “know what you want to say but can’t make mouth say it”, No weakness or paralysis |
| Neuromotor Execution Defects | Muscle weakness, paralysis, incoordination, Type of speech pattern depends on the location of the neural damage |
| Dysarthria | neurologic lesion of CNS or PNS, movement disorders classified based on how they sound; and how they sound corresponds with underlying neuropathology |
| Apraxia of Speech | Impairment of sensorimotor programming, not attributable to muscular weakness or language difficulties |
| Flaccid Dysarthria | LMN Lesion; Pattern of deficit depends on site of lesion: Trigeminal nerve?, Facial nerve?, Pharyngeal plexus (glossopharyngeal/vagus)?, Pharyngeal branch?, Superior laryngeal nerve?, Recurrent laryngeal nerve? |
| Clinical Presentation of Flaccid Dysarthria: | Breathiness, Hypernasality, Imprecise articulation, Nasal air emission, monopitch |
| Conditions associated with Flaccid Dysarthria | neoplasms, trauma, infections, CVA, congenital conditions, myasthenia gravis, Bell's palsy |
| Syptoms of Flaccid Dysarthria include: | inability to make a labial seal or elevate tongue for lingual sounds |
| Spastic Dysarthria | UMN lesion (typically bilateral, Patients appear slow, weak, diffusely involved in the face, often hemiparetic |
| Spastic Dysarthria Etiologies include | multiple strokes, TBI, encephalitis, cerebral palsy |
| Clinical Presentation of Spastic Dysarthria: | Imprecise consonants, Strained-strangled voice (vocal stenosis), Slow rate, Monopitch and loudness, Hypernasality, Pitch breaks |
| Ataxic Dysarthria | Lesion to cerebellum or cerebellar circuits; Several possible patterns of deficit including “robotic quality” and “drunken quality” |
| Ataxtic Dysarthria Etiologies include | neoplasms, progressive cerebellar degeneration, trauma, encephalitis, MS, ETOH toxicity, CVA, congenital conditions |
| Clinical Presentation of Ataxic Dysarthria: | Imprecise consonants, Robotic quality (equal and even stress), Irregular articulatory breakdown (drunken quality), Harsh voice |
| Hypokinetic Dysarthria | Lesions of the basal ganglia that create too much inhibition (not enough excitation); Patients appear stiff, masked, reduced movement, gait is slow and shuffling |
| Hypokinetic Dysarthria Etiologies include | Parkinson’s disease (idiopathic PD), and parkinsonism due to drugs, CVAs or other disease processes |
| Clinical Presentation of Hypokinetic Dysarthria: | Monopitch, Reduced loudness, Breathy voice, Short rushes of speech, “slurred” articulation, hypernasality |
| Hyperkinetic Dysarthria: Dystonia | Lesions to the basal ganglia that result in too little inhibition (too much facilitation); Slow hyperkinesia, with a “build up” of involuntary movement activity |
| Hyperkinetic Dysarthria (Dystonia) Etiologies include: | encephalitis, neoplasms, CVAs, toxic effects of drugs, cerebral palsy |
| Clinical Presentation of Hyperkinetic (dystonic) Dysarthria: | Imprecise consonants, Harsh voice, Strained-strangled voice, Monopitch and loudness, Vowel and consonant breakdowns |
| Hyperkinetic Dysarthria: Chorea | BG lesion causing too much facilitation; Quick hyperkinesia results in irregular, unsustained, random, unpatterned, rapid movements |
| Hyperkinetic Dysarthria (Chorea) Etiologies include: | Huntington’s, Sydenham’s chorea, encephalitis, Gilles de la Tourette syndrome |
| Clinical Presentation of Hyperkinetic (chorea) Dysarthria: | Imprecise consonants, variable rate, Harsh voice, Monopitch and excessive loudness variation, Inappropriate silences and prolonged intervals, Distorted vowels |
| Flaccid dysarthria, possible site of lesion | Trigeminal resulting in imprecise articulation |
| Flaccid dysarthria, possible site of lesion | Facial resulting in slurred speech |
| Flaccid dysarthria, possible site of lesion | Pharyngeal plexus glossopharyngeal/vagus; Pharyngeal branch affects levator veli palatine (hypernasality) |
| Flaccid dysarthria, possible site of lesion | Pharyngeal plexus glossopharyngeal/vagus; Superior laryngeal nerve affects cricothyroid (pitch control, so they sound monotone) |
| Flaccid dysarthria, possible site of lesion | Pharyngeal plexus glossopharyngeal/vagus; Recurrent laryngeal nerve affects intrinsic muscles of larynx (hoarse, breathy, weak voice) |
| Unilateral UMN dysarthria | UUMN lesion; weakness, incoordination, usually mild and transient to bilateral innervation |
| Clinical presentation of Unilateral Upper Motor Neuron Dysarthria | imprecise articulation only sometimes present |
| AOS (apraxia of speech) | Lesion to cortical tissue (maybe insula), Sensorimotor planning/programming deficit |
| Apraxia of Speech Etiologies include | CVA, tumor, infection |
| Clinical presentation of Apraxia of Speech | articulatory errors (perseverative, anticipatory, metathetic errors), articulatory groping, slowness, dysprosody, automatic speeech, inability to program sequences of sounds (especially consonants) |
Created by:
jrschwa1
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