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Neurology
Motor Speech Midterm
| Term | Definition |
|---|---|
| Other name for LMN | Final common pathway |
| Where does LMN start? | Motor nuclei in brainstem and spinal cord |
| Where does LMN end? | Muscle Fibers |
| Function of LMN | Carry out UMN commands for voulntary movement and posture, reflexive muscle actions |
| What are the primary LNM CNs for speech? | Trigamental, Facial, Vagus, hypoglossal, phrenic nerve/spinal intercostal nerves |
| Trigeminal | 3 main branches: Ophthalmic, Maxillary, Mandibular |
| Ophthalmic branch (v) | Sensory, upper face |
| Maxillary branch (v) | Sensory, mid face |
| Mandibular (v) | Sensory, inside cheek, anterior 2/3 tongue Motor, moves jaw |
| LMN damage results in _______ damage | Ipsilateral |
| Results from unilateral damage of mandibular branch (v) | Weak jaw ipsilateral to lesion, jaw deviation to weak side wen opened, slurred speech, but intelligible |
| Why does the jaw deviate to weak side when opened when there is unilateral damage to mandibular branch of V? | The strong side pushes it over |
| Results from bilateral damage of mandibular branch (v) | Jaw can't open or very weak, unable to close mouth (slow or reduced range) |
| Results from damage to sensory branches of V | Decreased face, cheek, tongue, palate sensation, slurred speech |
| Origin V | Pons |
| Origin VII | Pons |
| Facial | Motor and sensory, only motor has role in speech |
| VII innervation | Upper and lower face |
| Which innervations from VII are important for speech? | Lips and cheeks |
| Results from damage to VII | Affect entire face on ipsilateral side |
| Results from unilateral damage to VII | Ipsilateral side sages, winkles forehead, drooped eyebrow, asymmetries during oral mech, more visual speech disturbance than audible |
| Results from bilateral damage to VII | Lax mouth, can't retract/purse lips, fasciculations, drooling, articulatory distortion (specifically with sound requiring lip closure) |
| Glossopharyngeal nerve | Motor and sensory, IX |
| IX Motor | Innervate stylopharyngeous muscles in pharynx |
| IX sensory | Pharynx and posterior tongue (gag reflex) |
| What is typically damages along with IX? | X |
| Results from IX damage | Reduced pharyngeal elevation in swallow, speech can't be directly assessed |
| Origin of IX | Medulla |
| Vagus | One fo the most important for speech, 3 branches: pharyngeal, superior laryngeal, recurrent |
| Pharyngeal branch | Constricts pharynx, elevates/retracts palate |
| Superior laryngeal branch | Sensory: larynx, epiglottis, bot area Motor: Inferior pharyngeal constrictors and cricothyroid (pitch) |
| Recurrent laryngeal branch | Long one, motor for all intrinsic laryngeal muscles (except circothyroid), sensory from larynx |
| Results form unilateral damage to X pharyngeal branch | Soft palate lower on side of lesion (pull towards strong side) |
| Results from bilateral damage to X pharyngeal branch | Velum low at rest w/ minimal movement, no gag, nasal regurgitation |
| Results from bilateral and unilateral damage to X superior laryngeal branch | VF look normal, UL = VF appear shorter, BL = both VF look sort and bowed |
| Results from UL recurrent damage X | Affected VF is paralyzed/weak, poss dysphagia |
| Results from BL recurrent damage X | Both VF weak/paralyzed, airway compromise |
| Speech results from pharyngeal branch X | Nasality weather UL or BL |
| Speech results from superior laryngeal nerve and recurrent X | Breathy, aphonia, horse, reduced loudness, stridor |
| Accessory | Works with x from velum and larynx |
| XI damage | Not important for speech function |
| Hypoglossal | All intrinsic and extrinsic muscles of tongue, articulation and tongue movement |
| XII origin | Medulla |
| What CNs are damaged together? | XII, IX, X, and XI |
| UL damage on XII | Tongue weak ipsilaterally, deviate to weak Slurred speech, mild imprecise arctic. |
| BL damage on XII | Bilateral atrophy and fasciculations, limited protrusion Additional listener effort |
| Repration impairment | X |
| Voice impairment | X |
| Artic impairment | XII, VII, V |
| Velopharyngeal impairment | X |
| Prosody impairment | X, V, XII, spinal |
| Groups for UMN | Direct and indirect pathways |
| Other name for direct pathway in UMN | Pyramidal system |
| Subsystems of direct pathway | Corticobulbar and corticospinal |
| Other name for indirect pathway | Extra pyramidal system |
| Origin of the UMN | Motor contest of left and right hemispheres |
| Where does UMN end? | LMN |
| Functions of UMN | Skilled movement, regulate movement, maintain posture tone, framework for skilled actions |
| Functions of direct pathway | Skilled movement, regulating reflexes |
| Functions of indirect pathway | Regulate reflexes, maintain posture/tone/framework for skilled actions |
| UMNs innervate CN ________ | Bilaterally |
| Which two CN only receive contralateral input from UMNs? | Hypoglossal (XII) and facial (VII) |
Created by:
morganmc3
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