Oral Motor Exam

What is the main purpose of an oral motor exam?

Differential diagnosis, CNS/PNS, and lesion localization

What an the secondary purpose of an oral motor exam?

Determine motoric abilities vs impairments

What is the third purpose of an oral motor exam?

To establish baseline and rate severity

What are non-speech tasks?

The primary CNS/PNS exam

What is preliminary structural non-speech task inspections?

Looking for anatomical or structural abnormalities

What is function at rest non-speech task inspections?

Observing for clinical signs of neurological dysfunction (flaccidity, droop, fasciculations, resting tremor)

What is function in sustained postures and movement non-speech oral motor exam?

Testing appropriate function of all oral structure and cranial nerves for tremors, incoordination, weakness

How are structural impairments identified?

During the preliminary inspection

How are neurological impairments identified?

During the function at rest and in sustained postures/movements inspection

Unilateral upper and lower droop

LMN damage

Unilateral lower only droop

UMN damage

How do you test CN X?

Have patient hold out vowel and do pitch glide up and down

LMN lesions to CN X cause what

flaccid dysphonia, vocal fold paralysis, or breathy phonation

Bilateral UMN lesions to CN X cause what

spastic dysphonia, tight, harsh, pressed phonation

LMN lesion to CN XII

Tongue protrusion deviates ipsilateral (towards) lesion

UMN lesion to CN XII

Tongue protrusion deviates contralateral (away) from lesion

Reflexes as confirmatory signs

LMN injury depresses normal reflexes and UMN injury hyperactivate normal reflexes

What are types of reflexes?

gag, jaw jerk, sucking, snout, palmomental

What is the jaw jerk reflex?

Maxillary reflex from tap on chin causes jaw to jerk close (absent in 90%)