Motor Speech, Swallowing & Apraxia – Vocabulary Flashcards

This set of flashcards covers key vocabulary related to motor speech disorders, dysphagia physiology and assessment, apraxia types, cranial-motor anatomy, and common therapeutic techniques discussed in the lecture notes.

Chorea

Smooth, random, dance-like involuntary movements; typical of Huntington’s disease.

Ataxia

Drunken-like, uncoordinated speech and body movement caused by cerebellar damage.

Dystonia

Sustained, twisting muscle contractions that produce abnormal postures or movements.

Myoclonus

Sudden, brief, jerky muscle contractions often seen in epilepsy or metabolic disorders.

Tremor

Rhythmic, involuntary oscillation of a body part; common in Parkinson’s disease and essential tremor.

Bradykinesia

Pathologically slow initiation and execution of voluntary movement.

Rigidity

Uniform resistance to passive movement, giving a ‘lead-pipe’ or ‘cogwheel’ feel.

Spasticity

Velocity-dependent increase in muscle tone with exaggerated stretch reflexes.

Hyperkinesia

Excessive, involuntary movements due to over-activity of motor pathways.

Akinesia

Marked difficulty initiating voluntary movement, as in advanced Parkinson’s disease.

Upper Motor Neurons (UMNs)

Cortical and subcortical neurons that initiate voluntary movement and modulate tone; bilateral damage causes spasticity.

Lower Motor Neurons (LMNs)

Brainstem or spinal neurons that directly innervate muscle; lesions cause weakness, atrophy, fasciculations.

Spastic Dysarthria

Motor speech disorder from bilateral UMN damage; strained voice, slow rate, hyper-reflexes.

Flaccid Dysarthria

Speech disorder from LMN damage; hypernasality, breathy voice, fasciculations, rapid fatigue.

Ataxic Dysarthria

Cerebellar-based speech disorder with irregular articulatory breakdowns and excess-equal stress.

Hypokinetic Dysarthria

Basal ganglia disorder due to dopamine depletion; monopitch, reduced loudness, short rushes of speech.

Hyperkinetic Dysarthria

Basal ganglia disorder with excess dopamine; involuntary voice breaks, variable rate, distorted vowels.

Unilateral UMN Dysarthria

Mild dysarthria from one-sided UMN damage causing weakness and spasticity on the contralateral side.

Basal Ganglia

Subcortical nuclei regulating movement initiation, amplitude, and inhibition.

Cerebellum

Brain structure that coordinates timing, force, and sequence of movements for smooth motor control.

Area 4 – Primary Motor Cortex

Precentral gyrus controlling voluntary skeletal muscle; lesions cause weakness or paralysis.

Area 44 – Broca’s Area

Left inferior frontal gyrus responsible for speech production; damage produces Broca’s aphasia.

Areas 3, 1, 2 – Somatosensory Cortex

Post-central gyrus processing tactile input; damage yields numbness or impaired sensation.

Area 6 – Supplementary Motor Cortex

Anterior to motor cortex; plans and sequences complex movements.

Sound Production Treatment (SPT)

Evidence-based apraxia therapy using modeling, repetition and cueing to improve consonant accuracy.

Minimal Contrasts

Therapy technique practicing word pairs differing by a single phoneme to refine articulation.

Supraglottic Swallow

Breath-hold, swallow, cough sequence used to protect airway when closure is delayed or weak.

Super-Supraglottic Swallow

Hard breath-hold plus swallow & cough providing extra laryngeal closure for severe airway risk.

Effortful Swallow

Intentional, forceful swallow to increase tongue base retraction and pharyngeal pressure.

Mendelsohn Maneuver

Voluntarily sustaining laryngeal elevation during swallow to prolong UES opening.

Chin Tuck

Postural adjustment of lowering the chin to widen vallecular space and reduce aspiration risk.

Head Turn (to weaker side)

Rotating head toward damaged pharyngeal side to direct bolus down the stronger channel.

Penetration–Aspiration Scale (PAS)

Eight-point rating of material entering airway, ranging from 1 (no entry) to 8 (silent aspiration).

Videofluoroscopic Swallow Study (VFSS/MBSS)

Dynamic X-ray that visualizes bolus flow through all swallow phases using barium contrast.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Trans-nasal endoscopy providing direct laryngeal view before and after the swallow without radiation.

Cervical Auscultation

Listening to swallow sounds at the neck to infer pharyngeal movement and airway closure.

Surface Electromyography (sEMG)

Non-invasive electrodes measuring muscle activity during oral and pharyngeal swallow stages.

3-Ounce Water Swallow Test

Bedside screen where patient drinks 90 ml of water continuously; coughing or wet voice signals risk.

Yale Swallow Protocol

Standardized screening combining oral-motor exam, cognition check, and 3-ounce water swallow.

Heads-Up Effortful Swallow

Swallow performed with neck extension to assist clearance of vallecular residue; may worsen pyriform residue.

Lee Silverman Voice Treatment (LSVT LOUD)

High-effort program increasing vocal loudness and respiratory drive for Parkinson’s hypokinetic speech.

Apraxia of Speech (AOS)

Motor planning disorder causing groping, inconsistent sound errors, and disrupted prosody.

Childhood Apraxia of Speech (CAS)

Pediatric motor-planning deficit with inconsistent errors and increasing difficulty as utterances lengthen.

Inconsistent Phonological Disorder (IPD)

Phonological disorder with variable phoneme selection errors but preserved motor planning and imitation.

Ideational Apraxia

Inability to conceptualize multi-step tasks leading to misuse or sequence errors with tools/objects.

Ideomotor Apraxia

Breakdown in translating a motor idea into action; gestures poor on command but better with imitation.

Buccofacial (Oral) Apraxia

Impaired voluntary non-speech oral movements such as blowing or tongue protrusion.

Gait Apraxia

Difficulty initiating or planning walking despite normal strength, producing a ‘magnetic’ shuffle.

Myasthenia Gravis

Autoimmune LMN junction disorder causing fatigable weakness; can produce flaccid dysarthria.

Amyotrophic Lateral Sclerosis (ALS)

Neurodegenerative disease causing mixed spastic-flaccid dysarthria and progressive weakness.

Guillain-Barré Syndrome

Acute demyelinating polyneuropathy producing LMN flaccid dysarthria and dysphagia.

Orofacial Dyskinesia

Involuntary lip, tongue or jaw movements often related to excess dopamine states.

Masako Maneuver

Tongue-hold swallow strengthening pharyngeal constrictors by protruding tongue between teeth while swallowing.

Upper Esophageal Sphincter (UES)

Cricopharyngeal opening between pharynx and esophagus that relaxes during the swallow.

Lower Esophageal Sphincter (LES)

Distal esophageal valve that closes to prevent gastric reflux after bolus entry into stomach.

Oral Preparatory Phase

Voluntary stage where food is chewed, mixed with saliva, and formed into a cohesive bolus.

Oral (Propulsive) Phase

Tongue propels bolus posteriorly toward the oropharynx to trigger swallowing reflex.

Pharyngeal Phase

Reflexive stage with velopharyngeal closure, laryngeal elevation, and UES opening to move bolus.

Esophageal Phase

Involuntary peristaltic transport of bolus from UES through esophagus to stomach.

Thin Liquid

Fluid consistency like water; highest aspiration risk.

Nectar-Thick Liquid

Mildly thick fluid similar to apricot nectar; flows slowly.

Honey-Thick Liquid

Moderately thick fluid that pours like honey.

Pudding-Thick Liquid

Extremely thick, spoonable consistency resembling yogurt; does not pour.

Soft/Mechanical Soft Solid

Easily chewed foods such as cooked vegetables or tender meats.

Pureed Solid

Smooth, cohesive food requiring no chewing, e.g., applesauce.

Eight-Step Continuum

Hierarchical cueing program that gradually fades clinician support to improve word production in AOS.

Fasciculations

Visible, involuntary muscle twitches indicative of LMN damage.

Jaw Jerk Reflex

Pathologic hyperactive stretch reflex of the masseter seen in bilateral UMN lesions.

Spasmodic Dysphonia

Hyperkinetic laryngeal disorder causing spasms during speech, treated as a hyperkinetic dysarthria.

Cricopharyngeal Muscle

Principal muscle of the UES that relaxes during the pharyngeal swallow to allow bolus passage.

Diadochokinetic Rate

Speed and regularity of rapid alternating speech movements; slowed in CAS and ataxia.