Studied by 87 PeopleTags & Description
What is a motor speech disorder?
Speech disorders resulting from neurologic impairments affecting the planning, programming, control or execution of speech.
What is dysarthria?
Collective name to reflect abnormalities in strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production.
What is apraxia of speech?
Impaired capacity to plan or program the commands necessary for directing movements in accurate speech productions: can occur in absence of: disturbances associated with dysarthria and disturbances in any component of language.
What are the six cranial nerves that directly influence speech?
V- Trigeminal VII- Facial IX- Glossopharyngeal X- Vagus XI- Accessory XII- Hypoglossal
Which neurotransmitter plays a role in movement, motivation and reward, cognition and learning, attention, mood, and sleep?
Dopamine
Which neurotransmitter leads to movement but inducing contraction of muscle fibers?
Acetylcholine
The supratentorial, posterior fossa, spinal, and peripheral make up the major anatomic levels of the nervous system. True or False
True
The peripheral nervous system consists of?
Cranial Nerves Spinal Nerves Spinal Cord
What type of disease with diffuse effects could occur due to complications of kidney and liver disease?
Toxic metabolic
Which type of disease is typically chronic, progressive, and diffuse?
Degenerative
The Direct Activation Pathway is also known as?
Direct Motor System
Pyramidal System
The indirect activation pathway is also known as?
Extrapyramidal Tract
Brainstem Motor System
Brainstem Motor Pathway
Indirect Motor System
What does the cerebellar control circuit do?
Coordination and timing of movement
What does the basal ganglia control circuit do?
motor control executive function emotion motor control posture tone
The direct and indirect activation pathways are part of the ____ motor neuron system.
Upper
The following divisions are part of the speech motor system:
The control circuits The indirect activation pathway The final common pathway The direct activation pathway
The major anatomic levels of the nervous system include the supratentorial, posterior fossa, spinal, and peripheral level. The 10 of the 12 paired cranial nerves originate in the brainstem which is part of the ____ level.
Posterior Fossa
There are ____ cranial nerves involved in speech production.
6
The final common pathway includes the following:
Paired Cranial Nerves Paired Spinal Nerves
When describing or determining the specific pathologic process, the physician may refer to the course or temporal time line of the disease as acute, subacute, or chronic. If the symptoms developed within minutes, the condition would be considered
Acute
The pyramidal tract or direct motor system is referred to as the
Direct activation pathway
What are some neurologic speech disturbances?
Acquired neurogenic stuttering Palilia Echolalia Foreign Accent Syndrome Aprosodia Mutism
What are some functional and nonorganic speech disorders?
Certain mental health conditions: Schizophrenia Depression Conversion Disorder
What are some cognitive- linguistic deficits?
Changes in verbal expression Aphasia Akinetic mutism Can co-occur with MSDs
What changes in speech occur due to age?
Pitch Voice quality Stability Loudness Speech Breathing Patterns Rate Fluency Prosodic Variations Fine motor control
What are some differences in speech due to sex?
Difference seen in acoustical analysis. Different norms for men and women.
How can sensory deficits impact MSDs?
Hearing loss can result in degradation of speech.
What are some musculoskeletal defects that impact speech?
Injury Disease Congenital abnormality Surgical removal Cleft palate
What are some other factors that can impact speech based on the individual?
Personality Emotional state Speaking role
What are examples nonneurologic/ nonpsychogenic voice disorders?
Dysphonia Vocal abuse Hormonal Disturbances
What characteristics do perceptual methods evaluate?
Pitch Loudness Voice Quality Resonance Respiration Prosody Articulation
Why is training in perceptual methods important?
It is the gold standard. Requires lots of practice to train your ear.
How do acoustic methods evaluate speech?
Visually displays and helps quantify characteristics such as frequency, intensity, and temporal components.
What value do physiologic methods help when evaluating speech?
This includes visual imaging. Can help create a relationship between speech produced and the pathophysiology.
What are some pros to physiologic methods of evaluation?
Helps quantify characteristics.
What are some forms of physiologic evaluations?
kinematic measures- electroglottography, magnetometry aerodynamic measures- spirometry, nasal accelerometry
What are some examples of visual imaging?
Videofluoroscopy Nasoendoscopy Laryngoscopy Videostroboscopy
How do we categorize motor speech disorders?
Course Age Lesion Onset Neurologic Diagnosis Pathophysiology
What is the importance of age of onset?
Age can influence prognosis and treatment/ management decisions
How does site of lesion impact diagnosis?
Biggest goal in diagnosis Can predict deficits therefore prognosis and treatment
Localization of Flaccid Dysarthria?
LMN- Final Common Pathway
Neuromotor bases of Flaccid Dysarthria?
Execution
Neurologic bases of Flaccid Dysarthria?
Weakness
Localization of Spastic Dysarthria?
Bilateral UMN- indirect & direct pathways
Neuromotor bases of Spastic Dysarthria?
Execution
Neurologic bases of Spastic Dysarthria?
Spasticity
Localization of Ataxic Dysarthria?
Cerebellum Cerebellar control circuit
Neuromotor bases of Ataxic Dysarthria?
Control
Neurologic bases of Ataxic Dysarthria?
Incoordination
Localization of Hypokinetic Dysarthria?
Basal ganglia control circuit extrapyramidal
Neuromotor bases of Hypokinetic Dysarthria?
Control
Neurologic control of Hypokinetic Dysarthria?
Rigidity Reduced range of movement scaling problems
Localization of Hyperkinetic Dysarthria?
Basal ganglia control circuit extrapyramidal
Neuromotor bases of Hyperkinetic Dysarthria?
Control
Neurologic bases of Hyperkinetic Dysarthria?
Involuntary movements
Localization of Unilateral UMN Dysarthria?
Unilateral upper motor neuron
Neuromotor bases of Unilateral UMN Dysarthria?
Execution/ control
Neurologic bases of Unilateral UMN Dysarthria?
UMN weakness Incoordination Spasticity
Localization of Mixed Dysarthria?
Many locations
Neuromotor bases of Mixed Dysarthria?
Execution and/or control
Neurologic bases of Mixed Dysarthria?
More than one
Undetermined Dysarthria
Unknown location, neuromotor and neurologic bases
Localization of Apraxia of Speech?
Left (dominant) hemisphere
Neuromotor bases of Apraxia of Speech?
Motor Planning Motor Programing
Neurologic bases of Apraxia of Speech?
Planning and programming errors
Perceptual speech characteristics of Flaccid Dysarthria?
Continuous Breathy Diplophonia? Audible inspiration Nasal emissions Short phrases Hypernasality Rapid deterioration & recovery Imprecise AMRs
Physical characteristics of Flaccid Dysarthria?
Weakness Atrophy Fasciculations Hypoactive gag reflex Facial myokmia Rapid deterioration & recovery Synkinesis Nasal backflow when swallow
Perceptual speech characteristics of spastic dysarthria?
Slow rate Strained/ harsh Pitch breaks Slow but regular AMRs
Physical characteristics of spastic dysarthria?
Pathologic oral reflexes Lability of affect Hypertonia Hyperactive gag reflex
Perceptual speech characteristics of ataxic dysarthria?
Irregular articulatory breakdowns Excess but equally placed stress Distorted vowels Excessive loudness variation Irregular AMRs
Physical characteristics of ataxic dysarthria?
Dysmetric jaw, face, tongue Head tremors
Perceptual speech characteristics of hypokinetic dysarthria?
Monopitch Monoloudness Reduced loudness/ stress Rapid/ accelerated rate Inappropriate silence Rapidly repeated phonemes palilalia Fast & blurred AMRs
Physical speech characteristics of hypokinetic dysarthria?
Masked faces Tremors in jaw, lips, tongue Reduced range of motion AMR Resting tremor Rigidity
Perceptual speech characteristics of hyperkinetic dysarthria?
Prolonged intervals Sudden forced breathing Transient breathiness Transient vocal strain/ harshness Voice stops/ arrests Voice tremor Myoclonic vowel prolongation Intermittent hypernasality Deterioration with faster rate Inappropriate vocal noises Distorted vowels Excessive loudness variation Slow & irregular AMRs
Physical characteristics of hyperkinetic dysarthria?
Involuntary movement of facial/articulatory structures Sustained deviation of head position Motor tics Myoclonus of plate, pharynx, lips, etc Tremor of jaw, lip, tongue, etc Grimace during speech
Perceptual speech characteristics of unilateral UMN dysarthria?
Slow rate imprecise articulation irregular articulation errors strained voice reduced loudness
Physical characteristics of unilateral UMN dysarthria?
Unilateral lower face weakness Unilateral lingual weakness (no atrophy/ fasciculations) Nonverbal oral apraxia
What are the 4 anatomic levels?
Supratentorial Posterior Fossa Spinal Peripheral
What structures are in the supratentorial level?
Surface of cerebellum 4 Lobes Basal ganglia Thalamus Hypothalamus CN I & II
What MSDs occur in the supratentorial level?
Apraxia Spastic Unilateral UMN Hyperkinetic Hypokinetic
What structures are in the posterior fossa level?
Brainstem Cerebellum CN III-XII Spinal Nerves Tectum Tegmentum
Where and what is the tectum?
Posterior Fossa level Dorsal to aqueduct of Sylvius Inferior and superior colliculli (copora quadrigemina) Auditory and visual systems
Where and what is the tegmentum?
Posterior Fossa level Ventral to aqueduct of Sylvius & 4th ventricle White matter pathways and reticular formation
Are CN that deal with speech part of CNS or PNS?
PNS