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MSD Midterm Exam
Terms in this set (76)
The study of MSD helps us understand the...
organization of the sensorimotor system
Can impact one or many:
respiration, phonation, resonance, articulation
Nothing to do with cranial nerves; impaired capacity to plan/program the motor commands necessary for speech
Whole articulator; tongue must be moved to alveolar ridge
Muscle; superior long. muscle should be contracted
"adjustment" that occurs before or during execution of speech tasks
muscoskeletal-laryngoectomy, cleft lip/palate
non psychogenic-dysphonias, vocal abuse, hormonal dist.
psychogenic and related nonorganic- schizophrenia, depression
The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as...
changes in speech can be the initial or ONLY sign of
All statements regarding dysarthria are correct EXCEPT
impairment of cerebral cortex
Why do we use perceptual methods as our primary means of Dx and management?
sound different on a certain day, strained, different pitch
Speech symptom of issues in upper motor neuron
strained/strangled voice quality
Speech symptom of issues in lower motor neuron
high level of breathiness
Must keep in mind ____, ____, and ____ when using perceptual methods
age, gender, and style
Localization of Dysarthria
Lower motor neuron
Localization of Ataxic
Localization of apraxia of speech
Which is the most prevalent dysarthria?
Instrumental methods are the Gold Standard
_______ methods can visually and numerically quantify frequency, intensity, and temporal components of the speech signal
Impairment in the basal ganglia results in which type of dysarthria?
Hyperkinetic and hypokinetic
Brainstem (pons, medulla, midbrain, and cerebellum)
For a physical exam we need to observe the speech muscles....
-during sustained postures
deficits of intellect; memory impairments
How can we distinguish apraxia from dysarthria?
Apraxia is a deficit in motor programming and the Pt is not able to do voluntary tasks (but can do involuntary)
For patients with Dysarthria, motor movement is difficult regardless of the task
4 things to look for in Dysarthria
aids in context and gestures
Distinct speech symptom of Flaccid dysarthria
whole system weak; hypernasal/breathy, short phrases, reduced stress, diplophonia, audible nasal emission
Distinct speech symptom of Spastic dysarthria
Effortful, harsh and or short phrases; excess stress/monopitch; hypernasal
"Drunken" or "scanning" speech
Distinct speech symptom of Apraxia
Distinct speech symptom of hyperkinetic dysarthria
Palilalia- compulsive repetition of words or phrases
accelerating rate and decreased loudness
What are the hyperkinetic dysarthrias?
-Chorea (Huntington's disease)
-Dystonia (painful muscle movements)
-Essential voice tremor (organic)
-spasmodic dysphonia(inv. abduction that causes breathiness
Parkinson's disease; VERY FAST SPEECH RATE
Face drooping; AMR's better than "SMR's?"
**Damage is on same side as fasciculations
Ex. if on right then there is right UUMN
Cerebral spinal fluid is circulated in the _______space
Which neurotransmitter has an inhibitory function?
True or False: Post, cerebral artery supplies blood to the frontal lobe
A patient demonstrates repetitive tongue pumping and impaired laryngeal elevation: What neurological problem best accounts?
What is sialorrhea?
•The paired cranial nerves exit through the___________ and __________ foramina (holes) to innervate the speech muscles.
Posterior and middle fossae
What is in the supratentorial level of the nervous system?
hemispheres, lobes, basal ganglia, thalamus, cranial nerves I and II
What is the function of the visceral system?
•maintaining a balanced internal environment (homeostasis) through the regulation of visceral glands and organs.
What is the function of the CSF (ventricular) system?
•Cushioning the CNS against physical trauma and to help maintaining a stable environment for neural activity.
What is the function of the vascular system?
•Providing oxygen and other nutrients to neural structures and removing metabolic wastes from them.
What is the function of the consciousness system?
•Maintaining wakefulness, consciousness, awareness of the environment and, on a higher level, selective and sustained attention.
What is the function of the motor system?
Maintaining normal muscle tone and posture, and to the planning, control, and execution of voluntary movement, including speech.
glutamate (CNS) and acetylcholine (PNS)
Dopamine (BG), acetylcholine (CNS)
Source of input for LMN's
This pathway is also known as the pyramidal tract and contains corticobulbar and corticospinal tracts
Pathway for lower motor neuron
Final common pathway
What is the innervation ratio?
•The number of muscle fibers innervated by a single motor neuron
Damage to final common pathway can result in......?
-weakness or paresis
-reduced muscle tone
Damage to the direct motor pathway can lead to:
Unilateral UUMN dysarthria (hyporeflexia), or bilateral UUMN dysarthria (spastic)
Damage the indirect activation pathway can lead to....
•Hyperadduction of the vocal folds
•Mild symptoms if unilateral damage, but bilateral can be quite severe
•Bilateral UMN lesions can come with hyperactive reflexes, pathologic reflexes, dysphagia, and lability
Impact on speech
•Spasticity will slow speech
•Spastic dysarthria with bilateral UMN lesion
•Unilateral UMN dysarthria when damage is only on one side
True or False: •The control circuits do NOT have direct contact with LMNs.
Effects of Basal Ganglia Damage
•Chorea, athetosis, dystonia
establish candidacy for treatment, specify the treatment focus WHEN?
When activity or participation in communication situations are restricted
determine presence/absence of symptoms, provide counseling only at this stage WHEN?
How do we assess the VP during movement?
-prolongation on pressure consonants /s/, /p/ (nasal airflow)
A weak cough but sharp glottal coup may implicate what?
A weak coup but normal cough, or equally weak cough and coup, tends to be associated with?
laryngeal weakness or combined laryngeal and respiratory weakness
Vowel prolongation should last at least __ seconds
Is "puh-puh-puh-puh" an AMR or SMR
If there is significant deterioration of voice quality, resonance, or articulation, may be ___________ _____________
We may see a weak, breathy voice quality, and short vowel duration in patients with?
LMN damage (vagus nerve)
If the UMN is impacted, the likely diagnosis is...
An irregular AMR pattern can be associated with?
A breathy voice quality, monotone, monoloudness, and "mask" expression can be indicative of what?
Based on the ICF model, participation restriction in a patient with a MSD may be reflected as _______
Fewer social relationships
Establishing candidacy for treatment should be established AFTER what?
Activity or participation in communication situations are restricted
The best context for orofacial mechanism is...
At rest, during sustained postures and during movement
Post. cerebral Artery supplies blood to...
Occipital lobe, inferior and medial portions of temporal lobe, thalamus
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