Term
| What are motor speech processes? |
|
Definition
1. Message planning
2. Message coding
3. Motor planning
4. Motor programming.
5. Motor execution |
|
|
Term
| Two categories of motor speech disorders |
|
Definition
1. Disorders of motor planning/programming
2. Disorders of neuromotor execution. |
|
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Term
|
Definition
| Difficulty in motor programming: selecting and sequencing the appropriate sensorimotor commands for the positioning, movement of muscles to perform learned and intentional actions with a normal sensorimotor profile (no muscle weakness and/or muscle tone abnormalities). |
|
|
Term
| Characteristics of Apraxia |
|
Definition
| Speech errors, difficulty transitioning, prosodic disturbances, groping, difficulty initiating speech, more sound errors in longer words,perseverations |
|
|
Term
|
Definition
a collective name for a group of neurologic speech
disorders resulting from abnormalities in the
strength, speed, range, steadiness, tone, or
accuracy of movements required for control of the
respiratory, phonatory, resonatory, articulatory,
and prosodic aspects of speech production. The
responsible pathophysiologic disturbances are due
to central or peripheral nervous system
abnormalities and most often reflect weakness;
spasticity; incoordination; involuntary movements;
or excessive, reduced, or variable muscle tone |
|
|
Term
| What area of the brain is affected in flaccid dysarthria? |
|
Definition
|
|
Term
| Spastic dysarthria signifies what? |
|
Definition
| Bilateral upper motor neuron dysfunction |
|
|
Term
| Ataxic dysarthria is caused by what? |
|
Definition
| Problems in the cerebellum and cerebellar control circuits |
|
|
Term
| Hypokinetic dysarthria is caused by a problem where? |
|
Definition
| The substantia nigra of the basal ganglia |
|
|
Term
| What is the "gold standard" method of studying motor speech disorders? |
|
Definition
|
|
Term
| What are the methods of studying motor speech disorders? |
|
Definition
1. Perceptual
2. Acoustic
3. Physiological
4. Visual imaging (via nasendoscopy, larygoscopy, videofluoroscopy, videostroboscopy) |
|
|
Term
| What are the dimensions of motor speech disorders? |
|
Definition
1. Age of Onset
2. Congenital or Acquired
3. If acquired, acute, subacute or chronic
4. Cause/etiology
5. Natural course
a. Transient
b. Chronic/stationary
c. Improving
d. Progressive/degenerative
e. Exacerbating/remitting |
|
|
Term
| What are some treatment approaches? |
|
Definition
-AAC
-Normalize physiological support for speech
-Teach compensatory behaviors
-Medical approaches (i.e., prosthetics, surgical and drug treatments) |
|
|
Term
| What are the four major subsystems of the speech mechanism? |
|
Definition
1. Respiratory - lungs and such
2. Phonatory - larynx
3. VP system - Velopharynx
4. Articulatory system - mouth stuff |
|
|
Term
| What are the two pulmonary subdivisions? |
|
Definition
| Lung Volumes & Lung Capacities |
|
|
Term
| What are the four kinds of lung volumes? |
|
Definition
| Tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume |
|
|
Term
| What are the five lung capacities? |
|
Definition
| Total lung capacity, inspiratory capacity, resting expiratory level, vital capacity and functional residual capacity |
|
|
Term
|
Definition
| The maximum amount of air a person can expel after a maximum inhalation. |
|
|
Term
| What is the passage way from the trachea to the lungs called? |
|
Definition
|
|
Term
| Where does gas exchange take place? |
|
Definition
|
|
Term
|
Definition
| When breathing in or out deeply, the elasticity of both ribs and lung tissue itself is pushed past the neutral point. So for deep inhalation, the elastic recoil of the lung tissue wants to push air out. When air is pushed out very far, the elastic recoil of the cartilagenous portions of the ribs wish to open and pull more air back in. |
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|
Term
| What are the extrinsic muscles of the larynx? |
|
Definition
Infrahyoids (depressors): Sternohyoids, sternothyroids, omohyoids
Suprahyoids (Elevators): stylohyoid, mylohyoid, digastric, geniohyoid, thyrohyoids) |
|
|
Term
| How much subglottal pressure is needed to generate speech sound? |
|
Definition
|
|
Term
| What affects the amount of pressure needed to vibrate the vocal folds (4 things)? |
|
Definition
1. Glottal width
2. Frequency (of vibration)
3. Degree of adduction force
4. Vocal pathologies |
|
|
Term
| What are the resonating chambers of the velopharyngeal system? |
|
Definition
1. Pharynx
2. Mouth
3. Nose
4. Sinuses of the face and skull |
|
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Term
| What is the velopharynx? Describe the anatomical structure. |
|
Definition
| Four sided muscular tube, suspended bilaterally from bony components of the skull base: palatine, sphenoid, occipital and temporal bones. |
|
|
Term
| Velopharyngeal mechanism includes: |
|
Definition
Velum (front wall) - soft palate and uvula
Pharynx (back and side walls) will meet raised velum to complete closure. |
|
|
Term
| All velar muscles except the tensor are innervated by which nerves) |
|
Definition
Cranial nerve X and XI innervate which muscles?
(Tensor is CN 5) |
|
|
Term
| Name the 4 categories of VP closure |
|
Definition
1. Coronal
2. Sagittal
3. Circular
4. Circular with Passavant's ridge |
|
|
Term
| What are the articulators? |
|
Definition
1. Mobile - tongue, mandible, velum, lips, cheeks, pharynx, larynx
2. Immobile: alveolar ridge, hard palate, teeth
3. Other: sinuses |
|
|
Term
| What are the extrinsic tongue muscles? |
|
Definition
| Palatoglossus, styloglossus, hyoglossus and genioglossus |
|
|
Term
| What are the muscles of the jaw? |
|
Definition
Elevators: Masseter, medial pterygoid, temporalis
Depressors: digastric, mylohyoid, geniohyoid, lateral pterygoid |
|
|
Term
|
Definition
| the death of most or all of the cells in an organ or tissue due to disease, injury, or failure of the blood supply. |
|
|
Term
|
Definition
| a region in an organ or tissue that has suffered damage through injury or disease, such as a wound, ulcer, abscess, tumor, etc. |
|
|
Term
|
Definition
| a small localized area of dead tissue resulting from failure of blood supply. |
|
|
Term
|
Definition
| an inadequate blood supply to an organ or part of the body, esp. the heart muscles. |
|
|
Term
|
Definition
| A relatively narrow/centralized area of affected tissue |
|
|
Term
|
Definition
| Damage or injury that has multiple distinct points of injury. |
|
|
Term
|
Definition
| An injury that is not focal or multifocal, e.g. "_____ axonal injury" resulting from a severe concussion. |
|
|
Term
|
Definition
| Consists of cerebral hemispheres, basal ganglia and limbic system |
|
|
Term
|
Definition
| Consists of the thalamus and hypothalamus |
|
|
Term
|
Definition
| Comprised of the tectum and the tegmentum |
|
|
Term
|
Definition
| Composed of the medulla oblongata |
|
|
Term
|
Definition
| Contains the primary motor, somatosensory, auditory and visual cortex, as well as cortices responsible for speech production |
|
|
Term
|
Definition
| Another term for lower motor neurons |
|
|
Term
| What is the direct activation pathway and what is it responsible for? |
|
Definition
| This is responsible for voluntary movement, is composed of the corticobulbar and corticospinal tracts and comprises the UMN pyramidal tracts. |
|
|
Term
| What is the indirect activation pathway and what is it responsible for? |
|
Definition
| This is responsible for automatic movement (i.e. posture, muscle tone) and is the extrapyramidal UMN tract. Composed of corticalrubral, corticoreticular, rubrospinal, reticulospinal and vestibulospinal tract |
|
|
Term
| What are control circuits and what are they responsible for? |
|
Definition
| These come from teh basal ganglia and cerebellum. They are responsible for the integration and coordination of sensory with direct and indirect activation pathways. Part of the extrapyramidal and cerebellar systems, they influence posture, supportive and smooth directed movements. |
|
|
Term
| Progression of UMN damage |
|
Definition
| Spasticity, hyperreflexia (clonus), extensive plantar responses, loss of abdominal reflexes |
|
|
Term
| What is a plantar response? |
|
Definition
| This primitive reflex, in normal adults, causes flexion in the big toe. In instances of brain damage, this reflex will elicit extension, in which case it's known as "Babinski's Sign." |
|
|
Term
|
Definition
| This is a muscular spasm involving repeated, often rhythmic, contractions. |
|
|
Term
| What are three types of neurological lesions? |
|
Definition
| Cardiovascular accident (i.e., stroke), intracranial tumor and cervicospinal injury. |
|
|
Term
| What are the two main motor fiber tracts? What are their functions? |
|
Definition
Pyramidal - skilled voluntary movements, conscious, higher-level command.
Extrapyramidal - Coordination of basic movements, suppression of undesired movements and reflexes, posture and tone |
|
|
Term
| Describe the efferent motor pathways. |
|
Definition
| UMN innervation -> corticobulbar tracts -> descend via internal capsule --> cross midline into cranial nerve nuclei -> synapse after crossing onto respective cranial nerve nuclei, bilateral UMN innervation to upper face, jaw, larynx, pharynx. |
|
|
Term
| What is the internal capsule? |
|
Definition
| An area of white matter in the brain that separates the caudate nucleus and the thalamus from the putamen and the globus pallidus. |
|
|
Term
| The pyramidal system is also called what? |
|
Definition
| Another name for the Direct Activation pathway |
|
|
Term
| The pyramidal system originates in the motor cortex and then goes where? (two tracts) |
|
Definition
This pathway goes either to:
Lateral corticospinal tract (controls distal muscles of limbs)
Corticobulbar tract (functionally the same except that it controls cranial motor system) |
|
|
Term
| What happens when there is damage to the pyramidal system? |
|
Definition
| What causes spastic dysfunction in the distal muscles of the limbs and cranial motor systems? |
|
|
Term
| What is the extrapyramidal system composed of (3 things)? |
|
Definition
| Basal ganglia, cerebellum and substantia nigra comprise what system? |
|
|
Term
| LMNs are also known as what? |
|
Definition
| α
‐
motoneurons
is another term for what? |
|
|
Term
| Progression of LMN damage presents as what? |
|
Definition
| Muscle wasting/weakness, loss of reflexes, fasciculation/fibrillations, and hypotonia |
|
|
Term
| What are three types of LMN lesions? |
|
Definition
| Motor Neuron disease, poliomyelitis, and peripheral nerve neuropathy (e.g. diabetic neuropathy) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Acoustic/Vestibular nerve |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| This structure influences movements generated by primary cortex, contributes to intelligence and affective (i.e., emotional) function. Damage can produce too much or too little movement |
|
|
Term
| Components of the basal ganglia |
|
Definition
| Putamen, caudate nucleus, globus palidus, internal capsule, cerebral peduncle, red nucleus, substantia nigra, subthalamic nucleus |
|
|
Term
Basal Ganglia has ______ pathway and has a role in what?
|
|
Definition
Has:
-Direct and Indirect Pathway
Has role in:
-Scaling amplitude and velocity of movement
-Focusing neural activity to excite/inhibit different muscles. |
|
|
Term
| Basal ganglia does what to the command signals for movement? What problems might arise from this? |
|
Definition
| This filters command signals for movement. OVer-filtering might make intentional movement weak and slow. Too little filtering causes uncontrolled spontaneous movements. |
|
|
Term
| Excessive inhibition in the basal ganglia |
|
Definition
| This causes hypokinesia, bradykinesia, rigidity and resting tremor. |
|
|
Term
|
Definition
This word means dance and refers to uncontrollable, jerky movements.
Symptoms:
Hyperkinesia, athetoid movements, and diminished mental capacity and dementia. |
|
|
Term
|
Definition
| Another term for writhing movements |
|
|
Term
|
Definition
| Problems here lead to a delay in initiation of movement, dysmetria, and dysdiadochokinesia |
|
|
Term
|
Definition
Vestibulo-cerebellar dysfunction
Spino-cerebellar dysfunction |
|
|
Term
| Vestibulo-cerebellar dysfunction presents with ___________ |
|
Definition
|
|
Term
| Spino-cerebellar dysfunction presents with __________ |
|
Definition
| Wide-based 'drunken sailor' gait, characterized by uncertain start and stop, lateral deviations and unequal steps. |
|
|
Term
| What are two disorders of the developing pathway? |
|
Definition
1. Cerebral Palsy
2. Moebius Syndrome |
|
|
Term
| What are the two types of disorders of the mature pathway?P |
|
Definition
Progressive and Non-progressive
Progressive: ALS, Guillian-Barre, Parkinson's, Huntington's, MS
Non-progressive: TBI, Cortical CVAs |
|
|
Term
|
Definition
| Nonprogressive disorder of motion and posture due to damage to the neonatal brain, may be due to congenital malformation, 1.5-2 in every 100 live births. |
|
|
Term
| Major Classifications of CP (4) |
|
Definition
1. Spastic (hypertonia)
2. Athetoid
3. Ataxic
4. Mixed |
|
|
Term
| Types of Cerebral Palsy (5) |
|
Definition
| Hemiparesis, Diplegia, Triplegia, Quadriplegia (tetraplegia), paraplegia |
|
|
Term
|
Definition
Log Rolling
Segmental Rolling
Babinski Reflex
Grasping Reflex
Positive supporting reaction
Suckling reflex
Rooting reflex
Tonic neck
Moro reflex |
|
|
Term
|
Definition
survival reflexes occurring sequentially in the
first few weeks of fetal development
automatic, stereotyped movements, directed
by a very primitive part of the brain (brain
stem)
executed without involvement of higher levels
of the brain (the cortex). |
|
|
Term
|
Definition
LMN: Flaccidity
UMN: Spasticity
Corticobulbar: Ataxia, dysmetria, dysdiadochokinesia, asynergia
Basal Ganglia: Dyskensia (including athetosis, dystonia, chorea and tremor), rigidity |
|
|
Term
| Moebius syndrome (congenital facial diplegia) |
|
Definition
Bilateral facial paralysis of CN VII with abduscent nerve paralysis.
Etiology unclear
Hypoplasia of brainstem nuclei
Usually noticed when infant has difficulty nursing and closing eyes. |
|
|
Term
| Primary versus Secondary damage of TBI |
|
Definition
Primary damage: from the impact
Secondary damage: edema, hypoxia, anoxia, hypotension, vasospasm, production of free radicals and other cytotoxic substances. |
|
|
Term
| Diffuse and Variable diagnoses after TBI |
|
Definition
| Language and cognitive sequelae, 60% diagnosed with acute dysarthria. 10% diagnosed with chronic, typically mixed type. |
|
|
Term
| 5 Stages of functional limitations |
|
Definition
Stage 1: No Useful Speech
Stage 2: Natural Speech—Supplemented by
AAC
Stage 3: Reduced Speech Intelligibility
Stage 4: Detectable Speech Disorder with
Intelligible Speech
Stage 5: No Detectable Motor Speech Disorder |
|
|
Term
|
Definition
Lesion in vertebrosbasilar circulation
Affects upper cervical spinal cord, cerebellum, medulla oblongta and pons
15% of all strokes
Bulbar palsy |
|
|
Term
|
Definition
| Severe movement disorder caused by occlusion of basilar artery. |
|
|
Term
| Two kinds of signs in ALS |
|
Definition
| Bulbar signs and Spinal signs |
|
|
Term
| Diagnosis of ALS is based on |
|
Definition
Clinical History
Aggressive motor involvement
Absence of sensory findings
Electromyography
Widespread denervation pattern
Muscle biopsy
Denervation atrophy |
|
|
Term
|
Definition
Clinically Definite ALS
UMN as well as LMN signs in 3 regions
Clinically Probably ALS
UMN & LMN signs in at least 2 regions with UMN
signs > LMN signs
Clinically Possible-Laboratory Supported ALS
UMN & LMN dysfunction in 1 region OR
UMN signs alone in 1 region and LMN signs defined
by EMG in at least 2 limbs |
|
|
Term
|
Definition
CNS & PNS
Degeneration and loss of LARGE motor neurons
Sacral segment of spinal cord is spared
Absence of bowel and bladder symptoms |
|
|
Term
|
Definition
| Progressive neural degenerative disease characterized by degeneration of the dopaminergic pathway from the substantia nigra to the striatum, and overactivity of the indirect pathway. Average age of onset is 63. |
|
|
Term
| Symptoms of Parkinson's disease |
|
Definition
| Hypokinesia, bradykinesia, rigidity, resting tremor, normal sensation and intellect in early stages progressing to dementia. |
|
|
Term
| Surgical intervention in parkinson's disease |
|
Definition
| Medical intervention which creates a lesion in subthalamic nucleus or internal globus pallidus to suppress overactivity in the indirect pathway. |
|
|
Term
|
Definition
| Autosomal dominant genetic disease which is degenerative and fatal. Typically appears in 30s and 40s. Symptoms include hyperkinesia, athetoid movements and diminished mental capacity including dementia. |
|
|
Term
| Diagnosis of Huntington's Disease |
|
Definition
| This disease is diagnosed with family history, imaging studies, pattern of progressive deterioration, and the occurrence of chorea and psychiatric disrorders with no other apparent causes. |
|
|
Term
| Treatment of Huntington's Disease |
|
Definition
No cure, symptomatic treatment with antidepressants and neuroleptics (which may cause rigidity or over-sedation), PT and OT
Dementia is hallmark of disorder and may make AAC use difficult. |
|
|
Term
|
Definition
Progressive disease of white matter of CNS
UNKNOWN etiology
Prevalence in northern U.S. 1/1,000
Based on childhood residence
Southern U.S. 1/3 to ½ of Northern U.S.
Median age of onset 32 y/o
Ratio males:females—1:1.5
Symptoms depend on site of lesions |
|
|
Term
| Multiple Sclerosis pathology |
|
Definition
Inflammatory white matter lesions
continuously appear
Resolve and recur
Eventually the myelin is completely stripped
away
Axon is ‘bare’
Patches of destroyed myelin replaced by scar
tissue (plaques)
Called sclerosis |
|
|
Term
| Cognitive Impairments in MS |
|
Definition
Varies considerably
Location, number, activity of lesions
Self-report = 38%
Epidemiological studies suggest 3% show
cognitive changes
Neuropsychological tests
50-70% show cognitive changes |
|
|
Term
|
Definition
Segments of myelin sheath of peripheral nerve axons
are progressively destroyed
Incidence: 2.4 per 100,000
Maximal paralysis
3-4 weeks
Myelin sheath slowly regenerates
Muscle tone gradually returns
~Approximately 85% full recovery w/no residual
deficits
EDSP 255 | Seminar in MSD | Spring 2012 52 |
|
|
Term
| Communication Deficits in Guillain-Barre |
|
Definition
Anarthria
Flaccid dysarthria
Language & cognition usually
unimpaired
Motor control of entire body involved |
|
|
