ad # 1

What process is when the thoughts are converted to verbal symbols?

What is the selction and sequencing of sensorimotor programs that activate the speech muscles?

What are the innervations of the respiratory, phonatory, resonatory, and articulatory muscles.

What is the combined processes of speech motor planning, programming, and neuromuscular execution?

Changes in speech may announce the ________ of a neurologic disease.

The effects of neurologic disease are usually a _________ correlation with lesion and speech effect.

________ changes often are the first manifestation of disease.

Speech diagnosis does not always follow__________  _______.

Speech management is not always ________ from medical management.

Neurologic disorers are _____________.

______ neurologic disorders are curable.

________ disorders are a major cause of disability.

Neurologic speech disorders will _________ in prevalence because of increased survival rates for a number of neurologic diseases and increasing longevity.

Understanding the underlying _________ can help in planning treatment.

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.

For dysarthria the responsible pathophysiologic disturbances are due to ___________ or _______ nervous system abnormalities and most often reflect weakness, spasticity, incoordination, involuntary movements, or excessive, reduced, or variable muscle tone.

Dysarthria is a disorder of _________ or _________ _______.

Dysarthria is _________ in origin and can be categorized into different types according tot the localization of the causal disorder.

A neurologic speech disorder reflecting an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech.

Apraxia of speech can occur in the absence of _________  ______________ associated with the dysarthrias and in the absence of disturbance in any component of language.

Apraxia of speechs localization and management is ____________ than for that for most dysarthria and aphasia.

A speech disorder resulting from neurologic impairments affecting the motor planning, programming, neuromuscular control,  or execution of speech. They include the dysarthrias and apraxia of speech.

What is the compulsive repetition of utterances?

What is the unsolicited repetition of another's utterances?

Neurologic speech disturbances that are not MSDs are hard to distinguish apart from MSDs because they often co-occur. What are the 6 Neurologic speech disturbances?

___________ disturbances have been implicated in certain MSDs.

Motor speech processes and disorders should be thought of as _______________ and not just motor in character.

What nonneurologic disturbance inludes laryngectomy, cleft lip and palate, fractures, and abnormal variants in cavity size and shape?

In a _____________  ________ speech can be altered by injury, disease, congenital absence, loss to aging or poor care, or surgical removal of muscle, cartilage, or bone. 

What are some nonneurologic or nonpsychogenic voice disorders?

Speech undergoing changes as a result of abnormal psychologic states and they are not primarily neuromotor in nature.

________ are prominent among acquired communication disorders.

Approximately ____ of noncomatose people who have had strokes sufferf rom some kind of speech or language impairment.

_________ occurs in 25% of patients with lacunar (small) strokes and in one-third of those with traumatic head injury.

Dysarthria is present in 60%  of people with ___________ with increased prevalence as the disease progresses.

Dysarthria sometimes is a presenting sign of ________________ and often emerges during the diseases course.

What method for studying motor speech disorders are based on the auditory-perceptual attributes of speech?

What is the gold standard for clinical differential diagnosis, judgements of severity, many decisions about management , and the assessment for functional change?

What instrumental method can visually display and numerically quantify numerous aspects of the acoustic speech signal?

What instrumental method focuses on the movements of speech structures and air, muscle contractions, and neural activity? Can provide feedback during management.

What instrumental method uses numerous instruments to visually image parts of the upper aerodigestive tract during speech?

The parts of the nervous system that control voluntary movements are known collectively as the __________  ___________.

Where are the nerve cells located that play an important role in contolling the voluntary movements of the body?

The most important function of the ________ is to coordinate voluntary movements so that muscles contract with the correct amount of force and at the appropriate times.

__________ damage can cause significant deficits in thr performance of both gross and fine motor actions such as walking, writing, and speech.

In the brainstem the ________ _______________  project out form the CNS and they convey motor impluses from the CNS to the muscles of the larynx, face, tongue,pharynx, and velum.

In the motor system an imbalance between excitatory and inhibitory neurotransmitters may be a cause of _______.

______________ is thought to analyze tone patterns and sound properties and it may help in the localization of sound.

______________is thought to perform a preliminary analysis of depth and perhaps integration of visual informatio from both eyes.

__________ is where the cortex receives the first neural input about bodily sensation.

Most planning for movement does not originate in the _________ _____________ ___________.

The initial planning of a movement is formulated primarily in the ___________ ___________.

The ______ __________ ___________ is involved in the recognition of complex visual stimuli, integrating auditory stimuli with other centers of the brain, and the formation of memories.

The _______ association area plays an important role in initiating and planning volitional movements.

The _________ association area integrates bodily sensations and visual information.

The ______ association area is involved with visually guided movements.

__________ __________ is important in the planning of slow, continuous movements.

The neural tract from the substantia nigra to the striatum contains a large number of neurons that produce the neurotransmitter _________.

The motor speech disorder associated with PD is called ________ ____________.

__________ is a disturbance in the speed, range, and direction of moements. The muscle groups near the shoulders and pelvis in particular may be affected.

The gait of a person with ________ is wide-based, lurching, and stumbling. (drunken)

________ ________ is caused by lesions to the cerebellum. This tremor only occurs during the performance of voluntary movement.

Disorders caused by lesions to the cerebellum:

The motor speech disorder usually associated with cerebellar lesions is ______ ______.

Practically every sensory impulse from the body passes through the ______ on its way to the cortex.

The ________ __________ ________ receives the neural impulses that have been processed, smoothed, and coordinated by the basal ganglia , the cerebellum, and the thalamus.

The primary role in the _______ _________ is to take voluntary movement patterns that are formulated elsewhere and to transmit them to the cranial nerves via a tract of motor neurons called the pyramidal system.

Damage to the _________ ___________ usually results in muscle weakness and rapid fatigue. It is also reported that increased mental concentraion is needed to perform motor tasks that previously were accomplished with ease.

In the motor speech mechanism, _______ damage to the pyramidal system results in a loss of fine motor movements in the articulators, a condition known as __________ upper motor neuron dysarthria.

Damage that affects the pyramidal tract almost always will affect other _______ ________ as well, with results that complicate the clinical picture.

The ___________ system influences the reflexes, muscle tone, and some voluntary movements of the speech mechanism.

Upper motor neuron damage results in __________.

Spastic dysarthria is the result of ________ upper motor neuron damage.

Lower motor neuron damage results in muscle ________ or ______.

________ __________ is the result of damage to the lower motor neurons in those cranial nerves that innervate the muscles of speech production.

__________ characterizes the features of speech and the structures and functions related to speech.

The process of narrowing diagnostic possibilities and arriving at a specific diagnosis is known as?

What are characteristics of every one of the dysarthrias?

Motor speech disorders requires clinicians to match what they hear in a patient's speech with what they know about the functioning of the human ________ _________.

What are the two basic methods of evaluating motor speech disorders?

What method uses sophisticated devices to objectively measure the components of speech production?

What method uses the ears of the examiner to detect motor speech disorders?

What is the ultimate judge of whether or not there is a problem with an individuals speech?

What are the five components that speech is dependent on the coordinated interaction between?

When one or any combination of the five is affected by a neuromotor disturbance, the result will be a motor speech disorder, either _______ or _________.

What is a speech production deficit that results from neuromotor damage to the peripheral or central nervous system?

________ is not a language disorder!

__________ is strictly a speech production disorder caused by neuromotor damage.

What is a motor speech disorder defined as a deficit in the ability to sequence the motor commands needed to correctly position the articulators during the voluntary production of phonemes?

Apraxia of speech is the result of _______ nervous system damage. It is NOT the result of muscle weakness or slowness.

What disorder is the ability to sequence the motor commands needed to move the articulators smoothly from one posistion to another during the production of voluntary speech?

___________ is nearly always associated with damage to the left hemisphere of the brain?

______ can be caused by damage to many parts of the nervous systmen.

________ _________ means less air for speech production, which limits the affected individuals ability to speak in anything but short phrases.

Respiratory deficits that reduce the amount of air available for speech can also cause reduced ________ and _____ voice quality.

What is the production of voiced phonemes through vocal fold vibrations in the larynx?

Normal phonation is dependent on the _____ of the vocal folds and enough subglottic air pressure to set the vocal folds into vibration.

Spastic dysarthria causes the adduction to be too __ which causes the phonation to have a strained-strangled quality.

In flaccid dysarthria the damage may cause the adduction to be ________ or _____.

Neuromotor damage to the laryngeal muscles may reduce the ability to change _______ or ___________ during phonation.

What is the proper placement of oral or nasal tonality into phoemes during speech. It is accomplished by the raising and lowering of the velum.

_________ resonance is produced when the velum is raised and closes off the nasal canity from the coal airstream.

________ resonance is produced when the velum is lowered and the oral cavity is blocked by the lips or tongue, which thereby directs the entire airstream out through the nose.

WHen the velar muscles are damaged it results in a _______ quality because nasal resonance is being applied to phonemes that ordinarily have only oral resonance.

________ is the shaping of the vocal airstream into phonemes.

___________ is the melody of speech. It conveys meaning within an utterance through the use of stress and intonation.

Motor speech disorders are __________ disorders.

What are the six salient features of neuromuscular function?

______ speed of movement is a common characteristic of most dysarthrias.

In Hypokinetic dysarthria there may be ______ speed of movement.

How is Speed of movement assessed?

What task moves the articulators through a single series of rapide back and forth movements  such as puh, puh, puh?

What task moves the articulators repeatedly through a quick sequence of movements such as puh, tuh, kuh on one breath of air.

__________ is how far the articulators can travel during the course of a movement.

_________ can especially be affected by reduced range of movement in the articulators.

_________ is one in which strength, speed, range, direction, and timing are precisely coordinated.

What is the ability to hold a body part still?

What is the most common disorder in which involuntary movements prevent motor steadiness?

NOrmal _________ _________ is the small, constant amount of muscle contraction that is always present, even when a muscle is fully relaxed.

Decreased muscle tone is associated with muscle ______ or ________.

Increased muscle tone is associated with ___- or ________.

The ____________ nerve is examined during the tasks that require jaw movement.

What cranial nerve is trested when examining the tongue at rest and during movement?

What cranial nerve is innervated in the velum and pharynx at rest and during movement?

Phonatory and respiratory components of the speech mechanism are assessed at the same time because normal phonation is so dependent on an adequate supply of _________ _______ ________.

Weakened or paralyzed velar muscles result in ________ velopharyngeal closure, which is heard perceptually as __________.

_________ is most frequently a symptom of flaccid, spastic, and hypokinetic dysarthria.

__________ is rarely present in the speech of individuals with dysarthria or apraxia of speech.

___________ is an assessment of a patient's ability to move the articulators rapidly yet smoothly in a repetitive motion.

Individual's with flaccid and spastic dysarthria typically have ___ and ___ AMR's.

Individual's with ataxic and hyperkinetic dysarthria often have ________ and _________ AMR's.

Some people with hypokinetic dysarthria have AMRs that are more _______ than normal.

________ is a task that assesses a patient's ability to move the articulators in  rapid smooth sequence of motions.

Stress testing of the motor speech mechanism is screening for _______________, a disorder that causes a rapid fatigue of the muscles during a sustained motor activity.

__________ is a disruption if the ability to voluntarily sequence complex movements accurately.

What are the two types of apraxia that affect speech musculature?

What is a disruption in the sequencing of oral movements that are nonverbal, sometimes described as vegetative movements.

Usually these two types of apraxia are ___________.

Individual's with apraxia of speech especially have trouble when trying to say _________ words.

Usually __________ and ___________ speech are free of apraxic speech.

__________ dysarthrias are a perceptually distinctive group of MSDs produced by injury or malformation of one or more of the cranial or spinal nerves.

________ dysarthrias may be manifes in any or all of the respiratory, phonatory, resonatory, and articulatory components of speech.

The primary deviant speech characteristics of flaccid dysarthrias can be traced to muscle _________ and _______ muscle tone.

________ dysarthrias sometimes reflect involvement of only a single muscle group of speech subsystem.

What are they primary characteristics of flaccid dysarthria?

What is the complete inability to contract muscles?

What is the reduced muscle contraction and weakness?

What is reduced muscle tone, flabbiness?

What are reflexes diminished in strength?

What is it called when muscle wastes away, loses bulk?

What are visible arythmic twitches in resting muscles?

What are invisible contractions of muscle fibers?

What is rapid weakening and recovery with rest?

What is the most common motor neuron disease. It affects the bulbar, limb,  and respiratory muscles.

What is a motor neuron disease that primarily affects LMN's?

What is associated with progressive limb wasting and weakness, can be inherited or occur sporadically, can be congenital or acquired.

What is an uncommon x-linked recessive form of bulbospinal muscle atrophy that can be mistaken for ALS. Affects only men usually after age 30.

What is a group of genetic degenerative diseases associated with degneration of muscle fibers. Effects are generally diffuse, chronic, and progressive.

What is a disease of striated muscle that can be associated with a numner of infectious processes causing dysarthria or dysphagia?

What is an autoimune disease that is characterized by rapid weakening of voluntary muscles with use and improvement with rest.

What is characterized by weakness but with an improved response to repetitive nerve stimualtion. It occurs mostly in men with oat cell carcinoma of the lung.

The most common cause of _______ is contaminated food.

Any brainstem stroke that affects nuclei of speech cranial nerves can lead to ________ dysarthria.

What is caused by occlusion in the intracranial vertebral artery or the posterior inferior cerebellar artery. It leads to sensory loss, dysarthria and dysphagia.

What is caused by vascular lesions of the jugular vein and carotid artery, skull fractures, and tumors. It produces flaccid dysarthria.

What is caused by injury to the hypoglossal nerve and produces lingual weakness?

What is a disorder of unknown cause,but frequently is preceeded by viral infection, demyelination occurs in both peripheral and cranial nerves.

What is similar to Guillane-Barre but less acute and more prolonged in course. May suffer frequent reccurent attacks.

What is a rare viral disease, recover muscles that arent paralyzed in 6 months

What is a nonviral chonic infection that can occur in all organs and tissues?

Affected individuals may develop neurologic complications as a result of opportunistic infections.

What is the most common fungal infection is AIDS and can lead to cranial nerve palsies?

What is the most common CNS tumor in AIDS and can lead to cranial nerve involvement and flaccid dysarthria?

What can lead to cranial nerve involvement and flaccid dysarthria?

________ _________ most often but not always limited to the laryngeal branches of the vagus nerve, is a frequent cause.

What are characteristics of phonatory incompetence for flaccid?

What are characteristics of resonatory incompetence for flaccid?

What are characteristics of phonatory-prosodic insufficiency for flaccid?

What is a perceptually distinctive MSD produced by bilateral damage to the direct and indirect activation pathways of the CNS?

What are the characteristics of spastic dysarthria?

________ is a hallmark of upper motor neuron disease.

The clinical features of spastic dysarthria reflect the effects of __________ muscle tone and ________ on speech.

Damage to pyramidal tracts cause:

Damage to extrapyramidal tract causes:

What are the most salient features in patients with spastic dysarthria?

Spastic dysarthria are usually associated tow what two components of the motor system?

___________ disorders are more frequently associated with spastic dysarthria than with most other dysarthria type.

Lesions in both left and right hemispheres are required to produce the bilateral damage usually associated with _____________

Lacunar stokes and vascular dementia are usually associated with __________

What is an inflammatory demyelinating disease that affects the white matter of the brain or spinal cord.

___________ strokes accounted for most of the vascular causes

Complaints of fatigue occur more frequently in ____________ than _______ dysarthria

People with _________dysarthria have difficulty controlling laughter and crying.

Dysphagia is common in ________ dysarthria

_________ dysarthria is associated with impaired movement patterns rather than weakness of individual muscles.

The chief disturbances in __________ dysarthria are slowness and reduced range of individual and repetitive movements, reduced force of movement and excessive or biased muscle tone or spasticity.

prosodic excess for spastic-

articulatory-resonatory incompetence for spastic-

prosodic insufficiency for spastic-

phonatory stenosis for spastic-

What features of spastic dysarthria help distinguish it from other types of MSDs?

What is a perceptually distintive motor speech disorder associated with damage to the cerebellum? Its characteristics are most evident in articulation and prosody! 

_________ dysarthria most clearly reflects a breakdown in timing and coordination

__________ is caused by damage to the cerebellum.

__________ is a rhythmic tremor of the body or head that can occur with cerebellar disease.

________ is the most common of the abnormal eyes movements that can occur in cerebellar disease.

_______ is a common sign of cerebellar disease.

What are the most frequent causes for ataxic dysarthria?

What is the most frequent cause of ataxic dysarthria?

_____ speech AMRs are a distinguishing characteristic of ataxic dysarthria.

Articulatory inaccuracy for ataxic-

prosodic excess for ataxic-

phonatory prosodic insufficiency for ataxic-

Although uncommon. intermittent _____ is more frequently encountered in ataxic dysarthria thatn any other dysarthria.

What features of ataxic dysarthria help distinguish it from other motor speech disorders?

What is characterized by decreased range of movement and is associated with basal ganglia pathology and often is tied to lack of the neurotransmitter dopamine?

___________ ____________ are the most frequent causes of hypokinetic dysarthria.

__________ _________ is the most frequent single cause of hypokinetic dysarthria.

Although ___________  usually does not emerge for several years after the onset of other signs of PD it occurs in approximately 90% of patients, nearly always preceding the onset of dysphagia, whichoccurs in about 40% of cases.

___________ is a more generic term that refers to the clinical signs of the disease regardless of etiology.

What term is used to reger to degenerative neurologic diseases that include but go beyond signs and symptoms of parkinsonism.

What is an inadequate processing of dietary copper, can result in abnormal copper depositions in the liver and brain.

What is the most common infectious cause of parkinsonism?

Most PD patients develop __________ which typically is preceded by dysarthria.

What is the most significant underlying neuromuscular deficit in hypokinesia as it affects speech?

prosodic insufficiency for Parkinsonian patients-

What is the most prominent and debilitating speech feature in people with hypokinetic dysarthria?

Although not always present, ________ speech rate in hypokinetic dysarthria is unique among the dysarthrias

What is compulsive repetition of utterances with increasing rate and decreasing loudness?