442 neuromotor speech disorders

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jacwill
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247403
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442 neuromotor speech disorders
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2013-11-17 19:20:12
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442 neuro
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442 neuro
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  1. speech production results from complex interactions between several physiological subsystems
    • 1. respiratory-provides driving force for speech production
    • 2. phonatory/layngeal-provides the sound source=the vocal folds
    • 3. articulatory system-provides resonation, and shapes the source into intelligible speech sounds=filter
  2. what has to happen before speech production can occur
    we need to formulate what we wish to communicate
  3. _______ systems inthe brain interact with
    __________ systems to forumlate language
    neural, physiological
  4. what are the components for speech to occur
    • 1. motor-moving tongue etc
    • 2. sensory-assessing size of room and how to project voice
    • 3. cognitive-processing and thought pattern in general, think about what you are going to say before you say it
  5. neuromotor speech disorders result in damage to what motor control systems
    systems of either the pns or cns
  6. what are neuromotor speech disorders generally classified as
    • 1. apraxia
    •     -planning/programming impairment, disorder in the generation of motor signals (generation of tongue or lips is disabled)
    •     -damage to cortical or cortex/subcortical or below cortex areas disrupts the sequencing of speech movements (saying bat instead of tab or vice versa)
    • 2. dysarthria
    •     -results from damage to the nerve/muscles of the speech subsystems (damage to obicularis oris and puckering or pursing lips)
    •     -resulds in weakness or uncoordinated muscle movements
  7. why should we study motor speech disorders
    • they occur frequently
    • prevalence will continue to increase (people living longer)
    • announce onset of neurological disease
  8. how can we describe motor speech disorders
    congenital or acquried
  9. what cns structures are critically important for motor control
    • primary motor cortex (aka motor strip that lies anterior to the central sulcus also called the precentral gyrus)
    • promotor area of frontal lobe
    • supplementary motor cortex also of frontal lobe
    •       -broca's area located in the left hemi supplementary motor region SPEECH PROD
    •       -Insula lies inside of the lateral sulcus
    • cerebellum and basal ganglia: integrate neural impulses or signals from the cortex (organization)
    • sensory cortex (post central gyrus)
  10. cns organization for motor control
    • 1. pyramidial tract (direct motor system)
    •     signals from the motor cortex travel down the pyramidal tract and synapse or connect with neurons of either the brainstem or spinla cord to produce skilled movements
    •       -corticobulbar: pathway that starts at the motor strip and ends at the brainstem. axons branch out and synapse on different cranial nerve nuclei at different levels of the brainstem (eg midbrain, pons, medulla)
    •       -corticospinal: pathway that arises from sensory and motor cortical areas, crosses or decussates at the medulla then keeps traveling down the spinal cord. axons branch off at different levels to synapse with neurons in the ventral horn of spinal cord
    • 2. extra pyramidal tract (indirect motor system)
    •    -involved in the regulation/coordination of signals from the motor cortex
    •    -extremely old system phylogenetically
    •       -basla ganglia: these structures receive and transmit motor signals, produce dopamine (important in maintaining muscle tone). in a nutshell the bg is involved in coordinating signal for complex movements
    •       -cerebellum: integrating center compares output (actual movements) with motor signals from the cortex to adjust and smooth movements (feedback)
  11. what are the pns structures critically important
    for motor control
    cranial nerves motor and sensory: the nuclei of these nerves are housed in brainstem (pons, medulla, midbrain structures
  12. what are the important cranial nerves for speech production
    • CN V Trigeminal-face
    • CN VII Facial muscles-face
    • CN VIII Acoustic-hearing
    • CN IX Glossopharyngeal-tongue, larynx
    • CN X Vagus-pharynx
    • CN XI Spinal-accessory-spinal cord
    • CN XII Hypoglossal-tongue
  13. how many pairs of spinal nerves are there
    31 pairs that receive info form the body and muscles and transmit it  to the brain and receive signals from the brain and transmit to the body and muscles
  14. motor unit
    • includes the neuron, axon and all the muscle
    • fibers it innervates
  15. motor unit is known as the...
    final common pathway
  16. what are the two theoretical models of categorizing motor speech disorders
    • neuropsychological model
    • neuroanatomical model
  17. neuropsychological model
    • maintains that speech is the result of a series of processing levels-different disorders disrupt speech at the different processing levels
    •     -ideational-think about what we are going to say
    •     -language planning-semantics or sentence structure
    •     -motor planning/programming-organ placement, tongue
    •     -motor execution-talk
  18. neuroanatomical model
    • based on darley, aaronson, brown
    • after listening/classifying the speech of many patients with neuromotor speech problems, the authors decided that each type of neuromotor speech disorder may be associated damage to a specific area of the motor system

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