Group of speech disorders caused by paralysis, weakness, slowness, incoordination...NOT a language disturbance
Incapable of movement
Type of paralysis where movement is effortful w/ abnormally high levels of tension in resting muscles caused by UMN damage.
Term associated with dysarthria caused by LMN damage and flaccidity is the result
Term associated with dysarthria including hypokinetic & hyperkinetic-quick & hyperkinetic-slow caused by extrapyramidal system-basal ganglia damage.
Term associated with dysarthria affecting speech processes resulting in ataxia.
Spasticity, hyperreflexia, hypertonia, Babinski sign are all results associated with damage ________?
Flaccidity, fasciculations, & atrophy are all results associated with damage to _________.
Hypokinesis (rigidity) & Hyperkinesis are results of damage to _________.
Ataxia/Atonia is the result of damage to _________.
What speech process is affected by thoracic muscles?
What speech process is affected by the larynx?
What speech process is affected by the velum?
What speech process is affected by the tongue, lips, & mandible?
What speech process is affected by the combined effects on articulation, phonation, & respiration?
Unilateral damage to ___________ are to neurons in the motor cortex that connect to motor nuclei in the brain stem.
Unilateral damage to ___________ are to fibers that connect cortical motor neurons to motor nuclei in the brain stem (usually doesn't cause persisting dysarthria)
The muscles of the upper face, pharynx. larynx. & jaw are _____________ innervated.
Lower face, mastication, lips, palate, tongue are ______ innervated.
Effects on speech typically result from _________ lestions.
Refers to symptoms resulting from bilateral damage. Lesions occur separately on 2 sides (1st is "silent"; 2nd "unmasks" the damage)...may initially appear to resemble damage to UMN at the level of the bulb usually accompanied by exaggerated brainstem reflexes & spastic paralysis.
Pseudobulbar palsy (Suprabulbar)
Bilateral UMN (Corticobulbar)
This type of paralysis may accompany pseudobulbar palsy due to proximity; hyperreflexia/hypertonia of affected limbs contralateral to insult; positive Babinski sign reflects disruption of inhibitor tracts.
UMN Corticospinal tract lesions
What type of damage is characterized by flaccidity, fasciculations, atrophy, brainstem--bulbar palsy?
LMN---leasions of cranial nerves/nuclei
Lesion often destroys proximal pyramidal tract fibers for arm/leg prior to their decussation.
Acute idiopathic polyneuritis
Simultaneous inflammation of large # of spinal nerves
Paralysis, pain, atrophy
Unkonw cause; sequelae of viral infections
increased CSF protein
Guillain Barre Syndrome--Spinal Nerve Disease
Neurologic disease caused by damage to acetylcholine receptors on muscle cells characterized by abnormally rapid muscle fatigue with use.
Myasthenia Gravis--Neuromuscular Junction
Adult form of muscular dystrophy causing progressive weakening of muscles.
What are the 6 types of dysarthrias?
What type of dysarthria is distinguished by hyperactive reflexes, slow-limited-effortful movement, slow to reach targets, & strained-strangled monopitch-tone voice quality?
What type of dysarthria is distinguished by weakness, fasciculations, muscle atrophy, Myasthenia Gravis, inability to reach targets, nasal emission, breathy-short-weak-shallow voice w/ frequent pauses?
Involuntary movements that cause visible movements of muscle fibers.
What type of dysarthria is distinguished by incoordination, hypotonia, dysmetria, irregular articulatory breakdown, abrupt-irregular-"explosive" changes in loudness & pitch & unequal stress.
What type of dysarthria is distinguished by tremor, Parkinson's, inability to reach targets, rapid diadokinethesis, low amplitude, elevated pitch, monopitch-loudness, inappropriate pauses, shallow, reduced stress, & masked facies?
Cyclic, small amplitude involuntary movements, usually more severe in distal muscles than in proximal muscles.
Rigidity of facial muscles, causing fixed, unchanging facial expression; prominent characteristic of Parkinson's disease.
What type of dysarthria is distinguished by (chorea), ballisms, myoclonic, Tourettes, unsustained involuntary movements, harsh, monopitch, excessive variable loudness w/ irregular frequent pauses, dysphagia.
Which type of dysarthria is distinguished by athetosis, (dystonia), sustained, unpredictable, involuntary movements, strained-strangled, harsh monopitch-loudness voice quality?
What type of dysarthria is characterized by myoclonus, tics, chorea, ballism, rapid unpatterned, unsustained involuntary movements?
What type of dyarthria is characterized by athetosis, dystonia, sustained involuntary movements that build slowly to a peak before gradually subsiding?
Disease that causes quick & forceful involuntary movements?
Abnormally low levels of tension in resting muscles
Extreme form of chorea, in which limbs are flung wildly about by involuntary movements.
Fine, sudden, rapid, irregular twitching movements caused by contractions of groups of muscle fibers. Usually observable as dimpling or rippling of the skin over the muxle fibers. (Crossed legs & foot jerks or falling asleep and jerking awake)
Toxic hyperkinetic-quick infectious disease
Hereditary hyperkinetic-quick neurologic disease characterized by progressive chorea and dementia.
Hyperkinetic-Quick dyskinesia associated with jerks and tics
Stereotypic repetitive movements such as blinking, coughing, or sniffing; usually not related to nervous system pathology.
Persisting involuntary contractions of muscles, sometimes called torsion spasm.
Abnormal & involuntary muscle movements, often seen as a consquence of extrapyramidal disease. (tremor, chorea, ballism, dystonia, myoclonus, fasciculations, fibrillations, tics)
Clumsiness and incoordination of movements caused by cerebellar damage.
Slow & awkward movements; component of ataxia (disturbance of measure--overshooting picking something up)
Shrinkage/wasting away of tissues/loss of background mucle tone due to damaged gamma system
Type of dyskinesia with diminished range of movement resulting from rigidity--extrapyramidal activation of both extensors and flexors.
Degenerative hypokinetic disease affecting neurons in the midbrain and brain stem. Arteriosclerotic changes in basal ganglia (substantia nigra) causing deficiency in "dopamine"- neural transmitter substance.
Resistance of muscles to movement in any direction. ___________ is elicited in passive movement, involuntary contraction of the muscle being stretched; results in simultaneous stimulation of extensors & flexors. Prominent characteristic of Parkinson's disease.
Pill rolling tremor
Rigid facial expression
Short, stiff, shuffling steps
Disruption of volitional movement sequences in the absence of sensory loss, weakness, paralysis, or incoordination of the muscles involve in the movements. Usually a consequence of damage in premotor cortex.
Apraxia of speech
Most extreme inability to carryout movement sequences because of loss of the concept, knowledge, or idea of what the movements are intended to accomplish. (Especially "on command")...disruption of ideas needed to demonstrate use of objects (toothbrushing)...due to damage of left parietal lobe
More mild version of apraxia; inability to carryout movement sequences bec/ of loss of ability to organize motor plans or patterns for the movements. May demonstrate gestures that comprise of an action but is unable to assemble them into the proper sequence...damage in frontal lobe esp. premotor cortex.
Type of ideomotor apraxia affecting oral motor tasks not related to speech such as whistling, using a straw, or blowing feathers.
Type of ideomotor apraxia affecting tasks such as toothbrushing, suing a door key, or opening a padlock.
Type of ideomotor apraxia affecting thr formation of sounds and sound sequences.
Approach to understanding the functional architecture of nervous system by relating neurologically damaged patients' symptoms to damaged regions of the nervous system. Specific functions are localized "housed" in specific locations on the cortex.
Concept that all the various areas of cortex contribute to performing a given function..."to localize damage which destroys speech & localize speech are 2 different things."
Model that has the concept that certain regions of the brain may have specific responsibilities for some aspect of language function & these regions must "interconnect" to efficiently produce "language." Aphasia "syndromes"--damage to certain areas appears to produce relatively predictable collections of symptoms.
Ability of the brain to reassign functions served by one area to a different area, usually in response to brain injury...greatest in infants & declines steadily with age.
What connectionist component is responsible for the motor programming for speech?
What connectionist component is responsible for the activation of muscles for speech?
What connectionist component is responsible for the transmission of info from posterior areas to anterior areas?
What connectionist component is responsible for the comprehension & formulation of oral language?
What connectionist component is responsible for symbolic integration for reading?
What connectionist component is responsible for symbolic integration for writing?
What connectionist component is responsible for transmission of info between the hemispheres.
Wernicke's --> Arcuate Fasciculus --> Broca's --> Motor Strips (via Corpus Callosum)
Which connectionist explanation of language function is preceded by "associations"?
Heschl's Gyrus --> Wernicke's --> Arcuate Fasciculus --> Broca's --> Motor Strips (via Corpus Callosum)
Which connectionist explanation of language function follows the same sequence as spontaneous speech after going through Heschl's gyrus?
Heschl's Gyrus --> Wernicke's --> various areas (speech, gesture, writing)
Comprehension of speech
Actual comprehension must be demonstrated through some response modality in this connectionist explanation of language function.
Comprehension of Speech
Primary visual cortex --> Visual assoc. area --> Angular gyrus --> Wernicke's --> Arcuate Fasciculus --> Broca's --> Motor Strips
Wernicke's --> Supramarginal Gyrus --> Premotor cortex --> Motor Strip
What are the 3 Geographic classification systems for aphasia?
Geographic region of classification systems for aphasia in the left frontal lobe sometimes called the anterior language zone that plays an important part in planning and performing expressive language actions (speech, writing, and perhaps gesture).
What aphasias are associated with the Perisylvian region?
Region of the cortex just anterior to the lower end of the primary cortex.
Aphasia syndrome characterized by nonfluent speech that is labored, halting, effortful w/ many misarticulations and is "telegraphic" & "agrammatic", good comprehension, & poor repetition. Handwriting resembles speech...Auditory comprehension is better than speech...R. hemiplegia...spastic dysarthria may accompany.
Speech in which function words are left out
Speech in which content words (nouns, verbs, adjectives) are present but most function words (articles, prepositions, conjunctions) are missing. Common characteristic of speech of adults with Broca's aphasia.
Paralysis of an arm and a leg on one side of the body
Region of the cortex in the vicinity of the temporo-parietal-occipital junction.
Aphasia syndrome characterized by fluent but empty speech, poor comprehension, and poor repetition
Substitution errors in speaking made by aphasic persons
Errors in which a speaker substitutes one sound in a word for another , such as "lair" for "chair"w/out groping behaviors.
Literal (Phonemic) Paraphasias
Errors in which a speaker substitutes one word for another, such as saying "chair for "table".
Verbal (Semantic) Paraphasias
Nonword utterances that follow the phonologic conventions of the language...often are heard in the speech of adults w/ severe Wernicke's aphasia or global aphasia.
Excessive verbosity. Patients w/ mild-moderate Wernicke's or conduction aphasia are likely to exhibit.
Logorrhea (press of speech)
Nonsensical utterances, such as "There's a navy dog flying in the hoghouse this morning." in which words are uttered in syntactically legitimate strings, but which have no overall meaning; may contain neologisms.
Paragrammatisms (or Jargon depending on who you ask)
Meaningless strings of phonologically "correct" syllables with appropriate intonation but are just "gibberish".
Blindness in one-half of the visual field...Corresponding halves of the visual fields or retinae lesion deep in the temporal lobe causing right visual field cut.
Inability or impaired ability to retrieve and produce words; "word-finding" difficulties; may be a feature of all aphasias often follows diffuse damage from encephalitis, dementias, etc.
Anomic aphasia some consider to be a "very mild" form of _____________ aphasia.
Aphasia that involves lesions in auditory association area; primary S-L characteristic is word-finding w/ otherwise near normal expressive language & auditory comprehension.
What aphasia results from damage to the Arcuate Fasciculus deep in supramarginal gyrus; good comprehension/spontaneous fluent speech but repetition/self-correction is poor?
What type of aphasia is when the whole dominant hemisphere has damage?
What aphasia most often follows occlusion of the trunk of the MCA causing massive damage throughout the perisylvian region.
What geographic classification system of aphasia is located close to watershed areas outside the perimeter of the Sylvian fissure?
Rare aphasia syndrome characterized by good comprehension, sparse speech output, and good repetition. Damage in borderzone areas disturbing Broca's but spares arcuate fasciculus connections into portion of Broca's. Loss of initiative=pathological inertia. Apraxia prominent feature of spontaneous speech.
Transcortical Motor aphasia (Anterior isolation syndrome/dynamic aphasia)
Aphasia syndrome characterized by poor comprehension, fluent but empty & pathologic echolalic speech, and good repetition. Damage isolates Wernicke's but spares arcuate fasciculus.
Aphasia w/ characteristics of both receptive/expressive or fluent/nonfluent, but less severe.
Aphasia syndrome characterized by profound comprehension impairment, little or no functional language, does not repeat..."sterotypies" are common.
Aphasia that apparently is caused by damage in and around the basal ganglia. It's unknown if the damaged regions directly participate in language, or if this aphasia is caused by interfering w/ the function of other language-competent brain regions; results in various aphasia-like symptoms.
What are the dichotomous terms that identify classifications of aphasia?
Fluent vx. Nonfluent
Recptive vs. Expressive
Sensory vs. Motor
Posterior vx. Anterior
Rating scale that judges patients' aphasia type primarily on the characteristics of the speech they produce in an interview. Rates melodic line, phrase length, articulatory agility, grammatic form, paraphasia, repetition, & word finding in connected speech.
Boston Diagnostic Aphasia Examination (BDAE)
Aphasia symptoms are not bizarre & mysterious, rather they are ____________ __________ of everyday occurrences/behaviors.
What 2 basic underlying problems do all aphasias share to different degrees?