CSD 210 TEST QUESTIONS AND ANSWERS
LATEST UPDATE
Signs
Those characteristics observed by others
Symptoms
Those characteristics perceived by the disordered individuals themselves
Motor Speech disorder (definition)
Disorders of speech resulting from neurologic impairment affecting the motor
programming or neuromuscular execution of speech
Dysarthria
-Any disturbance of articulation or speech
-Any neurogenic disturbance of speech or language
-Severity correlated with illness or disease process
Apraxia
A neurogenic speech disorder resulting from impairment of the capacity to program
sensorimotor commands for the positioning and movement of muscles for the volitional
production of speech
Methods for studying and categorizing motor speech disorders
Perceptual, acoustic, physiologic
Phrenic Nerves
Nerves involved in respiration; they are spread from the cervical through thoracic
divisions of the spinal cord. Diaphragm 3-5th cervical segments
Flaccid Dysarthria
WCI: Injury or malformation at level of CN nucleus in brainstem or somewhere along
axon to periphery or neuromuscular junction.
Neuromuscular junction disease: Myasthenia Gravis, Botulism, Eaton Lambert
Syndrome
Vascular Disorders: Brainstem stroke
Infectious Processes: Herpes Zoster, Polio (Post polio syndrome
Demyelination Disease: Guillain-Barre, Chronic demyelinating neuritis
Muscular Disease: Muscular Dystrophy
Degenerative Disease: Progressive Bulbar Palsy, ALS (LMN part)
Anatomic: Arnold Chiari Malformation
Clinical Characteristics of Flaccid Dysarthria
Weakness: Paralysis vs. Paresis, Hypotonia (low amount of muscle tone), Diminished
reflexes, atrophy, Fasciculation, Fibrillations, Fatigue
Clusters of Impairment for Flaccid Dysarthria
Phonatory Incompetence: Breathiness, short phrases, audible inspirations
Resonatory Incompetence: Hypernasality, Imprecise Consonants, nasal emission, short
phrases
Phonatory-Prosodic insufficiency: Harsh voice, monoloudness, monopitch
UMN- Pyramidal/Direct Pathways
, Consists of corticobulbar and corticospinal tracts, arises mostly from motor cortex, most
corticobulbar tracts travel through the corona radiata and internal capsule
UMN Pyramidal Pathways
Generally Facilitate movement
Lesions: weakness, loss of skilled movements, decreased tone, Babinski sign
UMN- Extrapyramidal Pathways Definition
Major contributions from premotor areas
Make crucial connections with: Basal Ganglia, Cerebellum, Reticular formation,
Vestibular nuclei, red nucleus
UMN- Extrapyramidal Pathways Function
Generally Inhibitory- regulates reflexes for maintaining posture and tone
Lesions cause: Spasticity (increased resistance to stretch), Increased reflexes,
Weakness
Spasticity
Resistance to passive stretch, Hallmark sign of UMN Damage
Damage to Pyramidal/Extrapyramidal tracts
Damage almost always involves both systems resulting in:
paralysis/paresis, loss of skilled movement, spasticity, increased reflexes, pathological
reflexes,
Etiologies of Spactic Dysarthria
Degenerative, Inflammatory, Toxic, Metabolic, Traumatic, Vascular diseases
Vascular Disorders
Infarcts of internal carotid, middle and posterior cerebral arteries
Single cerebral CVA: No spastic dysarthria
Single brainstem CVA: Spastic dysarthria
CVA= cerebral vascular accident (stroke)
Anoxic Events
Pre, peri, postnatal complications resulting in an anoxic event or multiple infarcts:
cerebral palsy
Leukoencephalitis
Inflammation of white matter of brain or spinal cord
Necrosis of blood vessels and surrounding brain tissue
Degenerative disease
Primary lateral sclerosis (PLS)
-Subcategory of ALS
-Corticobulbar and corticospinal signs
-No LOWER MOTOR NEURON Involvement
Neurodegenerative
Under age 50
Clinical Characteristics of Spastic Dysarthria
Spasticity, Weakness, Reduced ROM, Slowness of movement
Clinical Observation of Spastic Dysarthria
Most effected-Lower face, tongue
Somewhat effected-Jaw, VP, Larynx
Reduced ability to produce fine, discrete movements
Nonspeech clinical findings
LATEST UPDATE
Signs
Those characteristics observed by others
Symptoms
Those characteristics perceived by the disordered individuals themselves
Motor Speech disorder (definition)
Disorders of speech resulting from neurologic impairment affecting the motor
programming or neuromuscular execution of speech
Dysarthria
-Any disturbance of articulation or speech
-Any neurogenic disturbance of speech or language
-Severity correlated with illness or disease process
Apraxia
A neurogenic speech disorder resulting from impairment of the capacity to program
sensorimotor commands for the positioning and movement of muscles for the volitional
production of speech
Methods for studying and categorizing motor speech disorders
Perceptual, acoustic, physiologic
Phrenic Nerves
Nerves involved in respiration; they are spread from the cervical through thoracic
divisions of the spinal cord. Diaphragm 3-5th cervical segments
Flaccid Dysarthria
WCI: Injury or malformation at level of CN nucleus in brainstem or somewhere along
axon to periphery or neuromuscular junction.
Neuromuscular junction disease: Myasthenia Gravis, Botulism, Eaton Lambert
Syndrome
Vascular Disorders: Brainstem stroke
Infectious Processes: Herpes Zoster, Polio (Post polio syndrome
Demyelination Disease: Guillain-Barre, Chronic demyelinating neuritis
Muscular Disease: Muscular Dystrophy
Degenerative Disease: Progressive Bulbar Palsy, ALS (LMN part)
Anatomic: Arnold Chiari Malformation
Clinical Characteristics of Flaccid Dysarthria
Weakness: Paralysis vs. Paresis, Hypotonia (low amount of muscle tone), Diminished
reflexes, atrophy, Fasciculation, Fibrillations, Fatigue
Clusters of Impairment for Flaccid Dysarthria
Phonatory Incompetence: Breathiness, short phrases, audible inspirations
Resonatory Incompetence: Hypernasality, Imprecise Consonants, nasal emission, short
phrases
Phonatory-Prosodic insufficiency: Harsh voice, monoloudness, monopitch
UMN- Pyramidal/Direct Pathways
, Consists of corticobulbar and corticospinal tracts, arises mostly from motor cortex, most
corticobulbar tracts travel through the corona radiata and internal capsule
UMN Pyramidal Pathways
Generally Facilitate movement
Lesions: weakness, loss of skilled movements, decreased tone, Babinski sign
UMN- Extrapyramidal Pathways Definition
Major contributions from premotor areas
Make crucial connections with: Basal Ganglia, Cerebellum, Reticular formation,
Vestibular nuclei, red nucleus
UMN- Extrapyramidal Pathways Function
Generally Inhibitory- regulates reflexes for maintaining posture and tone
Lesions cause: Spasticity (increased resistance to stretch), Increased reflexes,
Weakness
Spasticity
Resistance to passive stretch, Hallmark sign of UMN Damage
Damage to Pyramidal/Extrapyramidal tracts
Damage almost always involves both systems resulting in:
paralysis/paresis, loss of skilled movement, spasticity, increased reflexes, pathological
reflexes,
Etiologies of Spactic Dysarthria
Degenerative, Inflammatory, Toxic, Metabolic, Traumatic, Vascular diseases
Vascular Disorders
Infarcts of internal carotid, middle and posterior cerebral arteries
Single cerebral CVA: No spastic dysarthria
Single brainstem CVA: Spastic dysarthria
CVA= cerebral vascular accident (stroke)
Anoxic Events
Pre, peri, postnatal complications resulting in an anoxic event or multiple infarcts:
cerebral palsy
Leukoencephalitis
Inflammation of white matter of brain or spinal cord
Necrosis of blood vessels and surrounding brain tissue
Degenerative disease
Primary lateral sclerosis (PLS)
-Subcategory of ALS
-Corticobulbar and corticospinal signs
-No LOWER MOTOR NEURON Involvement
Neurodegenerative
Under age 50
Clinical Characteristics of Spastic Dysarthria
Spasticity, Weakness, Reduced ROM, Slowness of movement
Clinical Observation of Spastic Dysarthria
Most effected-Lower face, tongue
Somewhat effected-Jaw, VP, Larynx
Reduced ability to produce fine, discrete movements
Nonspeech clinical findings
