Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
65 Cards in this Set
- Front
- Back
|
Components of speech
*hint remember in hierarchy order |
Respiration (Speech Breathing)
Phonation Resonance Articulation Prosody |
|
|
Apraxia
* basic |
Disruption in MOTOR PLAN that is constructed within the brain
|
|
|
Dysarthria
* basic |
Disruption in MOTOR ACTIVITY (the execution of speech by the muscles in the periphery)
|
|
|
Congenital Speech Disorder
|
Typically STRUCTURAL ABNORMALITY or NERVOUS SYSTEM IMPAIRMENT
ex. Cleft lip / Palate |
|
|
Acquired Speech Disorder
|
Trauma
Accidents Disease Stroke Neoplasm |
|
|
How is dysarthria classified?
|
-- Site of lesion
-- What's going on with muscles -- Type of movement |
|
|
Spastic Dysarthria
* site of lesion |
Bilateral brain damage of UPPER and lower motor neuron (upper will influence motor that's why you say both)
|
|
|
Spastic Dysarthria
* characteristics |
-- too much muscle tone
-- muscle is tight and hard to move - this doesn't mean increased strength -- limited range of motion -- can become less tight with deep pressure / massage |
|
|
Flaccid Dysarthria
* site of lesion |
LMN or PNS injury
|
|
|
Flaccid Dysarthira
* characteristics |
-- too little tone - "floppy"
-- limited range of motion -- weak, more so than spastic & Can't move muscles quickly |
|
|
Ataxic Dysarthria
* characteristics |
-- unregulated movement
-- DRUNK! |
|
|
Ataxic Dysarthira
* site of lesion |
-- Cerebellum
* unilateral lesion will resolve fairly quickly |
|
|
Hypokinetic
* site of lesion |
-- basal ganglia
|
|
|
Hypokinetic
* characteristics |
-- restricted / lack of movement
-- related to muscle rigidity -- Parkinson's disease! |
|
|
Hyperkinetic
* site of lesion |
-- basal ganglia
|
|
|
Hyperkinetic
* characteristics |
-- too much movement
-- movements are involuntary - may be constant, elicited by other movements -- one movment that moves into the extremes or many movements -- tremor, motor ticks, chorea |
|
|
Error patterns for APRAXIA
|
Motor plan is mixed up with each attempt - will hear many different things: omissions, additions, substitutions, fillers
|
|
|
Error patterns for DYSARTHRIA
|
-- error patterns are predictable
-- most of what you hear are distortions |
|
|
Apraxia is a component of...
|
Broca's Aphasia
|
|
|
Only true dysarthria with damage to LMN
|
Flaccid
|
|
|
Trigeminal
|
(V)
- Mixed nerve Sensory - Facial Sensation - Anterior tongue Motor - Muscles of mastication |
|
|
Trigeminal CN impact on speech
|
- No facial sensation which would affect articulation (reduced feedback on sounds made with lips)
- Anterior tongue would affect swallowing (you need to know where the bolus is - No jaw movement |
|
|
Facial
|
(VII)
- Mixed nerve Sensory - Anterior tongue taste - Oral cavity Motor - muscles of facial expression |
|
|
Facial CN impact on speech
|
- When a bolus is in your mouth you can feel it because of 5, but you can taste it because of 7
- Motor impact on speech would primarily affect LABIAL sounds |
|
|
Hemispheres lesion will affect...
|
both sides of upper face but only opposit sides of lower
ex. Left hemi affects R&L UPPER face, only RIGHT LOWER face |
|
|
Auditory
|
(VIII)
Sensory nerve - Hearing / Vestibular |
|
|
Auditory CN impact on speech
|
- Would affect articulation - degree would depend on when hearing was lost (Born without hearing = poor artic, born with lost later = better artic)
- Odd resonance pattern |
|
|
Glossopharyngeal
|
(IX)
-- Mixed Sensory - Pharyngeal region - Posterior Tongue Motor - Pharyngeal muscles |
|
|
Glossopharyngeal CN impact on speech
|
- Important for triggering swallow - without sensation in pharyngeal region then it can't be triggered and bolus could be dumped in airway
-- Nasopharynx - hypernasal speech -- Affect taste on back of tongue -- Not a HUGE impact on speech -- Test with gag |
|
|
Vagus
|
(X)
-- Mixed Sensory - Laryngeal Sensation Motor - Laryngeal branch - intrinsic laryngeal muscles - Pharyngeal branch - velar elevation |
|
|
Vagus CN impact on speech
|
- sensation of larynx allows airways to be protected - if you don't have this sensation you won't cough and things could pass through larynx down to lungs
- hypernasal if you can't elevate velum (damage to pharyngeal branch) - vocal fold paralysis (damage to laryngeal branch) |
|
|
Unilateral damage to laryngeal branch of vagus
|
Breathy voice
|
|
|
Bilateral damage to laryngeal branch of vagus
|
No voice
|
|
|
Only muscle to abduct vocal folds
|
Posterior cricoarytenoid - if they can't contract then they can't pull the folds open
|
|
|
Spinal Accessory
|
XI
-- Motor nerve - neck muscle - assist with respiration |
|
|
Hypoglossal
|
(XII)
-- Motor nerve - innervates muscles of tongue |
|
|
Pharyngeal Plexus
|
CN 9, 10, 11
(glossopharyngeal, vagus, spinal accessory) |
|
|
Tongue CN
|
Hypoglossal (12)
Trigeminal (5) Facial (7) Glossopharyngeal (9) Vagus (10) |
|
|
Perceptual Assessment
|
-- ESSENTIAL b/c universally available, judges intelligibility
-- difficult to standardize b/c of patient and environment -- influencing factors - skills & experience of clinician |
|
|
Acoustic Assessment
|
-- supplements perceptual
-- Where's the breakdown? Rate? Pauses? Nasality? -- Oscillographic analysis (pauses/amplitude) -- Spectographic (frequencies) |
|
|
Phonation
|
Quality
Intensity Pitch |
|
|
Resonance examination
|
Velopharyngeal function
- examine for air leaks - listen to resonance - occlude and open nostrils |
|
|
Articulation eval
|
- Patterns of errors
- Where's the breakdown? -- single sounds -- words -- phrases/sentences -- conversation |
|
|
Speech Treatment - 5 principles
|
(CPEMM - courtney pets elephants, monkeys, & more)
Compensatory Strategies Purposeful activity Early Treatment Monitoring Motivation |
|
|
Behavioral Approach
|
- Traditional treatment that emphasizes new skills/compensation
- Can be implemented any time, anywhere - Most frequently implemented treatment approach |
|
|
Biofeedback / Instrumental
|
- Direct feedback regarding their performance
- IOPI - Visipitch - Intelligibility drills - vocalite |
|
|
Surgical/ Prosthetic
|
- Medical management of severe dysarthria
|
|
|
Hierarchy
|
BP - now that's a RAP
Respiration Phonation Resonance Articulation Prosody |
|
|
Hyperadduction phonation techniques
|
Yawn
Chew Medical management - botox |
|
|
When do people typically get botox for speech?
|
Spasmotic dysphonia
|
|
|
Hypoadduction treatment
|
Push/pull
LSVT (Lee Silverman Voice Treatment) |
|
|
Resonance treatment
|
-- Biofeedback via mirror, acoustic (listening to recording), airflow
-- Strengthening w/ CPAP or effort/compensatory strategies |
|
|
Articulation treatment
|
- compensatory strategies
- auditory, visual, temporal, targets/self eval - palatagrophy (biofeedback) - spectograph |
|
|
Prosody treatment
|
- stress patterns, rate, intonation patterns
- contrastive stress drills (let's eat grandma) |
|
|
Motor Learning Theory
|
Stimuli
# of trials Order of presentation Knowledge of performance Knowledge of feedback |
|
|
Hypoadduction treatment
|
Push/pull
LSVT (Lee Silverman Voice Treatment) |
|
|
Resonance treatment
|
-- Biofeedback via mirror, acoustic (listening to recording), airflow
-- Strengthening w/ CPAP or effort/compensatory strategies |
|
|
Articulation treatment
|
- compensatory strategies
- auditory, visual, temporal, targets/self eval - palatagrophy (biofeedback) - spectograph |
|
|
Prosody treatment
|
- stress patterns, rate, intonation patterns
- contrastive stress drills (let's eat grandma) |
|
|
Motor Learning Theory
|
Stimuli
# of trials Order of presentation Knowledge of performance Knowledge of results |
|
|
Hypoadduction treatment
|
Push/pull
LSVT (Lee Silverman Voice Treatment) |
|
|
Resonance treatment
|
-- Biofeedback via mirror, acoustic (listening to recording), airflow
-- Strengthening w/ CPAP or effort/compensatory strategies |
|
|
Articulation treatment
|
- compensatory strategies
- auditory, visual, temporal, targets/self eval - palatagrophy (biofeedback) - spectograph |
|
|
Prosody treatment
|
- stress patterns, rate, intonation patterns
- contrastive stress drills (let's eat grandma) |
|
|
Motor Learning Theory
|
Stimuli
# of trials Order of presentation Knowledge of performance Knowledge of feedback |
