Motor Speech Disorders

Front 1

What is the function of the Mandibular branch of the Trigeminal Nerve (CN V)?

Back 1

1. Sensory: provides sensation from anterior 2/3 of tongue.
2. Motor: innervates muscles of mastication and some muscles of the tongue and velum.

Front 2

If the Mandibular branch of the Trigeminal Nerve (CN V) is intact what should the patient be able to do?

Back 2

1. Resist closing and opening of the jaw.
2. See or feel the masseter bulge on clenching.

Front 3

What happens when there is a unilateral lesion to the Mandibular branch of the Trigeminal Nerve (CN V)?

Back 3

The jaw deviates to the weak side when opened.

Front 4

Does a unilateral lesion to the Trigeminal Nerve (CN V) impact speech?

Back 4

No, there is no functional impact on speech if there is unilateral damage to the Trigeminal Nerve (CN V).

Front 5

What happens when there is a bilateral lesion to the Mandibular branch of the Trigeminal Nerve (CN V)?

Back 5

The patient's jaw hangs open.

Front 6

What is the impact on speech if there is a Bilateral Trigeminal Lesion?

Back 6

Functional impact: imprecise articulation
The patient may try to compensate by going further with the tongue, which may not be able to move well due to the flaccid dysarthria, and damage to hypoglossus.

Front 7

What happens if the entire Trigeminal Nerve is damaged?

Back 7

The patient will have a lack of facial expression like a botoxed actress.

Front 8

What would be a treatment method for a patient that has a bilateral lesion to the Trigeminal Nerve?

Back 8

Have the client talk with his/her hand under their jaw in order to have an easier time to make articulatory contact.

Front 9

True/False: If the Facial Nerve is paralyzed, do all the branches get affected?

Back 9

True.

Front 10

What is the function of the Facial Nerve (CN VII)?

Back 10

Motor: innervates the muscles of facial expression. It innervates the lips which effects speech.
Sensory: taste.

Front 11

What would you see if there is peripheral damage to the Facial Nerve?

Back 11

You may see chin/perioral fasiculations which only happens in Flaccid Dysarthria.

Front 12

What would you see if there is Unilateral Damage to the Facial Nerve?

Back 12

You would see obvious asymmetry:
1) Flat nasiolabial fold
2) Droop at the corner of the mouth
3) Saliva accumulation
4) Reduced retraction and puffing
5) Drooling from one side of the mouth.

Front 13

What happens when there is a Unilateral lesion to the Facial Nerve?

Back 13

There is weakness or paralysis of the half of the face on the same side as the lesion.

Front 14

Does a Unilateral Lesion to the Facial Nerve effect speech?

Back 14

The effect on speech is not as major as the effect on the patient's facial features.

Front 15

What is the effect of a Bilateral Facial paralysis?

Back 15

The effect on speech is not nearly as bad because the tongue can still move.
The patient has trouble with bilabials and managing saliva.
It effects the visual information that a listener gets from the speaker.

Front 16

What is the function of the Glossopharyngeal Nerve (CN IX)?

Back 16

Motor: innervates Stylopharyngeus (dilates Pharynx, and contributes to Laryngeal elevation). It impacts swallowing more than speech production.
Sensory: innervates the Pharynx, posterior 1/3 of tongue, faucial pillars, tonsils, and soft palate.

Front 17

What is the effect of the damage to the Glossopharyngeal Nerve (CN IX)?

Back 17

1. Reduced pharyngeal sensation and decrease in gag reflex.
2. Probably reduced laryngeal elevation in swallow.

Front 18

What is the function of the Vagus Nerve (CN X)?

Back 18

Motor: innervates the soft palate, pharynx, and larynx.
Sensory: transmits sensation from the soft palate, pharynx, and larynx.

Front 19

What are the three branches of the Vagus Nerve (CN X)?

Back 19

1. Pharyngeal branch.
2. Superior laryngeal branch.
3. Recurrent laryngeal branch.

Front 20

What is the function of the Pharyngeal branch?

Back 20

1. Innervate the retraction and elevation of the soft palate during velopharyngeal closure for speech.
2. Pharyngeal constriction

Front 21

What would you see if a patient had damage to the Pharyngeal branch of the Vagus Nerve (CN X)?

Back 21

The patient's soft palate and pharyngeal walls will not move.
The patient will have hypernasal resonance, and a normal voice.

Front 22

What are the two parts of the Superior Laryngeal Nerve branch?

Back 22

1. Internal Laryngeal Nerve
2. External Laryngeal Nerve

Front 23

What is the function of the Internal Laryngeal Nerve (Superior Laryngeal Nerve)?

Back 23

It is a purely sensory nerve.
Provides sensation to the larynx and pharynx.

Front 24

What is the function of the External Laryngeal Nerve (Superior Laryngeal Nerve)?

Back 24

It is a motor nerve that innervates the cricothyroid muscle.
It is important for pitch changes.

Front 25

What is the function of the Recurrent Laryngeal Nerve?

Back 25

It innervates all of the intrinsic laryngeal muscles except for the cricothyroid.
The sensory fibers of the recurrent laryngeal nerves carry sensation from the vocal folds.

Front 26

What is the importance of the the superior and recurrent laryngeal nerves?

Back 26

These nerves are responsible for all laryngeal motor activities that are involved in phonation and swallowing.

Front 27

What happens when there is bilateral damage to all the branches of the Vagus Nerve (CN X)?

Back 27

This results in:
1) Hypernasality and breathy speech.
2) Incomplete closure of velopharyngeal port and opening of vocal folds results in:
a. short phrases due to loss of air.
b. loss of acoustic energy: muffledness.

Front 28

What happens when there is damage to the Pharyngeal branch of the Vagus Nerve?

Back 28

1. Unilateral
-Asymmetry will be observed: lower on weak side at rest, pulls up and over to strong side during "ah".
-A person will sound normal due to the strong side of the velum pulling everything up.
2. Reduced gag.

Front 29

What happens when there is damage to the Recurrent Laryngeal branch of the Vagus Nerve?

Back 29

1. Weak cough and glottal coup
2. Breathy and/or hoarse voice

Front 30

What is the function of the Accessory Nerve (CN XI)?

Back 30

Motor: Innervates the uvula, levator palatine, and intrinsic laryngeal muscle.

Front 31

What is the most critical nerve for Flaccid Dyarthria?

Back 31

Hypoglossal (CN XII)

Front 32

What is the function of the Hypoglossal Nerve (CN XII)?

Back 32

Innervates the intrinsic muscles of the tongue, and four of five extrinsic muscles (not palatoglossus).

Front 33

What happens when there is damage to the Hypoglossal Nerve (CN XII)?

Back 33

Unilateral damage: the tongue will point to the weak side.
Bilateral damage: the tongue will not move.

Front 34

What is the impact on speech when the Hypoglossal Nerve (CN XII) is damaged?

Back 34

The impact is imprecise articulation and some distortions.

Front 35

What is the function of the Spinal Nerves?

Back 35

They innervate the respiratory muscles.

Front 36

What is the function of the Phrenic Nerves?

Back 36

They innervate the diaphragm.

Front 37

What is the importance of intercostal and abdominal innervation?

Back 37

They are important for breath support.