Spinal Nerve & Cranial Nerve Damage
Damage to T1-T12 spinal inter-coastal nerves T6-L1 Thorax & C3-5 Phrenic nerve will present with changes where ______? and what will those symptoms look like during assessment?
In the Chest: rapid shallow breathing, reduced VC, short maximum phonation time, inadequate checking action, weak cough.
Reduced loudness, short breath groups, illogical breath groups, fade at the end of sentence, speaking on residual air. limited number of repetitions for AMR/SMR, short duration for prolonged vowels.
Name a condition with damage to the facial nerve AND a condition with the absence of the facial nerve.
Bells Palsy and moebius syndrome
What does the Limbic Level affect?
motivation, Emotion, Arousal, Appetite,Engagement
What are descending and ascending pathways?
Descending pathways- send motor signals to the body
Ascending pathways- send sensory signals back to the brain
The upper motor neuron level 2 systems, what are they?
Direct system- deals with rapid movements , very few synapses
Indirect system- deals with slower responses, multiple synapses
What does damage to the Trigeminal (V) nerve do at the level of the jaw and what symptoms will present during assessment?
weak mandibular valve, jaw sags open, reduced range of motion.
During assessment: severely reduced intelligibility, imprecise consonants and vowels
AMR/SMR: limited range of motion, imprecision and slow
Define self limiting
a symptom that will resolve itself
Name the two types of matter in the Central Nervous System.
Gray matter: Neural cells (that vary in complexity)
Spinal cord, Brainstem, cortical
White Matter: Axons, major descending pathways
Upper motor Neuron Lesion are also called
white matter lesions
TRUE or FALSE
Upper motor lesions usually affect both indirect and direct tract due to the proximity of the tracts.
TRUE
VII Facial Nerve: what changes will you see during motor assessment & what symptoms will present during assessment?
Change at the level of the lips: weak pursing, rounding, retraction, weak labial seal for holding air in cheeks.
Symptoms: Changes with articulation: imprecise bilabials, labiodentals, labial vowels, flutter of cheeks during speech.
AMR/SMR: imprecise
Which side will the tongue gravitate towards when there is damage?
towards the weak side.
What is gray matter responsible for at the cortical level?
EVERYTHING: it allows us to have ideas, remember things, move and think.
What are the two types of fibers?
Corticospinal fiber: longest fiber
Corticobulbar fiber
What is emotional lability? Which dysarthria will we see this?
Pseudobulbar affect or pathological laugh or cry
Spastic Dysarthria
Damage to CN X, Vagus Nerve results in
Hypernasal voice
Which side will the uvula point when there is weakness?
to the strong side
What is gray matter responsible for at the brainstem?
respiration and breathing
What are the three Upper motor neuron white matter fibers?
Association fibers - same hemisphere
Commissural fibers - opposite hemispheres
Projection fibers - from cortex to bulbar and spinal nuclei
What are some differences between Flaccid and Spastic Dysarthria?
Spastic = hypertonia & flaccid hypotonia
Spastic = more of a pattern of deficits
Flaccid = more specific muscles & spastic affects coordination of subsystems as a whole.
spastic= pseudobulbar affect
Spastic = cognitive deficits bc of damage to the cortex
Damage to CN XII, Hypoglossal Nerve will cause what symptoms?
imprecision in consonants and tense vowels
What is the importance of the Vestibular-Recticular?
Which subsystem is directly affected with damage to this level?
it is apart of the the autonomic nervous system that is responsible for respiration and swallowing.
* no direct impact on speech
What is gray matter responsible for at the spinal cord?
Reflex arcs (pain reflexes)
90% of all descending fibers cross over to the contralateral side at the ______?
Medulla
Spastic Dysarthria results from damage to the _____
which is also called _____ ?
Upper motor Neuron
other names: Bilateral motor neuron lesion & pseudobulbar palsy.