Normal v. Abnormal
What should we know about normal speech before diagnosing atypical speech?
Define Dysarthria.
A neurological motor speech impairment characterized by slow, weak, uncoordinated movement of the speech musculature.
Overview of the CNS
Composed of the brain and spinal cord.
12 cranial nerves in the brain
31 pairs of spinal nerves in spinal cord - acts as a communication system between the brain and the peripheral nerves.
What is the medical terminology to describe symptoms and the time increment associated with it?
Acute - within minutes
Subacute - within days
Chronic - within months
When assessing this cranial nerve, a clinician looks for weakness, asymmetry, and incoordination of jaw movement, evaluates sequential motion rates with /p p p/ and /m m m/, and conducts sensory testing of the face.
Trigeminal (V)
How prevalent are motor speech disorders?
The population is uncertain. It is estimated that 60% of individuals who suffer a stroke experience speech/language impairment. Dysarthria is most often associated with neurological conditions.
Define Apraxia
It is caused by damage to the parts of the brain related to executing speech.
These specialized brain cells are located in the spinal cord and brain and are responsible for transmitting movement-related signals. They are divided into upper and lower subtypes.
Motor Neurons
What is the medical terminology used to describe the disease and a brief description for each?
This cranial nerve is evaluated by assessing lip and facial movements with non-speech tasks such as smiling, frowning, and puffing air into the cheeks. It is also tested using /papapa/ to assess articulatory precision.
What is a typical motor speech process?
A person's ability to combine the process of speech-motor planning, programming, and neuromuscular execution.
What is the big difference between these two disorders?
Apraxia occurs due to motor planning. Dysarthria occurs due to muscle weakness.
These motor neurons originate in the brain and travel downward to form synapses with lower motor neurons.
The upper motor neurons
What are the 5 broad ideological categories that can result in a motor speech disorder?
Degenerative disease, inflammatory disease, toxic, neoplastic disease, traumatic injuries.
These three cranial nerves contribute to the integrity of pharyngeal, palatal, and laryngeal musculature, and their dysfunction may present with dysphagia, drooling, and abnormal palatal movement.
Glossopharyngeal (IX), Vagus (X), and Spinal Accessory (XI)
The nervous system becomes disordered. These changes in speech may indicate the presence of neurologic disease.
What kinds of medical conditions can cause Dysarthria?
The cell bodies of these motor neurons are located in the gray matter of the spinal cord and brainstem, where they form synapses with muscles in the body.
The lower motor neurons
What is a Traumatic Brain Injury? Describe the type of damage that could occur.
Damage may occur at the point of impact (coup) or on the opposite side of impact (counter-coup).
This nerve is assessed by checking tongue atrophy, fasciculations, and involuntary movements. It is further tested through alternating and sequential motion rates such as /pataka/ and /t t t/.
Hypoglossal (XII)
What are Motor Speech Disorders?
Speech disorders resulting from neurologic impairment affecting the motor planning, programming, neuromuscular control, and execution of speech.
Signs and Symptoms of Apraxia
Knowing the word you want to say, but the production is different
Made up words
Sound distortions
Inconsistent Errors
Fluency can be impacted - irregular stress, pace, tone
Neurons react to neurological diseases and disorders in different ways, sometimes showing structural changes that reflect specific damage.
Pathologic reactions
What is the prognosis for a TBI?
Worse with the severity of injury.
Around 90% of TBI's are deemed "mild" and do not cause permanent, long-term disability, BUT all types of severity for a TBI could cause significant, long-lasting disability.
Permanent disability is thought to occur in 10% of mild injuries, 66% of moderate injuries, and 100% of severe injuries.
This evaluation includes observing posture, and breathing patterns, and measuring sustained phonation and forced vital lung capacity to compare patient values to age and gender norms.
Respiration tasks for speech assessment