Neuroanatomy
These are the 4 lobes of the brain.
Frontal, occipital, temporal, parietal
These are 3 symptoms that are often associated with damage to Broca's area.
Agrammatic and telegraphic speech
Anomia
Self-repairs; aware of errors
Generally intact receptive language
Impaired repetition
Writing may be affected
True or False:
Acquired AoS may not co-occur with dysarthria.
True or False:
Dysarthria can impact any/all of the 5 subsystems of speech.
True
These are the 2 main types of TBI.
Bonus: Include causes
Open head (penetrating) - ballistic trauma, falls
Closed head (nonpenetrating) - falls, motor vehicle accidents, being struck by an object, sports accidents, violent assaults
1. Motor neurons
2. Sensory neurons
1. Efferent
2. Afferent
These are 3 symptoms often resulting from damage to Wernike's area.
Good speakers; poor communicators
Fluent, empty speech
Significant receptive deficits
Impaired repetition
Posterior lesion may cause visual/reading deficits
Anosoagnosia
Neologisms and paraphasias
Logorrhea
It is a type of apraxia that causes an inability to program and carry out non-speech, voluntary movements of the larynx, pharynx, tongue, or lips.
Oral apraxia
This means lack of appropriate muscle tone at rest.
Hypotonic/hypotonia
This degenerative disease is caused by repeated head trauma. Common symptoms include dementia, confusion, memory loss, headache, depression, and excessive aggression.
Chronic traumatic encephalopathy
It is responsible for monitoring motor plans and correcting errors.
Cerebellum
This is a quick definition of "expressive language deficit" (include the modalities and place of lesions in the brain).
Difficulty in formulation or production of language
-Speaking and Writing
-Due to lesions anywhere within the anterior portion of left cerebral hemisphere (Broca's area)
These are 2 treatment approaches for acquired AOS.
Sound production treatment (minimal pairs)
Phonemes for Restructuring Oral Muscular Phoneme Targets (PROMPT)
Melodic Intonation Therapy
Pacing boards
Intersystemic Reorganization (Hebbian learning)
AAC
This dysarthria is characterized by low muscle tone and muscle weakness due to damage to the lower motor neurons of the cranial nerves.
Also often present are fasciculation, muscle atrophy, hyporeflexia, hypernasality, and imprecise consonants.
Flaccid dysarthria
These are 2 motor deficits common following a TBI.
Severe gross and fine motor movement deficits, bilateral paresis/paralysis, or contralateral hemiplegia
Abnormal muscle tone
Damage to cerebellum results in ataxia
Motor speech disorders such as apraxia of speech and dysarthria
Dysphagia (difficulty swallowing)
It is a subcortical structure regulated by dopamine and plays a role in the initiation of movement, muscle tone maintenance, and inhibition of extraneous movements.
Basal ganglia
This is a quick definition of "paraphasia" (include 3 types).
Errors in phonemes, words, or phrases produced unintentionally due to language deficits.
1. Phonemic
2. Neologistic
3. Sematic
4. Unrelated
These are examples of:
Perseverative substitutions
Anticipatory substitutions
Phoneme additions
Perseverative: going there = going ghere
Anticipatory: going there = thoing there
Additions: vanishing = vanishwing
This type of dysarthria is characterized by incoordination due to damage to the cerebellum.
Symptoms often include slushy speech, affected muscles are hypotonic, slow voluntary movements, and force, range, timing, and direction of movements are inaccurate.
Ataxic dysarthria
These are 3 common cognitive deficits following TBI.
Attention
Memory
Problem-solving
Executive functioning
Impulsivity
Emotional lability
Underestimating deficits
Anosognosia
This structure gets information related to motor planning and programming that the cerebellum has ALREADY checked for errors and then sends that information back to the motor strip for refinement.
Thalamus
This non-fluent aphasia is similar to Broca's aphasia, but people often have INTACT repetition skills.
Bonus: Incude area of the brain that is damaged.
Transcortical Motor Aphasia
Bonus: Occlusion of anterior cerebral artery to supplementary motor cortex and area anterior to Broca’s
These are the 4 components of a Motor Speech Evaluation.
(Need 3 out of 4 to get points)
Case history (medical chart, interview with patient/family)
Oral motor evaluation
Completion of speech tasks to detect error patterns
Administration of a formal test of apraxia of speech, dysarthria, and/or speech intelligibility
This type of dysarthria is characterized by rigidity, reduced amounts of volitional movement, and reduced range of motion due to damage to structures of the basal ganglia and other CNS structures like the cortex.
Also present are monopitch and monoloudness, reduced stress, imprecise consonants, and short rushes of speech.
Hypokinetic dysarthria
Shaken Baby Syndrome is the most common cause of TBI in infants. What happens during this event in the brain?
Damage caused is usually due to rotational and acceleration-deceleration forces imposed on the child’s brain.
Diffuse axonal shearing, cerebral edema, and subdural hematoma may occur