Neuroanatomy
What is Diaschisis?
a temporary loss of function in areas remote from a lesioned area
The direct (pyramidal) pathway has two tracts:
Cortico spinal
Cortico bulbar
______________ is a treatment used most often with individuals who have global aphasia.
VAT
flat nasolabial fold is a confirmatory sign for ___________ type of dysarthria
Flaccid
Hypoadduction is typical in __________ population
PD
LMN (flaccid), some TBI
The decision to speak formed in the????? cortex.
Damage to the direct pathway can result in
Spasticity
UUMN Dys
________________is a nonverbal treatment approach that trains individuals to use hand gestures to indicate visually absent items
VAT
Hypernasality, nasal emission, continuous breathiness and fasciculations is a sign of
Flaccid Dysarthria
Flaccid Dysarthria Hypoadduction treatment focuses on increasing _______________ through effortful speech
medial compression
Based on neuroplasticity principles, How do we reconnect the damaged circuit?
increase facilitation involves providing additional structured input to circuits
______________ regulates motor functioning, especially tone and posture so that we have smooth, precise motor movement
Basal Ganglia
A 73 y/o retired businessman was admitted to the hospital for treatment of a language disturbance. The neurological examination was normal except for a R visual field defect most pronounced in teh upper quadrant, a mild right facial paresis, and a minimal sensory impairment. Conversational speech was fluent but interrupted by frequent word-finding pauses. 3-5 word phrases were produced with normal inflection and rhythm. Literal and verbal paraphasias were evident. Comprehension appeared intact through a series of demanding tests. Repetition of spoken language was severely disturbed. While the patent could repeat single digits and occasional single syllable words, double digits, multi-syllabic words, phrases, or sentences were contaminated with multiple paraphasic substitutions. When asked to name on confrontation, he was often incorrect because of literal paraphasic substitutions. Reading aloud produced paraphasic jargon, but he fully comprehended the written material. He was unable to write. Prominent buccofacial and limb apraxia persisted.
Conduction Ap.
Hyperactive reflexes are seen in ________________ type of dysarthria
Spastic
Adequate placement of bite block
lateral upper and lower teeth placement
_______________ integrates auditory information before sending it to MGB
Inferior Colliculus
Extrapyramidal system controls
repetitive
emotional movements
posture and tone
A 47 y/o professional piano player was admitted for language therapy. He was unable to give a history. The neurological examination showed a mild R hyperflexia, and sensory testing revealed astereognosis defective 2-point discrimination, and difficulty with position sense in the upper right extremity, but his appreciation of pain was intact and no visual field defect could be demonstrated. Language testing showed a limited but fluent output, consisting mostly of phrases such as "you know" and "oh boy" plus neologistic and semantic paraphasias. Almost no information was conveyed by the patient''s conversational speech he regularly failed tests of comprehension but appeared to gather some meaning from conversational speech (probably by interpreting verbal inflection and gesture). He was unable to name, most often producing generalizations (e.g., "one of those things") or a semantic substitution. Both reading and writing were severely disturbed. In marked contrast, his repetition of spoken language was flawless to the level of long, complex sentences. He even reproduced spoken nonsense material without difficulty.
TSA
hypertonia is seen in ____ dysarthria
UUMN
Spastic
OMEs are contraindicative to ___population
MG
______________ structure is responsible for Decoding at the phonemic level
Angular gyrus and supramarginal gyrus
______________ is the last leg of motor signal journey
FCP
A 64 y/o man was referred for evaluation for persistent aphasia secondary to a stroke 3 months earlier. A nonfluent output with sparse, dysarthric, and effortful verbalization and a R hemiparesis had been present. The paresis cleared over several weeks, leaving only slight clumsiness plus hyperactive reflexes on the R. The Pt verbal output, however, remained limited, effortful, hypophonic, and poorly articulated. Most verbalizations consisted of a single significant word; rarely was there a preposition or modifier. Comprehension was relatively intact, failing only when complex sequences of material were presented. Repetition was excellent, standing in stark contrast to the limited, nonfluent, spontaneous output. The patient could name most objects but often needed prompting. He could read, both out loud and for comprehension. He did not write spontaneously but could write to dictation.
TMA
palilalia is seen in _________ type of dysarthria.
hypokinetic
Hyperadduction is typical in
HD
Movement disorder
CP