Ch. 11 (Speech)
John, a 64 year old man, attends speech therapy once per week. He has extra, abnormal, and involuntary movements. What type of dysarthria does he have?
a. Hypokinetic
b. Hyperkinetic
c. Flaccid
d. Mixed
b. Hyperkinetic
Molly suffered damage to the visual processing areas of her brain after a stroke. She has been diagnosed with peripheral alexia, indicating that she may experience…
a. Reading difficulty due to a damaged reading system
b. Difficulty to the reading system
c. Reading difficulty due to visuospatial and attentional issues
d. Difficulty to the writing system
c. Reading difficulty due to visuospatial and attentional issues
About ______ of dysphasic patients aspirate without any signs.
a. ¼
b. ½
c. ⅓
d. ⅙
c. ⅓
The area of the brain that controls divided attention is located _____ in relation to the thalamus?
a. Superior
b. Dorsal
c. Ventral
d. Inferior
c. Ventral
All of these are ascending sensory tracts except what?
a. Dorsal Column
b. Spinothalamic
c. Spinocerebellar
d. Reticulospinal
d. Reticulospinal
If a patient were to suffer from a Hemorrhagic CVA in Brodmann’s areas 41 and 42, which modality of language would be affected?
a. Auditory Comprehension
b. Visual Comprehension
c. Oral Production
d. Written Expression
a. Auditory Comprehension
Which disease is the main cause of dysphagia?
a. ALS
b. Parkinson's disease
c. Traumatic Brain Injury
d. Stroke
d. Stroke
Which structure in the brain is associated with executive functions?
a. Broca's area
b. Prefrontal cortex
c. Parietal lobe
d. Primary motor cortex
b. Prefrontal cortex
If both LMN (Lower Motor Neurons) and UMN (Upper Motor Neurons) systems are damaged, this could result in:
a. ALS
b. Hypertonia
c. Babinski Symptoms
d. Ataxic
a. ALS
Which component of language involves sentence structure, word order, and the organization of sentences?
a. Phonology
b. Syntax
c. Semantics
d. Morphology
b. Syntax
Which Brodmann area is responsible for activating the muscles of swallowing?
a. BA 1-3
b. BA 4
c. BA 6
d. BA 44-45
b. BA 4
Which of the following defines selective attention?
a. Focusing on one stimulus over time
b. Shifting focus between two tasks
c. Focusing on one stimulus while ignoring others
d. Managing attention for multiple simultaneous tasks
c. Focusing on one stimulus while ignoring others
Chris walks into the ER with slowed speech, a strained voice, and imprecise consonants. What type of speech dysarthria could Chris be associated with?
a. Flaccid
b. Unilateral UMN
c. Spastic
d. Ataxic
c. Spastic
Jack has experienced a TBI as a result of a sports injury. He is showing damage to the Parietotemporal system. What symptoms may Jack be exhibiting?
a. Difficulty with analysis of words and understanding the meaning behind words
b. Difficulty with sight reading
c. Difficulty with analysis of words and understanding the grammatical breakdown of words
d. Difficulty with silent reading
a. Difficulty with analysis of words and understanding the meaning behind words
Which cranial nerve is involved in the esophageal phase of swallowing?
a. CN V
b. CN VII
c. CN X
d. CN XII
c. CN X
Ella used a mnemonic in order to help her study and remember all of the cranial nerves. What internal memory strategy did she use?
a. Repetition
b. Association
c. Visualization
d. Grouping
b. Association
Damage to the extrapyramidal system, which includes the basal ganglia and regulates motor control, can lead to which of the following diseases?
a. Lewy body dementia
b. Alzheimer's Disease
c. ALS
d. Huntington's Disease
d. Huntington's Disease
Which Brodmann’s Area(s) are NOT essential for the auditory comprehension of language?
a. 17, 18, and 19
b. 22
c. 41 and 42
d. 44
a. 17, 18, and 19
A 55 year old male recently suffered a stroke in the cortex. Which of the following symptoms is he most likely to show?
a. An impairment in the motor planning for swallowing (apraxia)
b. Impaired motor control of oral structures
c. Impaired center for automatic swallow response
d. Loss of coordination
a. An impairment in the motor planning for swallowing (apraxia)
What are the four types of attention controlled in the frontal and temporal lobes?
a. Selective, Divided, Alternating, Sustained
b. Sustained, Selective, Stable, Alternating
c. Alternating, Persistent, Supported, Oscillating
d. Divided, Stable, Supported, Alternating
a. Selective, Divided, Alternating, Sustained
John, a 50-year-old male, shows signs of muscle weakness and reduced reflexes in his left arm. A neurologist is suggesting an issue with motor neurons that have direct control of his muscle contraction. What type of neuron would that be?
a. Gamma motor neurons
b. Alpha motor neurons
c. Sensory neurons
d. Beta motor neurons
b. Alpha motor neurons
When seeing a dog walk by, Sarah told her friends, “Look over there! There’s a hog.” Sarah’s error in language is called:
a. Semantic Lexical Paraphasic Error
b. Mixed Lexical Paraphasic Error
c. Formal Lexical Paraphasic Error
d. Unrelated Lexical Paraphasic Error
b. Mixed Lexical Paraphasic Error
Mr. Bond, James Bond is a 60 year old male who complains of lip movement difficulty when chewing resulting in an inability to form a labial seal. Following an appointment with a neurologist, Mr. Bond is diagnosed with damage to one of his cranial nerves. Which of the following cranial nerves is associated with the oral stage?
a. Facial nerve
b. Pharyngeal nerve
c. Hypoglossal nerve
d. Oral labial nerve
a. Facial nerve
Which of the following is NOT classified primarily as a cognitive disorder impacting attention, memory, or executive function?
a. ADHD
b. Dementia
c. Parkinson’s disease
d. Right hemisphere disorder
c. Parkinson’s disease
Dr. Allan’s patient is struggling with involuntary, erratic, writhing movements in their face, arms, and trunk. They were previously misdiagnosed with Parkinson’s. What is this patient most likely to be experiencing?
a. Hypertonia
b. Dyskinesia
c. ALS
d. UMN Damage
b. Dyskinesia
What is paragrammatism?
a. A type of memory impairment affecting the ability to retain new information
b. A language disorder involving omissions of grammatical elements, such as articles and conjunctions
c. A motor speech disorder characterized by difficulty coordinating articulatory movements
d. A language disorder involving substitution errors in pronouns and verb tense.
d. A language disorder involving substitution errors in pronouns and verb tense.
_______ is a impairment in the motor planning for swallowing
a. Apraxia
b. Aphasia
c. Dysarthria
d. Dysphagia
a. Apraxia
Wyatt, a 17-year-old high school student, has been referred to a neurologist following a head injury. His mother reports that he is having difficulty focusing at school, displays frequent emotional outbursts, and has been making sexually inappropriate comments in class. He most likely has damage to which Brodmann area(s)?
a. BA 1, 2, 3
b. BA 9, 10, 11, 46, 47
c. BA 22
d. BA 44 and BA 45
b. BA 9, 10, 11, 46, 47
The following symptoms would indicate damage to what area?
Spastic muscles, clonus, abnormal Babinski sign, and no fasciculations.
a. Upper Motor Neurons (UMN)
b. Indirect Motor System
c. Lower Motor Neurons (LMN)
d. These symptoms consist of multi-system damage
a. Upper Motor Neurons (UMN)
A 59-year-old woman has difficulty writing despite normal motor function in her hand and intact reading ability. She cannot correctly spell words or form coherent sentences when writing, but her spoken language is fluent. She most likely has this type of agraphia:
a. Apraxic agraphia
b. Phonological agraphia
c. Deep agraphia
d. Global agraphia
b. Phonological agraphia
Teddy, a 63-year-old male with a history of stroke presents with difficulty swallowing, particularly when trying to swallow liquids. On examination, he has a weak gag reflex and impaired ability to elevate his soft palate. A modified barium swallow study shows aspiration during the pharyngeal phase of swallowing. His speech is slightly slurred, and there are signs of dysarthria. Which part of the central nervous system is most likely involved in Teddys swallowing dysfunction?
a. Cerebellum
b. Medulla
c. Motor cortex
d. Spinal cord
b. Medulla
Dementia is characterized by which of the following changes to the brain?
a. Brain atrophy, amyloid plaque, and neurofibrillary tangles
b. Cerebrospinal fluid accumulation in the brain ventricles causing brain tissue to be compressed against the skull
c. Degeneration of the substantia nigra and loss of dopaminergic innervation of the striatum
d. Degeneration of the basal ganglia and enlargement of the brain’s ventricles.
a. Brain atrophy, amyloid plaque, and neurofibrillary tangles
Sydney is a 55 year old female who was just diagnosed with apraxia of speech, what symptom is most likely to occur for her?
a. Difficulty swallowing
b. Difficulty writing complete sentences
c. Difficulty with articulatory placement
d. Difficulty remembering the meaning of words
c. Difficulty with articulatory placement
Luke is a second grade student whose teacher has been noticing that he has been struggling with understanding what his quiz questions are asking of him. Which cortical system is involved with Luke’s difficulties with semantic word analysis?
a. Anterior Reading System
b. Parietotemporal System
c. Occipitotemporal System
d. Lateral Reading System
a. Anterior Reading System
Mary is a 42-year-old female receiving outpatient speech services. Her speech therapist has noticed that, when asked to cough, Mary gives a very weak cough response. What clinical indicator of aspiration risk is Mary experiencing?
a. Abnormal gag reflex
b. Voice change after swallow
c. Cough after swallow
d. Abnormal volitional cough
d. Abnormal volitional cough
After suffering a stroke two weeks ago, Brenda has regained consciousness, but is exhibiting significant changes in her executive functioning. What might some of these changes look like, and which area of the brain was probably affected?
a. Brenda has forgotten how to type on a keyboard, tie her shoes and brush her teeth. The basal ganglia’s striatum was affected.
b. Brenda has lost her interest in art, has trouble understanding things from others’ perspective, and leaves easy tasks unfinished. The prefrontal cortex was affected.
c. Brenda has lost her sense of balance and coordination and has trouble coordinating her speech production. The cerebellum was affected.
d. Brenda has developed hypersomnia. The thalamus was affected.
b. Brenda has lost her interest in art, has trouble understanding things from others’ perspective, and leaves easy tasks unfinished. The prefrontal cortex was affected.
Mikayla was sent to the hospital for problems with her speech and struggling to pronounce her words correctly. They told her she has damage to her insular cortex. What disorder may Mikayla have?
a. TBI
b. Amyotrophic lateral sclerosis (ALS)
c. Apraxia of speech
d. Dysphagia
c. Apraxia of speech
Choose the lobe of the brain where oral production is located.
a. Parietal
b. Occipital
c. Frontal
d. Temporal
c. Frontal
Which of the following subcortical structures is believed to provide the attention needed in swallowing?
a. Premotor cortex
b. Anterior cingulate cortex
c. Insula
d. Primary sensory cortex
b. Anterior cingulate cortex
47-year old Randolph has right hemisphere disorder. What symptoms may Randolph be experiencing?
a. Rambling speech, aprosody, trouble interpreting emotion, deficits in maintaining attention, episodic memory deficits, denial of deficits
b. Poor judgment, highly emotional, heightened attention, apraxia of speech, lack of producing emotion, acceptance of deficits
c. Trouble interpreting emotion, wernicke's aphasia, hypersensitive to how their actions affect others
d. Deficits in episodic memory and declarative memory, deficits in sustained attention, hyper-aware of actions, broca's aphasia, denial of deficits
a. Rambling speech, aprosody, trouble interpreting emotion, deficits in maintaining attention, episodic memory deficits, denial of deficits
What type of scan would a healthcare professional recommend for assessing sensory tract disorders if we are looking at a functional issue such as a head injury?
a. CT
b. EEG
c. MRI
d. X-Ray
b. EEG
A patient with word production anomia will be able to…?
a. Know a word yet is unable to produce it in multiple modalities.
b. Know a word, and produce it in multiple modalities.
c. Does not know the meaning of any words.
d. Knows the meaning of words, but cannot produce them.
b. Know a word, and produce it in multiple modalities.
All of the following diseases are demyelinating diseases that affect swallowing except…
a. Guillain-Barre Syndrome
b. Multiple Sclerosis
c. Parkinson's Disease
d. Transverse Mylenitis
c. Parkinson's Disease
In what order do our general cognitive functions occur in a typical brain?
a. Perceiving, understanding, remembering, judging, reasoning
b. Reasoning, remembering, thinking, understanding, judging
c. Remembering, thinking, understanding, reasoning, judging
d. Perceiving, remembering, understanding, judging, reasoning
d. Perceiving, remembering, understanding, judging, reasoning
What are the major components of the sensory system involved in speech production?
a. Auditory Processing
b. Motor System
c. Sensory-Motor Interface
d. Sensory Feedback
a. Auditory Processing
Alexia is the acquired disorder of ______, while Agraphia is the acquired disorder of ________.
a. Writing, Reading
b. Vision, Writing
c. Reading, Writing
d. Spelling, Speaking
c. Reading, Writing
A 63 year old man is admitted due to an acquired autoimmune disease that has been affecting his neuromuscular transmission and has caused his muscles to fatigue with use. What disease may he have?
a. Muscular dystrophy
b. Myasthenia gravis
c. Multiple sclerosis
d. ALS
b. Myasthenia gravis
Which would be an example of an SLP properly assessing divided attention?
a. Allowing the child to play with toys and observing what they do when playing.
b. This is not important to do as an SLP because they have better things to do.
c. Participants are asked to identify several stimuli simultaneously. These can be red and green circles among various shapes and colors.
d. Reading a book with a child and not having any sort of structure with it.
c. Participants are asked to identify several stimuli simultaneously. These can be red and green circles among various shapes and colors.
Julia is a 6 year old girl who has been recommended for a speech evaluation by her pediatrician. Upon her initial evaluation, the SLP noted that Julia had several speech sound production errors and recommended that she begin speech intervention once a week. What area of speech should this SLP target in her intervention?
a. Prosody
b. Phonation
c. Articulation
d. Resonance
c. Articulation
Hazel, a 68 year old, recently had a stroke. She was released from the hospital and began her yearly tradition of writing her loved ones Christmas cards. When her niece gets her card, she realized Hazel wrote “Merry Santa” instead of “Merry Christmas”. These written semantic paraphasias are a characteristic of which type of disorder?
a. Deep Central Agraphia
b. Surface Central Agraphia
c. Pure Peripheral Alexia
d. Deep Central Alexia
a. Deep Central Agraphia
A patient comes in presenting difficulties keeping food and liquid out of their nasal cavity. Which area of the pharyngeal stage may be having problems?
a. Soft palate closure
b. Laryngeal closure
c. Laryngeal elevation
d. Pharyngeal constriction
a. Soft palate closure
George was in his garage working on his boat because the engine isn’t working like it should. While he was working, George heard his daughter call his name. He puts his tools down and turns around to see what she needs. She runs up to him and shows him her art project she did at school. After she showed him her project she went back inside and George went back to working on his boat. What type of attention is George showing?
a. Sustained Attention
b. Alternating Attention
c. Divided Attention
d. Selective Attention
b. Alternating Attention
The Upper Motor Tract (UMT) is made up of _____ and _____.
a. Brain and spinal cord
b. Basal ganglia and cerebellum
c. Cranial and spinal nerves
d. Broca and Wernicke’s areas
a. Brain and spinal cord
Karoline, a freshman at UNC-Asheville, struggles with understanding assigned readings for her Humanities courses. Her professors note that she is a hard-working student and that she does well with creative projects. However, she struggles to keep up in class discussions about the readings and she often receives failing grades on reading quizzes. What area of language does Karoline struggle with the most?
a. Semantics
b. Pragmatics
c. Syntax
d. Morphology
a. Semantics
Which of the following is a compensatory strategy for bolus movement to the pharynx?
a. Tongue pumping
b. Chewing food more than typical
c. Lifting of the head to increase gravitational assistance
d. Opening of the mouth
a. Tongue pumping
3-year old Samantha knows that to turn the TV on at home, she needs to press the button in the top right corner of the remote. While at her grandmother’s house, she tries to turn on the TV with the remote as she would at home. The TV does not turn on, so she tries pressing it again several times before giving up. Which cognitive function most closely aligns with Samantha’s decision to stop trying the button?
a. Reasoning
b. Remembering
c. Understanding
d. Perceiving
a. Reasoning
Jason has a spinal cord injury. His symptoms include muscle atrophy, fasciculations, decreased reflexes and flaccid paralysis. Which one of the following structures is most likely to be damaged?
a. Upper motor neuron damage
b. Lower motor neuron damage
c. Neither
d. Both
b. Lower motor neuron damage
Auditory comprehension of language begins with the cochlea to the cochlear nuclear complex via which cranial nerve?
a. VII
b. V
c. VIII
d. IV
c. VIII
How is the hypothalamus involved in swallowing?
a. Innervation of chewing muscles
b. Regulation of hunger and thirst cues
c. Regulation of sleep-wake cycle
d. Processes sensory information from the pharynx
b. Regulation of hunger and thirst cues
Kelly is preparing for a class presentation. She tracks deadlines using a planner, writes key points on note cards, and sets reminders on her phone to stay organized. Which memory strategy is Kelly primarily relying on?
a. Internal memory strategies
b. Visualization techniques
c. Repetition
d. External memory strategies
d. External memory strategies