Motor Speech

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Systems for speech:: 1. Resonance
2. Articulatory
3. Respiratory
4. Phonatory
5. Prosody
Disorders of speech resulting from neurologic impairment affecting the motor programming (apraxia)or neuromuscular execution (dysarthria)of speech.: Motor Speech Disorder
Thoughts converted to verbal symbols according to language rules -disorders: Aphasia and Dimentia: Cognitive-Linguistic Process
Verbal message organized for muscular execution -Disorders: Apraxia: Motor-Speech Programming
CNS+PNS activity execute speech-motor programs -Disorders: Dysarthria: Neuromuscular Execution
Disorder of neuromuscular Execution -refers to disorder utterance -7 types related to speech: Dysarthria
Impaired production of speech due to disturbances in the muscular control of the speech production mechanism: Dysarthria
A group of speech disorders resulting from disturbances in muscular control over the speech mechanism due to damage of CNS/PNS. It designates the problem in oral communication due to paralysis, weakness or incoordination of the speech musculature, or com: Dysarthria
Dyarthria is:: -neurologic in origin
-due to CNS or PNS damage
-diorder of movement due to abnormal neuromuscular execution
-affects speed, range, strength, timing, accuracy
-affects repira, phon.,reson., artic., prosody
subdivided into diff. toyes each with own lesion
Deficit in the ability to smoothly sequence the speech producing movements of the lips, tongue, and jaw: Apraxia
A neurogenic speech disorder resulting from impairment of the capacity to program sensorimotor commands for the positioning and movement of muscles for the volitional prod. of speech. It can occur w/out sig. weakness or neuromuscular slowness and in the: Apraxia
-common association with stroke and other neurologic disorders -rep. a significant proportion of comm. disorders: Motor Speech Disorders
Methods for studying and categorizing Motor Speech Disorders: 1. Perceptual
2. Acoustic
3. Subjective
4. Physiological
How do they sound? What does it look like?: Perceptual study method
Confirms perceptual. Measure acoustic signal (numeric). Give quantitaive data (Visipitch, CSL) of intensity, rate, frequency: Acoustic study method
? it's reliability ****Gold standard of study: Subjective method of study
Looking at biomechanical activity -measure muscle tone -Quantitative data EMG: Physiological method of study
Characterizing motor speech disorders. Look at:: 1.age of onset: congential or aquired?
2.course
3. site of lesion
4. neurologic diagnosis
5. pathophysiology
6. speech components
7. severity
8. perceptual charac.
Chronic stationary improving progressive degenerative exacerbating remitting: Course of motor speech disorders
weakness rigidity spasticity: Pathophysiology of motor speech disorders
Respiration phonation articulation: Speech components of motor speech disorder
Disease category that declines in function -ALS: Degenerative
Disease catergories: 1. degenerative
2. inflammatory
3. toxic
4. neoplastic
5. traumatic
6. vascular
Disease category that are focal and typically cause and absess (hole): Inflammatory
Disease category that is metabolic -drug toxicity or liver disease: Toxic
Disease category with tumors -astrocytoma: Neoplastic
Disease catorgory with injuries -closed head injury: Traumatic
Disease category with most common cuase of motor speech disorders -CVA,stroke: Vascular
Types of CVA: Bleed:
1. Hemmorhagic-in bleeding
Occlusive:
2. embolic-travelling clot
3. Thrombotic- blood clot formed but grew in place to stop blood flow
Types of disease course:: 1. transient
2. improving
3. progressive
4. exacerbating
5. stationary
Disease course where symptoms resolve completely after onset -i.e. transient ischemic attack: Transient
Disease course where severity is reduced but symptoms aren't resolved -i.e. stroke: Improving
Disease course where symptoms continue to progress or new ones appear -i.e. Parkinson's, ALS: Progressive
Disease course which is remitting, symptoms develop, improve, recur, worsen -i.e. MS: Exacerbating
Disease course where symtpoms remain unchanged after they reach max. severity -i.e. CP: Stationary
Types of disease localizing: 1. Focal
2. Multifocal
3. Diffuse
Type of disease localizing which involves a single area or contiguous group of structures -i.e. one stroke: Focal
Type of disease localizing which involves more than 1 area or group of structures, but not all over -i.e. 2 or 3 strokes: Multifocal
Type of disease localizing which involves roughly symmetric portions of the NS bilatterally -i.e. Diffuse Axonal injury: Diffuse
Symptom development types:: 1. acute- minutes
2. subacute- days
3. chronic- months
One of several major subdivisions of the NS: Motor system
PNS parts:: 12 cranial nerves (exit brain)and 31 spinal nerves (exit spinal cord)
CNS parts: Brain and spinal cord
Nerves:: CNS- called upper motor neurons
PNS- called lower motor neurons
Nerves that project from parts of CNS that are w/in cranium they innervate many organs and muscles of the head, neck, thorax and abdomen: Cranial
Nerves that branch from spinal cord and innervate most of the other muscles of the body including the chest, arms and legs: Spinal
-key component of NS - alomost all aspects/activity of NS originate and are processed here -commands to mucles for vol. motor begin here -recieves sensory info. from body and controls cognitive functions (reasoning, memory, lang., imaginin: Brain
-separated into R/L hemispheres -spe. by longitudinal fissure -4 lobes: Cerebrum
runs from front to back along middle brain: Longitudinal fissure
convolutions of the cerebrum: gyrus
grooves between the gyri: sulcus
4 lobes of the brain:: Frontal
Parietal
Occiptial
Temporal
Most prominant sulcus -runs horiz. along the lateral sides of each hemis. -sep. temporal from frontal: Lateral Sulcus
Sylvian Fissure
Sulcus located near center of lateral side of each hemis. and extends vertically from very top of the hemis. down to the lateral sulcus: Central sulcus
Rolandic Fissure
Gyrus immediately in front of central sulcus -organized according to functional movement: Pre-central Gyrus or
Motor Strip
Gyrus immediately behind the central sulcus: Post-central Gyrus or
Sensory strip (Primary Sensory Cortex)
Figure that reps. what areas are going to be responsible for what areas of the body on the motor strip: Homunculus "HAL"
Nerve cells in pre-central gyrus play an imp. role in controlling ________ ________ of the body: voluntary movements
name for cell bodies -higher cog. levels here (i.e. lang., motor planning, prob. solving): Grey matter
name for neurons: White matter
-surface of cerebrum -2-5mm thick -6 layers of NS cells -"grey" matter -1/3 is visible (rest hidden by sulci) -laid flat 340 sq. in. -1 of most imp. NS parts: Cerebral Cortex
Covering of CNS: Meningies
Minigie types:: Dura mater
Arachnoid membrane (web like)
Pia mater (flush with brain)
name for nerves in the CNS: tracts
name for nerves in the PNS: Nerves
Area of brain that acts as a passage-way for descending + ascending nerual tracts that travel between the cerebrum + Spinal cord -cranial nerves exit the brain here: Brainstem
Brainstem parts:: Midbrain
Pons
Medulla
"grey" matter area running through brain stm which is part of the RAS: Reticular formation
System important for attention, conciousness -damage may lead to coma -send alert to rest of brain (Thalamus decides where it should go): Reticular Activiating System (RAS)
Part of brain that controls certain integrative and reflexive actions such as respiration, conciousness, and some cardiovascular -contains places where cranial nerves project out form the CNS: Brainstem
Convey motor impulses from CNS to muscles of the larynx, face, tongue, pharynx and velum: Cranial Nerves
Points where cranial nerves are attached to brainstem -located w/in brainstem -begin PNS: Cranial Nerve Nuclei
Cranial nerve for: -Somatosensory info for face and head(touch and pain) -muscles for chewing -bilateral UMN inner. -ipsilateral LMN inner. -*sens. + motor comp: V. Trigeminal
Cranial nerve for: - Taste on ANTERIOR 2/3 of tongue -somatosensory info for ear -muscles for facial expression - bilateral UMN: forehead - contralateral UMN: lower face - ipsilateral UMN: forehead/face *sens.+ motor co: VII. Facial
Cranial nerve for: - Taste on POSTERIOR 1/3 of tongue - Somatosensory for tongue, tonsil, pharynx -controls some swallowing muscles -bilateral UMN inner -Ipsilateral LMN inner. -*sens. + motor comp.: IX. Glossopharyngeal
Cranial nerve for: -conrols muscles of larynx and pharynx -bilateral UMN inner -bilat, ipsilat, contra. LMN inner -*sens. + motor comp: x. Vagus
Cranial nerve for: -controls muscles used in head movement (neck and shoulders) -bilateral: XI. Spinal Accessory

*Test: head turn +shrug shoulders w/ and w/out resis.
Cranial nerve for: -Controls tongue muscles -contralateral UMN inner -Ipsilateral LMN inner -*motor comp only: XII. Hypoglossal
Bilateral innervation:: Both L and R sends commands
Ipsilateral innervation:: 1 side only sends commands
Contralateral innervation:: L sends commands to R
R sends to L
Constrictive pushing movement through muscle tube (esophagus) -associated w/ Vagus -snake like: Peristalsis
Area of brain attached to back of brainstem -makes neural connections w/ cerebral cortex and other CNS parts -coor. vol. muscle movements they contract at right time with right force -damage= sig. deficits in performance of both gross and: Cerebellum
When cranial nerves leave pre-central gyrus and are fanned out before they come together: Coronaradiata
When cranial nerves come together around the area of basal ganglia message comes down and lands on cell body and crosses over and shoots out of spinal cord to go to muscle to innervate it (then it is called a nerve): Internal Capsule
Nerves ABOVE the synapse -all the way until it hits the cell body damage= malfunction is on opp. side because it hs not crossed over yet: Upper Motor Neurons
Nerves BELOW the cell body -outside of the spinal cord -damage= malfunction is on same side: Lower Motor Neurons
Neurons that transmit neural impulses that cuase contractions in muscle and therby cause movement -efferent: Motor Neuron
Neurons that carry info. related to sensory stimuli -afferent: Sensory Neuron
Links neurons with other neurons and form conections -role in controlling movement: Interneurons
Transmitting impulses away from CNS: Efferent
Transmitting impulses toward the CNS: Afferent
Usuallu found in coursing bundles in the body -often functionally related to each other: Axons
Bundles of axons in CNS: Tracts
Bundles of axons outside of CNS: Nerves
Types of fibers:: Commisural
Association
Projection
Fibers between hemisphere -ex. corpus collosum: Commisural fibers
Fibers that connect 1 part of a hemis. -ex. arcuite fasciculus: Association fibers
Fibers that travel between higher and lower levels of CNS -ex. cortex to brainstem portion: Projection fibers
Tract from cortex to cranial nerves: Corticobulbar tract
Tract from cortex to reticular activating system in brain stem for activation: Corticoreticular tract
System of voluntary movement: Pyramidal system
PArts of Pyramidal system:: Motor strip
Corona Radiata
Internal capsule
System involved in postural support for skilled volun. movements of pyramidal system -comprised of diff. tracts: corticoreticular corticrubral:maint. of posture/tone Thalmucortical: Extrapyramidal System
System reposnsible for all motor activity involving striated muscle -essential for normal relfexes -maintaining muscle tone/posture -planning initiiation and control of vol. movement: Motor System
Primary motor pathway -brgins in cortex and ends in spine: Corticospinal pathway
Primary Cortex -for hearing: Heschl's Gyrus
Association cortex for interpretting information: Weirnicke's area
Cotex that comprises parts of cerebellum dedicated to analysis of a single type of neural imput -divided into areas for aud., visual, sensory, motor: Primary Cortex
Cortex for : -analyzing tone patterns and sound prop. -localizing sound *uppermost Temporal Lobe: Primary Aud. Cortex
Cortex for: -analysis of depth -integration of eye visual info. -damage=loss of conciousness *most posterior end of occipital: Primary Vicual cortex
Cortex for: -recieves info about body sensations: pressure, temp, touch, pain *on postcentral gyrus: Primary Sensory cortex
Cortex for: -recieves planned motor impulses form the brain and send them down: Primary Motor cortex
Cotexes that make senseof sensory impulses that have been initially analyzed by primary cortex: Association cortex
Association cortex that: -recog. complex visual stimuli -aud. stimuli -formulation of memory: Temporal
Association cortex that: -access to brain sensory areas -recieves emotion info.: Frontal
Association cortex that: -integrating body sensation with visual info.: Parietal
Association cortex that: -recieves visual sensory impulses: Visual
Term for lack of recognition of one's own deficits: Agnosagnosia
Areas which connect association and primary cortexes and take the info and smooth in out: Basal Ganglia and Cerebellum
Structure of brain which is subcortical "grey" matter - 3 structures that make up striatum -contians complex network of neural pathways -recieves neural info from many areas of cortex Much of it's info is sent to thalamus: Basal Ganglia
Black susbstance -just below BG -prod. dopamine-helps w/ proper neuron function -connected to striatum: Substantia Nigra
Brain structure that regulates muscle tone -maintains balance -coor. skilled movements -gives access to info. about body balance, position, posture damage= ataxia: Cerebellum
Brain sturcture located behind BG -doorway through which subcortical systems of NS comm. w/ cerebral cortex -recieves inputs of planned motor movements -practically every sensory impulse from body passes through: Thalamus
UMN damage=: Spasticity-muscles high in tone
"Spastic dysarthria"
LMN damage=: WEakness to muscle paralysis
"flaccid dysarthria"
Place where neural impulses arrives so a muscle contracts to cause a movement -axon of LMN makes a synaptic connection to muscle by releasing acetocholine: Neuromuscular Junction
Final common pathway damage=weakness/paralysis: LMN, cranial nerves in neuromuscular junction
Direct activation pathway: Motor strip, Pyramidal system
Indirect activation pathway: Extrapyramidal
Control circuits: Cerebellum, BG

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