Lecture 1 and 2

Question 1

Where is the primary motor cortex located?

Answer 1

Precentral gyrus in the frontal lobe.

Question 2

How is the primary motor cortex organized?

Answer 2

Somototopically

Question 3

Explain somototopic organization - think homunculus.

Answer 3

The bottom of the frontal lobe sends signals to the head and neck, and the upper portion sends signals to the lower body. More frontal lobe real estate is dedicated to our lips, tongue, and hands.

Question 4

Where is the somotosensory cortex located?

What is the function?

Answer 4

Postcentral gyrus

Primary receptor of general body sensations

Question 5

Name the 4 subcortical structures.

Answer 5

1) Diencephalon
2) Basal Ganglia
3) Substantia Nigra
4) Subthalamic Nucleus

Question 6

Subcortical Structures:

What 4 structures does the Diencephalon include?

Answer 6

1) Thalamus
2) Hypothalamus
3) Epithalamus
4) Subthalamus

Question 7

Where is the cerebellum located?

Answer 7

Rear of the brain, below the cerebrum

Question 8

With what is the cerebellum involved?

Answer 8

Coordination

Question 9

Where is the brainstem located?

Answer 9

Between the subcortical structures and the spinal cord

Question 10

What does the brainstem consist of?

Answer 10

Midbrain, pons, and medulla

Question 11

Where do upper motor neurons originate and terminate?

Answer 11

They originate in the cortex and terminate/synapse on lower motor neurons in either the brainstem (corticobulbar tract) or spinal cord (corticospinal tract)

Question 12

Where do lower motor neurons originate and terminate?

Answer 12

Originate in the brainstem or spinal cord and terminate on the muscles they innervate

Question 13

Muscles of the limbs only receive what type of innervation?

Answer 13

Unilateral, contralateral

Question 14

Most muscles of the head and neck receive what type of innervation?

Answer 14

Bilateral

Question 15

1)There are two pathways that a nerve signal must travel to reach a muscle - what are they?

Answer 15

1) The first is the lower motor neuron pathway and the 2nd is the upper motor neuron
2)

Question 16

What makes up the pyramidal system and for what is the pyramidal system responsible?

Answer 16

• Corticospinal and corticobulbar tracts

- Responsible for voluntary movement

Question 17

Where does the corticospinal tract originate?
Where does it cross over?
Where does it terminate?

Answer 17

• Begins in the cerebral cortex at different levels of the spinal cord. (Most axons originate in the primary motor cortex.)
• decussates at the pyramids of the lower medulla
• Terminates in the spinal cord at the level of the individual spinal nerves.

Question 18

Where does the corticobulbar tract originate?
Where does it cross over?
Where does it terminate?

Answer 18

• Begins in the cerebral cortex
• decussates at the level of the cranial nerve nuclei they innervate
• Terminates at the cranial nerve nuclei located at different levels of the brainstem

Question 19

For what is the frontal lobe responsible?

Answer 19

Motor planning

Question 20

What is motor planning?

What area is involved in motor planning?

Answer 20

• Formulating a plan by specifying motor goals. Not muscle specific.
• Supplementary motor areas

Question 21

Do the control circuits synapse directly on the lower motor neurons?

Answer 21

No

Question 22

Control circuits have what function?

Do they project to the LMN?

Answer 22

Integrate or help control diverse activities of the structures and pathways involved in motor performance.
No

Question 23

What are the 5 types of dyskonesias?

Answer 23

1) Tremor
2) Chorea
3) Athetosis
4) Dystonia
5) Myoclonus

Question 24

The term _____ is usually associated with extrapyramidal damage but may be used to describe movement disorders from other causes

Answer 24

Dyskinesia

Question 25

Name the lobes of the cerebellum.

Answer 25

Anterior, posterior, and flocculondular.

Question 26

The cerebellum has significantly more efferent or afferent pathways?

Answer 26

Afferent

Question 27

What is the main function of the cerebellum?

Answer 27

- Coordination of different muscle groups and balance. | - Also plays a role in motor programming, maintenance of muscle tone, and motor learning.

Question 28

Explain the cerebellum's use of feedforward and sensory feedback.

Answer 28

Feedforward - a motor plan is made regarding volitional movement from the muscles, tendons and joints. That plan is sent to motor programming. Sensory feedback - The motor program makes its muscle plan based on sensory feedback and sends an efferent copy back to the motor plan. The motor plan then makes adjustments.

Question 29

Cerebellar damage can cause _____ which is a lack of coordination of volunteer motor acts; the rate, range, timing, direction, and force of movement may be affected.

Answer 29

Ataxia

Question 30

Define dysarthria.

Answer 30

A collective name for a group of neurologic speech disorders. Abnormalities include strength, speed, range, steadiness, tone or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production.

Question 31

Define apraxia.

Answer 31

A neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech..

Question 32

True or false? Motor Speech Disorders (MSDs) don't tend to be closely associated with damage to specific regions/systems within the nervous system.

Answer 32

False

Question 33

Name the lesion locus for the following dysarthrias: a. Flaccid b. Spastic c. Ataxic d. Hypokinetic e. Hyperkinetic f. Unilateral Upper Motor Damage g. Mixed

Answer 33

a. LMN b. UMN (bilateral) c. Cerebellum (control circuit) d. Basal ganglia e. Basal ganglia f. UMN (unilateral) g. Two or more of the above

Question 34

The current classification system for MSDs comes from studies done at the ____ clinic in the 1960s and are based on _____-______ analysis.

Answer 34

Mayo | Auditory-perceptual

Question 35

Parkinson's always results in what type of MSD?

Answer 35

hypokinetic dysarthria

Question 36

True or false? | Degenerative disease can cause any type of dysarthria.

Answer 36

true

Question 37

True or false? | TBI can cause any type of dysarthria.

Answer 37

true

Question 38

Diseases of the neuromuscular junction can result only in which condition?

Answer 38

flaccid dysarthria

Question 39

During an OME, if a patient exhibits atrophy and fasciculations, to which MSD might this point? Hypotonia and are observed as well.

Answer 39

Flaccid dysarthria

Question 40

During an OME, if a patient exhibits pathologic oral reflexes, hyperactive gag, and psuedobulbar affect (uncontrollable laughter or crying but don't feel happy or sad), to which MSD might this point?

Answer 40

Spastic dysarthria

Question 41

During an OME, if a patient has normal findings, nothing uncommon, but the jaw, face, and lingual movements are dysmetric (undershooting or overshooting their target) - which MSD would this indicate?

Answer 41

Ataxic dysarthria

Question 42

During an OME, if a patient has masked like face, orofacial tremulousness and reduced ROM on nonspeech AMRs would indicate which MSD?

Answer 42

Hypokinetic dysarthria

Question 43

During an OME, if a patient has quick or slow, patterned or unpatterned involuntary movements at rest, during sustained postures, AMRs would indicate which MSD?

Answer 43

Hyperkinetic dysarthria

Question 44

During an OME, if a patient has unilateral facial weakness or unilateral lingual weakness without atrophy or fasciculation would indicate which MSD?

Answer 44

UUMN dysarthria

Question 45

A patient's speech is characterized by phonatory and resonatory abnormalities. Also exhibits continuous breathiness, diplophonia, audible inspiration, short phrases. Possible hypernasality. Which MSD?

Answer 45

Flaccid dysarthria

Question 46

A patient's speech is characterized by slow speech rate and steady AMRs and strained vocal quality. Which MSD?

Answer 46

Spastic dysarthria

Question 47

A patient's speech is characterized by irregular artic breakdowns during connected speech, irregular AMRs and dysprosody.

Answer 47

Ataxic dysarthria

Question 48

A patient's speech is characterized by monopitch, monoloudness, reduced loudness and stress, a tendency towards a rapid rate and rapid and blurred AMRs are characteristic.

Answer 48

Hypokinetic dysarthria

Question 49

A patient's speech is characterized by mildness and somewhat nebulous abnormalities. Tendency for speech AMRs to be regular while some irregularity during connected speech

Answer 49

UUMN

Question 50

Compensatory or restorative approach? | Trying to improve the physiology supporting speech

Answer 50

Restorative

Question 51

Compensatory or restorative approach? | Use of internal strategies such as speaking louder, or external strategies like AAC.

Answer 51

Compensatory

Question 52

When deciding whether or not someone is a candidate for a type of therapy include (6)?

Answer 52

1) medical prognosis 2) impairment and disability 3) environment and communication partners 4) motivation and needs 5) co-occurring 6) impairments/conditions healthcare system

Question 53

What does treatment focus on?

Answer 53

intelligibility, efficiency, naturalness of speech, or any combination of these.

Question 54

True or false? | Treatment should first focuses on what is quickest to fix and what will be most meaningful.

Answer 54

True

Question 55

Approaches that use speech tasks or indirect non-speech like strengthening exercises or posture would be a compensatory or restorative approach?

Answer 55

Restorative

Question 56

Making maximum use of residual physiological support would be a compensatory or restorative approach?

Answer 56

compensatory

Question 57

true or false? | most treatment is focused on compensated intelligibility.

Answer 57

true