OME

Question 1

why should you use the same OME form for every client? (2)

Answer 1

• to develop a knowledge base of what is typical vs atypical
• most OMEs are not standardized

Question 2

parts of motor speech ax? (7)

Answer 2

1. case history
2. OME and/or CNE
3. ax of intelligibility, comprehensibility, and efficiency
4. perceptual ax
5. instrumental ax (acoustic + physiologic)
6. estimates of functional communication and psychosocial impact
7. dx probes

Question 3

case history components? (2)

Answer 3

1. review of medical records
2. interview pt and family

Question 4

points to cover during interview of pt and family? (6)

Answer 4

1. complaints
2. communication profile
3. timeline/course
4. factors impacting speech (time of day, stress, fatigue…)
5. comp strategies
6. associated deficits (language, cognition, abnormal movements…)

Question 5

T or F: OME/CNE is intended to get info about speech production

Answer 5

false! only structural integrity, severity of physical change/damage, and localization of damage

Question 6

parameters of muscle function to assess? (6)

Answer 6

• muscle strength
• muscle tone
• speed
• steadiness
• range (includes symmetry)
• accuracy

Question 7

how are the upper vs lower facial muscles innervated by CN VII?

Answer 7

• upper: bilateral UMN innervation
• lower: contralateral UMN innervation

Question 8

what happens to the upper vs lower facial muscles if there is an UMN lesion? (2)

Answer 8

• upper: partial spastic paralysis of contralateral side
• lower: spastic paralysis of contralateral side

Question 9

what happens to the upper vs lower facial muscles if there is an LMN lesion? (2)

Answer 9

• upper: flaccid paralysis of ipsilateral side
• lower: flaccid paralysis of ipsilateral side

Question 10

what would happen if you asked someone with unilateral UMN damage vs unilateral LMN damage vs bilateral damage to pucker their lips?

Answer 10

• UMN: lips deviate toward weak side (contralateral to damage)
• LMN: lips deviate to weak side (ipsilateral to damage)
• bilateral: total facial paralysis

Question 11

diseases affecting CN VII? (3)

Answer 11

• bell’s palsy: temp facial paralysis due to trauma to nerve or virus
• acoustic neuroma: tumor at cerebellopontine angle
• lyme disease

Question 12

how are the jaw muscles innervated by CN V for UMN vs LMN? what does damage to each result in?

Answer 12

• UMN: bilateral. damage = open jaw, positive jaw jerk.
• LMN: unilateral and ipsilateral. damage = jaw deviating to weak side on opening + feels asymmetrical during clenching.

Question 13

how are the tongue muscles innervated by CN XII for UMN vs LMN? what does damage to each result in?

Answer 13

• UMN: bilateral (except palatoglossus, which is uni and contralateral). damage = protrusion to weak side (contra to lesion).
• LMN: ipsilateral. uni damage = tongue to weak side (ipsi to lesion). bi damage = bi weakness. atrophy + fasciculations!

Question 14

how are the velum muscles innervated by CN X for UMN vs LMN? what does damage to each result in?

Answer 14

• UMN: bilateral. damage = symmetrically weak soft palate.
• LMN: ipsilateral. uni damage = during phonation deviates to strong side. bi damage = symmetrically weak.

Question 15

larynx (CN X): if cough is weak or breathy this suggests… (3)

Answer 15

VF adductor weakness, poor resp support, or both

Question 16

larynx (CN X): if stridor is heard, this suggests…(1)

Answer 16

VF abductor weakness

Question 17

larynx (CN X): weak cough + sharp glottal coup suggests… (1)

Answer 17

resp weakness

Question 18

larynx (CN X): weak glottal coup + sharp cough or equal coup/cough suggests…

Answer 18

laryngeal weakness (+ resp weakness)

Question 19

fast tremors are associated with… (2)

Answer 19

• brainstem lesion
• ALS

Question 20

slow tremors are associated with… (1)

Answer 20

• cerebellar lesion

Question 21

essential tremors are associated with… (2)

Answer 21

• cerebellar lesion
• indep!

Question 22

how are the VFs innervated by CN X for UMN vs LMN? what does damage to each result in?

Answer 22

• UMN: bilateral. damage = complete VF para.
• LMN: ipsi. uni damage = uni VF para. bi damage = complete VF para.

Question 23

define the following reflexes and which nerve they are associated with:

a) jaw jerk
b) sucking reflex
c) snout reflex

Answer 23

a) tap open jaw, jaw jerks closed: CN V
b) stroke upper lip, lips suck: CN VII
c) tap philtrum, lips pucker: CN VII

Question 24

if reflexes like the jaw jerk, sucking reflex, snout reflex are ABSENT, does this suggest a UMN or LMN lesion?

Answer 24

LMN

Question 25

if reflexes like the jaw jerk, sucking reflex, snout reflex are PRESENT, does this suggest a UMN or LMN lesion?

Answer 25

UMN

Question 26

define oral stereognosis

Answer 26

determining the shape of an object with the tongue

Question 27

what is recommended to use for light-touch discrim measures?

Answer 27

semmes-weinstein monofillaments

Question 28

what is recommended for two-point discrim measures? (2)

Answer 28

- paper clip - disk-criminators

Question 29

which distances are assessed for two-point discrim and where?

Answer 29

- 3mm and 6mm - face, tongue (tip = +sensitivity)

Question 30

T or F: confirmatory signs are not diagnostic of an MSD

Answer 30

true