CD225 Exam 4 Study Guide Chapters 10,11,12
What are the Major Brain Structures Involved?
o Frontal lobe
o Direct activation pathway: pyramidal tract
o Indirect activation pathway: extrapyramidal tract
o Upper neuron system
o Basal ganglia
Dysarthria affects motor movements in what way?
o Speech, range, strength, timing
How are Dysarthria’s differentiated?
o In the way they differ with respiration, phonation, resonance, articulation, prosody
What are the 6 Dysarthria’s?
o Flaccid, spastic, ataxic, hypokinetic, hyperkinetic
o Weak and reduced tone
What type of dysarthria is present in ALS?
o Mixed: spastic and flaccid
o A nervous system disorder that causes rhythmic shaking
o Involuntary muscle contractions that cause repetitive or twisting movements.
o Slow hyperkinesia
Chorea o Think “dancing”
o Rapid and unpredictable movements
Apraxia of Speech is…
o Neurological speech disorder that impair the ability to plan or program the sensory and motor command
needed for speech production
A major etiology of motor speech disorders is….
What are the major areas of assessment of motor speech disorders? (5)
o respiration, phonation, resonance, articulation, prosody
What areas must be addressed in treatment?
Give an example goal for each of the following areas:
o Respiration: the patient will “let the air out slowly” without cues during conversational speech.
o Phonation: patient will sustain phonation of vowel for ___ second at highest/lowest pitch
o Resonance: patient will decrease nasal emission on phrases with visual feedback provided by a mirror held
under the nose
o Articulation: patient will maintain tongue placement between lips
o Prosody: patient will be able to discriminate fast rate from appropriate rate from tape recorded samples.
Disorders of Swallowing
o The disorder of swallowing
o Can occurs at any point during the passage of the bolus through the oral, pharyngeal, and esophageal structures to
List and Describe the 4 Phases of Swallowing
o One: anticipatory
Includes: salivating, cues that are preparing you to want to eat
People with neurological disorder may not get these cues o Two: oral
Position the bolus in the mouth
The tongue is the oral transporter: moves back into the mouth, swallow reflex is triggered
o Three: pharyngeal
Velum stops the bolus from entering the nasal cavity
A pressure vacuum is created
The hyoid bone (Adam’s apple) pushes up
o Four: esophageal
Muscles of the esophagus move the bolus downward (Peristaltic contractions)
Think about how a snake eats a mouse whole, this is what your esophagus does
Give examples of how the Oral, Pharyngeal, and Esophageal phases of swallowing can be impaired?
o Oral: poor lips seal, may have some spillage out of mouth
Reduced tongue function, reduced salivating, difficulty chewing
o Pharyngeal: aspiration
Open velopharyngeal allows food to enter the nasal cavity
Insufficient pharyngeal pressure causes trouble with channeling food down esophagus
Incomplete bolus movement
Residue can cause infection, think about the bacteria
___% over 55 experience swallowing difficulty
List causes of dysphagia in adults
o Stroke, cancer of the mouth or throat or larynx, HIVS/AIDS, multiple sclerosis, ALS, Parkinson’s disease, Spinal
Cord injury, dementia, mediciation and nonfood substances
Primary indication of dysphagia in infants is ________
Silent Aspiration is… what are signs and symptoms? o Client is aspirating but cannot cough to get eh bolus up because there is a decreased sensation and client cannot feel
that there is bolus there
o Signs and symptoms: Gurgling,
Three areas of concern that might result in referral:
o Observed difficulties during eating or drinking
o Client appears to be at risk for aspiration
o Client appears to not be receiving adequate nourishment
What is examined in an Oral-Motor Examination?
o Look at the hand out we got
o Tongue movement, jaw movement, lip movement
What is observed in a laryngeal exam?
o The vocal quality
Compare and Contrast: Bedside Swallow Evaluation, MBS, FEES
o Bedside Swallow Evaluation: reaction to food or drink, observes movement, records number of swallows, nasal
o MBS: Modified Barium Swallow Study
client is taken to x-ray machine, barium is mixed with food or drink, the SLP watches the x-ray as the
o FEES: Fiberoptic endoscopic evaluation of swallowing
The pole with the light, good for small clinic or nursing home because client doesn’t have to be shipped to
the hospital, the client swallows dyed food
What is Developmental Supportive Care?
o SLP’s way to take care of infant in the NICU
o Focuses on infant cues and environmental modifications
What are some environmental factors that should be considered in the NICU?
o Lighting/Visual Stimulation
o Sound/Auditory Stimulation o Handling/Tactile Stimulation
o Feeding/Oral Stimulation
What is the age of typical gestation for a newborn?
o 37-42 weeks
Compensatory Postures may include:
How can foods be mod