CD 225 Quiz: Study Guide Exam 4 (Chapters 10,11,12)

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Communicative Disorders
CD 225
Mary Bryan

CD225 Exam 4 Study Guide Chapters 10,11,12 Motor Speech  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 o cerebellum  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  Hypotonia: o Weak and reduced tone  What type of dysarthria is present in ALS? o Mixed: spastic and flaccid  Tremor: o A nervous system disorder that causes rhythmic shaking  Dystonia 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…. o  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? o  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  Define Dysphagia 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 the stomach  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 o Esophageal  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 regurgitation 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 person drinks 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
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