Nanat and Nphys 500

The physiology of speech.

Elements of PNS anatomy.

How the peripheral nervous system functions in speech production.

The cause of neurologically-based motor speech disorders.

None of the above.

The spinal nerves affected originate in the lumbar region.

It is likely that the problem lies in the Central Nervous System.

That damage is in the left cerebral hemisphere due to the principle of contralateral innervation.

It is the nerves controlling movement of structures on the rear side of the larynx that are affected

All of the above.

a. Her vocal folds are paralyzed.

b. She has laryngeal carcinoma.

c. She will have difficulty with voiced vs. voiceless consonant sound production.

Both answers a and c

None of the above

An afferent impulse

An abducted impulse

An adducted impulse

An efferent impulse

Part of a "sensory response feedback loop"

Is composed of the brain and spinal cord.

Includes the brain, spinal cord, and the cranial and spinal nerves.

Contains the Peripheral Nervous System as a subcomponent.

Is made up of 31 cranial and 12 spinal nerves.

None of the above.

The basal ganglia

The cranial nerves

The cerebellum

The spinal cord

The reticular formation

Lateralization.

Functional redundancy.

Hemispheric dominance.

Contralateral innervation

Localization

May or may not be dominant for processing of language tasks

Is almost never the dominant hemisphere for language comprehension and expression.

Is always dominant for speech and language related processing tasks.

Has no function in processing language.

None of the above

a. She may well be malingering since a blow to that part of the brain would be more likely to cause problems with comprehension of language rather than with speech.

b. It is likely that Wernicke’s area has been damaged and you recommend a CT scan to confirm your diagnosis.

c. Diffuse damage to the parietal lobe is indicated.

d. You suspect Broca’s area may have sustained damage as a direct result of the impact.

e. Both answers b and c.

Delineates the left are right cerebral hemispheres.

Defines the upper border of the temporal lobe.

Demarcates the occipital lobe.

Separates the frontal lobe from the parietal lobe

Separates the brain stem from the cerebellum.

Is located in the left temporal lobe.

Is associated with coordination of speech movements

Perceives and integrates perceptual information.

In involved in comprehension of both oral and written language and in calculation for mathematics.

None of the above

a. Occipital lobe

b. Parietal lobe.

c. Frontal lobe.

d. Temporal lobe

e. Both b and c.

Connect corresponding areas in left and right hemispheres.

Connect the spinal cord and brain stem with cortical sensory and motor areas.

Connect cranial and spinal nerves.

Connect areas within a hemisphere

Connect the central and peripheral nervous systems.

Cranial nerves

Dendrite clusters

Spinal nerves

Axon bundles

Projection fibers

a. Directly controls speech, voice and fluency due to its function in regulating the motor cortex and Broca's area

b. Is composed of 31 spinal and 12 cranial nerves

c. Is subdivided into "sympathetic' and "parasympathetic" branches

all of the above

both answers a and c

a. Is efferent, sending motor information from the Central Nervous System to the muscles

b. Conducts sensory information to the Central Nervous System from the muscles.

c. Is an afferent root.

d. Directly controls the laryngeal muscles and is essential to
the regulation of phonation.

e. Answers b, c and d.

a. The ability to produce labial and lingual consonants and vowels.

b. Overall speech intelligibility.

c. Control of laryngeal musculature and phonation.

d. All the above.

e. Both answers a and b.

Awareness of articulatory mistakes with attempts at self-correction.

No muscular weakness or paralysis.

Inconsistent speech errors.

Weakness in the speech and/or respiratory musculature

All of the above

Spastic dysarthria.

Flaccid dysarthria.

Developmental apraxia.

Hypokinetic dysarthria.

Apraxia of speech.

Hypotonia of affected muscles.

Breathy, harsh voice quality, impaired breath support with reduction in phonation time and difficulty in initiating speech.

Compensatory alterations of prosody.

Slowing of speech rate with an abnormal evenness in stress and spacing of syllables and words in order to avoid or prevent articulatory errors.

Visible and audible groping to achieve correct articulatory postures and sequences of postures needed to produce sounds and words.

a. Compensatory alterations of prosody.

b. Visible and audible groping to achieve correct
articulatory postures and sequences of postures needed to
produce sounds and words.

c. Slowing of speech rate with an abnormal evenness in stress and spacing of syllables and words in order to avoid or prevent articulatory errors.

All of the above

Answers a and c only.

Perceptual assessments assess the individual motor subsystems of the speech mechanism and define the underlying speech motor pathophysiology enabling development of optimal treatment programs.

Perceptual assessments highlight and quantify aspects of the speech signal that contribute to the perception of deviant speech.

Perceptual assessments provide objective documentation of the effects of treatment.

Perceptual assessments are readily available and do not require expensive equipment to implement

Perceptual assessments provide a three-dimensional display of voice frequency and amplitude as a function of time.

Spectrographic instrumentation is less expensive.

Oscilloscopic displays show only amplitude as a function of time while spectrographic displays show both frequency and amplitude

Spectrographic displays are more easily interpreted.

Data from spectrographic displays are objective while that from oscilloscopic displays are subjective.

All of the above

a. Improved objectivity of measurement.

b. Greater power for determining and measuring the specific affected subsystems of the speech motor system.

c. The relative inexpensiveness of equipment needed to implement physiological assessment methods.

Answers a and b only

Answers b and c only

To accurately measure the specific affected subsystems of the speech motor system.

To improve intelligibility

To begin treatment as early as possible.

To motivate the client.

To allow a period of mutism in the early recovery period.

The client’s gender.

The type of medical insurance the client has.

The patient’s cognitive, perceptual, and motor ability level

How long its been since the precipitating event.

Preexisting bilingual background.

Compensatory approach.

Pragmatic approach.

Biofeedback/instrumental approach.

Surgical and prosthetic approaches.

Behavioral approach.

a. Ethnicity

b. Diabetes

c. Hypertension

all of the above

answers b and c only

a. Reference to a stroke in the right cerebral hemisphere.

b. A notation that the client has “hemiparesis.”

c. A neurologist’s report detailing “thromboembolic stroke involving the left middle cerebral artery.

All of the above

Answers b and c only.

When damaged, is commonly associated with aphasia.

Appears to be involved in language processing and function to a greater extent than was previously thought

Is the dominant hemisphere for language processing and function.

Is the nondominant cerebral hemisphere.

Has a subservient role and cognition and language processing compared to the left hemisphere.

a. Problems in articulation and motor programming.

b. Speech that is slow and labored.

c. Abnormalities in normal speech flow and intonation.

all of the above

Answers a and c only

a. Broca’s aphasia.

b. Transcortical motor aphasia.

c. Wernicke’s aphasia.

Both b and c

None of the above

People with Broca’s aphasia have normal prosody and speech with relatively good language comprehension unlike transcortical motor aphasia.

Those with transcortical motor aphasia have better speech imitation skills than those of people with Broca’s aphasia but otherwise display similar symptoms

All language and speech functions are affected in transcortical motor aphasia, which is the most severe form of aphasia, unlike Broca’s aphasia which is the mildest
form.

Transcortical motor aphasia is characterized by word-finding difficulties (anomia) and fair to good language comprehension, while those with Broca’s aphasia display fluent but meaningless speech, impaired comprehension, and jargon.

None of the above

Occipital lobe dysfunction.

Damage or dysfunction in Broca’s area.

Motor speech disorders.

Disorders caused by traumatic injury to the Motor Cortex.

Damage or dysfunction in Wernicke’s area

Result from bursting of arterial walls due to high blood pressure or loss of elasticity due to aging.

Cause fluent aphasias while embolic strokes cause nonfluent types.

Are the result of plaque buildup which restricts vessels and produces clots that block them entirely, cutting off blood to the area served

Are caused by rupture of sacular aneurysms which are blisterlike balloonings of arteries occurring at vessel branch points.

Are more common than any other type.

a. Major problems for the nonaphasic spouse include lack of time alone, money, and dealing with the spouse’s dependency.

b. Communication difficulties are the most important problem other family members are likely to experience.

c. The nonaphasic spouse often begins to exhibit more concrete thinking, lose initiative, and becomes less inhibited.

All of the above

Answers b and c only.

Conduction aphasia.

Global aphasia

Transcortical motor aphasia.

Broca’s aphasia.

Anomic aphasia.

Determine if clinical intervention is feasible

Identify preexisting conditions that may have brought on the stroke.

Determine the type of aphasia.

Ascertain the likely period of spontaneous recovery.

Measure the severity of the condition.

Are in-depth evaluations employing a variety of formal assessment measures.

Are less structured and reliant on bedside observations of the patient

Rely on a combination of informal and formal tests of language ability.

Are more likely to be valid measures than those made several months post-stroke.

Are not recommended.

Promoting Aphasic Communication Effectiveness

Copying and Recalling Therapy.

Complexity Account of Treatment Efficacy.

Melodic Intonation Therapy.

Visual Action Therapy.

a. Both short and long-term memory must be impaired.

b. Cognitive impairments affecting abstract thought, judgment, and executive function should be present.

c. The patient displays symptoms of aphasia, apraxia, or agnosia.

All the above.

Answers a and c only.

Effortful articulation, telegraphic speech, impaired prosody, apraxia of speech

All language and speech functions affected, verbal stereotypes, severe deficits in comprehension and production, most severe form of aphasia.

Word-finding difficulties (anomia), fair to good language comprehension.

Difficulty imitating modeled speech, normal prosody and speech, relatively good comprehension.

Fluent but meaningless speech, impaired comprehension, jargon, word-finding difficulty (anomia) good articulation and intonation.