Neurology: Assessing Speech
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Transcript of Neurology: Assessing Speech
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ASSESSMENT OF SPEECH
Georgina GriggDaniel MichalikAmna Ghafoor
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SPEECH & LANGUAGE Speech:
Articulation & pronunciation Physical ability to form words Bulbar muscles
Language: Process by which thoughts & ideas become spoken Semantics Syntax
DYSARTHRIA
DYSPHASIA
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NEUROANATOMY
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ASSESSMENT OF SPEECH & LANGUAGE Simple conversation
Assess throughout history taking
3 main areas to assess Quality: dysarthria, dysphonia Content: expressive function – Broca’s area Understanding: receptive function – Wernicke’s area
Baseline orientation Time, place, person
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WHAT IS DYSPHASIA? Disorder of language
Comprehension Expression
Causes Acute
- CVD- Head injury
Progressive- Space-occupying lesion- Degenerative
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TYPES OF DYSPHASIAFluent (receptive) Non-fluent (expressive)Wernicke’s Broca’sConduction GlobalTrans-cortical sensory Trans-cortical motorNominal
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HOW DO WE TEST FOR IT? Fluency
- Familiar conversation Comprehension
- Command (progressive difficulty) Naming
- Name 3 common objects Repetition
- ‘no ifs ands or buts’ Reading & writing
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DYSPHONIA Inability to produce sounds using the vocal organs – harsh voice
Air expelled through glottis Pressure drop across larynx Vocal fold oscillation
Vocal fold paresis Myasthenia gravis Test:
“cough for me” – tests co-ordinated adduction and abduction of vocal chords
“Say aaaahhhhh” – Requires vocal cord tension
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DYSARTHRIA Motor speech disorder Dysfunction in the muscles needed to produce
speech Chest, neck, jaw, tongue, lips CN V, VII, IX, X, XII
Parkinsonism, Huntington’s, stroke, traumatic brain injury, ataxia
Abnormal rate and stress Slurring of speech
‘m’ ‘p’ ‘t’
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PSEUDOBULBAR & BULBAR PALSY
Bulbar LMN CN X, XI, XII Diminshed gag Tongue fasciculation,
wasting Jaw jerk normal Unilateral – raspy voice Bilateral – nasal speech GBS, Stroke, MND
Pseudobulbar UMN CN V, VII Facial expression,
mastication Bilateral degeneration of
corticobulbar tracts Gag reflex, tongue
spasticity Spastic dysarthria
“Daffy Duck” MS, MND
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THANK YOUQUESTIONS?