Unit 2 - Quizzes

False

"Fluent" aphasias are characterized by articulatory problems, motor programming deficits, and slow and labored speech that lacks the flow and intonation of normal speech.

Wernicke's aphasia.

"Fluent" aphasias include:

Are typically related to damage in more posterior regions of the brain such as Wernicke's area.

"Fluent" aphasias:

True

*Adduction* of the vocal folds is necessary in order to produce phonation.

True

*Fissure of Rolando* separates the frontal lobe from the parietal lobe.

Reference to a localized stroke in the right cerebral hemisphere.

A 54-year-old male client is referred to you for speech and language assessment. He was previously hospitalized after a sudden onset of complete right-side paralysis and loss of speech. As you read the client's file, you would be surprised to see:

Weakness in the speech and/or respiratory musculature.

A client who has flaccid dysarthria is likely to display:

Hypokinetic dysarthria

A condition frequently associated with Parkinson's Disease is:

An efferent impulse.

A neural impulse that travels from the motor cortex of the brain to activate muscle fibers used in speech is:

False

A neural impulse traveling from sensory receptors in the skin toward the spinal cord would be classed as an *"efferent"* impulse.

True

A part of treatment for neurogenic speech disorders is learning to produce what were once automatic motor responses as specific, purposeful behaviors.

The Glossopharygeal nerve (IX).

A patient is referred to you for a voice evaluation. When the patient speaks, you observe significant hypernasality which the patient says is a recent problem. The patient complains that food is "tasteless." Upon probing, you find the patient displays a reduced gag reflex. These symptoms cause you to suspect damage or dysfunction of:

True

A patient with hypokinetic dysarthria is likely to display slow movements and limited range of motion with general muscular rigidity.

Focus on establishing a form of communication aside from speech.

A period of mutism is common during the acute recovery phase of motor speech disorders. During this period, rehabilitation most likely will:

False

A person is said to have "dementia" if any of the following conditions exist: memory impairment, cognitive impairment, problems in processing language, producing speech, or recognizing objects.

Contralateral innervation.

A person with damage to the left brain hemisphere may suffer right side, unilateral vocal fold dysfunction. This illustrates the principle of:

True

A textbook diagram showing the component parts of the laryngeal system is one way of describing the system's *anatomy.*

Greater objectivity of data.

Advantage(s) of acoustic assessment of motor speech disorders compared to perceptual assessment include:

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

After a car accident in which she sustained a significant blow to the left, frontal area of her head, an adult patient complains of problems producing speech sounds accurately.

False

After a stroke causes a neurogenic speech disorder, it is essential to wait for the central nervous system to recover physiologically before beginning rehabilitation.

Patient variability over time and across settings greatly complicates maintaining adequate intra- and interrater reliability making observation results difficult to standardize.

Although perceptual assessment of dysarthric speech has been the "gold standard" and preferred assessment method, it has significant disadvantages including:

True

Among other functions, the parietal lobe perceives and integrates perceptual information.

Apraxia of speech.

An adult client is referred to you for a speech evaluation. You observe no significant evidence of slowness, weakness, incoordination or alteration of tone in the speech musculature. In connected speech the client inconsistently substitutes one phoneme for another, adds unnecessary phonemes, or repeats phonemes inappropriately. These symptoms are consistent with:

Flaccid dysarthria.

An adult patient is referred to you for a speech evaluation. Prior to the assessment you read the neurologist's report in which it is stated, "The client displays bilateral damage affecting lower motor neurons." This immediately suggests a need for your assessment to rule out or confirm the presence of:

The paralysis is likely to prevent the client from opening the folds which will impact production of voiceless sounds if the folds are paralyzed in the closed position.

An otolaryngologist tells you that a client being referred to you cannot *abduct* her vocal folds. This means:

True

Aphasia does not generally produce basic personality changes, rather, the disorder tends to emphasize aspects of the person's preexisting cognitive and social style.

True

Aphasias are classified based on locus of damage with nonfluent aphasias located in relatively anterior portions of the brain compared to loci of fluent aphasias.

False

Apraxia of speech is a group of speech disorders that are directly related to paralysis or weakness of speech musculature.

True

Areas of the frontal lobe of the brain are involved in *activating and controlling fine motor movements.*

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

As you read the neurologist's report on a geriatric patient referred to you for voice problems associated with unilateral, right side vocal fold paralysis, you come across the phrase "PET scan results suggest dysfunction of spinal nerves innervating the dorsal side of the larynx." This statement directly indicates:

True

Assessment for swallowing disorders (dysphagia) is the responsibility of the speech/language pathologist, and it should not be assumed that other specialists will necessarily conduct such assessment adequately.

Employing compensatory strategies.

Assisting a stroke patient with a neurogenic motor speech disorder to use his or her remaining strengths to develop alternative communicative methods is an example of:

Connect areas within a hemisphere.

Association fibers act to:

True

Because of *"contralateral innervation,"* muscles on the left side of the vocal folds are controlled by centers on the right side of the brain.

False

Because physiological assessment is both easier and less expensive to employ, it is preferred to perceptual assessment of motor speech disorders.

Association fibers Projection fibers Commissural fibers

Brain functions are integrated and areas of the brain are interconnected by:

False

Broca's aphasia, transcortical motor aphasia, and global aphasia are "fluent" aphasias.

True

Characteristics generally associated with nonfluent aphasias include effortful articulation, telegraphic speech, impaired prosody, and apraxia of speech.

Self-monitoring of behaviors and behavioral changes.

Children with neurogenic motor speech disorders are likely to have more difficulty than adults with:

The parietal lobe.

Closely associated with perception and integration of perceptual information such as touch, temperature, pressure, and involved in comprehension of oral and written language and calculation for mathematics, as well.

False

Commissural fibers connect areas *within* a hemisphere.

False

Common symptoms of Wernicke's aphasia include effortful articulation, telegraphic speech, impaired prosody, and apraxia of speech.

False

Compensatory alterations of prosody including pauses, slow speech rate and inappropriate equalization of stress are primary characteristics of apraxia of speech.

True

Damage or dysfunction of cranial nerve VIII can produce vertigo, dysequilibrium, nystagmus, and hearing loss.

Phonation

Damage or dysfunction to the Vagus nerves (X) will most significantly impact:

True

Dendrites differ from axons in that they are *afferent* extensions of neurons.

False

Diabetes and hypertension are uncontrollable risk factors linked to strokes which often cause adult aphasia.

True

If cortical brain damage results in motor impairment, observed paralysis will occur on the side of the body opposite the cerebral hemisphere in which the damage is located.

The patient displays symptoms of aphasia, apraxia, or agnosia. Significant deficits in long-term memory typically are apparent. Short-term memory is impaired. Cognitive impairments affecting abstract thought, judgment, and executive function should be present.

In order to meet the American Psychiatric Association's definition of "dementia:"

Analysis of muscle movements within the speech mechanism and instrumental assessment of individual motor subsystems of the speech mechanism.

Information provided by physiological assessment that is not provided by either perceptual or acoustic assessment of motor speech disorders includes:

Broca's area

Is associated with *coordination of speech movements.*

True

Language comprehension is associated with *Wernicke's area.*

The complexity of the vascular network supplying the brain provides alternate routes to supply the cortex with blood.

Localized rather than general damage to the brain usually occurs in the stroke process because:

True

Nonverbal aspects of cognition, visuospatial problem solving and artistic and creative mental activities are cognitive functions to which right cerebral hemispheric function is important.

True

One initial goal of evaluation in cases of aphasia is to determine if clinical intervention is feasible since some aphasic persons are not appropriate candidates for rehabilitation.

True

Oscillographic displays differ from spectrographic displays of acoustic data in that they are two dimensional, displaying wave amplitude as a function of time.

True

Paraphasias involve word substitutions which may be sound-based (phonemic) or meaning-based (verbal).

Language processing is largely localized in the left cerebral hemisphere.

People who experience damage to the right cerebral hemisphere usually escape having aphasia. This suggests:

False

People with aphasia often experience "catastrophic" reactions to frustration and this is especially true of those with severe global aphasia who are acutely aware of their limitations.

False

Perceptual assessment of dysarthric speech is based on a comprehensive assessment of the functioning of the subsystems of the speech production mechanism using a variety of instrumentation.

True

Perceptual assessments have a number of inherent inadequacies that limit their value in diagnosis and in determining treatment priorities.

Axon bundles

Peripheral Nervous System nerves are composed of:

Improved objectivity combined with greater capacity for measuring specific affected subsystem of the speech motor system.

Potential advantage(s) of physiological assessment in comparison with perceptual assessment for motor speech disorders include:

The expense and complexity of instrumentation required to implement it.

Potential disadvantage(s) of physiological assessment in comparison with perceptual assessment for motor speech disorders include:

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

Primary features of apraxia of speech include:

Frequent off-target production of speech sounds. Variable articulatory errors. Visible groping to achieve correct articulatory postures. Audible fumbling when attempting to produce intelligible speech.

Primary symptom(s) that characterize apraxia of speech include:

False

Projection fibers connect the spinal cord and brain stem with cortical sensory and motor areas.

True

Prosodic abnormalities are secondary characteristics of apraxia of speech thought to be compensatory attempts to avoid articulatory errors.

False

Prosodic errors constitute the primary features of apraxia of speech while slow movements and limited range of motion with general muscular rigidity are frequently observed secondary characteristics.

Rely on cortical reorganization or recruitment of the undamaged hemisphere to recover some previous skills.

Restorative treatment approaches for aphasia:

True

Strokes tend to produce localized rather than general damage to the brain because the complexity of the vascular network supplies the cortex with blood through a variety of alternative routes.

True

Surgical treatment procedures for motor speech disorders such a Teflon injections, laser surgery, and pharyngeal flap surgery are primarily employed only in cases of severe disability that are unresponsive to other forms of treatment.

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

Symptom(s) consistent with the presence of Broca's aphasia include:

Variable disturbances of basic motor process that underlie speech including respiration, phonation, and resonation.

Symptom(s) that differentiate dysarthrias from apraxia of speech include:

Judgments of overall speech intelligibility based on review of conversational samples.

Technique(s) employed in perceptual assessment of dysarthric speech include:

True

The "Sympathetic" branch of the Autonomic Nervous System arouses body processes to handle emergencies or threats.

True

The "behavioral approach" that teaches patients new skills or compensatory techniques by providing models for the client to imitate is the technique most widely employed in clinical treatment of motor speech disorders.

Acts as an antagonist to the sympathetic branch, relaxing and calming body processes and muscular arousal.

The "parasympathetic" branch of the Autonomic Nervous System:

right and left halves

The *sagittal* plane divides structures into:

False

The Central Nervous System includes the cranial and spinal nerves.

False

The left cerebral hemisphere is dominant for all language functions.

True

The longitudinal fissure defines the upper border of the temporal lobe.

Behavioral approach.

The most widely used treatment approach(es) for neurogenic motor speech disorders is (are):

False

The primary goal of therapy for motor speech disorders in the acute period of recovery involves development of self-monitoring skills to increase articulatory precision.

True

The right cerebral hemisphere may perform some types of language processing tasks better than the left hemisphere, and, for most people, may be dominant for such tasks.

True

The right cerebral hemisphere of the brain is involved in some aspects of language processing and function.

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

The right cerebral hemisphere:

True

The sole job of the Peripheral Nervous System is to carry sensory information to the Central Nervous System.

False

The spinal nerves affect speech directly through their connections to the facial and laryngeal muscles.

Are composed of 31 pairs. May have an indirect effect on speech production. Serve both afferent and efferent functions.

The spinal nerves:

Medulla Oblongata

The structure in the brain stem most directly involved in *regulation of breathing is:*

True

The term "thromboembolic stroke" is sometimes used instead of the specific terms "thrombotic" and "embolic" stroke, since the basic processes in the two types are the same.

False

The terms "hemiplegia" and "hemiparesis" are synonymous and are generally used interchangeably.

False

The terms anatomy and physiology can be used interchangeably since their meanings are similar.

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

The ventral root of spinal nerves:

During the initial two months after a stroke.

There are differing views about just how long the period of spontaneous recovery continues after a stroke and a variety of factors can influence the process. It is generally agreed, however, that MOST changes due to spontaneous recovery will occur:

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

Thrombotic strokes:

True

Through its actions that arouse or relax the body's musculature, the Autonomic Nervous System indirectly affects speech, fluency, and voice.

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

Transcortical motor aphasia differs from Broca's aphasia in that:

False

Two of the three body planes are the "cranial" and "caudal" planes.

False

Typical symptoms of agrammatism include word-finding problems during which the client may strain physically when searching for words and employ circumlocution to explain intended meanings.

Motor speech disorder

Verbal agnosia would be most likely to be associated with:

False

When clinicians use compensatory techniques in treating aphasia, they are counting on the ability of the brain to recover some of its previous skills through cortical reorganization.

True

When describing an upright human torso, the terms ventral/dorsal are equivalent to the terms anterior/posterior.

False

When doing an orofacial (oral-peripheral) examination on an elderly stroke patient, you observe atrophy of tongue muscles, deviation to the right side on protrusion of the tongue, and tongue fasciculations. These symptoms are suggestive of damage or dysfunction to cranial nerve X.

Both adduction and abduction of the vocal folds will be impaired

When vocal folds are paralyzed bilaterally:

False; spontaneous recovery

Within a few days after a stroke, swelling is reduced and some injured brain cells begin to function more normally through a process called "assisted recovery."

Wernicke's aphasia.

You assess a client referred to you for communication problems that have arisen after the client experienced a stroke. The client displays fluent but largely meaningless speech, impaired comprehension, jargon, and word-finding difficulty. Articulation and intonation are essentially within normal limits. You diagnose:

False

Dyarthrias differ from apraxia of speech in that individuals with dysarthrias show no significant evidence of slowness, weakness, incoordination, paralysis or alternation of speech muscle tone, which characterize apraxia of speech.

May or may not be dominant for processing of language tasks.

For left-handed persons, the left cerebral hemisphere:

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

For the purpose of making an acoustic assessment of speech for a client with a motor speech disorder, spectrographic displays of data might be preferred over oscilloscopic displays because:

Initiating and regulating gross motor activities of the lips, jaws, tongue and larynx

Frontal lobe is primarily involved in:

Controllable risk factors known to be associated with increased probability of stroke and related adult aphasia.

Hypertension and diabetes are:

False

Multi-infarct dementia, caused by a series of small strokes, is the most common cause of dementia in the elderly.

Rapid but inaccurate speech sound production that is largely unintelligible.

Secondary features of apraxia of speech include: None of the other suggested answers is correct.

Fissure of Rolando

Separates the frontal lobe from the parietal lobe.

Global aphasia.

Some people with aphasia are not candidates for speech/language rehabilitation. This is most likely to be true for those with:

True

Speech errors in dysarthrias usually are more consistent than are those associated with apraxia.

Age.

Spontaneous recovery immediately after a stroke is known to be most strongly influenced by:

Outlawing sale of all tobacco products intended for smoking.

Stroke is the most common cause of adult aphasia. Known risk factors suggest it is reasonable to expect that the incidence of stroke (and therefore adult aphasia) could be reduced by:

True

Stroke, tumor, trauma, infection, and/or toxic exposure that affects the cerebellum produces ataxic dysarthria.

False

The Peripheral Nervous System is a part of the larger Central Nervous System.

True

The Peripheral Nervous System is composed of 12 pairs of cranial nerves and 31 pairs of spinal nerves.

Is composed of nerves that carry sensory information to and motor information away from the CNS.

The Peripheral Nervous System:

Longitudinal fissure.

The brain is divided into a left and a right hemisphere. Anatomically, this division is marked by the:

False

The establishment of right and left hemisphere preferences for different functions is an example of the principle of "localization."

False

The five parts of the brain include the *Diencephalon, Mesencephalon, Reticular Activating System, Pons, and Medulla Oblongata.*

False

The five parts of the brain stem mediate and route signals between the *Peripheral Nervous System and the spinal cord.*