Speech disorders 0.0 / 5 ? MedicineNeurologyUniversityAll boards Created by: zCreated on: 14-03-16 19:36 Speech examination look for defects in: speech content dysphasia > cortical problem articulation dysathria > nv/muscle phonation dysphina > larynx 1 of 5 Dysphasia examine: fluency comprehension naming repetition, reading. writing introduce self + consent proves they can hear and understand (rules out receptive dysphasia) expression of speech - ask pt tell you what they have done today (tests for motor or expressive dysphasia - common in stroke pts) understanding spoken word - ask pt to perform verbal commands (e.g. close your eyes) tests for receptive dysphasia - may get some degree in expressive dysphasia too need a chain of command snot just one 2 of 5 Expressive vs receptive aphasia Expressive (Broca's) lesion of inferior portion of left frontal gyrus speech understood, but production distorted poor fluency telegraphic speech may have UMN R facial and hand weakness may have problems w/ naming Receptive (Wernicke's) lesion of posterior portion of superior temporal gyrus copious speech but incorrect word and syllable choice speech not understood (own or others) may have contralateral sensory loss or homonymous visual field deficit 3 of 5 Dysathria diffuclties w/ speech production look for additional signs bulbar function- flaccid/*******/ataxic NB bulbar=medulla oblongata involved causes: bulbar palsy - GBS, MG, MND, brainstem stroke pseudobulbar palsy - MS, MND, bilateral stroke involving corticobulbar tracts also- cerebellar/ataxic dysathria- get scanning dysathria (explosive, staccato) 4 of 5 Dysphonia difficulty w/ phonation problems w/ pharyngeal/laryngeal action look for quiet voice and bovine (hollow) cough causes: often due to local pathology - ENT referra tumour MND CN IX, XI problems 5 of 5
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