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All of the following are signs of lower motor neuron disease EXCEPT:

A 78 year-old male presents to your multi-disciplinary clinic for a baseline evaluation of speech and swallowing function. The medical history is significant for progressive weakness of the right arm and leg. Additionally, examinations reveal hyperreflexia and weakness of the right lower face, right lingual fasciculations and diffuse atrophy. Perceptually, the patient’s vocal quality is strained. The patient exhibits signs of pseudobulbar affect and denies knowledge of his deficits. A. Does this patient exhibit UMN signs, LMN signs, or both? Explain your answer (2 points).    

A 65 year-old male presents to the Emergency Department (ED) following a fall at home. Two days following admission you receive a consult for a bedside evaluation of speech-language and swallowing function. Based on chart review, his neurological exam is significant for: Adequate force through the orofacial structures. Reduced speed of appendicular and axial movement, reduced range of motion, and difficulty initiating movements across orofacial structures. D. You identify that the patient has a markedly fast rate, reduced conversational loudness, consonant imprecision, and reduced prosodic contour. What is the most likely motor speech diagnosis (1 point). What is one potential treatment approach to improve these symptoms (1 point).

Which nurse formed a “British Hotel” and offered her help during the Crimean War, but was denied potentially due to the color of her skin?

Which of the following neural substrates in considered the motor relay station:

 (4 points total – 2 of which will go towards extra credit): Discuss Van der Merwe’s framework for speech motor control. What each level represents and its utility for the ability to disentangle various disorders. Include examples of each.

A patient with a movement disorder presents to your clinic with a unilateral lingual paralysis.  Which of the following would you expect to be his/her most noticeable dysphagic symptom?

A 63 year-old female presents to your clinic complaining of a hoarse vocal quality, resonance imbalance (i.e. hypernasality, nasal emissions) and difficulty swallowing. An oral mechanism examination reveals appropriate function of the masticatory, facial, and lingual muscles; however, you note markedly reduced soft palate elevation. A. Based on this limited case history, name the lesion (1 point).

Put the following statements in the correct order (first to last, 1-5) describing the initiation of phonation based on the myoelastic aerodynamic theory: _______     Intrinsic laryngeal muscles adduct the vocal folds _______     Phonation threshold pressure is reached _______     Vocal folds are blown apart _______     Vocal folds are “sucked” back together _______    Subglottal pressure builds up

A 63 year-old female presents to your clinic complaining of a hoarse vocal quality, resonance imbalance (i.e. hypernasality, nasal emissions) and difficulty swallowing. An oral mechanism examination reveals appropriate function of the masticatory, facial, and lingual muscles; however, you note markedly reduced soft palate elevation. B. You decide to complete a motor speech evaluation. What specific tasks would you select to address her complaints of a hoarse vocal quality and resonance imbalance? (2 points).