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Case study 2 The following four questions (+bonus question a…

Case study 2 The following four questions (+bonus question at the end of the exam) will refer to this case information.  — A 65-year-old woman was admitted to the hospital after her son noticed a sudden onset of “slurred” speech while they were having lunch. Neurologic examination in the ER noted right-sided weakness in the hand, a hyperactive biceps reflex in the right arm, and a droop in the right side of the lower face. The neurologist noted speech difficulty, including mildly decreased intelligibility, and requested SLP consult.  You speak with the patient when she first arrives at your office. She says it feels like his tongue is thick and she can’t speak like she needs to for her job as an auctioneer. She also tells you that about a year ago, she suddenly developed some difficulty speaking clearly and with swallowing, as well as clumsiness in her right fingers, but all of those issues went away in about a week. She says it feels like her speech is worse this time. During this conversation, you note a slightly hoarse voice throughout as well as intermittent articulatory imprecision. You also note that sometimes it sounds like she says her son’s name, “Ned”, more like “Nen”.  During oral mechanism examination, you note the following:  Reduced range of movement one the right side of her mouth during smile and pucker Reduced range of movement in tongue lateralization to the right During DDK tasks, you note the following:  Typical rate with occasional mild slowdowns Occasional imprecise articulation for ta and ka