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SPEECH LANGUAGE PATHOLOGY PRAXIS
EXAM QUESTIONS & ANSWERS.
Spinal Accessory - Correct Answer-Cranial nerve XI, Motor, Shoulder, arm and throat movement Hypoglossal - Correct Answer-Cranial nerve XII, Motor, Tongue movement Internal Intercostals - Correct Answer-Muscles of exhalation; 11 pairs; pull the ribs downward to decrease the diameter of the thoracic cavity for exhalation External Intercostals - Correct Answer-Muscles of inhalation; 11 pairs; raise the ribs up and out to increase the diameter of the thoracic cavity for inhalation Thyroarytenoid - Correct Answer-Primary muscle of the vocal folds Olfactory - Correct Answer-Cranial nerve I, Sensory, Smell Optic - Correct Answer-Cranial nerve II, Sensory, Vision Oculomotor - Correct Answer-Cranial nerve III, Motor, Eye movement Trochlear - Correct Answer-Cranial nerve IV, Motor, Eye movement Trigeminal - Correct Answer-Cranial nerve V, Both, Face (Sensory), Jaw (Motor)
Abducens - Correct Answer-Cranial nerve VI, Motor, Eye movement Facial - Correct Answer-Cranial nerve VII, Both, Tongue (Sensory) Face (Motor) Acoustic or Vestibulocochlear - Correct Answer-Cranial nerve VIII, Sensory, Hearing and Balance Glossopharyngeal - Correct Answer-Cranial nerve IX, Both, Tongue and Pharynx (sensory), Pharynx (motor) Vagus - Correct Answer-Cranial nerve X, Both, Larynx, respiratory, cardiac and gastrointestinal systems Transverse Arytenoids and Lateral Cricoarytenoids - Correct Answer-Adducts the vocal folds Posterior Cricoarytenoids - Correct Answer-Abducts the vocal folds Recurrent Laryngeal Nerve - Correct Answer-Branch of the Vagus nerve, innervates VFs Levator Veli Palatini - Correct Answer-Elevates the velum Tensor Veli Palatini - Correct Answer-Tenses the velum and opens the Eustachian Tube. This muscle is innervated by the Trigeminal nerve. Midbrain - Correct Answer-Part of the Brainstem. Connects the brainstem and the cerebellum at the Substantia Nigra.
Four muscles of Velopharyngeal Closure - Correct Answer-Levator Veli Palatini - elevates soft palate Tensor Veli Palatini - tenses soft palate Palatoglossus - soft palate depression Palatopharyngeus - helps propel the bolus Aryepiglottic Folds - Correct Answer-Ring of connective tissue above the larynx that helps protect the airway Orbicularis Oris - Correct Answer-Primary Muscles of the Lips Anterior Cerebral Artery - Correct Answer-Artery that supplies the Basal Ganglia and Corpus Callosum Corpus Callosum - Correct Answer-Commisural fibers that join the two cerebral hemispheres Hypokinetic Dysarthria - Correct Answer-Characterized by a rush of rapid speech. This is the type of dysarthria in Parkinson's Disease Mucosal Wave - Correct Answer-The medial-lateral excursion of the vocal fold cover during vibration Bernoulli Effect - Correct Answer-Increased speed of air through the vocal folds creating a sucking effect moving the vocal folds together Bones that form the hard palate - Correct Answer-Maxillae and palatine bones
Orofacial Apraxia - Correct Answer-Impaired nonverbal movements of the tongue, lips and jaw Flaccid Dysarthria - Correct Answer-Caused by cranial nerve damage; lesion in the LMN; hypernasality a common characteristic; lack of innervation may cause fasciculations, especially in the tongue; breathy or strangles sounding speech depending if the VF abductors or adductors are affected Spastic Dysarthria - Correct Answer-Characterized by imprecise articulation, monotonous pitch and loudness, and harsh vocal quality; Lesion in the UMN; phonation and prosody of speech disordered Reliability - Correct Answer-Consistency or repeatability of a measurement or test Tympanogram Type C - Correct Answer-Tympanogram indicates Eustachian Tube dysfunction Ataxic Dysarthria - Correct Answer-Characterized by uncoordinated and reduced muscle tone; explosive speech; caused by cerebellar damage Developmental Stuttering - Correct Answer-Most common type of fluency disorder Swallow Center - Correct Answer-Reticular Formation of the Medulla Oblongata Aphonic - Correct Answer-Paralyzed lateral cricoarytenoid in an abducted position Transcortical Motor Aphasia - Correct Answer-Characterized by non-fluent speech, paraphasias, intact auditory comprehension, remarkable ability to repeat
Simple harmonic motion Natural Frequency - Correct Answer-A frequency at which the source of a sound vibrates naturally; it is affected by mass and stiffness Octave - Correct Answer-Interval between two frequencies Oscillation - Correct Answer-Back and forth movement of air molecules due to a vibrating object Fundamental Frequency - Correct Answer-Lowest frequency of a periodic wave; first harmonic Complex Tone - Correct Answer-When two or more sounds of different frequencies are combined; can be periodic or aperiodic F1 and F2 - Correct Answer-Vowel frequencies; represents tongue height and tongue advancement anterior to posterior Harmonics - Correct Answer-Tones that occur over the fundamental frequency and can be characterized as whole number multiples of the fundamental frequency Heuristic - Correct Answer-Children's attempt to have their environment and events explained to them; "Why that?" Brown's order of acquisition of morphemes - Correct Answer--ing prepositions plural s
irregular past tense posessive s articles past tense - ed regular third-person s irregular third person unconcractible auxiliary contractible copula contractible auxiliary Indicates semantic and syntactic complexity Piaget Stages of Cognitive Development - Correct Answer-Sensorimotor 0- 2 - 6 substages from birth to two Pre-operational 2- 7 - 2 substages preconceptual (2- 4 ) and intuitive (4-7) Concrete operations 7- 11 Formal operations 11+ Indirect Speech Acts - Correct Answer-Pragmatic skill used to convey politeness; typically developed by age 6 Expansion - Correct Answer-Clinician expands telegraphic speech into a more grammatically complete utterance. Simple addition of verb or action. Extension - Correct Answer-Clinician comments on child's utterance and adds new relevant information of semantic and grammatical information. More complex addition of verb, adjectives, pronouns, action.
McDonald's Sensorimotor Treatment Approach to Speech Sound Disorder - Correct Answer-Syllable is the basic unit of speech; bottom up approach; relies on coarticulation for correct production Diminutization - Correct Answer-Adding /i/ to target word; /dagi/ for /dag/ Distinctive Feature Approach - Correct Answer-Linguistic treatment approach to disordered sound production; train one sound in the pattern so generalization to other sounds will occur; minimal pairs is used in this approach example: tea-sea Hodson and Paden's Cycles Approach - Correct Answer-Designed to treat children with highly unintelligible speech; not focused on individual production/practice; auditory bombardment and repetition of cycles across several weeks Van Riper's Theory on Stuttering - Correct Answer-Stuttering occurs when the forward flow of speech is interrupted by a disrupted sound, syllable, or word repetition and the speaker's negative reaction to the stuttering Brutten and Shoemaker's definition of stuttering - Correct Answer-Part word and sound prolongations are a result of classically conditioned negative emotion. All other dysfluencies are due to operant conditioning Incidence - Correct Answer-Rate of occurrence in a specified group; long term study Prevalence - Correct Answer-Number of individuals who currently have a disorder among a cross section of a population
Stuttering behavior in children - Correct Answer-More dysfluencies on function words - pronouns and articles; typically occurs in first position of an utterance Stuttering behavior in adults - Correct Answer-More dysfluencies on content words Adaptation Effect - Correct Answer-Systematic reduction in the frequency of stuttering when a short passage is repeatedly read aloud; by 5th reading most reduction in dysfluent speech has occurred Bloodstein definition of stuttering - Correct Answer-Stuttering is caused by any belief that speech is a difficult task resulting in tension and speech fragmentation; quantity and disruptive nature of dysfluencies is considered Fluent Stuttering Treatment - Correct Answer-Developed by VanRiper Identify Desensitize Modify reduce avoidance cancellations - pause and say again more relaxed pull-outs - change stutter mid-course preparatory sets - changing manner of stutter to a less abnormal dysfluency Johnson's Theory of Stuttering - Correct Answer-Parents punish their children for normal dysfluencies and the child develops avoidance and apprehension Fluency Shaping Treatment - Correct Answer-Airflow management Easy onset
Injection Method - Correct Answer-Impound air into the oral cavity, pushes it back to the esophagus and vibrates the cricopharyngeus Recurrent Laryngeal Nerve Damage - Correct Answer-Affects vocal fold adduction; damage to left RLN may occur during cardiothoracic surgery effecting movement of left VF Blom Singer Device - Correct Answer-Tracheostomy patients can shunt air from the trachea to the esophagus for esophageal speech Anklyosis - Correct Answer-Stiffening of the joints and the movement of the arytenoids; caused by arthritis or cancer Jitter - Correct Answer-Variations in vocal frequency Jitter - Correct Answer-A voice disorder with hoarseness or tremor would show large amounts of________. Normal phonation of a sustained vowel occurs with less than 1% ________. Shimmer - Correct Answer-Cycle to cycle variation of vocal intensity. Shimmer - Correct Answer-More than 1dB of variation across a cycle is dysphonic. Large amounts of__________ indicate irregular vocal fold vibration MPT and s/z ratio - Correct Answer-Two tests that can determine adequacy of respiration, glottal efficiency, and possible presence of vocal pathology. 1st is average of three trials and the second is a ratio; if it is greater than 1/4 indicates a pathology
Speech or Sound Spectrogram - Correct Answer-Graphic representation of sound wave intensity and frequency as a function of time. Can provide quantitative information for baseline and treatment comparisons. Reduced Mucosal Wave Action - Correct Answer-Rough, gravelly sounding voice Wernicke-Korsakoff - Correct Answer-Disorder characterized by memory loss, difficulty processing abstract information, visual spatial impairment. Caused by heavy alcohol abuse Conduction Aphasia - Correct Answer-Caused by lesion in Arcuate Fasciculus and supramarginal gyrus; connection between Broca's and Wernicke's area; characterized by good syntax, prosody, and articulation with a disproportionate impairment in repitition Manometric Assessment - Correct Answer-measures the pressure in the upper and lower esophagus sphincter Recruitment - Correct Answer-Disproportionate increase in the perceived loudness of sound when loudness is increased linearly Carhart Notch - Correct Answer-Audiogram result typically found in patients with otosclerosis; bone conduction is within normal limits, but is reduced outside of normal limits at 2,000 Hz Construct Validity - Correct Answer-Test scores are consistent with theoretical predictions Content Validity - Correct Answer-Test measures what it purports to measure; is based on expert judgment
ABAB Treatment Design - Correct Answer-A is baseline and B is treatment Ex Post Facto Research - Correct Answer-A retrospective search for causes or events Pearson r Correlation - Correct Answer-Closer to 1.0 the more positive the correlation; closer to - 1.0 the more negative the correlation (example: rate of speech increases, fluency decreases). A number close to zero shows a weak correlation Nominal Scale - Correct Answer-No numeric value - example: always, sometimes, never Ordinal Scale - Correct Answer-Numeric scale based on level, not on known quantity Ratio Scale - Correct Answer-Scale with an absolute zero 8 - 9 weeks - Correct Answer-When Hard Palate forms in utero Landau-Kleffner Syndrome - Correct Answer-Childhood syndrome with sudden onset, language loss, seizures, and hyperactivity von Langenbeck Surgical Method - Correct Answer-Cleft repair raising two bipedicled flaps of mucoperitoseum bringing them together and closing the cleft
Angelman Syndrome - Correct Answer-Normal appearance; Syndrome presenting with seizures, stiff jerky gait, laughter/happy demeanor, excitable personality, hand-flapping; caused by chromosome 15 deleted from the mother or duplicated from the father Apert Syndrome - Correct Answer-Syndrome presenting with syndactyly (fused fingers), abnormal cranial bone growth, hearing loss, class III malocclusion, 25% of cases with cleft; caused by autosomal dominant mutations FGR2 at 10q25- 26 Cri du Chat Syndrome - Correct Answer-Syndrome presenting with low set ears, narrow oral cavity, laryngeal hypoplasia, hypertelorism (space between the eyes), micrognathia, oral clefts, baby's cry sounds like a cat; caused by absence of the short arm of 5th chromosome Crouzon Syndrome - Correct Answer-Syndrome presenting with Craniosynostosis
- early fusion of the cranial bones, small maxillary structure, hypertelorism, protrusion of eyeballs, strabismus, parrot like nose, malocclusion class III; caused by autosomal dominant inheritance Down Syndrome - Correct Answer-Syndrome presenting with midface dysplasia, shortened oral/pharyngeal structures, large tongue, short neck and excess skin at the back of the neck, cardiac malformations; caused by extra chromosome 21 resulting in 47 instead of 46 chromosomes Fragile X Syndrome - Correct Answer-Syndrome presenting with large forehead, poorly formed pinna, intellectual disability; caused by the expansion of the nucleic acid cytosine, guanine, guanine (CGG) which repeats too often on FMR1 on bottom of X chromosome
Velocardiofacial Syndrome VCFS - Correct Answer-Syndrome presenting with cleft palate, craniofacial abnormalities, feeding problems, and failure to thrive William's Syndrome - Correct Answer-Syndrome characterized by elfin face, low IQ 50-70; charming personality and unafraid of strangers; caused by deletion of 25 genes on one copy of chromosome 7q11. Mels Scale - Correct Answer-Measures pitch Absolute Threshold - Correct Answer-The point at which we detect a stimulus 50% of the time Contact Ulcers - Correct Answer-The posterior medial edge of the glottis is the usual site of occurrence Usually bilateral Pain is a common and usually the first complaint Hoarseness is not a major or first complaint Chronic stress and hard-driving personality is common Degree of loss based on Pure Tone Audiometry - Correct Answer-Normal - 15 - 25dB Mild 26-40 dB Moderate 41-55 dB Moderate-Severe 56-70 dB Severe 71-90 dB Profound 91+dB
Maximum air-bone gap - Correct Answer-60dB Aural Reflex - Correct Answer-Occurs when the tensor tympani and the stapedius muscles contract around 65-90 dB to protect the the bones of the middle ear Skinner Theory of Language Development - Correct Answer-Behaviorist - language is a set of verbal behaviors learned through operant conditioning; Operant conditioning is a type of learning in which the strength of a behavior is modified by its consequences, such as reward or punishment, and the behavior is controlled by antecedents called discriminative stimuli which come to signal those consequences Chomsky Theory of Language Development - Correct Answer-Nativist - language is species specific, and is an innate behavior in humans Piaget Theory of Language Development - Correct Answer-Cognitive - a child is an active partner in learning, cognitive structures and linguistic environment are responsible for language development Mean Length Utterance MLU - Correct Answer-Total number of morphemes divided by number of utterances; there is a high correlation between MLU and chronological age of the child. For example a 2 year old should have a MLU of 2. Porch Index of Communicative Ability - Correct Answer-Test includes information about prognosis and recovery; speech and language is not sampled to a greater extent Functional Communication Profile - Correct Answer-Developed by Sarno and assesses residual language function and functional communication
