Principles of Behavior Modification and Speech-Language Pathology, Exams of Nursing

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UCO SLP COMPREHENSIVE EXAM REVIEW (QUESTIONS BANK) QUESTIONS WITH CORRECT ANSWERS RATED 100% CORRECT!! [Document subtitle] Evatee 6 /25/24 UCO SLP

UCO SLP COMPREHENSIVE EXAM REVIEW

(QUESTIONS BANK) QUESTIONS WITH

CORRECT ANSWERS RATED 100% CORRECT!!

____ aphasia has easy and effortless speech, good articulation, neologism, and ineffective communication Answer - Fluent Lesions in the ___ portions of the brain cause fluent aphasia Answer - Posterior What are the 4 types of fluent aphasia? Answer - Wernickes Transcortical sensory Conduction Anomic ____ aphasia has impaired comprehension and paraphasic hyperfluency Answer - Wernickes ____ (irresistible urge to keep talking) is present in Wernickes aphasia Answer - Logorrhea Wernickes aphasia has impaired _____ comprehension Answer - Auditory Is reading and writing affected in Wernickes aphasia? Answer - Yes

In Wernickes aphasia, the patient tends to be ____ of deficits Answer - Unaware In Wernickes aphasia, the patient may appear confused because incessant speech that doesn't make sense Answer - True ____ skills are impaired in Wernickes aphasia Answer - Repetition Where is the damage seen in Wernickes aphasia? ____ portion of the _____ gyrus in the dominant hemisphere Answer - Posterior portion of the superior temporal gyrus In _____ aphasia, symptoms are similar to Wernickes aphasia except for echolalic repetition Answer - Transcortical sensory In transcortical sensory aphasia, symptoms are similar to Wernickes aphasia except for ___ Answer - Echolalic repetitions This type of aphasia has good repetition but significant echolalia Answer - Transcortical sensory Transcortical sensory aphasia has significant ___ Answer - Echolalia Client may repeat questions before responding Answer - Transcortical sensory aphasia What is the neurological symptom of transcortical sensory aphasia? Answer - Hemiparesis

Where is the damage seen in transcortical sensory aphasia? In the _____ areas of the _____ cerebral artery Answer - Posterior watershed areas of the middle cerebral artery Conduction aphasia has near normal _____ comprehension Answer - Auditory comprehension Does conduction aphasia have impaired repetition? Answer - Yes Conduction aphasia has fluency that is often interrupted by ____ and ____ Answer - Hesitations and self corrections _____ aphasia has hesitations and self corrections and reading and writing problems Answer - Conduction aphasia Wernickes and Broca's area are unaffected in ___ aphasia Answer - Conduction In ____ aphasia, word finding exceeds all other difficulties Answer - Anomic aphasia In anomic aphasia, _____ exceeds all other language problems Answer - Word finding (naming) difficulties ____ aphasia has good other language, good auditory comprehension, and reading comprehension is good Answer - Anomic Anomic aphasia is affected by ____ difficulties Answer - Word finding

What 2 types of fluent aphasia have impaired auditory comprehension? Answer - Wernickes and transcortical sensory What 2 types of fluent aphasia have good auditory comprehension? Answer - Conduction and anomic Which 2 fluent aphasia have good repetition skills? Answer - Transcortical sensory and anomic ____ aphasia has damage in arcuate fasciculus Answer - Conduction ____ aphasia damage site is unclear Answer - Anomic Nonfluent aphasia has ___ speech rate, ____ speaking effort, omission of ______ features, and ____ utterances Answer - Reduced Excessive Grammatical Shorter The damage in nonfluent aphasia has lesions in the ____ part of the brain Answer - Anterior ____ aphasia has difficulty initiating speech Answer - Nonfluent What are the 4 types of nonfluent aphasia? Answer - Broca's Transcortical motor Mixed transcortical Global

Where is the damage in Broca's aphasia? _____ cerebral artery Answer - Middle cerebral artery Where is the damage in transcortical motor aphasia? _____ frontal lobe Answer - Anterior superior frontal lobe Where is the damage in mixed transcortical aphasia? ______ area of the brain Answer - Watershed area of the brain Isolation of the speech area Answer - Mixed transcortical aphasia In mixed transcortical aphasia there is stenosis of the ____ artery Answer - Carotid What is the most severe nonfluent aphasia Answer - Global What area is affected in global aphasia? Answer - Perisylvian region Right sided hemiparesis or hemiplegia is a neurological symptom of ___ aphasia Answer - Broca's Akinesia, bradykinesia, hemiparesis, and buccofacial apraxia is a neurological symptom of ____ Answer - Transcortical motor Strong right hemiparesis, hemiplegia, and sensory loss along with hemineglect are neurological symptoms of ____ aphasia Answer - Global aphasia

What are the only nonfluent aphasia's that has good auditory comprehension? Answer - Transcortical motor and Broca's ____ naming is difficult in Broca's aphasia Answer - Confrontation Key features of ___ aphasia are nonfluent, limited agrammatic, effortful, slow, and uneven Answer - Broca's _____ and ____ parallel oral language in Broca's aphasia Answer - Reading and writing Which aphasia has difficulty with initiation of conversation? Answer - Transcortical motor ___ is evident in transcortical motor aphasia Answer - Muteness ____ is better than ____ in transcortical motor aphasia Answer - Reading Writing _____ aphasia has profound impairments in most language skills, fluency, grammar, naming, and possibly pointing Answer - Mixed transcortical _____ aphasia combined symptoms of nonfluent and fluent aphasia Answer - Mixed transcortical In ____ aphasia, all language areas are severely impaired Answer - Global

Is auditory comprehension impaired in global aphasia? Answer - Yes Aprosodic and monotonous, lacking in rhythm and intonation is ____ aphasia Answer - Brocas ____ aphasia has difficulty initiating speech Answer - Transcortical motor Verbal and nonverbal apraxia is present in ____ aphasia Answer - Global aphasia In ___ aphasia, they may repeat CV combos but most cannot repeat even simple, single words Answer - Global In Broca's aphasia, the patient is ____ with relevant responses to questions and is cooperative Answer - Alert Which test assesses the functional communication skills of adults with neurogenic communication disorders? Answer - CADL (communication abilities daily living) The CADL is good for what 3 types of diagnosis? Answer - TBI Right CVA dementia ____ is a comprehensive assessment of patients strengths and weaknesses in all language modalities Answer - Minnesota The Minnesota and BDAE 3 is good for what 2 diagnoses? Answer - Right or left CVA

This test is designed to highlight the features of patients performance that are characteristics of the particular aphasia deficits Answer - BDAE-3 (Boston diagnostic aphasia exam 3) ____ measures the cognitive processes of perception, discrimination, organization, recall of information, and problem solving Answer - SCATBI (scale for cognitive ability for TBI) SCATBI is good for what type of diagnosis? Answer - TBI _____ assesses certain verbal, gestural, and graphic abilities Answer - PICA (porch index of communicative ability) ____ measurements based on amount of assistance needed for ADL's Answer - FIM (functional independent measure) this test is good for patients with a TBI, CVA, MS, pain, Parkinson's, Dementia Answer - FIM This test measures the functional communication of adults with speech, language, and cognitive communication disorders Answer - ASHA FACS This test is used for adults over 55 with cognitive- linguistic deficits Answer - RIPA (Ross information processing assessment) What type of patient might be easier to response record for? Answer - Broca's

Are patients with RHS aware or unaware of their mental limitations Answer - Unaware _____ is a deficit in an individuals ability to sequence the voluntary motor movements needed to produce speech fluently Answer - Apraxia What is the dysarthria of Parkinson's? Answer - Hypokinetic The motor speech disorder usually associated with cerebellar lesions is ____ dysarthria Answer - Ataxic ____ is a speech production deficit that results from neuromotor damage to the peripheral or central nervous system Answer - Dysarthria Dysarthria is not a language disorder but is a _____ disorder caused by neuromotor damage Answer - Speech production ___ is a motor speech disorder defined as a deficit in the ability to sequence the motor commands needed to correctly position the articulators during the voluntary production of phonemes Answer - Apraxia The primary function of ____ is to exchange oxygen from the atmosphere for carbon dioxide from cells in the body Answer - Respiration ____ is the production of voiced phonemes through vocal folds vibrations in the larynx Answer - Phonation In motor speech disorders, _____ is the proper placement of oral or nasal tonality into phonemes during speech Answer - Resonance

____ is the shaping of the vocal airstream into phonemes Answer - Articulation ___ is the melody of speech Answer - Prosody ____ is caused by damage to the lower motor neurons in the cranial or spinal nerves Answer - Flaccid dysarthria Flaccid dysarthria is caused by damage to the ______ Answer - Peripheral Treatment for flaccid dysarthria often involves increasing _____ throughout the whole body Answer - Tension Is flaccid dysarthria caused by upper or lower motor neurons? Answer - Lower motor neurons What are the 6 cranial nerves of speech production? Answer - Trigeminal Facial Glossopharyngeal Vagus Accessory Hypoglossal Unilateral damage to the ____ nerve can result in weakness or paralysis in the jaw and velar muscles that are on the same side as the damage Answer - Trigeminal

Damage to the ____ nerve can affect the muscles of the entire face on the same side as the lesion if it occurs above the point where the facial nerve divides into its branches Answer - Facial Eliciting the gag reflex is one way to assess the function of what cranial nerve? Answer - Glossopharyngeal What nerve is one of the most important cranial nerves for speech production? Answer - Vagus Damage to the pharyngeal branch of the vagus nerve can affect the movement of the ___ Answer - Velum The recurrent nerve branch is a vital contributor to ____ because it supplies motor innervations for all the adductor and abductor muscles of the vocal folds Answer - Phonation What nerve is not a pure cranial nerve? Answer - Accessory Unilateral damage to the ____ cranial nerve results in weakness or paralysis in the half of the tongue that is on the same side as the nerve damage Answer - Hypoglossal Bilateral damage to the hypoglossal nerve will result in an overall weakness of the tongue Answer - Hypoglossal Many of the spinal nerves serve an important role in motor speech production because they provide motor innervations for the muscles of ____ Answer - Respiration

What are 3 common etiologies of flaccid dysarthria? ___ trauma ____ injury ____ injury Answer - Surgical trauma Head injury Neck injury ____ is an auto immune disease resulting in extreme muscle fatigue Answer - Myasthenia gravis Symptoms of myasthenia gravis include vocal change from a normal voice to _____, ____, and ____ voice Answer - Breathy, weak, audible ____ is often preceded by viral infections. Cause is unknown Answer - Guillian Barre What 2 common diseases are a cause of flaccid dysarthria? Answer - Myasthenia gravis Guillian Barre Polio is a cause of ____ dysarthria Answer - Flaccid Flaccid dysarthria can affect what areas of speech? Answer - All of them Respiration Phonation Resonance Articulation

Prosody Tx of flaccid dysarthria: Damage to trigeminal nerve you would work on _____ muscle strengthening Answer - Jaw Tx of flaccid dysarthria: Damage to facial nerve you would work on _____ strengthening exercises ____ puckering Holding a _____ Answer - Lip Lip Smile Tx of flaccid dysarthria: Damage to vagus nerve would be ____ of you could do ____ exercises Answer - Surgical Velar ____ is an important diagnostic marker for flaccid dysarthria Answer - Hypernasality __ __ __ is the second most prominent abnormal speech characteristic of flaccid dysarthria Answer - Imprecise consonant production ____ incompetence is an especially valuable confirmatory sign for the diagnosis of flaccid dysarthria Answer - Phonatory

Treatment for ____ deficits;

• pushing and pulling
• holding breath -hard glottal attack Answer - Phonation Contrastive stress drills and chunking utterances into syntactic units are treatment for ___ deficits Answer - Prosodic Damage to hypoglossal nerve you could work on ____ strengthening exercises Answer - Tongue ____ dysarthria is caused by bilateral damage to upper motor neurons Answer
• Spastic Spastic dysarthria is caused by bilateral damage to both the ___ and _____ neural pathways Answer - Pyramidal and extrapyramidal Damage must be ___ in order for it to be spastic dysarthria Answer - Bilateral ____ is the single most common cause of spastic dysarthria Answer - Stroke A single stroke can cause spastic dysarthria when it occurs in the ____ Answer - Brainstem A single stoke in one of the cerebral hemispheres cannot cause spastic dysarthria Answer - True

____ is a disease of unknown etiology that results in the progressive degeneration of lower and upper motor neurons Answer - ALS _____ is an immunologic disorder that results in the inflammation or complete destruction of the myelin sheath covering axons Answer - Multiple sclerosis What are 2 diseases that cause spastic dysarthria Answer - ALS and MS _____ are the most common articulation disorder with spastic dysarthria Answer - Imprecise consonants ___ vocal quality is the most common voice error in spastic dysarthria Answer - Harsh _____ vocal quality is one of the most distinguishing speech errors of spastic dysarthria Answer - Strained- strangled Nasal emission frequently accompanies Hypernasality in ___ dysarthria Answer

• Flaccid The hypernasality in spastic dysarthria usually doesn't include nasal emission in spastic dysarthria Answer - True ____ intonation is one of the most obvious characteristics in spastic dysarthria Answer - Mono pitch ____ doesn't really play a role in spastic dysarthria Answer - Respiration

Pseudobulbar affect is uncontrollably crying or laughing can appear in ___ dysarthria Answer - Spastic ___ dysarthria is caused by bilateral damage to the upper motor neurons of the pyramidal and extrapyramidal system and ____ dysarthria is caused by damage to lower motor neurons Answer - Spastic Flaccid the ___ tasks will best demonstrate the slow rate of phoneme production associated with spastic dysarthria Answer - AMR

1. Head and neck relaxation
2. Easy onset
3. Yawn sigh These are treatment for ____ deficits in spastic dysarthria Answer - Phonation Stretching is treatment for ___ deficits in spastic dysarthria Answer - Articulation
4. Pitch range 2.intonation profiles
5. Constrastive stress drills
6. Chunking utterances These are exercises for ____ deficits in spastic dysarthria Answer - Prosody ____ is caused by damage to the upper motor neurons that carry impulses to the cranial and spinal nerves that supply the speech muscles Answer - Unilateral upper motor neuron dysarthria

____ deficits are the primary characteristic of UUMN dysarthria Answer - Articulation The most apparent consequences of unilateral upper motor neuron damage are to the muscles of the lower ____ and ____ Answer - Face and tongue The primary articulation difficulty for nearly all patients with UUMN dysarthria is ____ Answer - Imprecise consonant ___ vocal quality can be evident in UUMN dysarthria Answer - Harsh ___ dysarthria is caused by damage to the cerebellar system Answer - Ataxic Speech errors in ataxic dysarthria are primarily ___ and ___ Answer - Articulatory and prosodic The ___peduncle allows the cerebellum to receive sensory information from the entire body Answer - Inferior The ___ peduncle is the largest of the cerebellar peduncles Answer - Middle The ___ peduncle is the cerebellums main output channel to the rest of the CNS Answer - Superior ____ dysarthria is caused by damage to the basal ganglia control unit Answer - Hypokinetic

Hypokinetic dysarthria is related to ___ Answer - Parkinson's Hypokinetic dysarthria is the only dysarthria where ____ rate of speech is a symptom Answer - Increased Individuals with Parkinsonism usually demonstrate ____muscle tone Answer - Increased What is the most prevalent symptom of Parkinsonism Answer - Tremor __is slow and reduced range of movement Answer - Bradykinesia __ is the result of increased muscle tone Answer - Muscular rigidity ___ is a delay in the initiation of movements Answer - Akinesia _____ disease is the most common form of Parkinsonism and is the single most frequency cause of hypokinetic dysarthria Answer - Idiopathic Parkinson's Errors in ___ and ___ are the most noticeable speech errors in hypokinetic dysarthria Answer - Prosody and articulation ___, ____, and ____ were the 3 most prominent prosody characteristics on hypokinetic dysarthria Answer - Monopitch Reduced stress Monoloudness

_____ is the most common articulation characteristic in hypokinetic dysarthria Answer - Imprecise consonants Chorea, myoclonus, tics, dystonia, and essential tremor are all examples of ____ movements Answer - Hyperkinetic Hyperkinetic dysarthria is caused by damage to the ____ Answer - Basal ganglia Hyperkinetic dysarthria is characterized by variable ____ imprecision, vocal ___, and ____ abnormalities Answer - Articulatory imprecision Harshness Prosodic Huntington's Disease goes with what dysarthria? Answer - Hyperkinetic ____ disease is a progressive disorder that is caused by the gradual degeneration of neurons in the basal ganglia and cerebral cortex Answer - Huntington's Chorea, Huntington's Disease, and tardive dyskinesia are etiologies of what dysarthria? Answer - Hyperkinetic Chorea affects ___ in hyperkinetic dysarthria Answer - Prosody ____ is the most common hyperkinetic movement disorder Answer - Essential tremor When the dystonia movement or posture is present in only one part of the body Answer - Focal dystonia

When the dystonic movement or posture includes two or more parts of the body Answer - Segmental dystonia When the dystonic movement or posture affects all 4 limbs Answer - Generalized dystonia Any disorder that can cause damage to two or more parts of the motor system has the potential to cause ___ dysarthria Answer - Mixed A ___ dysarthria is one in which a patients neurologic damage is restricted to a single anatomical portion of the motor system Answer - Pure What is the most common of the demylenating disease Answer - MS The general rule in treating mixed dysarthria is to first treat the component that is most severely affecting speech production Answer - True ____ is an articulatory disorder resulting from impairment, as a result of brain damage, of the capacity to program the positioning of speech musculatur and the sequencing of muscle movements Answer - Apraxia There is no significant weakness, slowness, or incoordination in reflex and automatic acts Answer - True ____ is the inability to make use of an object or gesture because the individual has lost the knowledge of the objects function Answer - Ideational apraxia

___ is a disturbance in the performance of the movements needed to use an object or make a gesture Answer - Ideomotor apraxia What is the most frequent cause of apraxia Answer - Stroke ___ errors are the most common problem in apraxia Answer - Articulation ____ of one phoneme for another are more common than distortions, omissions, or repetitions in apraxia Answer - Substitutions _____ are more likely to be in error than single consonants in apraxia Answer - Consonant clusters Phonemes in the ___ position of words are more likely to be errored in apraxia Answer - Initial Articulation is more ____ on real words compared to nonsense words Answer - Accurate Is describing a picture more difficult or easier than automatic speech ( counting) or reactive speech ( swearing) in apraxia Answer - More difficult Errors are ____ in apraxia Answer - Inconsistent Errors are ___ in dysarthria Answer - Consistent Disturbances in muscle control due to central of peripheral damage Answer - Dysarthria

In ___ there are moments of error free productions Answer - Apraxia Are there moments of error free productions in dysarthria? Answer - No Apraxia errors are characterized as ____ ( picked the wrong sound) Answer - Substitutions Dysarthria errors are characterized by ___ Answer - Distortions Apraxia has difficulty ___ speech Answer - Initiating Dysarthria has no difficulty initiating speech Answer - True Does apraxia or dysarthria have schwa insertions into consonant clusters Answer - Apraxia In dysarthria, consonant clusters are ____ Answer - Simplified In ____ there is frequent audible and visible groping for articulator placement Answer - Apraxia Is automatic speech or volitional speech better in apraxia? Answer - Automatic What task will highlight a slowed rate of phoneme production? Answer - AMR

The parts of the nervous system that control ____ movements are known collectively as the motor system Answer - Voluntary What is the largest division of the brain? Answer - Cerebrum The ____ nerves innervate many organs and muscles of the head, neck, thorax, and abdomen Answer - Cranial nerves The ___ nerves innervate most of the other muscles of the body, including the chest, arms, and legs Answer - Spinal nerves The extrapyramidal system transmits impulses that control ___ support Answer

• Postural support What are 2 characteristics of every one of the dysarthrias? Answer - Imprecise consonants and harsh vocal quality What task is especially useful in bringing out the symptoms of apraxia? Answer
• SMR Flaccid dysarthria affects what speech characteristics? Answer - All of them The _____ is the most successful treatment for resonance problems in individuals with dysarthria Answer - Palatal lift What speech areas are affected in spastic dysarthria? Answer - All of them except respiration is rare articulation is the primary characteristic of what dysarthria? Answer - UUMN

Toxic and metabolic conditions are etiologies of what dysarthria? Answer - Ataxic What are the primary speech characteristics of ataxic dysarthria? Answer - Articulation and prosody Tremor, bradykinesia, muscular rigidity, and akinesia are characteristics of what dysarthria? Answer - Hypokinetic Errors of ___ and ____ are the most noticeable speech characteristics in hypokinetic dysarthria Answer - Prosody and articulation A ___ or ____ vocal quality is common in most individuals with hypokinetic dysarthria Answer - Harsh or breathy The most common articulation deficit in hypokinetic dysarthria is imprecise consonant production, which is sometimes described as giving the patients speech a ___ quality Answer - Mushy In ___dysarthria, the clinician can make an accurate diagnosis just by observing the individuals uncontrolled movements Answer - Hyperkinetic Tardive dyskinesia is a disease in ____ dysarthria Answer - Hyperkinetic ____ is a movement disorder that can cause choreic movements of the face mouth and neck Answer - Tardive dyskinesia