CD 5673 Neurogenic Speech Disorders
Multiple Choice Questions
Developed by Students Enrolled Summer 1998
 
 
1. Cranial Nerve V, the Trigeminal nerve, the largest cranial nerve, has 3 branches and enervates 

(a) tongue movement - intrinsic and extrinsic muscles of tongue 

(b) feel sensation of anterior 2/3 of tongue, face, mouth, jaw; motor muscles of the jaw 

(c) pharyngeal base of tongue; taste and touch for posterior 1/3 of tongue 

(d) the soft palate and some velar muscles 

Lisa Absher 

2. Which is NOT true of the Vagus Nerve (Cranial nerve 10)?  

A. It makes up the Vagal Complex with cranial nerves 9 and 11. 

B. Damage to all its branches will produce weakness of the soft palate, pharynx, and larynx. 

C. It enervates the cricothyroid, an intrinsic muscle of the larynx. 

D. This Vagus nerve has three major branches. 

Suzanne Barry

3. The hypoglossal nerve, the 11th cranial nerve, enervates all of the following muscles except:  

a) thyroarytenoid muscle 

b) cricothyroid 

c) palatoglossus 

d) sternothyroid 

Wendy Almond 

4. This system is essential to the planning, initiation and control of 

voluntary movement, including speech. 

a. Sensory System 

b. Motor System 

c. Visceral System 

d. Vascular System 

Marla Akins

5. Which is NOT true of the UMN system? 

a) contained entirely within the CNS 

b) predominately a direct activation pathway 

c) includes the corticospinal and corticobulbar tracts 

d) includes the basal ganglia and cerebellar control circuits 

Karen Daly 

(hint: it's on page 43!)

6. This cranial nerve enervates all intrinsic muscles of the tongue and all but one extrinsic muscle, and is responsible for taste and tactile information: 

A. Accessory (11th) 

B. Superior laryngeal branch of Vagus (10th) 

C. Hypoglossal (12th) 

D. Trigeminal (5) 

Lisa Ammar-Khodja

7. Voice onset time is measured by: 

(a) perceptual analysis of speech, 

(b) acoustic analysis of speech, 

(c) kinematic analysis of speech, or 

(d) physiologic analysis of speech. 

Cathy Bass

8. Flaccid dysarthria is caused by damage to this location and typically 

results in these speech characteristics. 

A. Bilateral upper motor neuron; spasticity, increased tone 

B. Motor unit of the final common pathway; weakness, hypotonia 

C. Basal ganglia control circuit; rigidity, reduced range of movement 

D. Unilateral upper motor neuron; weakness, incoordination of tongue and lower face movements 

Melinda Bumgardner

8. According to the textbook what are the primary characteristics of flaccid paralysis? 

a) atrophy and fasciculations 

b) atrophy, fasciculations, and fibrillations 

c) rapid weakening and recovery with rest 

d) weakness, hypotonia, and diminished reflexes 

e) none of the above 

Tammy Camp

9. What is the most common motor neuron disease that affects the bulbar, limb, and respiratory muscles? 

a) Progressive Bulbar Palsy 

b) Amyotrophic Lateral Sclerosis (ALS) 

c) Guillain-Barre Syndrome 

d) Polymyositis 

e) none of the above 

Tammy Camp

10. Lesions in the basal ganglia control circuit can result in the following: 

a) Hyperkinetic dysarthria 

b) Hypokinetic dysarthria 

c) Both of the above 

Jennifer Cochran 

11. The components of the basal ganglia, the striatum and globus pallidus, are important for all but which of the following: 

a) maintaining normal posture 

b) mediating consciousness 

c) regulating muscle tone 

d) automatic activities, ie. chewing or walking 

e) movements associated with goal directed activities such as the arm swing during walking 

Jennifer Cochran

12. Which of the following is usually associated with deficits at all of the speech valves and for all components of the speech system, frequently produces pseudobulbar affect, and often results in pathological oral reflexes? 

a) flaccid dysarthria 

b) ataxic dysarthria 

c) spastic dysarthria 

d) hypotonic dysarthria 

Crystal Brevard

13. Lesions affecting this nerve may cause either unilateral or bilateral paralysis of the vocal folds: 

a) superior laryngeal nerve 

b) recurrent laryngeal nerve 

c) pharyngeal laryngeal nerve 

d) trigeminal nerve 

Betsy Fogleman

14. Bilateral tongue weakness may cause all of the following except: 

A) differences in resonance 

B) hyperkinetic movement disorders 

C) difficulty producing sounds requiring elevation of tongue 

D) restricted or exaggerated jaw movements 

Kristin Cook

15. Vascular disorders are more frequently associated with_______________ dysarthria than with most other dysarthria types. 

(a) Flaccid 

(b) Spastic 

(c) Ataxic 

(d) Hypokinetic 

(e) Hyperkinetic 

******Hint****** Ans. on pg. 130. 

Kelly G. Powell

16. A single brainstem stoke (can/can not) produce a spastic dysarthria, whereas a single cerebral hemisphere stroke (can/ cannot). 

(a) can; can 

(b) cannot; cannot 

(c) can; cannot 

(d) cannot; can 

Kelly Powell

17. Unilateral damage to the superior branch of the Xth cranial nerve, the vagus, will produce which of the following: 

a) breathy hoarse voice 

b) reduced pitch range 

c) mildly imprecise lingual consonants 

Ginger Bledsoe

18.Which type of motor speech disorder is most often associated with chronic alcoholism and traumatic brain injury (esp. in boxers)? 

a) Hyperkinetic 

b) Flaccid 

c) Spastic 

d) Ataxic 

Lori Hartley

19. This type of dysarthria is the result of damage to the cerebellar control circuit. 

a) spastic dysarthria 

b) flaccid dysarthria 

c) ataxic dysarthria 

d) hypokinetic dysarthria 

Donna Duncan

20. What is another term for "direct activation pathway"? 

a. extrapyramidal tract 

b. pyramidal tract 

c. final pathway 

Vanessa Carpino

21. Which type of dysarthria has a good prognosis (compared to others), is often mild, and is often of short duration? 

a. hyperkinetic 

b. ataxic 

c. unilateral upper motor neuron 

d. bradykinetic 

Amy Heavner

22. Which type of dysarthria carries the "classic" symptom of strained-strangled voice? 

a) hypokinetic 

b) spastic 

c) flaccid 

d) ataxic 

Sarah Hortenstine

23. During oral mechanism exams which motor speech disorder exhibited nasal regurgitation to be distinguishing when present: 

a. flaccid 

b. spastic 

c. ataxic 

d. hypokinetic 

e. hyperkinetic 

f. UUMN 

g. apraxia of speech 

hint: look on page 352 

Melanie McCurry

24. According to the book, characteristics of UUMN dysarthria include all of the following except: 

a) Lower facial weakness and hemiparesis 

b) Slow recovery in most cases 

c) Contralateral lingual weakness 

d) Common cause is stroke 

hint: p.232 

Lloyd Ann Corbett

25. Hyperkinetic dysarthria is perceptually distinguishable from other isolated dysarthria types by: 

a) lower facial weakness and hemiparesis 

b) visible abnormal orofacial, head, and respiratory movements 

c) rapid rate of speech 

d) articulatory inaccuracy and prosodic excess 

Lynne S. Kelley 

26. Apraxia of Speech is present in approximately more than _________ of patients who have communication disorders associated with left hemisphere pathology

A. 30% 

B. 10% 

C. 50% 

D. 65% 

Sandra Murtha

27. For Apraxia of speech which is not true for rate and prosody? 

A) silent pauses preceding initiation of speech. 

B) sound and syllable repetitions 

C) perception of foreign accent 

D) restricted or altered pitch, durational, and loudness contours within utterances. 

Kristin Schuppert

28. Which of the following is the most common cause of Apraxia of Speech? 

a) Degenerative disease 

b) Left hemisphere tumor 

c) Traumatic brain injury 

d) Vascular lesions 

e) Subjecting oneself to too much Kenny "Gee" 

Neil Waters

29. All of these are common characteristics of apraxia of speech except: 

a) pathologic oral reflexes 

b) Broca's aphasia 

c) right lower face weakness 

d) right hemiparesis 

There is a table on page 268 of book that will help with this one! 

Wendy Almond

30. During the assessment process, where would you look to find information about such things as cranial nerve functioning, orientation, and imaging? 

a) previous history report 

b) a previous speech/language assessment report 

c) occupational therapy report 

d) the admittance report 

e) social worker 

Kerri Roberts

31. Apraxia of speech is associated with: 

a) right hemisphere damage 

b) left hemisphere damage 

c) weakness 

Nancy Hamilton

32. Surgical trauma may cause any type of dysarthria with the possible exception of which one? 

A. Spastic 

B. Flaccid 

C. Hypokinetic 

D. Mixed 

Marla Akins

33. What type of dysarthria is found the most in patients with TBI? 

a) flaccid 

b) hyperkinetic 

c) hypokinetic 

d) spastic 

Julianne Watson

34. In apraxia of speech, which of the below is not true: 

a. there is evidence of misdirected formant trajectories in connected speech, in which formants would rise then fall. 

b. there is evidence of diminished formant trajectories, in which the frequency change in a formant transition was less than normal. 

c. there are perseverative trajectories, in which formant transitions resembled those in previous syllables. 

p.275 

Lani Reasoner

35. Apraxia of speech is associated with: 

a) right hemisphere damage 

b) left hemisphere damage 

c) weakness 

Nancy Hamilton

36. List the four parameter of respiratory assessment and identify each as a perceptual, kinematic, acoustic, or physiological measurement. 

A. vital capacity (kinematic), flow (kinematic), s/z ratio (kinematic) words per exhalation (perceptual) 

B. Pressure (perceptual), volume (perceptual), flow (perceptual), shape (perceptual) 

C. rest respiration (perceptual), vital capacity (physiological), s/z ratio (physiological), shape (perceptual) 

d. pressure (physiologic), rest respiration (perceptual), audible breathing (perceptual), words per exhalation (perceptual) 

Jena Poindexter

37. Which is NOT true of the UMN system? 

a) Contained entirely within the CNS 

b) Predominantly a direct activation pathway 

c) Includes the corticospinal and corticobulbar tracts 

d) Includes the basal ganglia and cerebellar control circuits 

(answer is on page 43) 

Karen Daly

38. Communication-oriented approaches to treatment are strongly dependent upon all of the following except: 

A) degree of disability and handicap 

B) type of dysarthria 

C) environment in which communication takes place 

D) severity of deficits that accompany the motor speech disorder 

Kristin Cook

39. As a treatment approach, "conservation of strength" is recommended for: 

a) flaccid only 

b) flaccid, spastic, and hypokinetic 

c) hyperkinetic and UUMN 

d) ataxic 

check page 406 

Karen Daly

40. Assessing speech by looking at the different subsystems can provide valuable information about function; however, it is important to remember 

that the subsystems are: 

A. Interdependent 

B. Intradependent 

C. Unrelated 

D. None of the above 

Melinda Bumgardner

41. Non-speech tasks assess speech articulators by: 

a) helping to identify the impairment 

b) allowing the removal of the language system influence 

c) a and b 

d) non-speech tasks do not assess speech articulators 

Jennifer Cochran

42. An oral mechanism exam is designed to test which of the following levels: 

a) disability 

b) handicap 

c) impairment 

d) how big of a bubble you can blow 

Crystal Brevard

43. All of the following are physiologic voice assessment measures except which one? 

a) electroglottograph 

b) s:z ratio 

c) stroboscopy 

d) electromyography 

Tammy Camp

44. Do Heather and Jena's uvulas deviate: 

a. to the left 

b. to the right 

c. mentally 

d. into the nostrils 

Amy Heavner

46. What is the most powerful single, behaviorally modifiable variable for improving intelligibility? 

a) articulation 

b) rate 

c) prosody 

d) resonance 

Betsy Fogleman

47. All of the following are auditory perceptual tasks for assessing the respiratory system EXCEPT: 

a) vary vowel loudness while sustaining a vowel 

b) phrase length 

c) change stress during syllable strings 

d) timing 

Lanette Sugg

48. Hypothetical situation:You gave a motor speech screening to the pt. Matthew Moore. He exhibited: 1) difficulty with repetition, 2) increased difficulty with volitionality & complexity, 3) groping of the articulators, & variable errors. These errors are key features of: 

a) flaccid dysarthria 

b) apraxia of speech 

c) spastic dysarthria 

d) ataxic dysarthria 

Kelly G. Powell

49. AOS is different from dysarthria in the following way: 

A) AOS is associated with right hemisphere pathology; dysarthria with left 

B) AOS is associated with left hemisphere pathology; dysarthria with right 

C) AOS is usually not present without abnormal oral mechanism findings. 

D) AOS is usually never associated with aphasia but dysarthria almost always is 

Lisa Heiney

50. Chapter 6: The nose-finger-nose test is used to detect (pick one) 

A dysynergia 

B dysmetria 

C dysdiadochokinesis 

D kinetic tremor 

Cindy Herold

51.Chapter 17: Behavior management of articulation would include the following: (Circle all that apply). 

A strength training 

B relaxation 

C increasing respiratory fx 

D stretching 

E biofeedback 

F exaggeration of consonants 

G rate 

Cindy Herold

52. Acoustic measurements include the following: 

a. loudness 

b. pitch 

c. electroglottograph 

d. fundamental frequency 

Nancy Hamilton

53. What is most successful in managing velopharyngeal incompetence in dysarthric patients? 

a. pharyngeal flap surgery 

b. botulinum toxin injection 

c. palatal lift prostheses 

d. Teflon injection 

Donna Duncan

54. The length of treatment for an acute care or rehab patient depends on: 

a) motivation of the patient 

b) stamina of the patient 

c) state of the patient 

d) all of the above 

Sarah Hortenstine

55. Patients generally stay at acute care rehabilitation settings for approximately _____________________ weeks. 

A) 25-30 

B) 2-4 

C) 10-15 

D) 36-40 

Cindy Herold

56. Practice Principles include 

A. Motivation: provide rationale, provide encouragement 

B. Elicitation: instruction (avoid verbal or overly verbal-- limit to the goal) 

C. Modeling-- active rather than static (pictures) 

D. All of the above. 

Lani Reasoner

57. The goal of management of motor speech disorders is to 

a) improve intelligibility, efficiency, and naturalness 

b) develop augmentative or alternative means of communication 

c) improve communication 

d) make lots and lots of money 

e) a, b, & c 

Lisa Absher

58. Respiratory support need not be the focus of dysarthria treatment if: 

A. the patient has adequate loudness 

B. the patient has the capacity for flexible breath patterning 

C. the patient can generate steady subglottal air pressure of 5 to 10 cm of water per 5 seconds. 

D. All of the above 

Lori Hartley

59. A patient exhibits mild unilateral UMN dysarthria, good comprehension skills, trial and error groping and articulatory inconsistencies. He probably has: 

A. Flaccid dysarthria 

B. Apraxia of speech 

C. Aphasia 

D. Mixed dysarthria 

pgs 277-278 

Lisa Heiney

60. When administering the Dysarthria Profile, what level and method is the task of resting breathing considered? 

a) disability/perceptual 

b) handicap/kinematic 

c) impairment/perceptual 

d) impairment/physiologic 

Vanessa Carpino

61. When comparing apraxia and aphasia, Apraxia has distinctive speech and language characteristics. Choose all of the characteristics of apraxia that would help make the distinction from aphasia. 

a) Prosody abnormal 

b) errors influenced by articulatory complexity 

c) nonspeech language modalities impaired 

d) Articulatory hesitancy & groping 

Refer to chart on page 358 

Ginger Bledsoe

62. Which is not one of the general orientations and primary goals of managing AOS? 

1. maximize the effectiveness 

2. efficiency 

3. improve physiologic support 

4. naturalness and communication 

hint: look on page 417 

Melanie McCurry

63. When treating the subsystems, if you are treating intelligibility which below is not one you would treat under this heading? 

1. intelligibility within specific contexts 

2. self-monitoring 

3. strengthening 

4. clarification strategies 

Melanie McCurry

64. What two COMPENSATORY STRATEGIES are helpful to teach patients when they do not wish to participate in intensive therapy, when all else fails, etc? 

a. breathing techniques and production of bubbles 

b. relaxation techniques and pitch adjustments 

c. slow down and overarticulate 

Amy M. Heavner

65. Which of the following is characteristic of variable practice? 

A Provides a wide variety of initial conditions and outcomes from which schemas can develop 

B constant practice may facilitate fast acquisition 

C variable practice facilitates learning 

D all of the above 

Jena Poindexter

66.All of the following relate to the PROMPT treatment technique except: 

a) prompts for restructuring oral muscular phonetic targets 

b) was developed for children with developmental apraxia of speech, but it has been used on adults. 

c) is characterized by the use of tactile cues to provide touch pressure 

d) incorporates language therapy 

e) uses kinesthetic and proprioceptive cues to facilitate speech production 

Kerri Roberts

67. It is (a) required, (b)courteous, (c) not necessary, to get a physician's order before doing an evaluation on a patient in a hospital. 

Lanette Sugg

68. If you are an SLP working in a hospital (contract therapist) do you need a physician's referral to be reimbursed for your services? 

a)sometimes 

b)always 

c)never 

d)depends on the physician 

Julianne Watson

69. What are some common protocols used in apraxia of Speech? 

a. Melodic Intonation Therapy (MIT) 

b. Multiple Input Phoneme Therapy (MIPT) 

c. Voluntary Control of Involuntary Utterances (VCIU) 

d. all of the above 

e. none of the above 

Vanessa Carpino 

70. There are several steps need to be considered when developing a lesson plan. Which is not one of them. 

A. How much time you have 

B. The order of the activity 

C. How quickly the client fatigues 

D. How much time till your next workout 

Kristin Schuppert 

71. Which etiology is the MOST common cause of AOS? 

a. tumors 

b. vascular lesions 

c. degenerative neurologic disease 

d. multiple sclerosis 

See Duffy pages 261-262 

Terri Simmons

72. Considerations for discharging patients to acute care rehabilitation may include: 

a. prognosis 

b. age 

c. therapy needs of the patient 

d. all of the above 

Terri Simmons

73. Which is NOT true of Apraxia of Speech? 

a) also called Broca's Aphasia 

b) muscles are capable of normal activity 

c) related primarily to R hemisphere damage 

d) person has awareness of errors 

Suzanne Barry

74. Implicit memories are: 

a) learning "how" 

b) when we are aware of our learning 

c) dependent on repetition 

d) both a & c 

Suzanne Barry

75. What target level and observation is noted by the Frenchay? 

a)disability and perceptual 

b)impairment/disability/handicap and perceptual 

c)impairment and perceptual 

d)impairment/disability and perceptual 

L.A. Corbett

76. What maneuver helps Parkinson's patients with pitch change? 

a)Robertson's Maneuver 

b)Masako Maneuver 

c)Heimlich Maneuver 

d)Mendelssohn 

L.A. Corbett

77. Which of the following apraxia treatment methods uses singing and spoken song? (ch. 18) 

A. PROMPT 

B. VCIU 

C. MIT 

D. the 8-step continuum for treating AOS 

Monica Parker

78. Which one of the following is not a general approach in the assessment of motor speech disorders? (from notes) 

a. assessment can be on-going 

b. assess one speech subsystem at a time because they are independent of each other 

c. can assess at a perceptual, acoustic, kinematic, or physiologic level 

d. may assess at impairment, disability, or handicap levels 

Monica Parker

79. When observing the velopharynx during an oral mechanism examination, important observations include all of the following EXCEPT: 

a. presence/absence 

b. symmetry of movement 

c. direct view of pharyngeal wall activity 

d. evidence of nasal airflow on mirror during vowel prolongation 

Lynne Kelley

80. Treatment of apraxia of speech should include: 

a) progressive complexity 

b) consistent and variable practice 

c) oral motor exercises 

d) a & b 

Lori Hartley

81. This technique is used with patients who have severe nonfluent aphasia. It may involve hand tapping rhythms and singing words and phrases 

a) PROMPT 

b) Melodic Intonation Therapy 

c) Multiple Input Phoneme Therapy 

d) Cuing strategies. 

Neil Waters