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. — An 83-year-old woman was admitted to the hospital after her spouse noticed a sudden onset of “garbled” speech. Neurologic examination in the ER noted left-hand weakness, dysphagia, and hyperactive reflexes on both sides. The neurologist noted speech difficulty, including decreased intelligibility, and requested SLP consult. You speak with the patient when she first arrives at your office. She says it feels “difficult” to speak and that she feels tight. 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 hand, but all of those issues went away in about a week. During this conversation, you note a hoarse, strained voice throughout, as well as decreased modulation of both pitch and loudness. You also note widespread articulatory imprecision. During oral mechanism examination, you note the following: Reduced range of movement in both smile and pucker, especially when trying to move between the postures quickly Reduced range of movement in tongue lateralization, especially when trying to move from side to side quickly During DDK tasks, you note the following: Slow but regular rate Imprecise articulation for all three places of articulation (pa, ta, ka) Hypernasality
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