21. You are a clinician in an acute inpatient hospital. You receive a consult for a 66 year-old male who presented to the ED due to a fall. His medical history is also significant for HTN, urinary incontinence, excessive sweating, and HLD.  Upon entry into the room the patient reports that he is falling much more frequently over the past 8 months, and has noticed significant decline of his speech function with listeners frequently asking him to repeat himself because of reduced loudness and consonant imprecision. He also acknowledges coughing/choking with thin liquids at home approximately once per meal. c). Based on your response to part (b) of question 21, tell me some key ways to disentangle these disorders (think speech and motor symptoms)? (2 points)

2. Video Case 2. A 28 year old female who carries a medical diagnosis of Friedrich’s ataxia presents to your outpatient clinic for reported changes to speech, language and voice function. In terms of speech and voice function she reports “slurred” speech and a “raspy/breathy” vocal quality. She also admits to mild anomia, difficulty maintaining attention, experiencing a globus sensation with solid foods, and smoking 1 pack of cigarettes per day. She is non-ambulatory and utilizes a motorized wheelchair. a). Motor Speech Evaluation: Perceptual speech evaluation is rated on a 0-7 point scale, with 0 indicating normal function and 7 indicating profound dysfunction. Please rate each subsystem and characteristic that you hear (6 points). Respiratory mechanism is involved with a severity rating of: Maximum phonation duration:      Maximum loudness:                Normal           Adequate          Inadequate                                      Loudness in conversation:      Normal           Adequate          Inadequate Laryngeal mechanism is involved with a severity rating of: Vocal quality:      Normal                Hoarse              Breathy (continuous)                               Breathy (transient)           Strained-strangled           Harsh              Rough Pitch range:         Normal            Adequate          InadequateVocal tremor:      Yes                      No Velopharyngeal mechanism is involved with a severity rating of:                               Resonance:          Normal            Hypernasal            HyponasalNasal emission:        Yes                        No                                                                                  Nasal assimilation:   Yes                        No Orofacial mechanism is involved with a severity rating of:                                    Conversation:           Precise               Imprecise                                                        Diadochokinesis:     Precise               Imprecise Rate is involved with a severity rating of:                                                                                            Speed:            Normal              Fast                  Slow                                                                        Pace:              Consistent        VariableDDK rate:      Normal             Fast                     Slow Prosody is involved with a severity rating of:                                                                    Intonation in conversation:           Normal            Variable            Monotonous                  Stress in conversation:                  Normal            Equal and excess                                                                                                                      Reduced stress               Excess loudness variation Fluency is involved with a severity rating of: Neurogenic stuttering:     Yes             No Palilalia:                             Yes              No Naturalness is involved with a severity rating of (0-7): Intelligibility in connected speech is:

The main role of the tonsils is to __________.

IFNs stimulate B cells to produce antibodies.

Which of the following types of cells is involved in adaptive immunity?

A patient who lacks intrinsic factor would likely develop __________.

Which of the following is considered a type of lymphocyte?

Arteries carry blood away from the heart; veins carry blood to the heart.

The second heart sound (the “dup” of “lub-dup”) is caused by the __________.

Steroid hormones are synthesized from __________.