1. General considerations
2. Dysphasias
3. Dysarthria
4. Dysphonia

General considerations

• If detect speech abnormality, ask pt. to say "British Constitution".
• If okay, then usually, nothing further needed.

Dysphasias

• Dysphasias are CERN:
  • Conductive
  • Expressive
  • Receptive
  • Nominal
• 3 most common are CRN. Distinguish them by asking to:
  • follow Command
  • Repeat statement
  • Name an object
• Conductive:
  • Repeat statements and names poorly.
  • Can follow commands.
• Expressive:
  • Understands, but cannot answer appropriately (including objects can't be named).
  • Other speech aspects normal.
  • Cause: Broca's area lesion.
• Receptive:
  • Cannot understand spoken or written word.
  • Cause: Wernicke's area lesion.
• Nominal:
  • Specifically can't name objects, but everything else OK..

Dysarthria

• Difficulty of articulation only.
• Can't say "British Constitution".
• Causes:
  • Alcohol intoxication (commonest)
  • Cerebellar
  • Bulbar or pseudobulbar palsy
  • Extrapyramidal dz

Dysphonia

• Husky voice, decreased volume.
• Causes: 
  • Laryngeal nerve palsy
  • Recurrent laryngeal
  • Hysterical