{"id":177,"date":"2010-06-09T09:30:31","date_gmt":"2010-06-09T08:30:31","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/the-speech\/"},"modified":"2023-01-12T00:28:12","modified_gmt":"2023-01-12T00:28:12","slug":"the-speech","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-neurological-examination\/voice-speech-language\/the-speech\/","title":{"rendered":"The speech"},"content":{"rendered":"<p>To be able to speak clearly, the muscles of the tongue, palate and lips, as well as the innervating <em>peripheral nerves<\/em> and corticobulbar tracts to the brainstem nuclei must be intact. In addition, the coordination of lip, tongue and palate movements must be unimpaired. This coordination is a function of the <em>extrapyramidal <\/em>system and the <em>cerebellum<\/em>. Speech impairment is known as dysarthria.<\/p>\n<ul>\n<li><em>Muscles, peripheral nerves (VII, IX, X and XII) and corticobulbar tracts.<\/em><br \/>\nFor the examination, please refer to the section \u2018The cranial nerves\u2019. If these structures are affected, the speech will be nasal, and if the corticobulbar tracts are involved it is, slow and stuttering as well, with particular problems with sounds that are formed in the mouth (p, b, t, d). This speech impairment is easy to distinguish from stuttering, which is considered to be a development disorder. Stuttering is less consistently present. The \u2018patient\u2019 interchanges stuttering with sentences in which they do not stutter at all.<\/li>\n<\/ul>\n<ul>\n<li><em>The extrapyramidal system.<\/em> A frequently-occurring extrapyramidal condition is Parkinson\u2019s disease.<br \/>\nThe diagnosis is usually not made on the basis of the patient\u2019s speech disorder as this is not an early symptom of the disease. The patient will start to talk more quietly, more monotonously and articulation will become less clear.<\/li>\n<\/ul>\n<ul>\n<li><em>The cerebellum. <\/em>The speech of patients with a diffuse cerebellar condition or one involving the cerebellar vermis becomes slow and stuttering. Sometimes so-called dysmetric articulation movements are seen. The patient appears to grimace when talking. In general, it remains easy to understand the patient.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>To be able to speak clearly, the muscles of the tongue, palate and lips, as well as the innervating peripheral nerves and corticobulbar tracts to the brainstem nuclei must be intact. In addition, the coordination of lip, tongue and palate movements must be unimpaired. This coordination is a function of the extrapyramidal system and the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6],"tags":[113,107],"class_list":["post-177","post","type-post","status-publish","format-standard","hentry","category-voice-speech-language","tag-the-neurological-examination","tag-voice-speech-language"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The speech - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. Prepare for your OSCE.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.qpercom.com\/sim\/index.php\/the-neurological-examination\/voice-speech-language\/the-speech\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The speech - Qpercom | Skills in Medicine\" \/>\n<meta property=\"og:description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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