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ECU Motor Speech Disorders > 4.1 Flaccid Dysarthria > Flashcards

4.1 Flaccid Dysarthria Flashcards

1
Q

What is the hallmark of Flaccid Dysarthria?

A

Weakness

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2
Q

What causes Flaccid Dysarthria?

2

A

Injury or malfunction of one or more of the cranial or spinal nerves

Lesions to the LMNs

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3
Q

Can Flaccid Dysarthria involve only a single muscle group (e.g., the tongue)?

A

Yes

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4
Q

Can Flaccid Dysarthria involve only a single speech subsystem (e.g., phonatory, articulatory)?

A

Yes

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5
Q

Can Flaccid Dysarthria involve several subsystems?

A

Yes

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6
Q

Can Flaccid Dysarthria involve several muscle groups, in a variety of combinations?

A

Yes

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7
Q

What Subtypes of Flaccid Dysarthria can be recognized?

4

A

Unilateral damage to a specific cranial or spinal nerve

Unilateral damage to a combination of cranial or spinal nerves

Bilateral damage to a specific cranial or spinal nerve

Bilateral damage to a combination of cranial or spinal nerves.

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8
Q

What will a pt.’s voice sound like that has Flaccid Dysarthria affecting the Vocal Fold Unilaterally?

A

Breathy

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9
Q

What will a pt.’s voice sound like that has Flaccid Dysarthria affecting the Vocal Fold Bilaterally?

(2)

A

Extremely breathy

Aphonia

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10
Q

What will a pt.’s articulation sound like that has Flaccid Dysarthria affecting the Facial Nerve Unilaterally?

(3)

A

Imprecise

Slurred

No affect

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11
Q

What will a pt.’s articulation sound like that has Flaccid Dysarthria affecting the Facial Nerve Bilaterally?

(2)

A

Extremely imprecise

Unintelligible

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12
Q

What are 12 etiologies of Flaccid Dysarthria?

A

Degenerative (40%)

Traumatic (22%)

Surgical (19%)

Nonsurgical (3%)

Muscle Disease (9%)

Vascular (9%)

Myasthenia Gravis (4%)

Infectious (4%)

Tumor (3%)

Demyelinating (2%)

Anatomic Malformation (1%)

Other (5%)

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13
Q

What is a Degenerative cause of Flaccid Dysarthria?

A

ALS

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14
Q

What are 3 Surgical causes of Flaccid Dysarthria?

A

Carotid endarterectomy

Thyroidectomy

Cardiac/chest surgery

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15
Q

What are 3 Nonsurgical causes of Flaccid Dysarthria?

A

TBI

Skull fracture

Neck trauma

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16
Q

What are 2 Muscle Disease causes of Flaccid Dysarthria?

A

Muscular dystrophy

Polymyositis

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17
Q

What are 3 Vascular causes of Flaccid Dysarthria?

A

Brainstem stroke

Anoxic encephalopathy

Aortic aneurysm

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18
Q

What is a Infectious cause of Flaccid Dysarthria?

A

Polio

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19
Q

What is a Demyelinating cause of Flaccid Dysarthria?

A

Guillain-Barre syndrome

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20
Q

What are 2 Other causes of Flaccid Dysarthria?

A

Radiation therapy

Drug toxicity

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21
Q

What are 7 Distinguishing Signs of a disorder of the LMN?

A

Weakness

Isolated muscle group(s) are affected

Reflexive, automatic, and voluntary movements are all affected (FCP)

Diminished movement, both voluntary and reflexive

Atrophy

Fasciculations

Fibrillations

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22
Q

What are 2 terms that denote weakness?

A

Hypotonia

Atonia

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23
Q

What qualities of the muscle creates the weakness seen in Flaccid Dysarthria?

(3)

A

Floppiness of the muscle

Reduced resistance to passive movement

Limited ability of the muscle to contract

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24
Q

What is the effect of muscle weakness?

A

Reduced or absent ability to contract muscles

25
What is the major impairment of Flaccid Dysarthria on Speech?
Weakness
26
What do we need to ask when we see Flaccid Dysarthria?
Is the resulting damage confined to isolated muscle groups or to several muscle groups?
27
How do we determine if the resulting damage from Flaccid Dysarthria is confined to isolated muscle groups or to several muscle groups? (3)
Determining which cranial nerve(s) is/are involved Determining the level of the lesion Determining whether the damage is unilateral or bilateral.
28
What is Atrophy?
Loss of muscle bulk
29
What are Fasciculations?
Visible, writhing movements
30
How do Fasciculations affect articulation?
It will be inaccurate but is usually still intelligible
31
What are Fibrillations?
Small contractions, but not visible
32
Can Flaccid Dysarthria be caused by lesions to the neuromuscular junction? What disease is this a hallmark of?
Yes Myasthenia gravis
33
What is a hallmark feature of Myasthenia Gravis?
Progressive weakness with use
34
What structures are involved in Flaccid Dysarthria? | 3
Nuclei of brainstem Cranial nerve Neuromuscular junction
35
What are cranial nerves?
Bundle of axons emanating from the specific brainstem nucleus
36
What abnormal speech characteristics can Flaccid Dysarthria create in the Resonatory System? (4)
Hypernasality Imprecise consonants Nasal emission Short phrases
37
What abnormal speech characteristics can Flaccid Dysarthria create in the Phonatory System? (3)
Breathiness Short phrases Audible inspiration
38
What abnormal speech characteristics can Flaccid Dysarthria create in the Phonatory-Prosodic System? (3)
Harsh voice Monoloudness Monopitch
39
How does Flaccid Dysarthria affect Direction? | 2
No effect Direction is normal
40
How does Flaccid Dysarthria affect Rhythm? | 2
Repetitive movements are regular Individual movements are normal or slow
41
How does Flaccid Dysarthria affect Rate? | 2
Repetitive movements are normal or slow Individual movements are reduced
42
How does Flaccid Dysarthria affect Range?
Repetitive movements are reduced
43
How does Flaccid Dysarthria affect Force?
Individual movements are weak
44
How does Flaccid Dysarthria affect Tone?
Reduced
45
What are the 4 Distinguishing Features of Flaccid Dysarthria?
Hypernasality Stridor Nasal emission Laryngeal and velopharyngeal signs
46
What is Bulbar Palsy?
Flaccid Dysarthria involving multiple cranial nerves
47
What is Bulbar Palsy associated with?
Intracranial pathology particularly in the brainstem
48
In what diseases/disorders is Bulbar Palsy common? | 9
Myasthenia Gravis (MG) Eaton-Lambert Wallenberg’s lateral medullary syndrome (LMS) Poliomyelitis Guillain-Barre Syndrome Muscular dystrophy Amyotrophic lateral sclerosis (ALS) Brainstem vascular disturbances Tumors
49
In MYASTHENIA GRAVIS (MG), what is the... - Locus? - Pathology? - Effect? (2) - Signs? (3)
– LOCUS – Neuromuscular junction (Tensilon test) – PATHOLOGY – Autoimmune disease – EFFECT – Rapid weakening of voluntary muscles Improves with rest – SIGNS – Flaccid Dysarthria Ptosis Dysphagia
50
In EATON-LAMBERT, what is the... - Locus? - Pathology? (2) - Effect? (2) - Signs?
– LOCUS – Neuromuscular – PATHOLOGY – Inadequate ACh (Acetylcholine) Doesn't cross neuromuscular junction correctly – EFFECT – Weakness at initiation Opposite of MG – SIGNS – Flaccid dysarthria
51
In WALLENBERG'S LATERAL MEDULLARY SYNDROME (LMS), what is the... - Locus? - Pathology? - Effect? (2) - Signs? (2)
– LOCUS – Lateral medulla – PATHOLOGY – Vascular – EFFECT – Ipsilateral facial sensory loss Contralateral extremity sensory loss – SIGNS – Dysphagia Flaccid Dysarthria
52
In POLIOMYELITIS, what is the... - Locus? (2) - Pathology? - Effect? - Signs? (2)
– LOCUS – Dorsal medulla Spine (lumbar and cervical) – PATHOLOGY – Infectious (viral) – EFFECT – CN IX CN X – SIGNS – Dysphagia Flaccid Dysarthria
53
In GUILLAIN-BARRE SYNDROME, what is the... - Locus? (2) - Pathology? (2) - Effect? (1+4) - Signs? (2)
– LOCUS – Ascending weakness PNS then CNS – PATHOLOGY – Demyelinating Viral (cause unknown) – EFFECT – Weakness in... - Limbs - Thorax - Pharynx - Oral – SIGNS – Dysphagia Flaccid Dysarthria
54
In MUSCULAR DYSTROPHY, what is the... - Locus? - Pathology? (2) - Effect? - Signs? (2)
– LOCUS – Muscle fibers – PATHOLOGY – Genetic Degenerative – EFFECT – Weakness – SIGNS – Dysphagia Flaccid Dysarthria
55
What does Progressive Bulbar Palsy affect?
Cranial nerves
56
What does Amyotrophic Lateral Sclerosis (ALS) affect? | 2
Cranial nerves Spinal nerves
57
Degenerative muscles disorders usually affect the ____ but can occasionally affect both ____ + _____.
LMN LMN+UMN
58
The likely nature of a Neuropathological Problem gives each disorder its __________ such as ______, ______, or ______.
Distinctive perceptual characteristics Weakness Spasticity Incoordination

ECU Motor Speech Disorders (16 decks)

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