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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
Q

What is the major impairment of Flaccid Dysarthria on Speech?

26
Q

What do we need to ask when we see Flaccid Dysarthria?

A

Is the resulting damage confined to isolated muscle groups or to several muscle groups?

27
Q

How do we determine if the resulting damage from Flaccid Dysarthria is confined to isolated muscle groups or to several muscle groups?

(3)

A

Determining which cranial nerve(s) is/are involved

Determining the level of the lesion

Determining whether the damage is unilateral or bilateral.

28
Q

What is Atrophy?

A

Loss of muscle bulk

29
Q

What are Fasciculations?

A

Visible, writhing movements

30
Q

How do Fasciculations affect articulation?

A

It will be inaccurate but is usually still intelligible

31
Q

What are Fibrillations?

A

Small contractions, but not visible

32
Q

Can Flaccid Dysarthria be caused by lesions to the neuromuscular junction?

What disease is this a hallmark of?

A

Yes

Myasthenia gravis

33
Q

What is a hallmark feature of Myasthenia Gravis?

A

Progressive weakness with use

34
Q

What structures are involved in Flaccid Dysarthria?

3

A

Nuclei of brainstem

Cranial nerve

Neuromuscular junction

35
Q

What are cranial nerves?

A

Bundle of axons emanating from the specific brainstem nucleus

36
Q

What abnormal speech characteristics can Flaccid Dysarthria create in the Resonatory System?

(4)

A

Hypernasality

Imprecise consonants

Nasal emission

Short phrases

37
Q

What abnormal speech characteristics can Flaccid Dysarthria create in the Phonatory System?

(3)

A

Breathiness

Short phrases

Audible inspiration

38
Q

What abnormal speech characteristics can Flaccid Dysarthria create in the Phonatory-Prosodic System?

(3)

A

Harsh voice

Monoloudness

Monopitch

39
Q

How does Flaccid Dysarthria affect Direction?

2

A

No effect

Direction is normal

40
Q

How does Flaccid Dysarthria affect Rhythm?

2

A

Repetitive movements are regular

Individual movements are normal or slow

41
Q

How does Flaccid Dysarthria affect Rate?

2

A

Repetitive movements are normal or slow

Individual movements are reduced

42
Q

How does Flaccid Dysarthria affect Range?

A

Repetitive movements are reduced

43
Q

How does Flaccid Dysarthria affect Force?

A

Individual movements are weak

44
Q

How does Flaccid Dysarthria affect Tone?

45
Q

What are the 4 Distinguishing Features of Flaccid Dysarthria?

A

Hypernasality

Stridor

Nasal emission

Laryngeal and velopharyngeal signs

46
Q

What is Bulbar Palsy?

A

Flaccid Dysarthria involving multiple cranial nerves

47
Q

What is Bulbar Palsy associated with?

A

Intracranial pathology particularly in the brainstem

48
Q

In what diseases/disorders is Bulbar Palsy common?

9

A

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
Q

In MYASTHENIA GRAVIS (MG), what is the…

  • Locus?
  • Pathology?
  • Effect? (2)
  • Signs? (3)
A

– LOCUS –

Neuromuscular junction (Tensilon test)

– PATHOLOGY –

Autoimmune disease

– EFFECT –

Rapid weakening of voluntary muscles

Improves with rest

– SIGNS –

Flaccid Dysarthria

Ptosis

Dysphagia

50
Q

In EATON-LAMBERT, what is the…

  • Locus?
  • Pathology? (2)
  • Effect? (2)
  • Signs?
A

– LOCUS –

Neuromuscular

– PATHOLOGY –

Inadequate ACh (Acetylcholine)

Doesn’t cross neuromuscular junction correctly

– EFFECT –

Weakness at initiation

Opposite of MG

– SIGNS –

Flaccid dysarthria

51
Q

In WALLENBERG’S LATERAL MEDULLARY SYNDROME (LMS), what is the…

  • Locus?
  • Pathology?
  • Effect? (2)
  • Signs? (2)
A

– LOCUS –

Lateral medulla

– PATHOLOGY –

Vascular

– EFFECT –

Ipsilateral facial sensory loss

Contralateral extremity sensory loss

– SIGNS –

Dysphagia

Flaccid Dysarthria

52
Q

In POLIOMYELITIS, what is the…

  • Locus? (2)
  • Pathology?
  • Effect?
  • Signs? (2)
A

– LOCUS –

Dorsal medulla

Spine (lumbar and cervical)

– PATHOLOGY –

Infectious (viral)

– EFFECT –

CN IX

CN X

– SIGNS –

Dysphagia

Flaccid Dysarthria

53
Q

In GUILLAIN-BARRE SYNDROME, what is the…

  • Locus? (2)
  • Pathology? (2)
  • Effect? (1+4)
  • Signs? (2)
A

– LOCUS –

Ascending weakness

PNS then CNS

– PATHOLOGY –

Demyelinating

Viral (cause unknown)

– EFFECT –

Weakness in…

  • Limbs
  • Thorax
  • Pharynx
  • Oral

– SIGNS –

Dysphagia

Flaccid Dysarthria

54
Q

In MUSCULAR DYSTROPHY, what is the…

  • Locus?
  • Pathology? (2)
  • Effect?
  • Signs? (2)
A

– LOCUS –

Muscle fibers

– PATHOLOGY –

Genetic

Degenerative

– EFFECT –

Weakness

– SIGNS –

Dysphagia

Flaccid Dysarthria

55
Q

What does Progressive Bulbar Palsy affect?

A

Cranial nerves

56
Q

What does Amyotrophic Lateral Sclerosis (ALS) affect?

2

A

Cranial nerves

Spinal nerves

57
Q

Degenerative muscles disorders usually affect the ____ but can occasionally affect both ____ + _____.

A

LMN

LMN+UMN

58
Q

The likely nature of a Neuropathological Problem gives each disorder its __________ such as ______, ______, or ______.

A

Distinctive perceptual characteristics

Weakness

Spasticity

Incoordination

ECU Motor Speech Disorders (16 decks)

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