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ECU Motor Speech Disorders > 5.1 - Spastic Dysarthria > Flashcards

5.1 - Spastic Dysarthria Flashcards

1
Q

What are the hallmarks of Spastic Dysarthria?

2

A

Reduced speed

Reduced range

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2
Q

What is the pathophysiology of Spastic Dysarthria?

A

Bilateral damage to the direct and indirect activation pathways of the CNS

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3
Q

Where might Spastic Dysarthria manifest?

A

In any or all speech systems

Respiration, phonation, resonance, articulation, prosody

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4
Q

Is Spastic Dysarthria usually confined to a single component?

A

No

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5
Q

What slows down movement and reduces range + force in Spastic Dysarthria?

A

The combined affects of weakness and spasticity

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6
Q

What is Spasticity a hallmark of?

A

Upper motor neuron disease

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7
Q

What cranial areas are involved in Spastic Dysarthria?

2

A

Corticobulbar tracts

Bilateral disease

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8
Q

If Spasticity is affecting speech, it will also be affecting _______.

A

Other muscle systems

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9
Q

What physical symptoms may be seen in an individual suffering from Spasticity?

(2)

A

Fingers curled inward

Arms pulled tight

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10
Q

What causes weakness in Spasticity?

A

Muscle stiffness

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11
Q

What are the two Activation Pathways of the UMN?

A

Direct Activation Pathway (Coricobulbar)

Indirect Activation Pathway (Basal Ganglia)

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12
Q

The Direct Activation Pathway (Coricobulbar) is primarily _______. It creates _____________.

A

Facilitatory

Discrete, skilled, voluntary movements

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13
Q

The Indirect Activation Pathway (Basal Ganglia) is primary _______. It regulates __________ and ___________.

A

Inhibitory

//

Posture + tone

Reflexes

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14
Q

What 6 symptoms may be seen when there are UMN lesions to the DIRECT Pathway?

A

Loss of skilled movement

Hypotonia

Weakness (distal > proximal)

Absent abdominal reflexes

Babinski’s sign (reflex on sole of foot)

Hyporeflexia

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15
Q

What 6 symptoms may be seen when there are UMN lesions to the INDIRECT Pathway?

A

Increased muscle tone

Spasticity

Clonus (muscular spasm)

Decorticate or decerebrate posture (overextended posture)

Hyperactive stretch reflexes

Hyperactive gag reflex

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16
Q

What type of Dysarthria is caused by UMN lesions to the DIRECT Pathway?

A

Flaccid

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17
Q

What type of Dysarthria is caused by UMN lesions to the INDIRECT Pathway?

A

Spastic

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18
Q

What are the distinguishing signs of UMN lesions?

3

A

Spasticity

Normal to hyperactive reflexes

Many muscle groups will be affected

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19
Q

What happens in the acute phase of UMN lesions?

In the later stages?

A

Hypotonia

Spasticity

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20
Q

What is the difference between how faccid dysarthria and spastic dysarthria affects muscle groups?

A

Flaccid dysarthria can affect isolated muscle groups

Spastic dysarthria affects patterns of movement in all muscle groups (but not necessarily equally)

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21
Q

Which type of Dysarthria is typically associated with Respiratory Incompentence: Flaccid or Spastic?

//

How? (4)

A

Flaccid

//

Hypernasality

Imprecise consonants

Nasal emission

Short phrases

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22
Q

Which type of Dysarthria is typically associated with a Slow Rate of Speech: Flaccid or Spastic?

A

Spastic

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23
Q

Which type of Dysarthria is typically associated with a Strained or Strangled Voice: Flaccid or Spastic?

A

Spastic

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24
Q

Which cranial nerves are involved in Hypernasality?

Which muscle groups?

A

CN X (Vegus)

Veleopharyngeal

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25
Which cranial nerves are involved in Imprecise Consonants? (4) Which muscle groups?
CN V (Trigeminal) CN VII (Facial) CN X (Vegus) CN XII (Hypoglossal) // Articulatory (Jaw, Face, Tongue, Velopharyngeal, Tongue)
26
Which cranial nerves are involved in Continuous Breathiness? Which muscle groups?
CN X (Vegus) Laryngeal
27
Which cranial nerves are involved in Monopitch? Which muscle groups?
CN X (Vegus) Laryngeal
28
Which cranial nerves are involved in Nasal Emission? Which muscle groups?
CN X Velopharyngeal
29
Which cranial nerves are involved in Audible Inspiration? Which muscle groups?
CN X Laryngeal
30
Which cranial nerves are involved in Harsh Voice Quality? Which muscle groups?
CN X Laryngeal
31
Which cranial nerves are involved in Short Phrases? (2) Which muscle groups? (2)
CN X Spinal // Laryngeal Respiratory
32
Which cranial nerves are involved in Monoloudness? (2) Which muscle groups? (2)
CN X Spinal // Laryngeal Respiratory
33
Which speech component is involved in Monopitch?
Laryngeal
34
Which speech component is involved in Reduced Stress?
Prosodic
35
Which speech component is involved in Harshness?
Laryngeal
36
Which speech component is involved in Monoloudness?
Laryngeal-respiratory
37
Which speech component is involved in Low Pitch?
Laryngeal
38
Which speech component is involved in a Slow Rate of Speech?
Articulatory-prosodic
39
Which speech component is involved in Hypernasality?
Velopharyngeal
40
Which speech component is involved in a Strained-Strangled Voice Quality?
Laryngeal
41
Which speech component may be involved in Short Phrases? | 3
Laryngeal-respiratory Velopharyngeal Articulatory
42
Which speech component is involved in Distorted Vowels?
Articulatory
43
Which speech component is involved in Pitch Breaks?
Laryngeal
44
Which speech component is involved in a Continuous Breathy Voice?
Laryngeal
45
Which speech component is involved in Excess or Equal Stress?
Prosodic
46
What other symptom may be seen in UMN Lesions?
Lability (Pseudobulbar affect) [pathological laughing or crying]
47
How might reflexes be affected in Flaccid Dysarthria?
Both voluntary and involuntary are affected
48
How might reflexes be affected in Spastic Dysarthria?
Reflexes are normal or exaggerated
49
How is Direction of Movement affected in Spastic Dysarthria?
Normal
50
How is Rhythm of Movement affected in Spastic Dysarthria?
Repetitive movements are regular
51
How is Rate of Movement affected in Spastic Dysarthria? | 2
Repetitive movements are slow Individual movements are slow
52
How is Range of Movement affected in Spastic Dysarthria? | 2
Repetitive movements are reduced Individual movements are reduced and/or weak
53
How is Force of Movement affected in Spastic Dysarthria?
Individual movements are reduced
54
How is Muscle Tone affected in Spastic Dysarthria?
Excessive
55
What are the Articulatory-Resonatory Characteristics of Spastic Dysarthria? (3)
Imprecise consonants Distorted vowels Hypernasality
56
What are the Phonatory Characteristics of Spastic Dysarthria? (5)
Low Pitch Pitch Break Harshness Slow Rate Strained-Strangled Voice
57
What are the Prosodic Characteristics of Spastic Dysarthria? | 4
Monoloudness Monopitch Reduced Stress Short Phrases
58
What sorts of Prosodic Excess may be seen in Spastic Dysarthria? (2)
Excess or Equal Stress Slow Rate
59
How is Naturalness affected in Spastic Dysarthria?
Impaired
60
What may patients complain about with Spastic Dysarthria? | 4
Slow speech (due to difficulty manipulating articulators quickly and precisely) Increased effort to speak Chewing and swallowing problems Difficulty controlling emotions
61
What did Dr. Ellis say are the 3 most important characteristics of Spastic Dysarthria Speech?
Reduced ROM Reduced VOM Impairments in all subsystems
62
In CVAs (causing spastic dysarthria), what is the.... - Locus? (3) - Pathology? (3) - Effect? - Signs? (2)
– LOCUS – Bilateral cortical Lacunar infarcts (white matter disease) Single brainstem – PATHOLOGY – Internal carotid artery Middle cerebral artery Posterior cerebral artery – EFFECT – Bilateral corticobulbar pathways are disrupted – SIGNS – Spastic Dysarthria Dysphagia
63
In BINSWANGER'S SUBCORTICAL ENCEPHALOPATHY (with MID), what is the.... - Locus? - Pathology? - Effect? - Signs? (3)
– LOCUS – Bilateral UMN – PATHOLOGY – Hypertensive lacunar strokes – EFFECT – Impairment of corticobulbar pathways – SIGNS – Spastic Dysarthria Dysphagia Dementia
64
Why can a single lesion to the brainstem cause spastic dysarthria?
All corticobulbar tracts course through the brainstem
65
In PRIMARY LATERAL SCLEROSIS (PLS), what is the.... - Locus? (2) - Pathology? - Effect? - Signs? (2)
– LOCUS – Corticobulbar tracts Corticospinal tracts – PATHOLOGY – Degenerative disorder – EFFECT – Spasticity in speech + limbs – SIGNS – Spastic Dysarthria Impaired function of limbs (Progressive pseudobulbaire palsy)
66
What is different about the name "UMN Dysarthria"?
It is anatomic, not pathophysiologic
67
How has UMN Dysarthria been considered historically? | 2
Mild Temporary
68
What may mask UMN Dysarthria? | 2
Aphasia Apraxia of Speech
69
What might UMN Dysarthria be the only sign of?
Neurologic disease
70
What may be seen in Unilateral UMN Dysarthria? | 4
Unilateral weakness of the tongue Unilateral weakness of the face Spasticity Incoordination
71
What may be seen Contralaterally in Unilateral UMN Dysarthria? (3)
Hemiplegia Hemiparesis Lower facial weakness
72
What may be seen on the affected side in Unilateral UMN Dysarthria? (3)
Positive Babinski reflex (on sole of foot) Weakness Spasticity
73
What pathway lesions are usually present in Unilateral UMN Dysarthria? (2)
Indirect pathway lesions Direct pathway lesions
74
What may cause Unilateral UMN Dysarthria? | 1+4
Any process damaging UMNs unilaterally such as... - Tumors - Trauma - Stroke (most common) - Degenerative disease (not common)
75
What might patients complain about in Unilateral UMN Dysarthria? (3)
“Slurred, thick, or slow speech” Dysphagia and chewing difficulties Drooling on affected side (due to lack of closure)
76
What signs can distinguish Unilateral UMN Dysarthria from other dysarthria types? (3)
Unilateral central facial weakness Unilateral tongue weakness Severity is rarely worse than moderate
77
How might the speech subsystem be affected in Unilateral UMN Dysarthria? (4)
Articulatory breakdowns Slow rate of speech Slow + irregular AMRs Reduced loudness
78
What is Neuropathophysiology?
The likely nature of the neuromotor problem that gives it its distinctive perceptual characteristics (e.g., weakness, spasticity, incoordination, etc.)
79
Breathiness is usually associate with ______ Dysarthria.
Flaccid
80
Glottal Fry is usually associate with ______ Dysarthria.
Spastic
81
A Strained-Strangled Voice is usually associate with ______ Dysarthria.
Spastic
82
A Slow Rate of Speech is usually associate with ______ Dysarthria.
Spastic
83
______ is almost always affected in Spastic Dysarthria.
Voice Quality

ECU Motor Speech Disorders (16 decks)

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