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ECU Motor Speech Disorders > 6.1 - Ataxic Dysarthria > Flashcards

6.1 - Ataxic Dysarthria Flashcards

1
Q

What are the hallmarks of Ataxic Dysarthria?

A

Irregular articulatory breakdown

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2
Q

What is the cause of Ataxic Dysarthria?

A

Injury or malfunction to the Cerebellar Control Circuit

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3
Q

Where is Ataxic Dysarthria most evident?

2

A

In articulation

In prosody

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4
Q

Where does the Cerebellum receive input?

What does it plan and initiate?

A

Regions of the cerebral cortex

Complex and highly skilled movement

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5
Q

From where does the Cerebellum receive innervations?

A

From the sensory systems that monitor the course of movements

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6
Q

How does the Cerebellum influence movement?

A

By modifying activity patterns of the UMNs

Prominent projections to most UMNs

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7
Q

What is the primary function of the Cerebellum?

2

A

To detect difference or “motor error” between intended movement and actual movement and through its projections to the UMN’s

To reduce error

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8
Q

What does the Cerebellum correct?

A

Motor error in real time and over longer periods (such as in motor learning)

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9
Q

What are the major INPUTS to the cerebellum from the cortex?

3

A

Parietal Cortex

Cingulate Cortex

Frontal Cortex

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10
Q

What are the major INPUTS to the cerebellum from other areas of the brain?

(4)

A

Red nucleus

Superior colliculus

Spinal cord

Reticular formation

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11
Q

What are the major OUTPUTS from the cerebellum?

5

A

Motor Cortex (via relay in VL nuclei of thalamus)

Red nucleus

Vestibular nuclei

Superior colliculus

Reticular formation

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12
Q

When the cortex is injured, the effects are seen _________. When the cerebellum is injured, the effects are seen _______.

(Think directionality)

A

Contralaterally

Ipsilaterally

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13
Q

What is the Pathophysiology of Ataxic Dysarthria?

2

A

Bilateral or generalized disease

Focal lesions

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14
Q

What is involved in bilateral or generalized disease that causes Ataxia Dysarthria?

A

Both cerebellar hemispheres

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15
Q

What kinds of Focal Lesions can cause Ataxic Dysarthria?

2

A

Superior cerebellar peduncle (major cerebellar-cortical pathway for voluntary movement)

Possibly other focal lesion(s)

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16
Q

What are 7 distinguishing signs of Ataxia Dysarthria?

A

Disordered stance, gait, and head posture

Truncal titubation (rocking of head/neck/trunk)

Nystagmus (rapid oscillation of eyes)

Dysmetria (past-pointing)

Dysdiadochokinesis

Intention tremor (tremor apparent during movement or sustained postures)

Hypotonia associated with excessive pendulousness (extremity, allowed to swing freely in a pendular manner)

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17
Q

What are the two types of tremors?

A

Resting/Involuntary

Action

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18
Q

What disorder is associated with Resting/Involuntary Tremors?

A

Parkinson’s disease

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19
Q

What are the 3 types of Action Tremors?

A

Postural

Isometric

Kinetic

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20
Q

What is an example of a Postural Tremor?

A

Essential Tremor

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21
Q

When might Isometic Tremors be experienced?

A

After or during exercise

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22
Q

What are the 2 types of Kinetic Tremors?

A

Simple

Intention

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23
Q

What is an example of a Simple Tremor?

A

Essential Tremor

24
Q

What is an example of an Intention Tremor?

A

Cerebellar Tremor

25
Q

What is an Essential Tremor?

3

A

Action tremor

Affects upper extreme ties asymmetrically

Primarily affects hands

26
Q

When does the tremor begin in patients with Cerebellar Tremor?

A

As the finger nears the target

27
Q

When does the tremor begin in patients with Parkinson’s Disease?

A

As the beginning of movement but will lessen as it reaches its target

28
Q

When does the tremor begin in patients with Essential Tremor?

(2)

A

At the beginning of movement

As finger nears the target

29
Q

What do patients often complain about with tremors?

4

A

Difficulty during meals when trying to bring food to mouth or when drinking from a cup

Unsteady gait

Slurred speech

Abnormal eye movements

30
Q

What is often seen in an oral motor exam in patients with Ataxic Dysarthria?

A

Usually nothing unusual

31
Q

What is seen in AMRs in patients with Ataxia Dysarthria?

A

Irregularities (in both speech and non speech)

32
Q

What are the most useful AMRs when testing for Ataxia Dysarthria?

(3)

A

Conversational speech

Reading

Speech

33
Q

What is the most distinguishing characteristic of Ataxia Dysarthria?

A

Irregular AMRs

34
Q

What is seen in Direction of Movement in Ataxia Dysarthria?

A

Inaccuracy

35
Q

What is seen in Rhythm of Movement in Ataxia Dysarthria?

A

Repetitive movements are irregular

36
Q

What is seen in Rate of Movement in Ataxia Dysarthria?

2

A

Repetitive movements are slow

Individual movements are slow

37
Q

What is seen in Range of Movement in Ataxia Dysarthria?

2

A

Repetitive movements are excessive to normal

Individual movements are excessive to normal

38
Q

What is seen in Force of Movement in Ataxia Dysarthria?

A

Individual movements are normal to excessive

39
Q

What is seen in Muscle Tone in Ataxia Dysarthria?

A

Reduced

40
Q

What Articulatory-Resonatory characteristics are seen in Ataxic Dysarthria?

(3)

A

Imprecise consonants

Distorted vowels

Irregular articulatory breakdown

41
Q

What Prosodic characteristics are seen in Ataxic Dysarthria?

4

A

Excess + equal stress – or – reduced stress variation

Prolonged phonemes

Prolonged intervals

Slow rate

42
Q

What Phonatory-Prosodic characteristics are seen in Ataxic Dysarthria?

(3)

A

Harshness

Monopitch

Monoloudness

43
Q

How is Naturalness affects in Ataxic Dysarthria?

A

Impaired

44
Q

What kind of loudness may be seen in Ataxic Dysarthria?

A

Explosive

45
Q

What do patients often complain about with Ataxic Dysarthria?

(5)

A

They sound drunk or intoxicated

They stumble over words

They bite cheek when they eat or speak

Their speech becomes worse with alcohol

They have difficulty coordinating breathing and speech

46
Q

What 4 terms are associated with Ataxic Dysarthria?

A

Scanning

Telescoping

Prosodic excess (scanning speech)

Articulatory inaccuracy (telescoping)

47
Q

What does Scanning mean in regard to Ataxic Dysarthria?

3

A

Measured

Excess and equal stress (word-by- word)

Slow

48
Q

What does Telescoping mean in regard to Ataxic Dysarthria?

2

A

Inconsistent articulatory breakdown

“A syllable or series of syllables are suddenly or unpredictably run together… transient accelerated character”

49
Q

What does Prosodic excess (scanning speech) mean in regard to Ataxic Dysarthria?

(3)

A

Excess and equal stress

Prolonged phonemes

SMRs tend to be slow and even

50
Q

What does Articulatory inaccuracy (telescoping) mean in regard to Ataxic Dysarthria?

(2)

A

Equalization of stress

SMRs irregular

51
Q

In FRIEDREICH’S ATAXIA, what is the….

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

– LOCUS –

Spinocerebellar

– PATHOLOGY –

Metabolic

Hereditary

– EFFECT –

Begins in adolescence

Degeneration over 20 years

– SIGNS –

Ataxic-Spastic Dysarthria

Spasticity increases over time as disease affects the spinal cord

52
Q

In MULTIPLE SYSTEMS ATROPHY (MSA) / OLIVOPONTOCEREBELLAR ATROPHY (OPCA), what is the….

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

– LOCUS –

Olivopontocerebellar

– PATHOLOGY –

Hereditary

– EFFECT –

Onset between 20-40

Gradual widespread neurological impairment

– SIGNS –

Mixed Dysarthria

53
Q

In PAROXYSMAL ATAXIC DYSARTHRIA (PAD), what is the….

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

– LOCUS –

Cerebellum

– PATHOLOGY –

Paroxyms triggered by changes in oxygen supply

– EFFECT –

Brief episodes

May signal MS or familial cerebellar ataxia

– SIGNS –

Ataxic Dysarthria

54
Q

In CEREBELLOPONTINE ANGLE (CPA) TUMORS (e.g., acoustic neuroma), what is the….

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

– LOCUS –

Cerebellopontine Angle

Involves meninges of CNs

– PATHOLOGY –

Mass effect on cerebellar circuit

– EFFECT –

Impairment of CN function

Cerebellar signs

– SIGNS –

Ataxic-Flaccid Dysarthria

(Due to CN involvement)

(Severe weakness and error detection issues)

55
Q

What other 4 disorders can cause Ataxic Dysarthria?

A

Trauma, e.g., dementia pugilistica (“punch-drunk” encephalopathy)

Toxic/metabolic, e.g., alcohol abuse; other substances

Hypothyroidism

Normal pressure hydrocephalus (NPH)

56
Q

What Resonatory Characteristics are seen in Ataxic Dysarthria?

(4)

A

Hypernasality

Imprecise consonants

Nasal emission

Short phrases

57
Q

What Phonatory Characteristics are seen in Ataxic Dysarthria?

(3)

A

Breathiness

Short phrases

Audible inspiration

ECU Motor Speech Disorders (16 decks)

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