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ECU Motor Speech Disorders > 7.1 - Hypokinetic Dysarthria > Flashcards

7.1 - Hypokinetic Dysarthria Flashcards

1
Q

What are the hallmarks of Hypokinetic Dysarthria?

2

A

Increased speed

Reduced range

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2
Q

What causes Hypokinetic Dysarthria?

A

Injury or malfunction of basal ganglia control circuit

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3
Q

What is Hypokinetic Dysarthria most evident in?

3

A

Voice

Articulation

Prosody

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4
Q

What does Hypokinetic Dysarthria reflect the effects of?

4

A

Rigidity

Reduced force

Reduced ROM

Slow individual but sometimes fast repetitive movements

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5
Q

What do we want to know about neural pathways in Hypokinetic Dysarthria?

A

Is there a disruption in the Direct Pathway (as in Parkinson’s) or in the Indirect Pathway?

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6
Q

What kind of movements is seen when there is a disruption in the DIRECT pathway of the BG?

A

Involuntary Movement

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7
Q

What kind of movements is seen when there is a disruption in the INDIRECT pathway of the BG?

A

Constant Movement

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8
Q

What kind of movement is seen in Parkinson’s Disease?

2

A

Slow movement

No arm movement

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9
Q

What 5 things does the Basal Ganglia Control Circuit?

A

Regulates muscle tone

Regulates movements that support goal-directed movement (arm-swing)

Controls postural adjustments (shoulder/writing)

Adjusts movements to the environment (speaking with restricted jaw opening)

Assists in the learning of new movements

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10
Q

What is the Pathophysiology of Hypokinetic Dysarthria?

What is the effect?

A

Neurotransmitter imbalance involving Dopamine

Basal ganglia cannot exert inhibitory (modulatory) influence over cerebral cortical output

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11
Q

What are the 5 Distinguishing Signs of Hypokinetic Dysarthria?

A

Resting tremor

Rigidity

Bradykinesia

Akinesia

Postural abnormalities

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12
Q

What are the 4 signs of Resting Tremor in Hypokinetic Dysarthria?

A

Head tremor

Limb tremor

Pill-rolling

Tremor of jaw, lip, tongue

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13
Q

What are the signs of Rigidity in Hypokinetic Dysarthria?

A

Resistance to passive stretch in all directions

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14
Q

What are the 4 signs of Bradykinesia in Hypokinetic Dysarthria?

A

Reduced speed of movement (brady=slow)

Slow initiation

Slow movement

“Freezing”

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15
Q

What are the 6 signs of Hypokinesia/Akinesia in Hypokinetic Dysarthria?

A

Reduced range of movement

Festinating gait

Reduced eye blink

Reduced frequency of swallowing

Micrographia

Masked facies (blank face)

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16
Q

What are the 4 signs of Posture in Hypokinetic Dysarthria?

A

Stooped

Poor adjustment to tilting or falling

Difficulty turning in bed

Difficulty going from sitting to standing

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17
Q

How does Hypokinetic Dysarthria affect Direction?

A

Normal

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18
Q

How does Hypokinetic Dysarthria affect Rhythm?

A

Repetitive movements –

Regular

19
Q

How does Hypokinetic Dysarthria affect Rate?

2

A

Repetitive movements- fast

Individual movements – slow

20
Q

How does Hypokinetic Dysarthria affect Range?

2

A

Repetitive movements –
Very reduced

Individual movements – reduced

21
Q

How does Hypokinetic Dysarthria affect Force?

A

Individual movements -

reduced

22
Q

How does Hypokinetic Dysarthria affect Tone?

23
Q

What is seen Prosodically in Hypokinetic Dysarthria?

10

A

Monopitch

Monoloudness

Reduced stress

Short phrases

Rapid/Variable rate

Short rushes of speech

Imprecise consonants

Inappropriate silences

Increasing rate in segments

Increased rate overall

24
Q

What is seen in Naturalness in Hypokinetic Dysarthria?

25
What kind of voice is heard in Hypokinetic Dysarthria? Why? (2)
Harsh-breathy voice // Related to rigidity, not flaccidity Loss of appropriate reciprocity between agonist and antagonist muscles
26
What 4 physical vocal aspects may be see in the vocal folds in patients with Hypokinetic Dysarthria?
Vocal fold bowing (gap) Reduced range Slowness “Tremulousness”
27
What 4 Non-Speech Symptoms may be seen in Hypokinetic Dysarthria?
Reduced eye blinking Infrequent swallow Drooling Tremulousness
28
What 6 Speech Qualities may be seen in Hypokinetic Dysarthria?
Overall rapid rate Short rushes of speech Whispered speech Rapid, accelerated, blurred AMR’s Imprecise consonants Prosodic insufficiency (Mumbling quality + Monopitch/monoloudness)
29
What is the Prominent Clinical Feature of Hypokinetic Dysarthria?
Rapid Rate
30
What might cause the Rapid Rate heard in Hypokinetic Dysarthric Speech?
Possibly “blurring” of acoustic contrasts that lead to perception of increased rate.
31
In UMN dysarthrias (both the “______” and “______” neural control circuits above the CN nuclei) that affect __________ in similar (though not equal) ways, may be ______, and not related to ___________ groups
Direct Indirect Movement patterns Asymmetric Isolated muscle
32
What do patients often complain about with Hypokinetic Dysarthria? (6)
Reduced voice loudness (if aware) Rapid rate of speech Stiff lips Difficulty getting speech out Speech is mumbled Occasional stuttering
33
In PARKINSON'S DISEASE (PD), what is the.... - Locus? - Pathology? - Effect? - Signs? (3)
– LOCUS – Basal Ganglia – PATHOLOGY – Dopamine depletion – EFFECT – Loss of cells in Basal Ganglia – SIGNS – Hypokinetic Dysarthria Gait Masked facies (blank face)
34
What is Stage 0 of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?
No parkinsonism signs
35
What is Stage I of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?
Unilateral signs not causing any disability in everyday life
36
What is Stage II of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?
Predominantly unilateral signs cause a degree of disability
37
What is Stage III of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)? (2)
Bilateral involvement with a certain degree of postural instability Autonomous patient
38
What is Stage IV of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)? (3)
Severe handicap Not able to walk Partial loss of autonomy
39
What is Stage V of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)? (2)
Patient confined to bed or wheelchair No longer autonomous
40
In NIGROSTRIATAL DEGENERATION, what is the.... - Locus? - Pathology? (2) - Effect? - Signs?
– LOCUS – Basal Ganglia – PATHOLOGY – Rare Not responsive to dopaminergic drugs – EFFECT – Multi-system atrophy (MSA) – SIGNS – Hypokinetic Dysarthria
41
What are 5 other disorders that may experience Hypokinetic Dysarthria?
Alzheimer’s Disease “Vascular parkinsonism” Toxic-metabolic (e.g., Wilson’s disease – excessive copper) Pugilistic encephalopathy Viral encephalitis
42
What is the “type” of dysarthria is related to? | 2
The “locus of lesion” Not the etiology per se
43
What is the clinical sign that is only seen in Hypokinetic Dysarthria?
Speech rate is perceived as, or actually is, rapid or accelerated

ECU Motor Speech Disorders (16 decks)

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