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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?

A

Excessive

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?

A

Unnatural

25
Q

What kind of voice is heard in Hypokinetic Dysarthria?

Why? (2)

A

Harsh-breathy voice

//

Related to rigidity, not flaccidity

Loss of appropriate reciprocity between agonist and antagonist muscles

26
Q

What 4 physical vocal aspects may be see in the vocal folds in patients with Hypokinetic Dysarthria?

A

Vocal fold bowing (gap)

Reduced range

Slowness

“Tremulousness”

27
Q

What 4 Non-Speech Symptoms may be seen in Hypokinetic Dysarthria?

A

Reduced eye blinking

Infrequent swallow

Drooling

Tremulousness

28
Q

What 6 Speech Qualities may be seen in Hypokinetic Dysarthria?

A

Overall rapid rate

Short rushes of speech

Whispered speech

Rapid, accelerated, blurred AMR’s

Imprecise consonants

Prosodic insufficiency (Mumbling quality + Monopitch/monoloudness)

29
Q

What is the Prominent Clinical Feature of Hypokinetic Dysarthria?

A

Rapid Rate

30
Q

What might cause the Rapid Rate heard in Hypokinetic Dysarthric Speech?

A

Possibly “blurring” of acoustic contrasts that lead to perception of increased rate.

31
Q

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

A

Direct

Indirect

Movement patterns

Asymmetric

Isolated muscle

32
Q

What do patients often complain about with Hypokinetic Dysarthria?

(6)

A

Reduced voice loudness (if aware)

Rapid rate of speech

Stiff lips

Difficulty getting speech out

Speech is mumbled

Occasional stuttering

33
Q

In PARKINSON’S DISEASE (PD), what is the….

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

– LOCUS –

Basal Ganglia

– PATHOLOGY –

Dopamine depletion

– EFFECT –

Loss of cells in Basal Ganglia

– SIGNS –

Hypokinetic Dysarthria

Gait

Masked facies (blank face)

34
Q

What is Stage 0 of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

A

No parkinsonism signs

35
Q

What is Stage I of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

A

Unilateral signs not causing any disability in everyday life

36
Q

What is Stage II of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

A

Predominantly unilateral signs cause a degree of disability

37
Q

What is Stage III of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

(2)

A

Bilateral involvement with a certain degree of postural instability

Autonomous patient

38
Q

What is Stage IV of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

(3)

A

Severe handicap

Not able to walk

Partial loss of autonomy

39
Q

What is Stage V of the Hoehn + Yahr PD Staging Scale for Parkinson’s disease (PD)?

(2)

A

Patient confined to bed or wheelchair

No longer autonomous

40
Q

In NIGROSTRIATAL DEGENERATION, what is the….

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

– LOCUS –

Basal Ganglia

– PATHOLOGY –

Rare

Not responsive to dopaminergic drugs

– EFFECT –

Multi-system atrophy (MSA)

– SIGNS –

Hypokinetic Dysarthria

41
Q

What are 5 other disorders that may experience Hypokinetic Dysarthria?

A

Alzheimer’s Disease

“Vascular parkinsonism”

Toxic-metabolic (e.g., Wilson’s disease – excessive copper)

Pugilistic encephalopathy

Viral encephalitis

42
Q

What is the “type” of dysarthria is related to?

2

A

The “locus of lesion”

Not the etiology per se

43
Q

What is the clinical sign that is only seen in Hypokinetic Dysarthria?

A

Speech rate is perceived as, or actually is, rapid or accelerated

ECU Motor Speech Disorders (16 decks)

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