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Motor Speech Exam 2 > Ataxic Dysarthria > Flashcards

Ataxic Dysarthria Flashcards

1
Q

T/F:For Ataxic Dysarthria (AD) it is beneficial to work on oral motor strengthening exercises.

A

False.

-AD is a problem of coordination so it is NOT beneficial to work on strengthening exercises.

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2
Q

AD primarily affects __ & ___.

A
  • articulation

- prosody

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3
Q

T/F: AD is a cerebellar control circuit dysfunction.

A

TRUE

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4
Q

The cerebellum receives input primarily from (1) and provides output to (2) and then to (3).

A

The cerebellum receives input primarily from MOTOR CORTEX and provides output to CORTEX (THROUGH THALAMUS) and then to PERIPHERAL SYSTEM.

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5
Q

Cerebellum’s major function is?

A

Error control

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6
Q

The cerebellum imposes control on?

A

posture and movement initiated elsewhere.

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7
Q

Explain how the cerebellum coordinates: posture, locomotion, and coordinated activities.

A

By adjusting activities of the indirect and direct motor systems and through them, the activities of the LMN system.

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8
Q

Lesions in the cerebellum cause..

A
  • Hypotonia

- Errors in: force, speed, timing, range, direction of movements (e.g. INCOORDINATION)

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9
Q

T/F: Reduced m. tone and incoordination cause fast rate of speech and inaccuracy in speech movements.

A

FALSE: causes SLOW rate of speech and inaccuracy in speech movements.

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10
Q

In AD, does the role of the cerebellum breakdown in motor control and organization?

A

YES

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11
Q

T/F: In AD, speech reflects the weakness seen in other dysarthrias.

A

FALSE: It DOES NOT reflect the weakness seen in other dysarthrias, BUT RATHER, POORLY CONTROLLED AND INCOORDINATED SPEECH.

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12
Q

List the 3 lobes of the cerebellum.

A
  • Anterior
  • Posterior
  • Flocculonodular
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13
Q

What does the anterior lobe consist of and what is it important for?

A
  • Most of the vermis
  • Anterior aspect of the cerebellar hemispheres

Important in regulating:

  • posture
  • gait
  • m. tone of the trunk of the body
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14
Q

What does the posterior lobe make up and where is it located?

A
  • Makes up: greater part of the cerebellum

- Located: between the anterior lobe and the flocculonodular lobe

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15
Q

What is the posterior lobe important for?

A

For coordinating:

  • Skilled, voluntary muscle activity
  • M. tone
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16
Q

The flocculonodular lobe includes?

A

inferior part of the vermis and the attached flocculi

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17
Q

Explain flocculi.

A

Small appendages in the posterior inferior region.

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18
Q

What is the vermis?

A

The middle of the cerebellum

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19
Q

There are 2 hemispheres to each side of the vermis which are both connected to?

A
  • opposite thalamus

- opposite cerebral hemispheres

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20
Q

T/F: Hemispheres in the cerebellum control function on the contralateral side of the body.

A

FALSE: ipsilateral

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21
Q

T/F: Left side of the cerebellum controls the left side of the body and connects to the right cerebral hemisphere.

A

TRUE

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22
Q

T/F: The right side of the body is controlled by the right cerebral hemisphere and the left cerebellar hemisphere.

A

FALSE:

Right side of the body is controlled by the LEFT cerebral hemisphere and the RIGHT cerebellar hemisphere.

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23
Q

Where are Purkinje cells found and about how many are there?

A

Found in: cortex of the cerebellum

How many: 15 million

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24
Q

Purkinje cells connect to other nuclei deep in the cerebellum and information is passed through these connections.
Name the nuclei important in speech control and explain why.

A

Denate nucleus- aids in initiating movement and regulating posture.

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25
Q

3 structures where tracts of nerve fibers enter and leave the cerebellum through.

A

(1) inferior cerebellar peduncle
(2) middle cerebellar peduncle
(3) superior cerebellar peduncle

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26
Q

T/F: Each cerebellar hemisphere connects to the rest of the nervous system through 3 bundles of nerve fibers: superior, middle, inferior peduncles.

A

TRUE

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27
Q

Inferior peduncle coordinates info between the __ and __. It is mainly (afferent or efferent) pathway.

A
  • Coord info between MEDULLA & CEREBELLUM.

- EFFERENT pathway

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28
Q

T/F: Superior peduncle is a bridge between brainstem and cerebrum.

A

FALSE: Midbrain & Cerebellum

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29
Q

T/F: Middle peduncle is a bridge between the pons and cerebellum. It is afferent.

30
Q

T/F: Superior peduncle= afferent

A

FALSE: efferent

31
Q

Cerebellar lesions causing speech problems are usually (unilateral or bilateral).

A

-Bilateral or in the vermis (midline) or generalized.

BUT, it can be due to a more focal lesion.

32
Q

What is Frederich’s ataxia?

A
  • Symptoms shown in childhood & progress over time
  • Hereditary
  • Due to autosomal recessive pattern
  • Ends in death after about 20 yrs
  • Ataxic Dys is common but usually not first sign
33
Q

Multiple Sclerosis?

A
  • May result in cerebellar lesions & Ataxic Dys

- Lesions aren’t just in the cerebellum

34
Q

T/F: Lesions in the vascular system cannot impact cerebellar function and cannot cause AD.

A

FALSE: they CAN imapct cerebellar function and cause AD.

35
Q

Vascular diseases that affect the cerebellum are usually caused by:

A
  • aneurysms
  • arteriovenous malformations (AVM)
  • cerebellar hemorrhage
36
Q

T/F: 75% of metastatic brain tumors develop in the cerebellum.

A

FALSE: 25%

37
Q

T/F: TBI often results in ataxic dysarthria and limb ataxia.

38
Q

Boxers who have sustained hits to the head may develop dementia pugilistica or ______ which involves cerebellar dysfunction.

A

“punch-drunk encepalopathy”

39
Q

Boxers who develop “punch-drunk encepalopathy” may also develop ___.

A

Ataxic Dysarthria

40
Q

T/F: Acute alcohol abuse produces AD permanently.

A

FALSE: usually isn’t permanent

41
Q

Does AD, as a result of chronic alcoholism, develop due to the effect of alcohol or due to nutritional problems?

A

Nutritional problems.

42
Q

Can severe malnutrition w/ vitamin deficiencies result in cerebellar damage & AD?

43
Q

Neurotoxic levels of certain drugs may result in cerebellar symptoms. List 3 examples of harmful drugs.

A

(1) Lithium
(2) Dilantin
(3) Valium

44
Q

What is hypothyroidism?

A

Endocrine imbalance caused by not enough secretion of thyroxin by thyroid glands.

45
Q

Can hypothyroidism ALWAYS lead to AD?

A

No. Only when severe.

46
Q

When a pt has AD caused by severe hypothyroidism, their voice may be..

A
  • Hoarse
  • Gravely
  • Excessively low pitched
47
Q

T/F: Normal pressure hydrocephalus (NPH) often results in AD.

A

TRUE

*Ventricles may be enlarges but CSF pressure is normal.

48
Q

What are some complaints a pt with AD might have?

A
  • slurred speech
  • stumble over words
  • bite cheek when eating
  • can’t coordinate breathing w/ speaking
  • difficulty swallowing (not very often)
49
Q

T/F: For a pt with AD, limited alcohol intake results in improvement of speech.

A

FALSE: results in QUICK DETERIORATION of speech

50
Q

T/F: Pts with AD complain about swallowing less often than pts with flaccid or spastic dys.

51
Q

What helps pts with AD improve their intelligibility?

A

Slowing their speech

52
Q

List general clinical characteristics of Ataxia.

A
  • Problems standing or walking (most prominent signs)
  • Broad based gait
  • Titubation
  • Abnormal eye movement
  • Hypotonia
  • Dysmetria
  • Dysdiadochokinesis
53
Q

Explain titubation.

A

Rhythmic tremors of body or head- looks like a rocking motion of trunk or head. Can be rocking side to side or forward & back or in a rotary motion.

54
Q

What are the two types of abnormal eye movements seen in pts with AD..

A

(1) Nysgtagmus- jerking back and forth of eyes at rest

(2) Oculodysmetria- rapid eye movements as the pt tries to fix eyes on a visual target.

55
Q

T/F: Hypotonia is also found in LMN disorders.

56
Q

What are the most prominent signs of Ataxia?

A
  • Problems standing and walking.
  • Broad based gait (feet far apart)- to counter imbalance.
  • May lift legs too high when walking
57
Q

What is a common sign of cerebellar problems where the person is not able to control range of movement and is seen typically over or undershooting a target?

58
Q

What is dysdiadochokinesis?

A

Decomposition of movement occurring in cerebellar problems. Results in error in sequence and speech of the component parts of a movement-produces incoordination.

59
Q

How would you assess dysdiadochokinesis?

A
  • side to side tongue wiggling

- patting floor with the ball of the foot

60
Q

Ataxia is the product of:

A
  • dysmetria

- dysdiadochokinesis

61
Q

Describe ataxic movements.

A
  • halting
  • imprecise
  • jerky
  • poorly coordinated
  • lacking in speed & fluidity
62
Q

Cerebellar disorders are often seen with __ or ___ tremor.

A

Intention or kinetic tremor

-Seen in movement but sometimes in sustained postures.

63
Q

T/F: Tremor (intention or kinetic) usually worsens the closer one gets to the target.

64
Q

T/F: In AD, the gag reflex is usually abnormal.

A

FALSE-normal

65
Q

T/F: In AD, there are NO pathological reflexes.

66
Q

T/F: AD primarily has problems with articulation and resonance.

A

FALSE:

  • articulation
  • prosody
67
Q

T/F: In AD, sometimes (rarely) you may see hyponasality due to improper timing of VP function and articulatory gestures for nasal consonants.

68
Q

For AD, how/what would you assess?

A

Assess:

  • conversational speech
  • reading
  • AMRs

Have pt repeat sentences with multisyllabic words such as “The municipal judge sentenced the criminal”.

69
Q

Having the pt repeat sentences with multisyllabic words may result in:

A

Distinctive irregular articulatory breakdowns

70
Q

According to Duffy, a pt with AD is going to have regular or irregular AMRs?

A

Irregular

AMRs are one of the most important distinguishing characteristics of AD.

71
Q

Best distinguishing features of AD (according to Duffy)

A
  • Irregular AMRs
  • Irregular & transient articulatory breakdowns
  • Telescoping
  • Excess & equal stress
  • Excess loudness variations
  • Dysprosody
  • Vowel distortions

Motor Speech Exam 2 (3 decks)

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