benchmark 3 - final Flashcards
hyperkinetic dysarthria is what level of motor organization
extrapyramidal
t/f abnormal involuntary movement are often called hyperkinesia
true
what are the 3 main cerebral structures of extrapyramidal level
basal ganglia
subthalamic nucleus
substantia nigra
hyperkinetic dysarthria symptoms
- involuntary, unprogrammed, extra movements
- occurs in any muscles or group of muscles
- the inhibitory nature of extrapyramidal level is inhibited
- result from a failure of extrapyramidal level to inhibit the extra impulses from the cortex
3 general classifications of hyperkinetic dysarthria
quick, slow, tremor
what is QUICK hyperkinetic dysarthria
- quick, unsustained, involuntary movements
- myoclonus: FASTEST
- tourette’s (tics): FAST
- chorea: SLOWER than tics and clonus
myoclonus (quick hyper)
- FASTEST hyperkinetic disorder
- characterized by involuntary single or repetitive brief jerks of a body part
- sudden large transient “shock like” contraction –> can be momentarily postponed/reduced
- involuntary, irregular jerks in chest, larynx, VP, lips, tongue and jaw
- irretractable hiccups
- idiopathic or brain/spinal injury; meds reaction
myoclonus: essential assessment
conversational speech is usually unaffected
respiration, phonation and vowels are unprogrammed
palatal myoclonus (resonance) –> tends to go away during sleep
AMR/SMR: fleeting interruptions
Tourette’s (tics) (quick hyper)
- involuntary, compulsive, rapid, nonrhythmic movement –> can be postponed but not suppressed
- postponing can make worst
- rapid and arrhythmic tic movements
- odd vocalizations
- facial grimaces
- slower palatal myoclonus (resonance)
- etiology is unknown
Tourette’s (tics): essential assessment
Type of quick hyperdysartheira
- simple phonic tics (noises) –> like sniffing, throat clearing, barking
- complex phonic tics (linguistically meaningful) –> coprolalia (profanity), echolalia, palilialia, loud talking
Chorea (quick hyper)
- quick rapid involuntary, irregular, fleeting, unpredictable, non stereotyped movement
- contraction than release = smoother dance-like movement
- can occur at rest but increases with voluntary movement
t/f Sydenham’s chorea is not progressive
true
two common type of chorea
- sydenham’s –> childhood fever
- huntington’s chorea –> progressive genetic with dementia
Chorea essential assessment
- **every aspect of speech is affected
- highly variable, can not predict
- respiration –> bursts of loudness
- phonation –> roughness, strain-strangled, low pitch
- articulation –> irregular breakdown, variable rate, prolonged phonemes
- AMR/SMR –> slow, unpredictable
- vowel –> short, irregular pitch
Slow hyperkinetic dysarthria
- Athetosis –> slow
- Dystonia –> slowest
Athetosis - slow hyperkinetic dysarthria
- involuntary, irregular, unpredictable, non-stereotyped movements interfering with all skilled movement –> slightly slower than chorea
- stiff, high muscle tone, hypercontraction
- fluctuating b/w flaccid spastic tone, distal movement, tremors increase with stress
- shallow noisy stridor breathing
- facial grimacing
- etiology –> early onset from birth trauma and anoxia OR later onset –> stroke; tumor in basal ganglia
Athetosis - slow hyperkinetic dysarthria –> essential asessment
conversational speech
- bursts of loudness
- groaning voice, explosive, phonation arrest
- lack of coordination of voicing and articulation
- amr/smr –> unpredictable
- vowel –> reduced duration, irregular pitch
Dystonia - slow hyperkinetic dysarthria
- involuntary, random movements interfere with all skilled movements; action-induced (not seen at rest); contractions build up slowly; reduced strength
- primary dystonia is hereditary; secondary is brain trauma or inflammation (encephalitis)
3 types of dystonia
- generalized
- segmental
- isolated/focal
generalized dystonia
generalized –> whole body; starts in childhood with foot turning in
- symptoms improve with sensory tricks such as touching chin,face or pencil b/w teeth during speech (more of a sensory feedback issue than psychological)
- breathing irregular, abnormal posture
- larynx - indirect exam –> VFs appear normal; endoscopy –> reveals involuntary hyperadd/abduction during speech
- involuntary movements in velopharynx and lips, tongue jaw
segmental dystonia
- segmental –> 2+ structures; starts as adult; clenching in eyes+lips/jaw = meige; clenching in jaw+tongue = oromandibular meige
isolated/focal dystonia
- isolated/focal –> one area, starts as adult
types: spasmodic dysphonia (laryngeal dystonia; most common); blepharospasm (difficult to open eyes); torticollis (humped to one side); limb dystonia (writers cramps) - females are more affected
- action induced –> speaking; symptoms emerge during connected speech
- improves with laugh, singing, whisper, etc.