chapter 5

Question 1

neurologic basis of spastic dysarthria

Answer 1

bilateral damage to umn tracts

Question 2

umns are in the

Answer 2

CNS
-descending motor tract, terminates at level of brainstem

Question 3

role of umn in spastic dysarthria

Answer 3

-bilateral damage to umns of pyramidal/extrapyramidal neural pathways

Question 4

pyramidal system damage spastic

Answer 4

can result in weak/slow skilled movements

Question 5

extrapyramidal system damage spastic

Answer 5

can result in weakness, increased muscle tone (spasticity), and abnormal reflexes

Question 6

onset may mimic

Answer 6

flaccid dysarthria, however very quickly spasticity sets in

Question 7

significance of bilateral damage

Answer 7

damage must be bilateral, affecting both left and right tracts of pyramidal and extrapyramidal systems
-weakness and slowness, particularly in tongue and lips
-spasticity most noticeable in laryngeal muscles
-abnormal reflexes (primitive reflexes)

Question 8

causes of spastic dysarthria

Answer 8

strokes, degenerative diseases, traumatic head injury, infections of brain tissue, tumors

Question 9

stroke

Answer 9

most common cause of spastic; will only result in spastic when two or more strokes occur in certain combos in the cerebrum or a single stroke occurs in the brainstem (before the cranial nuclei)

Question 10

amyotrophic lateral sclerosis (ALS)

Answer 10

degenerative neurologic disease of unknown cause; terminal, average life expectancy 22 months from time of onset, causes spastic when UMN involvement predominant

Question 11

traumatic head injury

Answer 11

can produce widepsread injury to brain, causing bilateral damage to pyramidal and extrapyramidal systems

Question 12

multiple sclerosis

Answer 12

suspected immunological disorder resulting in inflammation or complete destruction of myelin sheath covering axons - bilateral involvement of umns results in spastic

Question 13

other causes

Answer 13

brainstem tumor, cerebral anoxia, viral infection in cerebral tissue, bacterial infection in cerebral tissue

Question 14

speech characteristics of spastic dysarthria

Answer 14

-speech errors are a result of spasticity, slowness, weakness in vocal-tract muscles

Question 15

respiration less effected in spastic because

Answer 15

the phrenic nerve

Question 16

articulation

Answer 16

-very common
-impercise consonant production
-vowel distortions

Question 17

imprecise consonant productions spastic

Answer 17

result of abnormally short voice onset time for voiceless consonants, incomplete articulatory contact, incomplete consonant clusters

Question 18

phonation spastic

Answer 18

harsh vocal quality, strained-strangled voice quality, low pitch

Question 19

harsh vocal quality spastic

Answer 19

most common phonatory error, occurs when air leaks through partially open glottis during phonation

Question 20

strained-strangled vocal quality

Answer 20

tight hyperadduction of VFs

Question 21

low pitc spastic

Answer 21

result of increased muscle tone in larynx

Question 22

resonance spastic

Answer 22

hypernasality - caused by spasticity in velar muscles which slows and reduces range of soft palate movement and results in incomplete velopharyngeal closure during non-nasal speech sounds; does not include nasal emissions

Question 23

prosody spastic

Answer 23

monopitch, monoloudness, short phrases, slow rate of speech

Question 24

monopitch spastic

Answer 24

caused by overall tenseness of laryngeal muscles, resulting in reduced ability to contract/relax to vary pitch

Question 25

monoloudness spastic

Answer 25

caused by overall increased muscle tone in laryngeal muscles

Question 26

short phrases prosody

Answer 26

natural consequence of speaking through abnormally tight larynx, making it difficult to use longer utterances

Question 27

slow rate of speech spastic

Answer 27

caused by reduced speed and range of movement

Question 28

pseudobulbar affect

Answer 28

uncontrollable crying or laughing that can accompany damage to umn's brainstem, appears to be caused by damage to part of brain important in inhibiting emotions; pretty specific to spastic

Question 29

drooling spastic

Answer 29

due to impaired control of saliva or less frequent swallowing

Question 30

bulbar palsy

Answer 30

atrophy and weakness in muscles innervated through medulla, including tongue, velum, larynx, and pharynx

Question 31

pseudobulbar palsy

Answer 31

weakness and slowness in same muscles

Question 32

key evaluation tasks for spastic dysarthria

Answer 32

conversational speech and reading, alternate motion rate (AMR) task, vowel prolongation

Question 33

treatment of phonation deficits

Answer 33

harsh or strained-strangled voice quality caused by hyperadduction of VFs

Question 34

exercises for phonation deficits

Answer 34

head and neck relaxation; easy onset phonation; DO NOT work on strengthening

Question 35

symptoms of phonation deficits

Answer 35

weakness, reduced speed of movement, reduced rom

Question 36

imprecise consonant production

Answer 36

primary articulation error in spastic dysarthria; stretching exercises: tongue-stretching, lip-stretching; traditional artic. exercises

Question 37

traditional artic. treatments

Answer 37

concentrate on increasing patient awareness of articulation errors and practicing best phoneme production; intelligibility drills, phonetic placement, exaggerating consonants, minimal contrast drills

Question 38

treatment of prosody deficits

Answer 38

activities that help patient regain vocal-tract flexibility needed to appropriately vary pitch and loudness: pitch range exercises, intonation profiles, contrastive stress drills, chunking utterances into syntactic units

Question 39

treatment of resonance deficits

Answer 39

hypernasality caused by slowness and reduced rom, surgical and prosthetic treatments: pharyngeal flap procedure, teflon injections, palatal life; decreasing verlar hypertonicity, behavioral-based treatments