chapter 5 Flashcards

1
Q

neurologic basis of spastic dysarthria

A

bilateral damage to umn tracts

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2
Q

umns are in the

A

CNS
-descending motor tract, terminates at level of brainstem

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3
Q

role of umn in spastic dysarthria

A

-bilateral damage to umns of pyramidal/extrapyramidal neural pathways

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4
Q

pyramidal system damage spastic

A

can result in weak/slow skilled movements

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5
Q

extrapyramidal system damage spastic

A

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

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6
Q

onset may mimic

A

flaccid dysarthria, however very quickly spasticity sets in

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7
Q

significance of bilateral damage

A

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)

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8
Q

causes of spastic dysarthria

A

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

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9
Q

stroke

A

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)

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10
Q

amyotrophic lateral sclerosis (ALS)

A

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

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11
Q

traumatic head injury

A

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

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12
Q

multiple sclerosis

A

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

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13
Q

other causes

A

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

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14
Q

speech characteristics of spastic dysarthria

A

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

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15
Q

respiration less effected in spastic because

A

the phrenic nerve

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16
Q

articulation

A

-very common
-impercise consonant production
-vowel distortions

17
Q

imprecise consonant productions spastic

A

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

18
Q

phonation spastic

A

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

19
Q

harsh vocal quality spastic

A

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

20
Q

strained-strangled vocal quality

A

tight hyperadduction of VFs

21
Q

low pitc spastic

A

result of increased muscle tone in larynx

22
Q

resonance spastic

A

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

23
Q

prosody spastic

A

monopitch, monoloudness, short phrases, slow rate of speech

24
Q

monopitch spastic

A

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

25
Q

monoloudness spastic

A

caused by overall increased muscle tone in laryngeal muscles

26
Q

short phrases prosody

A

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

27
Q

slow rate of speech spastic

A

caused by reduced speed and range of movement

28
Q

pseudobulbar affect

A

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

29
Q

drooling spastic

A

due to impaired control of saliva or less frequent swallowing

30
Q

bulbar palsy

A

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

31
Q

pseudobulbar palsy

A

weakness and slowness in same muscles

32
Q

key evaluation tasks for spastic dysarthria

A

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

33
Q

treatment of phonation deficits

A

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

34
Q

exercises for phonation deficits

A

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

35
Q

symptoms of phonation deficits

A

weakness, reduced speed of movement, reduced rom

36
Q

imprecise consonant production

A

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

37
Q

traditional artic. treatments

A

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

38
Q

treatment of prosody deficits

A

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

39
Q

treatment of resonance deficits

A

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