Diagnosis of dysarthria disorders

Question 1

Why is differential diagnosis of MSDs so important? (5)

Answer 1

• Define clinical condition
• Distinguish MSD, language, cognitive impairments
• To guide management goals and decisions
• To help localise and diagnose underlying neurological disease
• To support prognostic reasoning, counselling, education

Question 2

Lower motor neurone system - role in speech

Answer 2

• Carry out commands from UMNs, influenced by basal ganglia and cerebellar control circuits
• Nuclei of cranial and peripheral nerves (originating in brain stem)
• Neuromuscular junctions
• Their axons

Question 3

LMNs involved in respiration

Answer 3

Spinal nerves

Question 4

LMNs involved in phonation

Answer 4

Vagus X
- Larynx, vocal folds

Question 5

LMNs involved in resonance

Answer 5

Vagus X + glossopharyngeal IX + accessory XI
- Soft palate, velopharynx

Question 6

LMNs involved in articulation

Answer 6

Trigeminal V - jaw
Facial VII - lips
Hypoglossal IX - tongue

Question 7

All LMNs involved in speech execution

Answer 7

Spinal, CN V trigeminal, CN VII facial, CN IX hypoglossal, CN X vagus, CN XI accessory

Question 8

What is the role of the cerebellum in speech?

Answer 8

• Regulate or impose control on movement initiated elsewhere
• Coordinated timing and sequence of movements
• Helps to scale size of muscle actions
• Maintain steadiness
• Monitors and adjusts movement based on feedback

Question 9

What is the role of the basal ganglia in speech?

Answer 9

• Regulates and scales movement
• Key role in motor control
• Basic anatomy = caudate nucleus, putamen, globus pallidus, substantia diagra
• Damage can result in too little/too much movement
• Hypokinesia or hyperkinesia