Dysarthria

Question 1

Motor speech disorder produced by injury or malfunction of one or more of the cranial or spinal nerves

Answer 1

Flaccid

Question 2

Shallow breathing aka reduced inhalatory and exhalatory volumes is a respiratory characteristic of which dysarthria

Answer 2

spastic

Question 3

Some PT’s with this nerve lesion develop brief attacks of severe pain that begin in the throat and radiate down the neck to the back of the lower jaw.

Answer 3

IX

Question 4

Increased muscle tone, spasticity, hyperexcitiable reflexes can occur due to damage to

Answer 4

extrapyradmial tract

Question 5

5. People with spastic paralysis commonly exhibit
   a. Decreased skilled movements
   b. Weakness
   c. Increased muscle tone
   d. Spasticity
   e. All of the above

Answer 5

E. All of the above

Question 6

This nerve is assessed clinically by examining the gag reflex, particularly asymmetry in the ease with which the reflex is elicited

Answer 6

IX

Question 7

7. T/F. Polio affects LMN cell bodies, most often on the lumbar and cervical spinal cord

Answer 7

True

Question 8

This dysarthria is associated with disease of the basal ganglia control circuit.

Answer 8

Hyperkinetic

Question 9

Pt may have breathing rates faster than normal, reduced vital capacity = has an affect on prosody and loudness, reduced vowel duration; difficulty alternating between vegetative breathing and speech breathing, short rushed of speech, inappropriate pauses. Which dysarthria would you suspect ?

Answer 9

hypokinetic

Question 10

Torticollois are _________ of the neck.

Answer 10

spasms of the neck. present. in dystonia

Question 11

Tourette’s syndrome is the prototypic _________________ disorder.

Answer 11

tic disorder

Question 12

Which of the following characteristics can be seen in a person with chorea

a. Intermittent hypernasality
b. Artic. Distortions and irregular breakdowns; slow and irregular AMRs
c. Variable patterns of stress, effortful speech
d. All of the above

Answer 12

all of the above

Question 13

13. Violent looking movements are usually a sign of which disorder
    a. Chorea
    b. Dystonia
    c. Ballismus
    d. Clonus

Answer 13

C. Ballismus

Question 14

15. A PT is drooling, has a resting tremor of jaw and lips, he is not blinking or smiling. When you ask him to open his mouth, you notice his tongue is strikingly tremulous and his upper lip appear immobile. The size, strength, symmetry of the jaw, face and tongue appear to be normal. Which dysarthria can you suspect?

Answer 14

Hypokinetic

Question 15

Name the most common etiologies in hypokinetic dysarthria:

Answer 15

Parkinson disease, PSP, dementia, parkinsonism with ALS – Parkinson like symptoms that can be associated with ALS

Question 16

Pressure or light touch to the jaw, cheek, or back of the neck are all tricks to inhibit movements for which disorder?

a. Chorea
b. Dystonia
c. Athetosis

Answer 16

b. dystonia

Question 17

The pyramidal tract is unilateral. T/F

Answer 17

false. bilateral

Question 18

19. The indirect pathways are crucial for _____________________ and ______________________.

Answer 18

Regulating reflexes and maintaining posture and tone. Many of their activities are inhibitory

Question 19

Which pathway/neurons are responsible for skilled, discrete movements?

Answer 19

direct pathway. WMN

Question 20

Excessive/inappropriate Coughing, grunting, throat clearing, screaming, moaning, humming, whistling, lip smacking, echolalia can all be as a result of

Answer 20

Tourette’s syndrome

Question 21

T/F In myoclonus the most striking abnormality is motor unsteadiness.

Answer 21

false. In chorea the most striking abnormality is motor unsteadiness

Question 22

T/F the extrapyramidal tract is not part of the UMN system

Answer 22

False

Question 23

T/F The non speech AMRs of the jaw, lips, and tongue may are usually regular in ataxic dysarthria.

Answer 23

false. The non speech AMR;s of the jaw, lips, and tongue are usually irregular in ataxic dysarthria

Question 24

This dysarthria is more wide spread, and it is not generally confined to a single component

Answer 24

spastic

Question 25

Strained-harsh vocal quality, voice stoppages, forced respiration, excess loudness variations are most likely to be present in a person with

Answer 25

chorea

Question 26

This dysarthria characteristics are most evident in articulation and prosody.

Answer 26

ataxic

Question 27

Name common clinical signs of cerebellar disease in the lateral hemispheric zone

Answer 27

Hypotinia, desmetria, dysdiadochokinesis, ataxia, tremor, ocular motor abnormalities, dysarthria

Question 28

Name 5 common clinical signs of cerebellar disease in the midline zone?

Answer 28

Distorted stance and gate, truncal titubation (unsteady, stumbling gate, swaying of head while sitting), rotated or tilted head postures, ocular motor abnormalities, dysarthria

Question 29

Poorly timed, controlled and coordinated movements are common characteristics of which dysarthria

Answer 29

ataxic

Question 30

This dysarthria seem to result from a failure of the basal ganglia pathways to properly inhibit cortical motor discharges

Answer 30

hyperkinetic

Question 31

Hyperkinetic dysarthria may be a result due to which of the following a. There may be a disruption of the equilibrium between excitatory and inhibitory neurotransmitters b. Portions of the cerebellar circuit may also be implicated. c. There may be abnormal or inadequate neural firing of any of the structures of the basal ganglia d. All of the above

Answer 31

all of the above

Question 32

The speech characteristics of this dysarthria are usually the product of abnormal, rhythmic or irregular and unpredictable, rapid or slow involuntary movements

Answer 32

hyperkinetic

Question 33

which of the following motor disorders can occur as a common side effect of antipsychotic drugs? a. Ticks b. Myclonus c. Dyskinesia d. Chorea

Answer 33

c. dyskinesia

Question 34

What is a palatal tremor?

Answer 34

palatopharyngolaryngeal myoclunus) is a unique form associated with movements of the soft palate, pharyngeal walls, and laryngeal muscles - It can be confined to a single muscle

Question 35

Movement results in voice arrests, slow speaking rate, deterioration of AMR’s with increased rate, quick or fine jerky movements of orofacial muscles during speech. Pt is aware of the imprecise speech and inability or reluctance to speak at normal or rapid rates. a. Resting tremor b. Action myoclonus c. Tourette syndrome d. Tics

Answer 35

b. Action myoclonus

Question 36

T/F Tourette’s syndrome is characterized by multiple motor and vocal tics that have been present for less than 1 year

Answer 36

false. more than one year

Question 37

Damage to which of the following can be a cause of Tourette’s syndrome a. UMN b. Basal ganglia c. LMN d. Association cortex e. B and D

Answer 37

e. Basal Ganglia and Association cortex

Question 38

Which of the following is NOT correct for chorea a. Jaw, face, tongue and palate are usually normal in size, symmetry, and strength b. Reduced gag reflex c. Pathological reflexes may not be present

Answer 38

b. reduced gag reflex -> gag reflex is often normal

Question 39

Reduced velocity and range of lips movements, Reduced jaw stability during vowel prolongations, Reduced tongue strength, Reduced speech rate but may be able to increase rate upon request, Many speakers appear to have accelerated speaking rates on AMRs and connecting speech evidencing poor voluntary control, Undershoot articulatory target (placement of articulators is not where it should be). These are all articulatory characteristics of which dysarthria ?

Answer 39

hypokinetic

Question 40

Artic, prosody and resonance are usually normal but brief moments of silence in respiration is affected a. Myoclonus b. Ballismus c. Tremor d. Dyskinesia

Answer 40

myoclonus

Question 41

his disorder frequently co-occurs with OCD or ADHD a. Ballismus b. Tourette’s c. Athetosis d. Chorea

Answer 41

b. Tourette’s

Question 42

T/F UMN acute lesions will lead to reduced tone and weakness is evident but they generally evolve into increased tone and spasticity.

Answer 42

true

Question 43

The most definite speech characteristics of spastic dysarthria are ____________ and _________________.

Answer 43

phonation and prosody

Question 44

Name the different pathological reflexes?

Answer 44

Suck, snout, palmomental, jaw jerk

Question 45

Damage to parts of the pyramidal system serving speech will result in ____________________________________________________________

Answer 45

Weak slow movements of the tongue, lips, velum

Question 46

Extrapyramidal tract is the _____________________________________ from ______________.

Answer 46

Indirect pathway from cortex to LMN

Question 47

Hyperadduction of vocal folds leads to __________ vocal quality. This is a characteristic for _________________ dysarthria

Answer 47

Hyperadduction of vocal folds leads to harsh vocal quality. This is a characteristic for spastic _ dysarthria

Question 48

Extrapyramidal system is responsible for

Answer 48

maintaining posture, regulating reflexes and monitoring muscle tone

Question 49

Progressive weakness with use is a hallmark characteristic in people with a. ALS b. Myasthenia gravis c. PSP

Answer 49

b. myasthenia gravis

Question 50

T/F Fibrilations are present in muscle disease.

Answer 50

false

Question 51

T/F One of the most obvious characteristic for spastic dysarthria is imprecise articulation.

Answer 51

false

Question 52

Trauma to cranial or cervical nerves can cause ____________________ dysarthria.

Answer 52

flaccid

Question 53

This dysarthria sometimes results from damage to confined to isolated muscle groups (tongue) or speech subsystems (phonation)

Answer 53

flaccid

Question 54

UMN are grouped into _______________ and ___________________ .

Answer 54

pyramidal and extrapyramidal tract

Question 55

imprecise consonants, vowel distortions, reduced rate, prolonged phonemes, slow phoneme-phoneme transitions, voicing of voiceless stops.

Answer 55

spastic

Question 56

Genetic skeletal muscle diseases associated with muscle fiber degeneration and their replacement with fatty and fibrous connective tissues are known as _____________________________.

Answer 56

muscular dystrophy

Question 57

Progressive bulbar palsy affect UMN that supply cranial nerves T/F

Answer 57

false. affects LMN that supply cranial nerves

Question 58

Myoclonic movements can be seen a. On the external surface of the neck b. Lips or nares c. Tongue d. All of the above

Answer 58

all of the above

Question 59

Myoclonus is always multifocal T/F

Answer 59

false

Question 60

Involuntary movements are the theme that ties together the manifestations of this dysarthria a. Mixed b. Ataxic c. Hyperkinetic

Answer 60

hyperkinetic

Question 61

which of the following motor disorder can affect breathing without having effects on speech a. chorea b. dyskinesia c. myoclonus

Answer 61

dyskinesia

Question 62

Name some degenerative diseases associated with flaccid dysarthria

Answer 62

ALS, Progressive bulbar palsy, muscular dystrophies

Question 63

Pt complains of ear clicks, and a clicking sensation in the larynx, but doesn’t complain of any speech difficulty. You suspect a. Chorea b. Myoclonic movements c. Athetosis

Answer 63

b, myoclonic mvmts

Question 64

This dysarthria often has prominent effects on prosody

Answer 64

hyperkinetic

Question 65

MonoP, monoL,, vocal flutter, slow to initiate phonation, inappropriate silences, harsh and breathy quality, difficulty transitioning from voiced to voiceless and voiceless to voiced phonemes. These are all characteristics of which dysarthria

Answer 65

hypokinetic

Question 66

The pyramidal tract form part of the ____________.

Answer 66

UMN system

Question 67

What is the origin of UMN?

Answer 67

brain stem and cortex

Question 68

UMN are divided in which two tracts ?

Answer 68

corticobulabar and corticospinal

Question 69

Damaged to Extra and pyramidal system will result in

Answer 69

Weakness, increased muscle tone (spasticity) and abnormal reflexes (ex- pyramidal)

Question 70

A person with apraxia who cannot converse intelligibly or even attempt to imitate multisyllabic words may be able to (more than one answer) a. Imitate complex CVCVCV words b. Produce AMRs c. Imitate simple CVC syllables d. Say the months of the year e. Count f. Sing a familiar tune

Answer 70

b. Produce AMRs c. Imitate simple CVC syllables e. Count f. Sing a familiar tune

Question 71

Spastic dysarthria is a hallmark of lower motor neuron disease. T/F

Answer 71

false, UMN

Question 72

Which degenerative disease may produce flaccid dysarthria secondary to cranial nerve involvement

Answer 72

ALS