Dysarthria Flashcards
Motor speech disorder produced by injury or malfunction of one or more of the cranial or spinal nerves
Flaccid
Shallow breathing aka reduced inhalatory and exhalatory volumes is a respiratory characteristic of which dysarthria
spastic
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.
IX
Increased muscle tone, spasticity, hyperexcitiable reflexes can occur due to damage to
extrapyradmial tract
- People with spastic paralysis commonly exhibit
a. Decreased skilled movements
b. Weakness
c. Increased muscle tone
d. Spasticity
e. All of the above
E. All of the above
This nerve is assessed clinically by examining the gag reflex, particularly asymmetry in the ease with which the reflex is elicited
IX
- T/F. Polio affects LMN cell bodies, most often on the lumbar and cervical spinal cord
True
This dysarthria is associated with disease of the basal ganglia control circuit.
Hyperkinetic
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 ?
hypokinetic
Torticollois are _________ of the neck.
spasms of the neck. present. in dystonia
Tourette’s syndrome is the prototypic _________________ disorder.
tic disorder
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
all of the above
- Violent looking movements are usually a sign of which disorder
a. Chorea
b. Dystonia
c. Ballismus
d. Clonus
C. Ballismus
- 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?
Hypokinetic
Name the most common etiologies in hypokinetic dysarthria:
Parkinson disease, PSP, dementia, parkinsonism with ALS – Parkinson like symptoms that can be associated with ALS
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
b. dystonia
The pyramidal tract is unilateral. T/F
false. bilateral
- The indirect pathways are crucial for _____________________ and ______________________.
Regulating reflexes and maintaining posture and tone. Many of their activities are inhibitory
Which pathway/neurons are responsible for skilled, discrete movements?
direct pathway. WMN
Excessive/inappropriate Coughing, grunting, throat clearing, screaming, moaning, humming, whistling, lip smacking, echolalia can all be as a result of
Tourette’s syndrome
T/F In myoclonus the most striking abnormality is motor unsteadiness.
false. In chorea the most striking abnormality is motor unsteadiness
T/F the extrapyramidal tract is not part of the UMN system
False
T/F The non speech AMRs of the jaw, lips, and tongue may are usually regular in ataxic dysarthria.
false. The non speech AMR;s of the jaw, lips, and tongue are usually irregular in ataxic dysarthria
This dysarthria is more wide spread, and it is not generally confined to a single component
spastic
Strained-harsh vocal quality, voice stoppages, forced respiration, excess loudness variations are most likely to be present in a person with
chorea
This dysarthria characteristics are most evident in articulation and prosody.
ataxic
Name common clinical signs of cerebellar disease in the lateral hemispheric zone
Hypotinia, desmetria, dysdiadochokinesis, ataxia, tremor, ocular motor abnormalities, dysarthria
Name 5 common clinical signs of cerebellar disease in the midline zone?
Distorted stance and gate, truncal titubation (unsteady, stumbling gate, swaying of head while sitting), rotated or tilted head postures, ocular motor abnormalities, dysarthria
Poorly timed, controlled and coordinated movements are common characteristics of which dysarthria
ataxic
This dysarthria seem to result from a failure of the basal ganglia pathways to properly inhibit cortical motor discharges
hyperkinetic
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
all of the above
The speech characteristics of this dysarthria are usually the product of abnormal, rhythmic or irregular and unpredictable, rapid or slow involuntary movements
hyperkinetic
which of the following motor disorders can occur as a common side effect of antipsychotic drugs?
a. Ticks
b. Myclonus
c. Dyskinesia
d. Chorea
c. dyskinesia
What is a palatal tremor?
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
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
b. Action myoclonus
T/F Tourette’s syndrome is characterized by multiple motor and vocal tics that have been present for less than 1 year
false. more than one year
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
e. Basal Ganglia and Association cortex
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
b. reduced gag reflex -> gag reflex is often normal
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 ?
hypokinetic
Artic, prosody and resonance are usually normal but brief moments of silence in respiration is affected
a. Myoclonus
b. Ballismus
c. Tremor
d. Dyskinesia
myoclonus
his disorder frequently co-occurs with OCD or ADHD
a. Ballismus
b. Tourette’s
c. Athetosis
d. Chorea
b. Tourette’s
T/F UMN acute lesions will lead to reduced tone and weakness is evident but they generally evolve into increased tone and spasticity.
true
The most definite speech characteristics of spastic dysarthria are ____________ and _________________.
phonation and prosody
Name the different pathological reflexes?
Suck, snout, palmomental, jaw jerk
Damage to parts of the pyramidal system serving speech will result in ____________________________________________________________
Weak slow movements of the tongue, lips, velum
Extrapyramidal tract is the _____________________________________ from ______________.
Indirect pathway from cortex to LMN
Hyperadduction of vocal folds leads to __________ vocal quality. This is a characteristic for _________________ dysarthria
Hyperadduction of vocal folds leads to harsh vocal quality. This is a characteristic for spastic _ dysarthria
Extrapyramidal system is responsible for
maintaining posture, regulating reflexes and monitoring muscle tone
Progressive weakness with use is a hallmark characteristic in people with
a. ALS
b. Myasthenia gravis
c. PSP
b. myasthenia gravis
T/F Fibrilations are present in muscle disease.
false
T/F One of the most obvious characteristic for spastic dysarthria is imprecise articulation.
false
Trauma to cranial or cervical nerves can cause ____________________ dysarthria.
flaccid
This dysarthria sometimes results from damage to confined to isolated muscle groups (tongue) or speech subsystems (phonation)
flaccid
UMN are grouped into _______________ and ___________________ .
pyramidal and extrapyramidal tract
imprecise consonants, vowel distortions, reduced rate, prolonged phonemes, slow phoneme-phoneme transitions, voicing of voiceless stops.
spastic
Genetic skeletal muscle diseases associated with muscle fiber degeneration and their replacement with fatty and fibrous connective tissues are known as _____________________________.
muscular dystrophy
Progressive bulbar palsy affect UMN that supply cranial nerves T/F
false. affects LMN that supply cranial nerves
Myoclonic movements can be seen
a. On the external surface of the neck
b. Lips or nares
c. Tongue
d. All of the above
all of the above
Myoclonus is always multifocal T/F
false
Involuntary movements are the theme that ties together the manifestations of this dysarthria
a. Mixed
b. Ataxic
c. Hyperkinetic
hyperkinetic
which of the following motor disorder can affect breathing without having effects on speech
a. chorea
b. dyskinesia
c. myoclonus
dyskinesia
Name some degenerative diseases associated with flaccid dysarthria
ALS, Progressive bulbar palsy, muscular dystrophies
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
b, myoclonic mvmts
This dysarthria often has prominent effects on prosody
hyperkinetic
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
hypokinetic
The pyramidal tract form part of the ____________.
UMN system
What is the origin of UMN?
brain stem and cortex
UMN are divided in which two tracts ?
corticobulabar and corticospinal
Damaged to Extra and pyramidal system will result in
Weakness, increased muscle tone (spasticity) and abnormal reflexes (ex- pyramidal)
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
b. Produce AMRs
c. Imitate simple CVC syllables
e. Count
f. Sing a familiar tune
Spastic dysarthria is a hallmark of lower motor neuron disease. T/F
false, UMN
Which degenerative disease may produce flaccid dysarthria secondary to cranial nerve involvement
ALS
