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SPA 762 > Dysarthrias > Flashcards

Dysarthrias Flashcards

1
Q

What are the most distinguishing PERCEPTUAL speech characteristics of Flaccid dysarthria?

A
  • Continuous breathiness
  • Audible inspiratory stridor
  • Short phrases
  • Hyper nasality
  • Intelligibility is affected
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2
Q

What is Flaccid dysarthria classified as primarily?

A

Muscle weakness

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3
Q

What are the most distinguishing PERCEPTUAL speech characteristics of Spastic dysarthria?

A
  • Strained or harsh vocal quality (phonation)
  • Hyper-nasality
  • Excessive prosody
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4
Q

What are the most distinguishing PERCEPTUAL speech characteristics of Hypokinetic dysarthria?

A
  • Breathy
  • Rough
  • Mono pitch and mono loudness
  • reduced loudness
  • reduced stress
  • short rushes of speech
  • imprecise consonants
  • variable speed
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5
Q

What is Spastic dysarthria classified as primarily?

A
  • Spasticity
  • Muscle rigidity
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6
Q

What is Ataxic dysarthria classified as primarily?

A
  • Reduced movement control
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7
Q

What is Hypokinetic dysarthria classified as primarily?

A

Reduced movement

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8
Q

What are the most distinguishing PERCEPTUAL speech characteristics of Ataxic dysarthria?

A
  • Sounds drunk
  • Excessive prosody
  • Excess and equal stress
  • Excessive loudness
  • distorted vowels
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9
Q

What are the most distinguishing PERCEPTUAL speech characteristics of Hyperkinetic dysarthria?

A
  • Voice sounds shaky
  • sudden forced inspiration/expiration
  • voice tremor
  • marked deterioration with increased rates
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10
Q

ALS has a natural and very common association with which type of dysarthria?

A

mixed spastic-flaccid dysarthria

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11
Q

What are usually the initial signs of ALS and mixed spastic-flaccid dysarthria?

A
  • hyper nasality
  • slowed speech (slower than 250 words per minute)
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12
Q

What is Hyperkinetic dysarthria classified as primarily?

A
  • Excess movement
  • Visibly abnormal orofacial, head, and respiratory movements
  • Bizarre involuntary movements
  • Possibly psychogenic etiology
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13
Q

Distinguishing physical characteristics of Flaccid dysarthria?

A
  • Hypotonia
  • Weakness
  • Atrophy
  • Diminished reflexes
  • Negative babinksi
  • rapid deterioration and recovery with rest
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14
Q

Distinguishing physical characteristics of Spastic dysarthria?

A
  • Hyperactive reflexes (gag, Babinksi)
  • Pathological oral reflexes (sucking, snout, jaw)
  • Reduced ROM
  • Loss of fine skilled movements
  • Poor control of emotion
  • Hypertonia
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15
Q

Distinguishing physical characteristics of Ataxic dysarthria?

A
  • Dysmetric jaw, face, tongue AMRs
  • Head tremor
  • incoordination
  • Gait is off (waddle)
  • Falling back
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16
Q

Distinguishing physical characteristics of Hypokinetic dysarthria?

A
  • Masked facial expression
  • resting tremor (head, limbs, pill rolling), Tremulous jaw, lips and. tongue
  • slowed onset of movements
  • drooling - swallowing infrequency
  • Reduced ROM on AMR tasks
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17
Q

Distinguishing physical characteristics of Hyperkinetic dysarthria?

A
  • Involuntary head, jaw, face, tongue, velar, laryngeal, and respiratory movements
  • relatively sustained deviation of head position
  • multiple motor tics
  • myoclonus of palate, pharynx, larynx, lips, nares, tongue or respiratory movements
  • jaw, lip, tongue, pharyngeal or palatal tremor
  • facial grimacing during speech
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18
Q

Distinguishing physical characteristics of UUMN dysarthria?

A
  • unilateral lower face weakness
  • unilateral lingual weakness with atrophy/fasciculations
  • nonverbal oral apraxia
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19
Q

Cause of Flaccid dysarthria?

A

LMN damage (final common pathway, motor unit)
* Distinctive because it is produced by injury or malfunction of one or more of the cranial or spinal nerves

20
Q

Cause of Spastic dysarthria?

A
  • Bilateral damage to the direct and indirect activation pathways of the CNs
  • Upper motor neuron
21
Q

Cause of UUMN dysarthria?

A
  • associated with damage to the UMN
    pathways that carry impulses to the cranial and spinal nerves that supply the speech muscles
  • usually temporary and mild
22
Q

Cause of Ataxic dysarthria?

A

Damage to the cerebellar control circuit

23
Q

Cause of Hypokinetic dysarthria?

A
  • Damage to the basal ganglia control circuit
  • Imbalances among neurotransmitters are responsible for many motor problems associated with basal ganglia control circuit malfunction.
24
Q

Cause of hyperkinetic dysarthria?

A
  • Damage to the basal ganglia control circuit
  • Afferent pathway
  • Product of abnormal, rhythmic or irregular and unpredictable, rapid
    or slow movements
25
Q

Cause of AOS?

A
  • Damage to the left cerebral hemisphere, particularly the frontal-parietal and related subcortical circuits
26
Q

Etiologies on Flaccid dysarthria

A
  • ALS
  • MD (often mistaken for PD)
  • Progressive bulbar palsy
  • Polio
  • Neurological complications of AIDS
27
Q

Etiologies for Spastic dysarthria

A
  • Vascular: strokes in the internal carotid and middle and posterior cerebral artery
    distributions, lesions in both left and right hemisphere, single brainstem stroke
  • Degenerative: primary lateral sclerosis
  • Inflammatory: leukoencephalitis
  • Congenital: cerebral palsy
28
Q

Etiologies for Ataxic dysarthria?

A
  • Degenerative disease (Friedreich’s ataxia Shy– - - Drager syndrome
  • Progressive supranuclear palsy (PSP)
  • Multiple system atrophy
  • MS
29
Q

Etiologies for Hypokinetic dysarthria

A
  • Degenerative: Parkinson’s, Parkinsonism’s
  • Vascular: nonhemorrhagic stroke, vascular parkinsonism, hypoxia
  • Toxic metabolic conditions: antipsychotics, antidepressants (long-term use), radiation
  • exposure
  • Trauma: deep brain stimulation for PD, tumor resection, postoperative, closed head
  • injury
  • Infectious conditions: encephalitis
30
Q

Etiologies for Hyperkinetic dysarthria?

A
  • Idiopathic: orofacial dyskinesia, dystonia, or tremor; essential tremor, spasmodic torticollis, chorea
  • Toxic metabolic conditions: Heavy metals
  • Degenerative diseases: Huntington’s Disease
  • Infectious processes
  • Traumatic: PPM (secondary to posterior fossa tumor removal)
  • Vascular disorders: Brainstem or BG stroke, Neoplasm
  • Other: Tourette’s syndrome
31
Q

What are some of the patient complaints for Flaccid dysarthria?

A
  • Slurred speech
  • Tongue feels thick
  • Sudden brief periods of pain
  • Specific to affected CN’s
32
Q

What are some of the patient complaints for Spastic dysarthria?

A
  • Slowed speech
  • Gets tired when talking (fatigue)
  • Increased efforts to speak
  • Poor control of emotions
  • Drooling
33
Q

What are patient complaints for UUMN?

A
  • Slurred thick slow speech
  • Deterioration under fatigue
  • Drooling because of lack of swallow frequency
  • Facial droop
34
Q

What are patient complaints for Ataxic dysarthria?

A
  • Sounds drunk
  • Feels as if they are stumbling over words
  • Bite tongue or cheek while eating
  • Speech deteriorates with alcohol intake
35
Q

What are the patient complaints for Hypokinetic dysarthria?

A
  • Quiet or weak vocal quality however they often deny it
  • Voice cannot be heard in a loud environment
  • Voice lacks emotion
  • Speech rate is too fast
  • Hard to get speech started
  • “stutter” for sound, syllable or word repetitions
36
Q

What are the patient complaints for hyperkinetic dysarthria?

A
  • Voice sounds shaky
  • Short of breath
  • Not aware of tremor
  • Tremor gets worse with fatigue or stress
  • Tremor improves with alcohol
37
Q

Wha are the patient complaints for AOS?

A

“I have words I want to say but they don’t come out the right way”
“I am not as fluent as I was before

38
Q

What are subcategories of Hyperkinetic dysarthria?

A
  • Tourette’s
  • Dystonia (strained harsh vocal quality)
  • Spasmodic torticollis
  • Essential tremor (rhythmic)
  • Chorea (speech sounds slurred and slow, hard to talk, difficulty with chewing and swallowing)
  • Myoclonus (adductor voice arrests, slow rate, imprecise speech)
39
Q

Hyperkinetic dysarthria can manifest in all subsystems but is prominent in?

A
  • Prosody
  • Rate
40
Q

Hyperkinetic dysarthria: Essential Tremor

A
  • Rhythmic
  • Vertical laryngeal movements
  • Tremor.. especially during phonation in the jaw, lips, tongue, palate and pharynx
  • adductor and abductor oscillations of the TVF
  • Normal pitch and loudness
41
Q

Hyperkinetic dysarthria: Myoclonus

A
  • Ear clicks
  • Usually no speech complaints
  • Myoclonic movements in palate, pharynx, larynx, lips, nares, tongue, respiratory muscles, beneath neck muscles (can see)
  • no issues with respiration and phonation
  • articulation and prosody normal but could have brief silent intervals
42
Q

Hyperkinetic dysarthria: Spasmodic Torticollis

A
  • Reduced pitch and pitch variability
  • reduced rate, delayed speech initiation and slow AMRs
  • Patient says speech is normal
  • Complaints relate to neck movements and pain
  • Dysphagia
  • Sensory tricks that reduce spasms temporarily and abnormal posturing
  • Sustained deviation of head to right or left forward and back
43
Q

Hyperkinetic dysarthria: Dystonia

A
  • waxing and waning head and neck, face, tongue, palate, pharyngeal, laryngeal, thoracic-abdominal movements (present at rest, sustained phonation)
  • Slow effortful speech
  • Strained and harsh vocal quality
  • voice tremor
  • Involuntary orofacial movement
  • “tricks” improve speech temporally
  • Chewing and swallowing problems
44
Q

Hyperkinetic dysarthria: Tourette’s

A
  • Vocal tics
  • Motor tics (eye blinks, head twitch, facial grimacing, jumping, touching, obscene gestures)
  • inability to inhibit the tics for sustained periods of time
  • often associated with behavioral and psychiatric disorders (OCD, phobia, hyperactivity, ADD, LD)
  • humming, whistling, lip smacking, echolalia, palilalia, sniffling, coughing grunting, throat clearing, screaming, moaning
45
Q

Hyperkinetic dysarthria: Myoclonus

A
  • Mostly respiration and phonation affected
  • quick, gross, or fine jerky movements
  • inability or reluctance to seat at normal or rapid rates
  • adductor voice arrests
  • slow rate / increased rate
  • decreased precision
  • deterioration of AMR regularity with increased rate
46
Q

Hyperkinetic dysarthria: Chorea (slurred, hard to talk, difficulty with chewing and swallowing)

A
  • Respiration and phonation (sudden forced inspriation-expiration, voice stoppages, transient breathiness, strained harsh voice quality, excessive loudness)
  • Resonance and articulation (distortions and irregular breakdown, and slow and irregular AMRs)
  • Prosody (prolonged intervals and phonemes, variable rate, inappropriate rate, inappropriate
    silences, and excessive-inefficient variable patterns of stress)
  • Quick, un patterned involuntary movements
  • Effortful speech
  • Involuntary orofacial movements
  • Chewing and swallowing problems
47
Q

Hyperkinetic dysarthria: Tremor

A
  • Voice sounds shaky and tight
  • Short of breath
  • Not aware of tremor
  • Tremor gets worse with fatigue or stress
  • Improves with alcohol

SPA 762 (5 decks)

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