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Neuro > Dysarthrias - Diff Dx > Flashcards

Dysarthrias - Diff Dx Flashcards

1
Q

Dysarthria

A

a speech disorder resulting from weakness, paralysis, or incoordination of the muscles of the speech mechanism

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2
Q

Motor Speech Disorder

A
  • disorders of speech resulting from neurological impairment affecting the motor programming or neuromuscular execution of speech (Duffy, 1995, p.5)
  • includes dysarthria & apraxia of speech
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3
Q

Flaccid dysarthria - Neural basis?

A

Final common pathway (spinal & cranial nerves) (aka LMN)

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4
Q

Spastic dysarthria- Neural basis?

A

Bilateral direct & indirect activation pathways (pyramidal and extrapyramidal systems) (aka UMN)

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5
Q

Ataxic dysarthria - Neural basis?

A

Cerebellum

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6
Q

Hypokinetic dysarthria - Neural basis?

A

Basal Ganglia

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7
Q

Hyperkinetic dysarthria - Neural basis?

A

Basal Ganglia

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8
Q

Mixed Dysarthria - Neural basis

A

?

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9
Q

Flaccid Dysarthria - Physiology?

A

Weakness

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10
Q

Spastic Dysarthria - Physiology?

A

Spasticity

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11
Q

Ataxic Dysarthria - Physiology?

A

Incoordination

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12
Q

Hypokinetic Dysarthria - Physiology?

A

Rigidity, Reduced ROM

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13
Q

Hyperkinetic Dysarthria - Physiology?

A

involuntary movements

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14
Q

Mixed dysarthria - Physiology?

A

?

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15
Q

Unilateral UMN - neural basis & physiology?

A

Neural basis: unilateral UMN

Physiology - Weakness & possibly incoordination

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16
Q

Often ______ ______ are the 1st sign of a neurological disease

A

speech symptoms

17
Q

Identification of speech symptoms can assist w/ medical dx and care (T/F)

A

True

18
Q

Flaccid dysarthria - Symptoms

A

Can vary widely depending on what cranial nerves are involved. Unlike most dysarthria types, this dysarthria sometimes reflects involvement of only a single muscle group (e.g., tongue) or speech subsystem (e.g., phonatory).

19
Q

Flaccid dysarthria - clinical characteristics?

A
  • Weakness
  • Hypotonia & Reduced Reflexes
  • Muscle Atrophy
  • Fasciculations & fibrillations
  • Progressive weakness with use, when damage is at the neuromuscular junction as in Myasthenia Gravis (Rapid weakening w/ use and Recovery with rest)
20
Q

Flaccid dysarthria - General oral motor exam would look like?

A

Expect to see

  • Weakness & Reduced ROM for articulators
  • Jaw deviates to weak side when opening (unilateral mandibular lesions)
  • Tongue deviates to weak side when protruded
  • Drooling
21
Q

Flaccid dysarthria - Articulation?

A

imprecise articulation

22
Q

Flaccid dysarthria - Resonance?

A
  • Hypernasality

- Nasal Emission

23
Q

Flaccid dysarthria - Prosody?

A
  • Short Phrases

- Monoloudness & mono pitch

24
Q

Flaccid dysarthria - Phonation?

A
  • Breathy voice

- Audible inspiration

25
Q

Flaccid dysarthria - Commonly associated neurological diagnoses?

A
  • Brainstem stroke (could lead to locked-in syndrome)
  • Gullain - Barre Syndrome (GB)
  • Mysathenia Gravis (MG)
  • Muscular Dystrophy (MD) (Duchenne, Myotonic)
26
Q

Flaccid dysarthria - Trigeminal Sensory Neuropathy

A
  • Viral etiology is common, but also associated w/ diabetes, sarcoidosis, and connective tissue disease.
  • Facial numbness is occasionally a presenting symptom of Multiple Sclerosis (MS).
27
Q

Flaccid dysarthria - Trigeminal Nerve (V) lesions - Nonspeech oral mech exam - - In cases of bilateral weakness what would be pt complaints & what would you expect to see?

A

can include chewing difficulty, drooling, and recognition that the jaw is difficult to close or move

28
Q

Flaccid dysarthria - Trigeminal Nerve (V) lesions - Nonspeech oral mech exam - - if sensory branches are affected, what would be pt complaints & what would you expect to see?

A

pt may complain of decreased face, cheek, tongue, teeth, or palate sensation. (Assess during OME by having pt close eyes and indicate when light touch or pressure is applied to the affected area)

29
Q

Flaccid dysarthria - Trigeminal Nerve (V) lesions - Nonspeech oral mech exam - - In pts with unilateral mandibular branch lesions, what would be pt complaints & what would you expect to see?

A
  • jaw will deviate to weak side when opened
  • partly opened jaw may be pushed easily to the weak side by the examiner
  • degree of master or temporals contraction felt on palpation when the pt bites down may be decreased on the weak side

Neuro (6 decks)

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