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Motor Speech Disorders > Exam 2 - Flaccid Dysarthria > Flashcards

Exam 2 - Flaccid Dysarthria Flashcards

1
Q

caused by:

A

impairments of LMNs in cranial or spinal nerves

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2
Q

weakness + low tone in:

A

speech or respiratory musculature results in distinctive qualities

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3
Q

flaccid dysarthria is characterized by:

A

slow, labored articulation
marked degrees of hypernasality
hoarse-breathy phonation

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4
Q

flaccid dysarthria is caused by;

A

paralysis, weakness, hypotonicity, atrophy, and hypoactive reflexes

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5
Q

LMN =

A

CNS (cranial/spinal nerves)

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6
Q

flaccid dysarthria occurs from damage to:

A

LMN system
cranial and spinal nerves + neuromuscular junction

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7
Q

flaccid dysarthria is NOT due to what type of stroke?

A

cortical

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8
Q

six pairs of CNs play a vital role in speech production

A

trigeminal V
facial VII
glossopharyngeal IX
Vagus X
Accessory XI
Hypoglossal XII

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9
Q

damage to CNs that cause flaccid dysarthria could be from:

A

brainstem stroke
growing tumor
viral or bacterial infections
physical trauma
surgical accidents

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10
Q

trigeminal nerve

A

V
jaw + facial sensation

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11
Q

facial nerve

A

VII
branches out from brainstem just below the trigeminal (V) nerve

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11
Q

3 main branches of CN V:

A

trigeminal:
ophthalmic, maxillary, and mandibular

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11
Q

most important CN V branch for speech?

A

mandibular

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11
Q

nerve attached to brainstem at level of pons:

A

trigeminal (V)

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12
Q

branches of CN VII:

A

facial nerve
temporofacial (upper) and cervicofacial (lower)

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13
Q

cranial nerve IX

A

glossopharyngeal
originates in brainstem at medulla, coursing out to pharynx

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14
Q

damage to CN IX also usually affects which nerve?

A

vagus (X)

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15
Q

CN that likely plays role in speech resonance and phonation by shaping pharynx into appropriate positions needed to produce various phonemes correctly:

A

glossopharyngeal (IX)

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16
Q

Vagus nerve

A

X
controls velum and intrinsic laryngeal muscles

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17
Q

one of the most important CNs for speech production

A

X

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18
Q

originates in the brainstem at the medulla

A

vagus (X)

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19
Q

3 branches of CN X that are important for speech:

A

pharyngeal
external superior laryngeal nerve branch
recurrent nerve branch

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20
Q

damage to pharyngeal branch of CN X can affect:

A

movement of velum and resonance

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21
Q

damage to external superior laryngeal nerve branch of CN X can affect:

A

pitch

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22
damage to recurrent nerve branch of CN X can cause:
breathy phonation
23
symptom of damage to CN X:
hypernasality
24
CN XI:
accessory originates in medulla just below the vagus nerve
25
this CN works in conjunction with CN X helping innervate intrinsic muscles of velum, pharynx, and larynx
CN XI - accessory
26
velum deviates to:
STRONG SIDE
27
most muscles deviate to:
WEAK SIDE
28
originates in the medulla
CN XII - hypoglossal
29
CN XII
hypoglossal - tongue
30
which CN provides motor innervation for all intrinsic and most extrinsic muscles of the tongue?
CN XII
31
damage to hypoglossal nerve results in:
weakness of tongue or paralysis
32
primary characteristics of hypoglossal nerve damage:
imprecise articulation phoneme distortion slow lingual movements
33
lingual twitches (fasciculations) are a sign of:
LMN damage
34
why are the spinal nerves important for speech?
provide motor innervation for the muscles of respiration
35
damage to spinal nerves generally must be widespread to significantly impair:
respiration
36
injury to phrenic nerve
provides motor innervation to the diaphragm
37
causes of flaccid dysarthria:
physical trauma neuropathies of undetermined origin muscular diseases tumors
38
flaccid dysarthria: disruption of motor impulses along cranial or spinal nerves (LMNs) that innervate
muscles of speech production
39
physical trauma
surgical trauma with accidental stretching or cut of cranial nerve head and neck injury
40
brainstem stroke or tumor
occurs with interruption of blood flow to the brain or when there is a growth on or near the brainstem
41
hemorrhagic
artery breaks
42
ischemic
artery is blocked
43
myasthenia gravis
affects neuromuscular junction Sx are rapid fatigue of muscular contractions over short time w/ recovery after rest
44
myasthenia gravis is caused by:
antibodies that block/damage muscle tissue that receives the neurotransmitter acetylcholine
45
neurotransmitter that causes muscle contractions
acetylcholine
46
when acetylcholine is blocked,
LESS muscle contractions occur
47
symptoms of myasthenia gravis are often chiefly:
velar inadequacy (hypernasality) ptosis
48
Ax of myasthenia gravis should include:
stress testing
49
stress testing
count from 1 to 100 or read lengthy paragraph
50
Guillain-Barre syndrome
demyelination usually occurring in the PNS (LMN damage)
51
the cause of GB syndrome is:
unknown but frequently occurs after certain kinds of infections and immunizations
52
progression of GB:
rapid w/ Sx including weakness/numbness in limbs then flaccid dysarthria and dysphagia if CNs affected
53
GB recovery rate:
high, lasting weeks or months
54
other causes of flaccid dysarhtira;
muscular dystrophy progressive bulbar palsy palsy and neuralgia anatomic anomalies ALS MS Polio
55
muscular dystrophy causes:
progressive degeneration of muscle tissue
56
progressive bulbar palsy can affect:
both UMNs and LMNs, although often present only in LMN
57
palsy and neuralgia
inflammation and degeneration of cranial nerves
58
masticator palsy
CN V
59
important non speech symptoms of flaccid dysarthria
diminish/absent reflexes muscle atrophy inhalatory stridor fasciculations deviation of jaw
60
inhalatory stridor
audible phonation/wheezing sound
61
flaccid dysarthria - look for:
cluster of symptoms
62
flaccid dysarthria - severity level:
within each area varies for each patient
63
flaccid dysarthria - resonance:
reflects damage to the pharyngeal branch of CN X because innervates most muscles of velum
64
hypernasality nasal emission weak pressure consonants shortened phrases
resonance
65
most noticeable resonance error
hypernasality
66
nasal emission
weak velopharyngeal closure
67
weak pressure consonants
decreased intraoral air pressure (trouble with stops)
68
shortened phrases
wasted air that escapes through nasal cavity during speech
69
flaccid dysarthria - articulation:
imprecise consonant production
70
articulation range of severity
mild distortion to complete unintelligibility
71
reason for imprecise consonant production is damage to:
facial and hypoglossal nerves
72
damage to trigeminal nerve (V) could also affect articulators because:
it could cause difficulty elevating jaw sufficiently to bring articulators into contact with each other
73
phonatory incompetence
incomplete adduction of vocal folds during phonation
74
phonatory incompetence with flaccid dysarthria caused by:
damage to recurrent branch of CN X
75
**strongest confirmatory sign of flaccid dysarthria as correct diagnosis:
combined presence of HYPERNASALITY and PHONATORY INCOMPETENCE
76
hypernasality + phonatory incompetence =
flaccid dysarthria
77
may or may not be a component of flaccid dysarthria:
weakened respiration
78
weakened respiration symptoms of flaccid dysarthria:
reduced loudness shortened phrase length strained vocal quality if speaking on residual air to prolong phrase length
79
symptoms of prosody
monopitch monoloudness
80
not unique to flaccid dysarthria so NOT a definite diagnostic marker
prosody
81
flaccid dysarthria - prosody:
weakened laryngeal muscles that are unable to make fine vocal fold adjustments necessary for normal pitch and loudness variations
82
key evaluation tasks for flaccid dysarthria:
oral mech exam conversational speech and reading DDKs prolonged vowel speech stress test
83
conversational speech and reading task
can evoke hypernasality, imprecise consonants, shortened phrase length, mono-pitch and -loudness
84
DDKs
will highlight slowed rate of phoneme production
85
prolonged vowel
helpful in eliciting breathy voice quality heard in phonatory incompetence and useful for observing respiratory weakness
86
speech stress test
necessary in suspected cases of myasthenia gravis
87
**if you want to improve speech, work on:
SPEECH in therapy
88
treatments for flaccid dysarthria are presented according to:
which cranial nerve or combination of nerves are damaged
89
if improving speech production is the goal, treatment activities should concentrate directly on:
speech production
90
unilateral damage to CN V
trigeminal nerve typically minimal - no effect on speech production
91
bilateral damage to CN V
trigeminal nerve rare but can leave jaw muscles very weak or, in severe cases, cause inability to close jaw
92
treatment for resonance due to damage to vagus nerve
CN X pharyngeal flap procedure PPW augmentation palatal lift
93
most frequent treatment for resonance in flaccid dysarthria:
palatal lift
94
what treatment can be effective for mild hypernasality?
modification of speech reduced rate; more open position mouth; increased loudness
95
treatments for phonation:
conscious effort into speaking more loudly pushing and pulling procedures hard glottal attack head turning and sideways pressure on the larynx
96
treatments for prosodic deficits
pitch range exercises intonation profiles contrastive stress drills chunking utterances into syntactic units
97
damage to facial (VII) and hypoglossal (XII) CNs, affects:
speech production primarily by decreasing lip or tongue strength and ROM traditional articulation drills often used
98
traditional articulation drills
intelligibility drills, phonetic placement, exaggerating consonants, minimal contrast drills
99
treatment for respiratory weakness:
correct posture compensatory prosthetic devices speaking immediately on exhalation cueing for complete inhalation
100
flaccid dysarthria is caused by:
any process that damages LMNs used in speech production
101
primary speech characteristics of flaccid dysarthria include:
hypernasality imprecise consonants breathy voice quality
102
Tx for flaccid dysarthria:
WORK ON SPEECH

Motor Speech Disorders (14 decks)

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