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Final Exam Flashcards

1
Q

Flaccid Dysarthria cause

A

Anything that disrupts flow of motor impulses along cranial or spinal nerves that innervate muscles of speech production. Damage to LMN.

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2
Q

Conditions that damage LMN- Flaccid Dysarthria

A
  1. physical trauma, 2. brainstem stroke, 3. GB syndrome, 4. myasthenia gravis, 5. polio.
    Other: Tumor, muscular dystrophy, progressive bulbar palsy.
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3
Q

Flaccid Dysarthria speech characteristics

A

Hypernasality, imprecise consonants, hoarse-breathy phonation. Monopitch/monoloudness, shortened phrases, reduced loudness, strained vocal quality, nasal emissions.

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4
Q

Flaccid Dysarthria Eval Tasks

A

Conversational speech and reading
AMR task
Prolonged vowel

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5
Q

Conversational speech and reading- Flaccid Dysarthria

A

evokes errors of resonance (hypernasality), articulation (imprecise consonants), prosody (monopitch/monoloud)

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6
Q

AMR Task- Flaccid Dysarthria

A

evokes slow rate of phoneme production

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7
Q

Flaccid Dysarthria Treatment

A

Grouped by cranial nerve or combination of cranial nerve damage.
Individualized for each patient

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8
Q

Flaccid Dysarthria Characteristics

A

weakness in speech/respiratory musculature
muscle weakness, hypotonicity, atrophy, paralysis, and hypoactive reflexes of involved speech system musculature

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9
Q

Spastic Dysarthria cause

A

Bilateral Upper Motor Neuron damage

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10
Q

Spastic Dysarthria causes of bilateral UMN damage

A

Stroke, degenerative diseases, TBI, brain infection, tumor

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11
Q

Spastic Dysarthria specific conditions

A

Multiple Sclerosis, ALS

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12
Q

Pseudobulbar affect

A

uncontrollable crying or laughing. Caused by damage to areas of brain important in inhibiting emotions. spastic dysarthria

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13
Q

Pseudobulbar palsy

A

weakness and slowness in muscles of tongue, velum, larynx, pharynx caused by damage to upper motor neurons. Spastic dysarthria.

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14
Q

Amyotrophic Lateral Sclerosis (ALS)

A

Terminal degenerative disease
unknown cause
causes spastic when UMN involvement predominant

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15
Q

Multiple Sclerosis (MS)

A

Immunologic disorder
inflammation/destruction of myelin sheath

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16
Q

Spastic Dysarthria speech characteristics

A

Result of: spasticity, slowness, weakness in vocal tract muscles
Imprecise consonants
harsh vocal quality, strained-strangled vocal quality
hypernasality
monopitch/monoloud, short phrases, slow rate

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17
Q

Spastic Dysarthria eval tasks

A

Conversational speech and reading
AMR task
Vowel prolongation

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18
Q

Conversational speech and reading- Spastic Dysarthria

A

Evokes: hypernasality (resonance), imprecise consonants (articulation), monopitch/monoloudness (prosody)

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19
Q

AMR task- Spastic Dysarthria

A

Evokes slow rate (prosody)

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20
Q

Vowel prolongation- Spastic Dysarthria

A

Evokes harsh vocal quality, strained-strangled vocal quality (phonation)

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21
Q

Spastic Dysarthria Treatment

A

Patient specific
Primary goals target: phonation, articulation, prosody, resonance
Resonance not significantly affected

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22
Q

Spastic Dysarthria phonation treatment

A

head neck relaxation exercises
easy onset
yawn-sigh exercises

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23
Q

Spastic Dysarthria articulation treatment

A

stretching tongue and lips
traditional artic drills- intelligibility, phonetic placement, exaggerating consonants

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24
Q

Spastic Dysarthria prosody treatment

A

pitch range exercises
intonation profiles
contrastive stress drills
chunking utterances

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25
Spastic Dysarthria resonance treatment
pharyngeal flap procedure teflon paste pharyngeal wall procedure
26
Unilateral Upper Motor Neuron Dysarthria cause
Any condition that damages upper motor neurons on one side of the brain
27
UUMN Dysarthria neuro basis
Damage to muscles of lower face and tongue (receive unilateral innervation)
28
UUMN Dysarthria causes
Any condition that causes UUMN damage In left hemisphere can co-occur w/aphasia or AOS In right hemisphere can co-occur w/cognitive & visual deficits associated with that side of brain
29
UUMN Dysarthria causes
Stroke- most common Tumors- not common TBI- not common
30
UUMN Dysarthria speech characteristics
imprecise consonants mild-moderate speech production errors
31
UUMN Dysarthria Articulation
Primarily affected. Tongue and lower face affected more than anything else Weakness, decreased RoM, decreased fine motor control of tongue Imprecise consonants, irregular artic breakdowns, slow AMR, irregular AMRs
32
UUMN Dysarthria Phonation
Mild-moderate harsh vocal quality result of mild vocal fold weakness
33
UUMN Dysarthria Resonance
Hypernasality Damage may cause mild weakness in velum Shouldn't affect speech much
34
UUMN Dysarthria Eval Tasks
Medical records Conversational speech/reading- imprecise consonants, irregular artic breakdowns AMR tasks- slow rate of production Prolonged vowel- harsh vocal quality
35
UUMN Dysarthria Treatment
Not high tx priority when co-occurring w/aphasia or AOS Intelligibility drills, phonetic placement, exaggerating consonants, minimal contrast drills
36
Ataxic Dysarthria cause
damage to cerebellum
37
Ataxic Dysarthria conditions
degenerative diseases, stroke, toxic conditions, TBI, tumor, infections
38
Ataxic Dysarthria characteristics
problems with timing, force, range, direction (cerebellar ataxia) hypotonia of muscles, intention tremors, wide/staggering gait
39
Ataxic Dysarthria speech characteristics
Scanning speech Imprecise consonants Equal + excess stress Paradoxical movements- respiration/decreased air
40
Ataxic Dysarthria eval tasks
AMR- slow rate, difficulty maintaining rhythm with repetitions. AMRs irregular w/severe cases. Speed up then slow down. Conversational speech + reading Repeat sentences w/numerous multisyllabic words
41
Ataxic Dysarthria treatment
Focus on artic + prosody Artic- slow rate, intelligibility drills, overarticulation, phonetic placement, minimal contrast drills Prosody- slow rate (finger tap, cued reading, metronome), contrastive stress drills, pitch range exercises, intonation profile, chunking utterances
42
Parkinsonism cause
Basal ganglia dysfunction. Reduction of dopamine in striatum -> too much acetylcholine
43
Hypokinetic Dysarthria cause
Parkinsonism- Idiopathic Parkinson's disease, Neuroleptic-induced parkinsonism, postencephalitic parkinsonism, traumatic head injury, toxic metal poisoning, stroke
44
Hypokinetic Dysarthria speech characteristics
Monopitch, monoloud (most common), reduced stress Imprecise consonants, repeated phonemes, palilalia, increased rate harsh/breathy quality, aphonia, low pitch
45
Parkinson characteristics
resting tremor Bradykinesia- slow & reduced range of movement Akinesia- delay in initiation of movements Muscle rigidity spasticity disturbances of postural reflexes
46
Hypokinetic Dysarthria eval tasks
Conversational speech and reading- evoke prosody errors, detect short rushes AMR- highlight artic errors Vowel prolongations- assess vocal quality
47
Hypokinetic Dysarthria treatment
pharmacologic- LDopa Surgical- ablation, deep brain stimulation speech-language therapy
48
Hypokinetic Dysarthria behavioral treatment
artic- rate reduction (pacing boards, hand/finger tapping, metronome, DAF), stretching, traditional artic drills (intelligibility, phonetic placement, overartic) phonation- push/pull procedure, hard glottal attack, LSVT) respiration- speak on exhale, cue for exhale, optimal breath group prosody- slow rate of speech (intonation profiles, contrastive stress, chunking)
49
Hyperkinetic Dysarthria causes
Disorders associated with damage to basal ganglia. Affect prosody and rate primarily.
50
Hyperkinetic Dysarthria causes
Chorea Huntington's disease Stroke Tardive dyskinesia Myoclonus Essential tremor Tics Dystonia Other: degen. diseases, TBI, stroke, infections
51
Hyperkinetic Dysarthria speech characteristics
prolonged intervals between syllables and words variable rate of speech inappropriate silences excess loudness variations prolonged phonemes rapid, brief inhalations or exhalations voice stoppages intermittent breathy voice quality
52
Chorea
movement disorder characterized by random involuntary movements of limbs, trunk, head, and neck. often described as dance like b/c appear to be smooth and coordinated
53
Huntington's disease
progressive disorder caused by gradual degeneration of neurons in basal ganglia and cerebral cortex
54
Tardive Dyskinesia
movement disorder that can cause choreic movements of the face, mouth, and neck
55
Myoclonus
hyperkinetic movement disorder distinguished by involuntary and brief contractions of part of a muscle, a whole muscle, or a group of muscles in the same area of the body.
56
Tic Disorders
rapid movement that can be controlled voluntarily for a time, but is performed frequently because of a compulsive desire to do so.
57
Dystonia
Hyperkinetic movement disorder of muscle tone. Movements have a slower, more sustained quality than those seen in chorea.
58
Essential tremor
benign hyperkinetic movement disorder that causes tremulous movements in affected body parts. Faster than parkinsonism tremor. Disappears at rest.
59
Hyperkinetic Dysarthria eval tasks
vowel prolongation- harsh, strained/strangled quality voice, vocal tremor AMR- irregular artic breakdowns conversational speech and reading- imprecise consonants, vowel distortions, prolonged phonemes, silences, monopitch/monoloudness, short phrases, harshness, excessive loudness variations, sudden inhale/exhale careful observation of associated involuntary movements
60
Hyperkinetic Dysarthria treatment
Medical- drugs that suppress involuntary movements (botox), deep brain stimulation Behavioral- dependent on disorder
61
Mixed Dysarthria
Occurs when neurologic damage extends into two or more parts of the motor system can be LMN + UMN, cerebellum + basal ganglia, UMN + basal ganglia
62
Mixed Dysarthria causes
any disorder affecting two or more parts of motor system. single or multiple strokes, tumors, TBI, degen. diseases, infectious diseases Multiple Sclerosis, ALS, multisystems atrophy, Wilson's disease, Friedreich's ataxia,
63
Multiple Sclerosis
Progressive demyelinating disease. can cause any pure or any combo of mixed dysarthria. Ataxic-spastic most common
64
ALS
Progressive degeneration of any of four areas of motor neurons Spastic-Flaccid predominant
65
Wilson's disease
Rare hereditary disorder preventing normal metabolism of dietary copper Ataxic-spastic-hypokinetic
66
Freidreich's Ataxia
Rare, inherited, progressive disorder. causes neuron degeneration in cerebellum, brainstem, and spinal cord Ataxic-spastic dysarthria
66
Freidreich's Ataxia
Rare, inherited, progressive disorder. causes neuron degeneration in cerebellum, brainstem, and spinal cord Ataxic-spastic dysarthria
67
Mixed Dysarthria treatment
treat most severe component first if elements equally affected treat in this order: respiration, resonation, phonation, articulation, prosody
68
Apraxia of Speech cause
stroke (most common), degenerative disease, trauma, tumor
69
Apraxia of Speech
motor programming disorder. deficit in ability to select and time-sequence motor commands needed to correctly position the articulators.
70
Apraxia of Speech speech characteristics
Artic and prosody primarily affected inconsistent speech errors
71
Apraxia of Speech eval tasks
SMR- motor planning Conversational speech and reading- prosody Repeating words of increasing length Reading or repeating low-frequency multisyllabic words in isolation or sentences
72
Diagnosing AOS
Diagnose only when determined significant number of patient's speech errors match those known to apraxia of speech Rule out other conditions that cause movement difficulties similar to those seen in apraxia. Muscle weakness, sensory loss, comprehension deficit, incoordination
73
AOS treatment
Articulatory kinematic treatments rate and rhythm procedures AAC

Motor Speech Disorders (1 decks)

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