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motor speech disorders > Final Exam > Flashcards

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
Q

Spastic Dysarthria resonance treatment

A

pharyngeal flap procedure
teflon paste
pharyngeal wall procedure

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26
Q

Unilateral Upper Motor Neuron Dysarthria cause

A

Any condition that damages upper motor neurons on one side of the brain

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27
Q

UUMN Dysarthria neuro basis

A

Damage to muscles of lower face and tongue (receive unilateral innervation)

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28
Q

UUMN Dysarthria causes

A

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

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29
Q

UUMN Dysarthria causes

A

Stroke- most common
Tumors- not common
TBI- not common

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30
Q

UUMN Dysarthria speech characteristics

A

imprecise consonants
mild-moderate speech production errors

31
Q

UUMN Dysarthria Articulation

A

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
Q

UUMN Dysarthria Phonation

A

Mild-moderate harsh vocal quality
result of mild vocal fold weakness

33
Q

UUMN Dysarthria Resonance

A

Hypernasality
Damage may cause mild weakness in velum
Shouldn’t affect speech much

34
Q

UUMN Dysarthria Eval Tasks

A

Medical records
Conversational speech/reading- imprecise consonants, irregular artic breakdowns
AMR tasks- slow rate of production
Prolonged vowel- harsh vocal quality

35
Q

UUMN Dysarthria Treatment

A

Not high tx priority when co-occurring w/aphasia or AOS
Intelligibility drills, phonetic placement, exaggerating consonants, minimal contrast drills

36
Q

Ataxic Dysarthria cause

A

damage to cerebellum

37
Q

Ataxic Dysarthria conditions

A

degenerative diseases, stroke, toxic conditions, TBI, tumor, infections

38
Q

Ataxic Dysarthria characteristics

A

problems with timing, force, range, direction (cerebellar ataxia)
hypotonia of muscles, intention tremors, wide/staggering gait

39
Q

Ataxic Dysarthria speech characteristics

A

Scanning speech
Imprecise consonants
Equal + excess stress
Paradoxical movements- respiration/decreased air

40
Q

Ataxic Dysarthria eval tasks

A

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
Q

Ataxic Dysarthria treatment

A

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
Q

Parkinsonism cause

A

Basal ganglia dysfunction. Reduction of dopamine in striatum -> too much acetylcholine

43
Q

Hypokinetic Dysarthria cause

A

Parkinsonism- Idiopathic Parkinson’s disease, Neuroleptic-induced parkinsonism, postencephalitic parkinsonism, traumatic head injury, toxic metal poisoning, stroke

44
Q

Hypokinetic Dysarthria speech characteristics

A

Monopitch, monoloud (most common), reduced stress
Imprecise consonants, repeated phonemes, palilalia, increased rate
harsh/breathy quality, aphonia, low pitch

45
Q

Parkinson characteristics

A

resting tremor
Bradykinesia- slow & reduced range of movement
Akinesia- delay in initiation of movements
Muscle rigidity
spasticity
disturbances of postural reflexes

46
Q

Hypokinetic Dysarthria eval tasks

A

Conversational speech and reading- evoke prosody errors, detect short rushes
AMR- highlight artic errors
Vowel prolongations- assess vocal quality

47
Q

Hypokinetic Dysarthria treatment

A

pharmacologic- LDopa
Surgical- ablation, deep brain stimulation
speech-language therapy

48
Q

Hypokinetic Dysarthria behavioral treatment

A

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
Q

Hyperkinetic Dysarthria causes

A

Disorders associated with damage to basal ganglia. Affect prosody and rate primarily.

50
Q

Hyperkinetic Dysarthria causes

A

Chorea
Huntington’s disease
Stroke
Tardive dyskinesia
Myoclonus
Essential tremor
Tics
Dystonia
Other: degen. diseases, TBI, stroke, infections

51
Q

Hyperkinetic Dysarthria speech characteristics

A

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
Q

Chorea

A

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
Q

Huntington’s disease

A

progressive disorder caused by gradual degeneration of neurons in basal ganglia and cerebral cortex

54
Q

Tardive Dyskinesia

A

movement disorder that can cause choreic movements of the face, mouth, and neck

55
Q

Myoclonus

A

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
Q

Tic Disorders

A

rapid movement that can be controlled voluntarily for a time, but is performed frequently because of a compulsive desire to do so.

57
Q

Dystonia

A

Hyperkinetic movement disorder of muscle tone. Movements have a slower, more sustained quality than those seen in chorea.

58
Q

Essential tremor

A

benign hyperkinetic movement disorder that causes tremulous movements in affected body parts. Faster than parkinsonism tremor. Disappears at rest.

59
Q

Hyperkinetic Dysarthria eval tasks

A

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
Q

Hyperkinetic Dysarthria treatment

A

Medical- drugs that suppress involuntary movements (botox), deep brain stimulation
Behavioral- dependent on disorder

61
Q

Mixed Dysarthria

A

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
Q

Mixed Dysarthria causes

A

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
Q

Multiple Sclerosis

A

Progressive demyelinating disease. can cause any pure or any combo of mixed dysarthria.
Ataxic-spastic most common

64
Q

ALS

A

Progressive degeneration of any of four areas of motor neurons
Spastic-Flaccid predominant

65
Q

Wilson’s disease

A

Rare hereditary disorder preventing normal metabolism of dietary copper
Ataxic-spastic-hypokinetic

66
Q

Freidreich’s Ataxia

A

Rare, inherited, progressive disorder. causes neuron degeneration in cerebellum, brainstem, and spinal cord
Ataxic-spastic dysarthria

66
Q

Freidreich’s Ataxia

A

Rare, inherited, progressive disorder. causes neuron degeneration in cerebellum, brainstem, and spinal cord
Ataxic-spastic dysarthria

67
Q

Mixed Dysarthria treatment

A

treat most severe component first
if elements equally affected treat in this order: respiration, resonation, phonation, articulation, prosody

68
Q

Apraxia of Speech cause

A

stroke (most common), degenerative disease, trauma, tumor

69
Q

Apraxia of Speech

A

motor programming disorder. deficit in ability to select and time-sequence motor commands needed to correctly position the articulators.

70
Q

Apraxia of Speech speech characteristics

A

Artic and prosody primarily affected
inconsistent speech errors

71
Q

Apraxia of Speech eval tasks

A

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
Q

Diagnosing AOS

A

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
Q

AOS treatment

A

Articulatory kinematic treatments
rate and rhythm procedures
AAC

motor speech disorders (1 decks)

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