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Motor Speech > Flaccid > Flashcards

Flaccid Flashcards

1
Q

flaccid dysarthria is cased by damage to what

A

lower motor neurons

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2
Q

lower motor neurons include what

A

cranial nerves and spinal nerves

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3
Q

flaccid characteristics

A
  • slow labored articulation
  • marked degrees of hyper nasal resonance
  • hoarse-breathy phonation
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4
Q

last and only “road” neural impulses from upper motor neurons travel to reach muscles

A

final common pathway

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5
Q

the six pairs of cranial nerves that play a role in speech production

A
  • trigeminal
  • facial
  • glossopharyngeal
  • vagus, accessory
  • hypoglossal
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6
Q

specific causes of damage to your lower motor neurons

A
  • physical trauma
  • brainstem stroke
  • myasthenia gravis
  • Guillain-Barre syndrome
  • polio
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7
Q

flaccid dysarthria is caused by anything that …

A

disrupts the flow of motor impulses along cranial or spinal nerves that innervate muscles of speech production

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8
Q

what nerve is one of the most important nerves of respiration (and motor speech production) that come out of C3, C4, and C5

A

phrenic nerve

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9
Q

damage to the phrenic nerve can cause

A
  • paralyzed diaphragm
  • decreased loudness
  • shortened, breathy, or strained vocal quality
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10
Q

physical trauma can include

A
  • surgical trauma
  • head and neck injury
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11
Q

a brainstem stroke is also known as a

A

cerebrovascular accident (CVA)

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12
Q

damage from a CVA depends on what

A

the amount of lower motor neurons that are lost and don’t receive blood flow from that stroke

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13
Q

what does Myasthenia Gravis affect

A

the neuromuscular junction

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14
Q

symptoms of Myasthenia Gravis

A
  • rapid fatigue of muscular contractions over a short time with recovery after rest
  • hyper nasality
  • decreased loudness
  • breathy voice quality
  • decreased articulatory precision
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15
Q

how would you assess Myasthenia Gravis

A

with a stress tess

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16
Q

what is a stress test

A

counting from 1 to 100 or to read a lengthy paragraph

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17
Q

Guillain-Barre Syndrome results in

A

demyelination (depletion of the myelin sheath on the neuron)

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18
Q

Guillain-Barre frequently occurs when?

A

after certain kinds of infections and immunizations

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19
Q

symptoms of Guillian-Barre

A
  • flaccid dysarthria
  • dysphagia
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20
Q

recovery of Gillian-barre syndrome

A
  • high recovery rate, lasting weeks or months
  • 5% die in acute stages
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21
Q

polio is what

A

an infectious viral disease that attacks cell bodies of lower motor neurons

22
Q

what does polio most frequently affect

A

cervical and thoracic spinal nerves

23
Q

polio causes

A
  • labored inhalation during speech
  • shortened speech phrases
  • speaking on residual air
  • decreased loudness
24
Q

Can polio also affect spinal nerves?

A

yes

25
Q

Others causes of flaccid dysarthria

A
  • tumors
    (growing in or near the brainstem)
  • muscular dystrophy
    (progressive degeneration of muscle tissue)
  • progressive bulbar palsy
    (often only present in LMN but can he in the UMN as well)
26
Q

Main word or flaccid characteristic

A

weaknesses

27
Q

resonance in flaccid

A
  • hypernasality (most noticeable voice quality error)
  • nasal emission
  • weak pressure consonants
  • shortened phrases
28
Q

articulation in flaccid dysarthria

A
  • imprecise consonant production
29
Q

damage to the trigeminal nerve affects articulation in that

A

they would have difficulty in elevating the jaw sufficiently to bring articulators into contact with each other

30
Q

intervention for problems with jaw movement

A

use your hand to elevate the jaw or use a jaw sling

31
Q

phonation in flaccid dysarthria

A

phonatory incompetence (incomplete adducting of the vocal folds during phonation)

32
Q

incomplete adduction of the vocal folds during phonation results in

A
  • breathy voice quality or whisper
  • weak or paralyzed adductor and abductor muscles
33
Q

what is the strongest confirmatory sign of flaccid dysarthria

A

hypernasality and phonatory incompetence

34
Q

respiration in flaccid dysarthria

A

weakened respiration (decreased inhalation of impaired control of exhalation) may be present

35
Q

respiration symptoms in flaccid dysarthria

A
  • reduced loudness
  • shortened phrase length
  • strained vocal quality if speaking on residual air to prolong phrase length
  • monoloudness *
  • monopitch *
  • may inhale frequently (affects prosody)
36
Q

prosody in flaccid dysarthria

A

weakened laryngeal muscles that are unable to make many fine vocal-fold adjustments necessary for normal pitch and loudness variations

37
Q

prosodic symptoms

A
  • monopitch
  • monoloudness
38
Q

is prosody a definite diagnostic marker for flaccid dysarthria?

A

nope!

39
Q

key evaluation tasks for flaccid

A
  • conversational speech and reading
  • alternate motion rate (AMR)
  • prolonged vowel
  • speech stress test
40
Q

what is the primary task for evaluating flaccid

A

conversational speech and reading

41
Q

conversational speech and reading can evoke errors of what

A
  • resonance (hypernasality)
  • articulation (imprecise consonants)
  • respiration (shortened phrase length)
  • prosody (mono pitch, mono loudness)
42
Q

what will AMR highlight in flaccid dysarthria

A

a slow rate of phoneme production (showing the weak articulation movement)

43
Q

what will a prolonged vowel evoke in flaccid

A
  • helpful in seeing the breathy voice quality heard in phonatory incompetence
  • useful in observing respiratory weakness
44
Q

why is a speech stress test necessary in flaccid

A

for myasthenia gravis (to show the tired)

45
Q

the traditional approach to treating motor speech disorders is to

A
  • use assessment data to identify deficits
  • begin working with patients use appropriate treatment goals
  • increase complexity of tasks as patients improve
  • work toward generalization of improvements
46
Q

Rosenbek made 6 additional recommendations

A
  • help pts recognize differences in their speech
  • help pts have a willingness to change their speech for the better
  • work closely with pts when setting goals for treatment
  • insist that pts are talking therapeutically in their sessions even in small talk
  • ensure pts are learning to list, evaluate, and self-correct their speech
  • progressively add cognitive-linguistic load to treatment tasks to ensure pts are working toward generalization
47
Q

treatment for flaccid are presented according to what

A

which cranial nerve or combination of nerves are damaged

48
Q

respiration treatment for flalccid

A
  • correct posture
  • compensatory prosthetic devices
  • speaking immediately on exhalation
  • cueing for complete inhalation
49
Q

phonation treatment for flaccid

A
  • pushing and pulling procedures
  • holding breath
  • hard glottal attack
  • head turning
  • sideways pressure on the larynx
50
Q

articulation treatment for flaccid

A

traditional articulation drills

51
Q

resonance treatment for flaccid

A
  • velar strength-training procedure
  • modification of speech
  • reduced rate
  • more open-position mouth during speech
  • increase loudness

Motor Speech (2 decks)

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