Flaccid Dysarthria

Question 1

what is DAB?

Answer 1

The DAB approach for classifying the dysarthrias is used by many clinicians charged with differential diagnosis. It is also used by many researchers investigating the acoustic and physiologic bases of MSDs.

Question 2

structures in the brain are _________ in proximity

Answer 2

close

Question 3

many patients who have a stroke will/will not fit textbook definitions of dysarthria

Answer 3

will not

Question 4

traditional __________ gives us a framework for classification of our observations based on pathophysiology

Answer 4

taxonomy

Question 5

flaccid dysarthria is damage in

Answer 5

lower motor neurons

Question 6

flaccid dysarthria is also known as

Answer 6

bulbar palsy / lower motor lesions

Question 7

flaccid dysarthria is damage to

Answer 7

bulbar - spinal tracts

Question 8

what is a direct tract?

Answer 8

does not have many synapses; damage a direct tract would be focused on rapid movements

Question 9

what is an indirect tract?

Answer 9

does have many synapses; damage would be focused on balance and posture

Question 10

flaccid dysarthria is the speech dysarthria that results from damage to a

Answer 10

spinal or cranial nerve

Question 11

damage to the final common pathway affects…

Answer 11

individual muscles or muscle groups

Question 12

what is the final common pathway?

Answer 12

the rate that a signal takes from CNS until the signal reaches an endpoint

Question 13

all efferent motor nerve impulses travel along the ____________ to the muscles

Answer 13

final common pathway

Question 14

FCP controls what type of movements?

Answer 14

voluntary
reflexive
autonomic

Question 15

neurons have

Answer 15

dendrites
axon
cell body

Question 16

helper cells

Answer 16

glial cells
astrocyte
schwann

Question 17

what is a synaptic cleft?

Answer 17

space between axon and a muscle fiber or a dendrite

Question 18

firing across a synapse is an __________________ process

Answer 18

all or none

Question 19

myoneural junction is

Answer 19

a space between axon and muscle

Question 20

when a synapse fires, all the muscles connected to that ________________ contract

Answer 20

motor unit

Question 21

functional motor units include:

Answer 21

cell body
axon
dendrites
myoneural junction
muscle fibers

Question 22

strength of contraction is dependent on…

Answer 22

1. number of motor units

2. rate of firing

Question 23

1 stimulated nerve = 1 impulse =

Answer 23

1 muscle contraction

Question 24

muscle contraction process

Answer 24

dendrite carries info toward the cell body > cell body does impulse > axon carries info away from body > muscle fibers shorten and contract

Question 25

phases of muscle contraction

Answer 25

• latent period: delay in response
• contraction: muscle is shortened
• relaxation

Question 26

flaccid dysarthria etiologies

Answer 26

• idiopathic (don’t know)
• tumor
• traumatic injury (severed nerve)
• brainstem stroke
• infection (meningitis, herpes)

Question 27

what is Bell’s palsy a result of?

Answer 27

damage to cranial nerve 7

Question 28

poliomyelitis

Answer 28

an acute, viral and infectious disease

Question 29

Guillain barre

Answer 29

autoimmune disease

Question 30

what are some genetic etiologies of flaccid dysarthria?

Answer 30

1. mobius syndrome - born without facial nerve

2. muscular dystrophy - genetic component, symptoms start to emerge with youth

Question 31

global changes with dyarthria

Answer 31

1. signal does not reach the muscle
2. hypotonia: low muscle tone
3. lack of steadiness
4. reduced reflexes

Question 32

what may hypotonia entail?

Answer 32

low muscle tone
flaccidity
changes in symmetry
loss of muscle mass--atrophy
weakness to individual nerves and muscles
limited range of motion

Question 33

what may lack of steadiness entail?

Answer 33

tremor

fasciculations; spontaneous, involuntary twitches

Question 34

what are fasciculations?

Answer 34

involuntary spontaneous twitches under the skin

Question 35

what do reduced reflexes entail?

Answer 35

hyporeflexia

reduced strength

Question 36

what are the spinal nerves related to respiration?

Answer 36

T1-T12 spinal intercostal nerves
T6-L1 throat
C3-C5 phrenic nerve

Question 37

damage to individual nerves causes damage to ______________

Answer 37

individual muscles

Question 38

when doing a motor assessment for flaccid dysarthria damage to spinal nerves, we would only really see changes in

Answer 38

the chest: rapid shallow breathing, reduced vital capacity, short maximum phonation time, inadequate checking action, weak cough

Question 39

when flaccid dysarthria damage occurs to cranial nerve V, it rarely occurs in

Answer 39

isolation

Question 40

if damage to cranial nerve V is unilateral

Answer 40

there are usually no symptoms because the jaw is strong enough for most individuals to move their jaw for speech

Question 41

in motor exam for damage to cranial nerve V, you would only see differences in

Answer 41

jaw: weak mandibular wale, jaw sags open, reduced range of motion

Question 42

in motor exam for damage to cranial nerve V, would see impairments in articulation such as:

Answer 42

bilateral impairment - severely reduced intelligibility, imprecise consonant and vowels, can be slow
unilateral impairments - usually insignificant
* most difficulty in conversational speech

Question 43

facial paralysis will result from damage to

Answer 43

cranial nerve VII

• unilateral weakness
• half of face unresponsive

Question 44

what percentage of patients will recover from damage to cranial nerve VII?

Answer 44

75%