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FLACCID ON CHART > FLACCID DYSARTHRIA > Flashcards

FLACCID DYSARTHRIA Flashcards

1
Q

Flaccid Dysarthria

A
  • Caused by injury or disease of one or more cranial or spinal nerves involved in speech, to the muscles involved in speech, or to the junction between them
  • Reflect problems in the nuclei, axons, or neuromuscular junctions that make up the motor units of the Final Common Pathways (FCP).
  • May be manifest in any or all of the respiratory, phonatory, resonatory, and articulatory components of speech.
  • Muscle weakness and reduced muscle tone in one or more groups of muscles
  • Decrease in the speed, range and accuracy of speech movements.
  • These are problems of EXECUTION not planning or programming.
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2
Q

ONE WORD for Flaccid

A

WEAKNESS

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3
Q

RESPIRATION

A
  • Decreased/reduced loudness
  • Short phrase length
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4
Q

PHONATION (voicing/utterance)

A
  • Monopitch
  • Breathiness (rapid/shallow breathing)
  • Hoarseness
  • Diplophonia (two different pitches/2 voices at different rates, different frequencies)
  • Aphonia (without voice/complete loss of voice)
  • Reduced pitch and loudness range
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5
Q

RESONANCE (refers to the way airflow for speech is shaped as it passes through the pharynx (throat), oral (mouth) and nasal (nose) cavities)

A
  • Hypernasality
  • Nasal emission (air that escapes out of nose)
  • Weak pressure on consonants (air coming out of nose limits air pressure build up in mouth)
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6
Q

ARTICULATION

A
  • Imprecise alternating motion rates (sharpness of sound)
  • Imprecise consonants
  • Decreased precision and rate on “puh” (CN 7: Facial) but not “tuh” or “kuh” (CN 12: Hypoglossal)
  • Distortion of bilabial and labiodental consonants
  • May exaggerate jaw movement because of weak lip
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7
Q

PROSODY (variation in pitch, loudness, and duration)

A
  • Decreased pitch range
  • Slow rate
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8
Q

NON-SPEECH (Oral Mech)

A
  • Atrophy (loss of physical muscle volume)
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9
Q

NON SPEECH- CN V: TRIGEMINAL

A
  • Difficulty resisting lateral pressure on jaw (unilateral)
  • Jaw hangs open at rest (bilateral)
  • Difficulty with chewing or drooling is sometimes reported
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10
Q

NON SPEECH- CN VII: FACIAL

A
  • Infections can trigger Bell’s Palsy,
  • Drooping eyebrow and unwrinkled forehead on affected side,
  • Ipsilateral (located on same side of body) does not blink or close
  • Lip may droop and not seal during eating (biting lip) (Unilateral)
  • Reduced Blink/face movement
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11
Q

NON SPEECH- CN IX: GLOSSOPHARYNGEAL (sensory part of back of tongue)

A
  • Faucial pillars
  • Asymmetric gag reflex if damage is unilateral
  • Pain in the upper pharynx
  • Decreased pharyngeal elevation during swallow
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12
Q

NON SPEECH- CN X: Vagus (Oral) (vocal folds and velum)

A
  • Pharyngeal branch- velar movement and upper throat

Unilateral

  • Velum will hang lower on the side of the lesion and pulls toward the strong side during swallow and phonation
  • Decreased gag reflex on the impaired side

Bilateral

  • Velum hangs low and does not elevate during swallow or phonation
  • Absent or near-absent gag reflex
  • Nasal regurgitation during swallow
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13
Q

NON SPEECH CN X: VAGUS (Larynx)

A

Superior laryngeal- changes pitch

Recurrent laryngeal- opens and closes vf’s (comes down neck and goes up to your heart) gets cut when doing heart surgery and one of the vf’s is paralyzed.

Unilateral

  • Decreased reflexive and volitional cough strength
  • Increased chance of penetration and aspiration during swallow
  • Visible reduction of movement on side of lesion during endoscopy

Bilateral

  • Respiratory stridor during inhalation if vocal folds are paralyzed adducted
  • Cough sharpness severely reduced or absent
  • Significant risk of aspiration if vocal folds are paralyzed abducted
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14
Q

NON SPEECH- CN XII: HYPOGLOSSAL

A

Unilateral

  • Atrophy and fasciculations on the side of damage
  • Tongue deviates to the weak side on protrusion

Bilateral

  • Atrophy and fasciculation on both sides of the tongue
  • Limited movement of tongue laterally and on protrusion
  • Saliva accumulation and decreased bolus control during eating
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15
Q

NEUROANATOMY

A
  • Trigeminal CN V (5)
  • Facial CN VII (7)
  • Glossopharyngeal CN IX (9)
  • Vagus CN X (10)
  • Hypoglossal CN XII (12)

(FINAL COMMON PATHWAY)

** Lower motor neurons originate in the brainstem at the cranial nerve nuclei (cell body) and terminate at the neuromuscular junction

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16
Q

CLINICAL CHARACTERISTICS

A
  • Hypotonia (low muscle tone)
  • Hyporeflexia (absent or decreased reflexes)
  • Weakness
  • Atrophy
  • Fasciculations
  • Progressive weakness

**With rest or certain medications, the person will recover strength very quickly

17
Q

Summary of Common Characteristics

A
  • Hypernasality
  • Nasal emission
  • Imprecise consonants
  • Breathiness
  • Dysphonia
  • Decreased pitch range
  • Decreased loudness
18
Q

ETIOLOGIES

A
  • Degenerative Disease
  • Physical Trauma
    - Surgery
    - Head/neck injury
  • Brainstem stroke
  • Head and Neck Cancer
  • Guillain-Barre Syndrome
  • Myasthenia Gravis
  • Multiple Sclerosis
  • ALS
  • Traumatic Injury

(HGMMAT)

19
Q

Treatments

A

Is the cause progressive?
- Work on maintenance and compensation

Respiratory system treatments
- Postural adjustment and monitoring
-Working on maximum loudness and/or vowel duration
- Working on monitoring inhalation/exhalation rates and phrase lengths and adjusting them

Articulation treatments
- Strength training (e.g., oral-motor exercises) are frequently used, but their efficacy when used alone is limited at best
- Using a bite-block during therapy to force tongue movement and limit jaw compensation
- Make them talk, focusing on the appropriate voice/place/manner, overarticulation, rate modification

Voice treatments
- Adjust voice onset via effortful closure, easy onset, etc. as necessary

20
Q

Dysarthria

A

Is the impaired production of speech due to disturbances in the muscular control of the speech mechanism

  • Can include impaired articulation, resonance, phonation, and respiration
21
Q

Apraxia

A

Is a deficit in the ability to smoothly sequence the speech-producing movements of the tongue, lips, jaw, etc.

  • Primarily affects articulation and prosody
21
Q

Flaccid Dysarthria

A
  • Caused by injury or disease of one or more cranial or spinal nerves involved in speech, to the muscles involved in speech, or to the junction between them
  • Reflect problems in the nuclei, axons, or neuromuscular junctions that make up the motor units of the Final Common Pathways (FCP).
  • May be manifest in any or all of the
    respiratory
    phonatory
    resonatory
    articulatory components of speech.
  • Muscle weakness and reduced muscle tone in one or more groups of muscles
  • Decrease in the speed, range and accuracy of speech movements.
  • These are problems of EXECUTION not planning or programming.

FLACCID ON CHART (1 decks)

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