Flaccid Dysarthria Flashcards
Flaccid Dysarthria
injury of final common parthway/LMN
Etiology of Flaccid Dysarthria
-Neuromuscular junction = myasthenia gravis
-vascular disorders = brainstem stroke
-infectious processes = polio
-demyelinating disease = guillain-barre
-muscle disease = muscular dystrophy
-degenerative disease = progressive bulbar palsy
-anatomic anomalies
Salient neuromuscular features of Flaccid Dysarthria
reduced muscle tone, weak, normal speech, range, steadiness, and accuracy
Ipsilateral clinical features of flaccid dysarthria
hypotonia, paresis/paralysis, atrophy, fasciculation, fibrillation, hyporeflexia
Unilateral motor clinical features of Trigeminal Nerve
-jaw deviates to weaker side, weak biting, and drooling
bilateral motor clinical features of trigeminal nerve
jaw remains open at rest, chewing difficulty, drooling
sensory clinical features of trigeminal nerve
loss of facial sensation, lip, tongue, and palate
Unliateral (motor/sensory) speech deficits of trigeminal nerve
minimal effect
bilateral motor speech deficit of trigeminal nerve
imprecision/slowness for PUH & jaw related sounds
Bilateral (sensory) speech deficits
severe articulatory deficits
Unilateral clinical features of facial nerve
facial droop, unwrinkled forehead (ipsilateral)
Bilateral clinical features of facial nerve
bilateral facial weakness
Unilateral speech deficit of facial nerve
cheeks flutter, poor labial closure, poor AMR for PUH, mild articulatory distortion
bilateral speech deficits for facial nerve
severe distortion and inability to articulate labial sounds
Bell’s Palsy
86% spontaneous recovery
Sensory function of glossophryngeal nerve
pharynx, posterior 1/3 of tongue, sensory part of gag reflex
motor function of glossopharyngeal nerve
pharyngeal elevation
clinical features of glossopharyngeal nerve
reduced gag reflex & glossopharyngeal neuralgia
speech deficits of glossopharyngeal nerve
resonance
List the branches of the vagus nerve
- pharyngeal nerve
- superior laryngeal nerve
- recurrent laryngeal nerve
Function of the pharyngeal nerve
pharyngeal constriction & palatal elevation/retraction
Function of the superior laryngeal branch
internal laryngeal nerve = sensory aryepiglottic folds
external laryngeal nerve = motor cricothyroid muscle; lengthening VF for pitch adjustments
Function of recurrent laryngeal branch
motor = all intrinsic laryngeal muscle
Sensory = general sensation from glottal & subglottal areas
Unilateral speech deficits above the three branches
mild-moderate hypernasality, reduced loudness, breathiness, reduced pitch, vocal flutter
Bilateral speech deficits above three branches
severe hyper nasality, imprecise pressure consonants, mildly reduced loudness
Unilateral speech deficits below the pharyngeal branch
ipsilateral VF in abducted position, breathiness, reduced loudness, reduced pitch, rapid vocal flutter
Bilateral speech deficits below the pharyngeal branch
both VF in abducted positions; symptoms of greater severity
Unilateral speech deficits of superior laryngeal nerve
mild breathiness/hoarseness, reduced loudness, mild disability to alter pitch
Bilateral speech deficits of super laryngeal nerve
mild/moderated breathiness, decreased loudness, reduced ability to alter pitch