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Motor Speech Disorders > Flaccid Dysarthria > Flashcards

Flaccid Dysarthria Flashcards

1
Q

Lesions in the LMN system causes which type of dysarthria?

A

Flaccid Dysarthria.

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2
Q

Lesions in the UMN system causes which type of dysarthria?

A

Spastic Dysarthria.

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3
Q

The primary unique deficit in Flaccid Dysarthria is _________.

A

Weakness to the muscles.

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4
Q

What can be a result of the palate being flaccid aka too weak to close?

A

Hypernasality can occur.

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5
Q

What is the difference b/w paralysis and paresis?

A 
Paralysis= all the LMN input to muscle is gone.
Paresis= partial loss of nerve impulse. Very little input aka weaker muscle mvmt.
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6
Q

T/F Weakness is only seen in Flaccid Dysarthria.

A

False; atrophy & fasiculations are only seen in Flaccid dysarthria.

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7
Q

What is hypotonia?

A

Reduced muscle tone.

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8
Q

What happens when a muscle atrophies?

A

The muscle starts to waste away, thus it loses its bulk/mass.

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9
Q

What happens to reflexes in Flaccid Dysarthria?

A

They are weakened/ slowed down. They are not as accurate or they can be completely gone.

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10
Q

What are fasiculations and what is the difference b/w fasiculations and fibrillations?

A

Fasiculations are quick jerky mvmts of the resting muscle. Fasiculations are visible and fibrillations are not.

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11
Q

What is Myasthenia Gravis (MG)?

A

A neuromuscular junction dz where the muscles fatigue quickly with use. Gets better when the muscles rest.

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12
Q

Explain what is happening neurologically in MG?

A

Ach RECEPTORS are affected, not the actual Ach. They do not respond to Ach, thus weakness occurs.

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13
Q

What are some characteristics of MG?

A

Drooping eyelids, weak facial muscles, flaccid dysarthria.

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14
Q

How do you test for MG?

A

Count to 100. Give Tensilon. Pt should show rapid improvement after this injection.

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15
Q

What are the common age groups for MG?

A

Men= after 50; Women=20-40

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16
Q

Which kind of stroke can result in Flaccid Dysarthria?

A

Brainstem stroke that affects CN nuclei.

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17
Q

What kind of d/o Wallenberg’s Lateral Medullary Syndrome? Which type of dysarthria can result from it?

A

Vascular; Flaccid.

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18
Q

What is an example of an infectious/ viral dz which can affect LMN cell bodies?

A

Polio.

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19
Q

What are the 8 etiologies of Flaccid dysarthria? Give an example of each.

A

1) Neuromuscular Junction dz - Myasthenia Gravis (MG)
2) Demylenating dz- Guillian Barre
3) Degenerative dz- aka motor neuron dz =ALS
4) Muscle dz- muscular dystrophy
5) Infectious Processes- Polio
6) Vascular d/o= Wallenberg or brainstem stroke.
7) Radiation treatment
8) Anatomic Anomalies

20
Q

Which is the most common motor neuron dz that affects both UMN and LMN? Which dysarthria does this d/o typically result in?

A

ALS. It results in mixed dysarthria with flaccid component.

21
Q

T/F All symptoms of damage in Flaccid dysarthria are due to lesions in the UMN system.

A

False. Lesions are in the LMN system.

22
Q

What are the three branches of the Trigeminal Nerve (V)?

A

1) Sensory ophthalmic branch
2) Sensory maxillary branch
3) M&S mandibular branch

23
Q

T/F The Trigeminal Nerve (V) is rarely damaged on it’s own.

A

True.

24
Q

Unilateral LMN damage to the Trigeminal nerve (V) will cause the jaw to_____________.

A

Deviate to the side of weakness, can be easily pushed.

25
Q

Bilateral LMN damage to the Trigeminal nerve (V) will cause the jaw to _______________.

A

Hang open at rest.

26
Q

T/F Unilateral damage to the Trigeminal nerve (V) will significantly impact speech.

A

False.

27
Q

How do you assess a pt that may have a LMN lesion in CN V?

A

Have pt read or converse, do AMRs, will be slow/imprecise for “puh”

28
Q

T/F The facial nerve (VII) is only concerned with motor components for speech.

A

True.

29
Q

Which sounds are produced with the lip muscles innervated by the facial nerve (VII)?

A

bilabials & labiodentals.

30
Q

Bell’s Palsy is the result of damage to which nerve? What kind of lesion (uni or bi)?

A

Facial Nerve (VII); unilateral.

31
Q

T/F Bell’s Palsy only affects the upper facial muscles.

A

False; Both upper and lower facial muscles.

32
Q

Which nerve is important and aids the muscles that are responsible for building intraoral pressure (cheeks)?

A

Facial Nerve (VII).

33
Q

What is the sensory portion of the Facial Nerve (VII) responsible for?

A

Taste in the anterior 2/3 of the tongue.

34
Q

What are the symptoms of Bell’s Palsy?

A

Forehead may be unwrinkled , eyebrow drooped, eye open and unblinking, tip of nose & corner of mouth may be drawn toward affected side. Drooling may occur. Pt smile may be crooked.

35
Q

What is synkinesis?

A

Abnormal contraction of a muscle next to the muscle that is normally moving.

36
Q

How do you assess for the Facial Nerve (VII)?

A

Stress testing, convo reading, AMRs.

Look for bilabial closure, precision more affected that speed. Vowels are not usually affected.

37
Q

What does LMN bilateral lesion in the Facial Nerve (VII) cause?

A

Facial symmetry, not as striking. Pt may not be able to retract lips or puff up cheeks (bilabials and labiodentals may not be produced).
Drooling may occur.
Pt complains of not being able to move lips well for speech and for eating.
Synkinesis may appear.

38
Q

Why would you see a flutter in cheeks for pts with damage to the Facial Nerve (VII)?

A

Because they have less resistance to intraoral pressure.

39
Q

With unilateral lesions to the LMN of the Facial Nerve (VII), what will the pt exhibit?

A

Weakness on one side and to compensate they will exaggerate their mvmt of the lips. They may have poor production of the /p/.

40
Q

With bilateral lesions to the LMN of the Facial Nerve (VII), what will the pt exhibit?

A

The pt may substitute linguadentals for bilabials. ex: /t/ for /p/

41
Q

T/F The Glossopharyngeal Nerve (IX) is rarely damaged on it’s own.

A

True.

42
Q

How would you assess CN IX (Glossopharyngeal)?

A

Check for gag reflex (not always reliable), check for symmetry of the reflex, check for reduced reflex, decreased sensation in the area.

43
Q

If hypernasality is occurring, what CN is likely damaged?

A

Pharyngeal Branch of the Vagus Nerve.

44
Q

What is the function of the palatoglossus muscle? Which CN innervates it?

A

Contraction can either depress soft palate or pull sides of tongue up and back.
The Pharyngeal Branch of the Vagus Nerve (X) innervates it.

45
Q

If there are pitch problems occurring in a pt, which CN is likely damaged? Be specific.

A

Vagus nerve (X)- superior laryngeal branch- external branch.

Motor Speech Disorders (3 decks)

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