L9: Ataxic Dysarthria Flashcards
what are the cerebellar regions?
medial zone -> vermis and intermediate part of the hemisphere
lateral zone –> lateral hemisphere
what is the medial zone of the cerebellum also referred to as?
vestibulocerebellum and spinocerebellum bc of connections to vestibular and brainstem nuclei and regions of the spinal cord
what does the medial zone of cerebellum contribute to?
axial and trunk control
balance and posture
gait and locomotion
vestibular reflexes
coordination bw head and eye movements
muscle tone
what is the lateral zone of the cerebellum also referred to as?
cerebrocerebellum bc of the connections to the motor and premotor cortex
what does the lateral zone of cerebellum contribute to?
coordination of voluntary movements
planning and initiation of movement
sensorimotor learning
(muscle tone and tremor)
lateral zone of cerebellum may act as a ____, _____ intended and actual performance, and making ____ when errors occur
comparator
comparing
corrections
cerebellar function is modified by _____ experience and appears to play an important role in _____ …. may have some ______ functions
motor
motor learning
language
what are the 4 general symptoms of cerebellar damage?
inaccuracy of voluntary movements
slowness of movement
hypotonia
other symptoms
what are the 5 specific inaccuracy of voluntary movement symptoms in cerebellar damage?
dysmetria
hypometria and hypermetria
terminal or intention tremor
dysdiadochokinesia
decomposition of movements
dysmetria
inaccuracies in the range and direction of movement trajectories toward spatial targets
hypometria and hypermetria
undershoot and overshoot of spatial targets
terminal or intention tremor
oscilating movements towards the end of a movement 3-5 Hz
Intentional or kinetic tremor (3-5 Hz) during a sustained posture or movement may also be observed
dysdiadochokinesia
irregular patterns of movement during rapid alternating movements
decomposition of movements
components of movement not executed in a smooth seq of actions
what does slowness of movement involve?
slowness of movement trajectories
delays in the onset of movements
delays in the termination of movements (lack of check)
hypotonia
diminished resistance to passive movement
flabby feel to muscles
what are the other symptoms we may see in cerebellar damage?
ataxic gait (wide side to side movements)
pendular reflexes (continued leg swing after stretch reflex)
muscular fatigue and reduced strength
oculomotor dysfunction (nystagmus and ocular dysmetrias)
list the causes of cerebellar disorders from most common to least common? (demyelinating, traumatic, undertemined, vascular, degen, tumor, toxic, inflam, other)
degen - 37%
vascular - 20%
undetermined - 13%
other - 10% (ex. autoimmune, genetic)
traumatic - 9%
demyelinating - 5%
tumor - 3%
toxic - 2%
inflam - 2%
______ lesions are most commonly associated w ataxic dysarthria (degen diseases) but can also be ___ and _____
bilateral lesions
focal and unilateral
when lesions are focal they are primarily associated w damage to the _____ lateral cerebellar hemisphere
right
(note R cerebellar H connects to L cerebral H)
what are perceptual aspects of resp impairment in AD?
irregular articulatory breakdown
excess loudness variation
explosive speech
what are aspects of resp impairment in AD has been found via instrumental measures?
reduced vital capacity and total lung volume (coordination issue)
reduced max phonation time
paradoxical resp activity
abrupt and irregular resp movements
overal resp impariments in AD can be described as…
difficulty regulating output of resp apparatus for speech due to irregular and discoordinated rib cage and abdominal movements
describe palatopharyngeal impairment in AD
hypernasality is generally not a major concern
abnormal timing or slowness of palatal movements probably the source of any hypernasality
what are the perceptual aspects of laryngeal impairment in AD?
harsh voice
monopitch
monoloudness
irregular articulatory breakdown
what are aspects of laryngeal impairment in AD has been found via instrumental measures?
abnormally high jitter (may be related to laryngeal hypotonia)
abnormally restricted pitch and loudness variation during connected speech
irregularities in pitch and loudness during prolonged vowels
overal laryngeal impariments in AD can be described as…
harsh, monotone voice that may show inappropriate and irregular pitch and loudness variations (these irregularities may relate to respiratory discoordination)
what are the perceptual aspects of oral articulation impairment in AD?
imprecise consonants
distorted vowels
irregular articulatory breakdown
prolonged phonemes
prolonged intervals
slow rate
what are aspects of oral articulation impairment in AD has been found via instrumental measures?
longer segments (ex. stop gaps)
longer syllables/words/phrases
correlation bw utterance durations and severity of speech
slower speech movements and AMRs (both primary and compensatory)
more variable seg and VOT durations
variable and inaccurate movement trajectories
what are the perceptual aspects of prosodic impairment in AD?
excess and equal stress (scanning speech)
prolonged phonemes and intervals (pauses)
monopitch
monoloudness
what are aspects of prosodic impairment in AD has been found via instrumental measures?
loss of durational distinctions bw tense and lax vowels
overall flat pitch contour
equalization of stressed/unstressed syllables
Friedrich’s ataxia is …
Childhood degenerative disease
Recessively inherited
1 in 50,000
before 20 yrs (about 20 year survival)
Ataxia (can be mixed with spastic symptoms)
a phonetic intell test found that in Friedrich’s ataxics there is a distinct profile of errors including….
- Final plosive voicing (voiced)
- Glottal/Null (glottal)
- Stop/Nasal (nasal)
- r versus w ( r )
- Final consonant/null (consonant)
- Initial plosive voicing (voiceless)
