L9: Ataxic Dysarthria Flashcards

1
Q

what are the cerebellar regions?

A

medial zone -> vermis and intermediate part of the hemisphere

lateral zone –> lateral hemisphere

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2
Q

what is the medial zone of the cerebellum also referred to as?

A

vestibulocerebellum and spinocerebellum bc of connections to vestibular and brainstem nuclei and regions of the spinal cord

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3
Q

what does the medial zone of cerebellum contribute to?

A

axial and trunk control

balance and posture

gait and locomotion

vestibular reflexes

coordination bw head and eye movements

muscle tone

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4
Q

what is the lateral zone of the cerebellum also referred to as?

A

cerebrocerebellum bc of the connections to the motor and premotor cortex

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5
Q

what does the lateral zone of cerebellum contribute to?

A

coordination of voluntary movements

planning and initiation of movement

sensorimotor learning

(muscle tone and tremor)

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6
Q

lateral zone of cerebellum may act as a ____, _____ intended and actual performance, and making ____ when errors occur

A

comparator

comparing

corrections

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7
Q

cerebellar function is modified by _____ experience and appears to play an important role in _____ …. may have some ______ functions

A

motor

motor learning

language

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8
Q

what are the 4 general symptoms of cerebellar damage?

A

inaccuracy of voluntary movements

slowness of movement

hypotonia

other symptoms

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9
Q

what are the 5 specific inaccuracy of voluntary movement symptoms in cerebellar damage?

A

dysmetria

hypometria and hypermetria

terminal or intention tremor

dysdiadochokinesia

decomposition of movements

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10
Q

dysmetria

A

inaccuracies in the range and direction of movement trajectories toward spatial targets

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11
Q

hypometria and hypermetria

A

undershoot and overshoot of spatial targets

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12
Q

terminal or intention tremor

A

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

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13
Q

dysdiadochokinesia

A

irregular patterns of movement during rapid alternating movements

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14
Q

decomposition of movements

A

components of movement not executed in a smooth seq of actions

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15
Q

what does slowness of movement involve?

A

slowness of movement trajectories

delays in the onset of movements

delays in the termination of movements (lack of check)

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16
Q

hypotonia

A

diminished resistance to passive movement

flabby feel to muscles

17
Q

what are the other symptoms we may see in cerebellar damage?

A

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)

18
Q

list the causes of cerebellar disorders from most common to least common? (demyelinating, traumatic, undertemined, vascular, degen, tumor, toxic, inflam, other)

A

degen - 37%

vascular - 20%

undetermined - 13%

other - 10% (ex. autoimmune, genetic)

traumatic - 9%

demyelinating - 5%

tumor - 3%

toxic - 2%

inflam - 2%

19
Q

______ lesions are most commonly associated w ataxic dysarthria (degen diseases) but can also be ___ and _____

A

bilateral lesions

focal and unilateral

20
Q

when lesions are focal they are primarily associated w damage to the _____ lateral cerebellar hemisphere

A

right

(note R cerebellar H connects to L cerebral H)

21
Q

what are perceptual aspects of resp impairment in AD?

A

irregular articulatory breakdown

excess loudness variation

explosive speech

22
Q

what are aspects of resp impairment in AD has been found via instrumental measures?

A

reduced vital capacity and total lung volume (coordination issue)

reduced max phonation time

paradoxical resp activity

abrupt and irregular resp movements

23
Q

overal resp impariments in AD can be described as…

A

difficulty regulating output of resp apparatus for speech due to irregular and discoordinated rib cage and abdominal movements

24
Q

describe palatopharyngeal impairment in AD

A

hypernasality is generally not a major concern

abnormal timing or slowness of palatal movements probably the source of any hypernasality

25
what are the perceptual aspects of laryngeal impairment in AD?
harsh voice monopitch monoloudness irregular articulatory breakdown
26
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
27
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)
28
what are the perceptual aspects of oral articulation impairment in AD?
imprecise consonants distorted vowels irregular articulatory breakdown prolonged phonemes prolonged intervals slow rate
29
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
30
what are the perceptual aspects of prosodic impairment in AD?
excess and equal stress (scanning speech) prolonged phonemes and intervals (pauses) monopitch monoloudness
31
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
32
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)
33
a phonetic intell test found that in Friedrich's ataxics there is a distinct profile of errors including....
1. Final plosive voicing (voiced) 2. Glottal/Null (glottal) 3. Stop/Nasal (nasal) 4. r versus w ( r ) 5. Final consonant/null (consonant) 6. Initial plosive voicing (voiceless)