Lecture 12 Flashcards
What are the two basic kinds of motor speech syndromes?
dysarthria and apraxia of speech
a group of neurologic speech disorders resulting from abnormatlies in the strength, speed, range, steadiness, tone or accuracy of moments required for control of the systems required for speech production =
Dysarthria
think “drunk” speech/actions
Dysarthria results from abnormalities in what system(s)?
central or peripheral nervous systems
Characteristics of Dysarthria
- weakness
- spasticity
- incoordination
- involuntary movements
- excessive/reduced/variable muscle tone
unilateral upper motor neuron dysarthria (UUMN) and spastic dysarthria –>
upper motor neuron lesions
flaccid dysarthria –>
lower motor neuron lesions
hyperkinetic dysarthria and hypokinetic dysarthria –>
basal ganglia lesions
ataxic dysarthria –>
cerebellar and cerebellar pathway lesions
mixed dysarthrias –>
mixed lesions
unilateral upper motor neuron (UUMN) dysarthria
- symptoms are usually mild due to unilateral nature of the upper motor neuron lesions
- mild speech impairment **
- cause is usually stroke
- imprecise articulation
non speech findings of UUMN dysarthria
- unilateral central facial weakness contralateral to lesion
- unilateral tongue weakness
Common characteristics of spastic dysarthrias
- strained harsh voice quality -reduced variability of pitch and loudness.
- slow rate of speech
- regular speech AMR’s
AMR stands for?
alternate motion rates
ex. of AMR
puh-puh-puh-puh…
tuh tuh tuh tuh tuh…
kuh kuk kuh kuh…
______ permit judgements of rate, rhythm, precision, and range of motion of rapid movements of lips, jaw and tongue.
AMR’s
Normal adults can produce an even rythm at a rate of about __ to __ syllables/second.
5 to 6
Lesions that cause Spastic Dysarthria occur where?
in the central nervous system –> affect upper motor neuron pathways bilaterally
Nonspeech findings of Spastic Dysarthria
- slow rate of orofacial movements
- reduced range of motion
- hyperactive gag reflex/oral reflexes
- exhibit pseudobulbar affect or laughter/crying
- drooling
Flaccid dysarthria symptoms affect _______, _______, _______, _______.
respiration
phonation
resonance
articulation
damage to what cranial nerves leads to speech symptoms of flaccid dysarthria?
CN V, CN VII, CN X, CN XII.
Flaccid Dysarthria lesions occur?
cell bodies, axons, and neuromuscular junction of lower motor neurons
Nonspeech findings of flaccid dysarthria
weakness, loss of muscle tone, oral reflexes absent or reduced, atrophy of affected muscles.
(findings depend on which cranial nerves are affected)
Characteristic speech symptoms of Ataxic dysarthria
irregular breakdowns in articulation (drunk speech), slow speech rate, vowel prolongation, speech AMR’s
Lesiosn that lead to Ataxic Dysarthria occur?
in the cerebellum or cerebellar control circuits/pathways.
usually associated w/ bilateral or generalized cerebellar disease.
Nonspeech findings of ataxic dysarthria
size, strength, symmetry and reflexes may be normal but during non-speech AMR’s, repetitive movements of jaw, face, and tongue are done slowly and irregularly
hypokinetic dysarthria is characterized by?
accelerated speech rate and hypophonia , speech AMR’s are rapid/blurred
hypokinetic dysarthria is caused by lesions associated with disease of the ____________.
basal ganglia control circuit
parkinson’s disease
nonspeech findings of hypokinetic dysarthria
expressionless face at rest
tremor in jaw, face or tongue at rest
reduced range of motion
hyperkinetic dysarthria is characterized by?
quick or slow, rythmic or arrhythmic involuntary movements that interrupt, distort or slow speech movements.
Hyperkinetic dysarthria
affects respiration, phonation, resonance, prosody, and articulation
Hyperkinetic dysarthria Tremor affects some of the muscles of speech, but is frequently restricted to the larynx? T or F?
False, it affects all the muscles of speech.
Chorea speech is characterized by?
quick, unsustained and unpredictable movements that may be evident at rest.
Dystonia speech is characterized by?
slow and sustained speech movements that may affect any or all parts of the speech system.
Lesiosn of hyperkinetic dysarthria occur due to damage in the ________.
basal ganglia circuits
Nonspeech findings of hyperkinetic dysarthria
size, strenth and symmetry are normal and no hyper or hypoflexia; but there are involuntary movements during oral motor exam can be ovserved.
Apraxia is a disorder of ________ movement.
learned
Apraxia is not caused by paralysis, weakness or incoordination. T or F?
True.
It is a disorder of motor planning.
Oral Apraxia (nonverbal oral apraxia (NVOA) refers to what?
difficulty carrying out volitional oral non speech movements.
Apraxia of speech (AOS) is characterized by
imprecise or distorted articulation that is often accompanied by substitutions, ommisions, or additions of sounds. speech rate is also slow.
Lesions in the ________ hemisphere lead to apraxia of speech.
dominant;
apraxia of speech is associated with left (dominant) hemipshere damage
Nonspeech findings of AOS
size, strength, symmetry & reflexes of oral mechanism muscles may be normal but right lower facial & tongue weakness often occur
