Lecture 12

Question 1

What are the two basic kinds of motor speech syndromes?

Answer 1

dysarthria and apraxia of speech

Question 2

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 =

Answer 2

Dysarthria

think “drunk” speech/actions

Question 3

Dysarthria results from abnormalities in what system(s)?

Answer 3

central or peripheral nervous systems

Question 4

Characteristics of Dysarthria

Answer 4

• weakness
• spasticity
• incoordination
• involuntary movements
• excessive/reduced/variable muscle tone

Question 5

unilateral upper motor neuron dysarthria (UUMN) and spastic dysarthria –>

Answer 5

upper motor neuron lesions

Question 6

flaccid dysarthria –>

Answer 6

lower motor neuron lesions

Question 7

hyperkinetic dysarthria and hypokinetic dysarthria –>

Answer 7

basal ganglia lesions

Question 8

ataxic dysarthria –>

Answer 8

cerebellar and cerebellar pathway lesions

Question 9

mixed dysarthrias –>

Answer 9

mixed lesions

Question 10

unilateral upper motor neuron (UUMN) dysarthria

Answer 10

• symptoms are usually mild due to unilateral nature of the upper motor neuron lesions
• mild speech impairment **
• cause is usually stroke
• imprecise articulation

Question 11

non speech findings of UUMN dysarthria

Answer 11

• unilateral central facial weakness contralateral to lesion
• unilateral tongue weakness

Question 12

Common characteristics of spastic dysarthrias

Answer 12

• strained harsh voice quality -reduced variability of pitch and loudness.
• slow rate of speech
• regular speech AMR’s

Question 13

AMR stands for?

Answer 13

alternate motion rates

Question 14

ex. of AMR

Answer 14

puh-puh-puh-puh…
tuh tuh tuh tuh tuh…
kuh kuk kuh kuh…

Question 15

______ permit judgements of rate, rhythm, precision, and range of motion of rapid movements of lips, jaw and tongue.

Answer 15

AMR’s

Question 16

Normal adults can produce an even rythm at a rate of about __ to __ syllables/second.

Answer 16

5 to 6

Question 17

Lesions that cause Spastic Dysarthria occur where?

Answer 17

in the central nervous system –> affect upper motor neuron pathways bilaterally

Question 18

Nonspeech findings of Spastic Dysarthria

Answer 18

• slow rate of orofacial movements
• reduced range of motion
• hyperactive gag reflex/oral reflexes
• exhibit pseudobulbar affect or laughter/crying
• drooling

Question 19

Flaccid dysarthria symptoms affect _______, _______, _______, _______.

Answer 19

respiration
phonation
resonance
articulation

Question 20

damage to what cranial nerves leads to speech symptoms of flaccid dysarthria?

Answer 20

CN V, CN VII, CN X, CN XII.

Question 21

Flaccid Dysarthria lesions occur?

Answer 21

cell bodies, axons, and neuromuscular junction of lower motor neurons

Question 22

Nonspeech findings of flaccid dysarthria

Answer 22

weakness, loss of muscle tone, oral reflexes absent or reduced, atrophy of affected muscles.

(findings depend on which cranial nerves are affected)

Question 23

Characteristic speech symptoms of Ataxic dysarthria

Answer 23

irregular breakdowns in articulation (drunk speech), slow speech rate, vowel prolongation, speech AMR’s

Question 24

Lesiosn that lead to Ataxic Dysarthria occur?

Answer 24

in the cerebellum or cerebellar control circuits/pathways.

usually associated w/ bilateral or generalized cerebellar disease.

Question 25

Nonspeech findings of ataxic dysarthria

Answer 25

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

Question 26

hypokinetic dysarthria is characterized by?

Answer 26

accelerated speech rate and hypophonia , speech AMR’s are rapid/blurred

Question 27

hypokinetic dysarthria is caused by lesions associated with disease of the ____________.

Answer 27

basal ganglia control circuit

parkinson’s disease

Question 28

nonspeech findings of hypokinetic dysarthria

Answer 28

expressionless face at rest
tremor in jaw, face or tongue at rest
reduced range of motion

Question 29

hyperkinetic dysarthria is characterized by?

Answer 29

quick or slow, rythmic or arrhythmic involuntary movements that interrupt, distort or slow speech movements.

Question 30

Hyperkinetic dysarthria

Answer 30

affects respiration, phonation, resonance, prosody, and articulation

Question 31

Hyperkinetic dysarthria Tremor affects some of the muscles of speech, but is frequently restricted to the larynx? T or F?

Answer 31

False, it affects all the muscles of speech.

Question 32

Chorea speech is characterized by?

Answer 32

quick, unsustained and unpredictable movements that may be evident at rest.

Question 33

Dystonia speech is characterized by?

Answer 33

slow and sustained speech movements that may affect any or all parts of the speech system.

Question 34

Lesiosn of hyperkinetic dysarthria occur due to damage in the ________.

Answer 34

basal ganglia circuits

Question 35

Nonspeech findings of hyperkinetic dysarthria

Answer 35

size, strenth and symmetry are normal and no hyper or hypoflexia; but there are involuntary movements during oral motor exam can be ovserved.

Question 36

Apraxia is a disorder of ________ movement.

Answer 36

learned

Question 37

Apraxia is not caused by paralysis, weakness or incoordination. T or F?

Answer 37

True.

It is a disorder of motor planning.

Question 38

Oral Apraxia (nonverbal oral apraxia (NVOA) refers to what?

Answer 38

difficulty carrying out volitional oral non speech movements.

Question 39

Apraxia of speech (AOS) is characterized by

Answer 39

imprecise or distorted articulation that is often accompanied by substitutions, ommisions, or additions of sounds. speech rate is also slow.

Question 40

Lesions in the ________ hemisphere lead to apraxia of speech.

Answer 40

dominant;

apraxia of speech is associated with left (dominant) hemipshere damage

Question 41

Nonspeech findings of AOS

Answer 41

size, strength, symmetry & reflexes of oral mechanism muscles may be normal but right lower facial & tongue weakness often occur