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558 Midterm 2a > Lecture 12: Clinical Speech Syndromes of the Motor System > Flashcards

Lecture 12: Clinical Speech Syndromes of the Motor System Flashcards

1
Q

name of the category of motor speech syndromes characterized by abnormalities in strength, speed, range, steadiness, tone, or accuracy of movements required for control of respiratory, phonatory, resonator, articulatory, and prosodic aspects of speech production

A

dysarthria

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2
Q

name of the category of motor speech syndromes whose central or PNS abnormalities most often reflect weakness, spasticity, incoordination, involuntary movements, slowness of speech, or excessive, reduced, or variable muscle tone

A

dysarthria

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3
Q

UMN lesions : UUMN dysarthria and spastic dysarthria :: LMN lesions : ___ dysarthria

*note: UUMN (unilateral upper motor motor neuron)

A

flaccid

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4
Q

name of the type of lesions responsible for both hypokinetic and hyperkinetic dysarthria

A

basal ganglia lesions

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5
Q

name of the type of lesions responsible for ataxic dysarthria

A

cerebellar and cerebellar pathway lesions

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6
Q

true or false: mixed lesions lead to mixed dysarthrias

A

true

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7
Q

name of the type of dysarthria characterized by the following symptoms:

very mild, relative mildness of speech impairment, usually due to stroke, imprecise articulation (harshness, reduced loudness, hyper nasality, slow rate of speech)

A

UUMN (unilateral upper motor neuron) dysarthria

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8
Q

re: UUMN dysarthria

where do these lesions occur?

A

unilateral upper motor neuron dysarthria; lesions in:

cerebral hemisphere (usually motor cortex), descending white matter pathways, internal capsule, brainstem

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9
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

unilateral lower facial weakness, unilateral tongue weakness

A

UUMN (unilateral upper motor neuron) dysarthria

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10
Q

name of the type of dysarthria characterized by the following symptoms:

strained-harsh voice quality, monopitch, monoloudness, slow rate of speech (slow AMRs)

A

spastic dysarthria

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11
Q

name of the measurement of rate, rhythm, precision, and range of motion of rapid movements of the lips, jaw, and tongue; patient is asked to breathe and repeat: /p p p/ /t t t/ and /k k k/

A

alternate motion rate (AMR)

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12
Q

what is the AMR for normal adults?

A

5 - 6 syllables per second

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13
Q

name of the type of lesions responsible for spastic dysarthria

A

central nervous system lesions and lesions affecting the upper motor neuron pathways

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14
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

slow rate of orofacial movements, reduced range of motion, hyperactive gag reflex, pseudo bulbar effect, pathologic laughter and crying, drooling, dysphagia

A

spastic dysarthria

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15
Q

name of the type of dysarthria whose symptoms vary depending on the location of LMN damage, potentially affecting: respiration, phonation, resonance, and articulation

A

flaccid dysarthria

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16
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

bilateral trigeminal weakness (reduced jaw movements, weakened closure, articulatory contacts between the tongue, lips, and teeth)

A

CN V

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17
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

imprecise articulation of sounds requiring facial movements, paresis or bilateral weakness resulting in distortion of sounds, prevented production of bilabials and labiodentals if paralysis occurs bilaterally

A

CN VII

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18
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

voice and resonance changes

A

CN X

*note: occurs because this cranial nerve innervates both the muscles of the larynx and soft palate

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19
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

vocal cord paralysis, hoarseness, breathiness, diplophonia

A

CN X

*note: diplophonia is when two pitches are perceived rather than one because the two vocal cords are vibrating at different rates

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20
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

vocal breathiness and / or inhalators stridor

A

CN X

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21
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

restricted control of vocal pitch

A

CN X

22
Q

true or false: unilateral lesions of the superior laryngeal nerve produce significant dysphonia

A

false; they do not produce significant dysphonia

23
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

nasality, audible nasal emission, significant weakness of sounds requiring intramural pressure

A

CN X

24
Q

damage to which cranial nerve results in the following flaccid dysarthria symptoms:

articulatory tongue imprecisions (weakness, atrophy, and fasciculations)

A

CN XII

*note: unilateral hypoglossal lesions : mild articulatory imprecision :: bilateral lesions : severe articulatory imprecisions

25
Q

lesions in which areas often lead to flaccid dysarthria?

A

cell bodies, axons, or neuromuscular junction of the LMNs, CN V, VII, X, XII, cervical and thoracic spinal nerves

26
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

damage expressed as weakness and loss of muscle tone, oral reflexes reduced or absent, atrophy of affected muscles, fasciculations

A

flaccid dysarthria

27
Q

name of the type of dysarthria characterized by the following speech symptoms:

“drunken” speech, slow speech rate, unsteady vowel prolongations, slow and irregular AMRs

A

ataxic dysarthria

28
Q

lesions in which areas often lead to ataxic dysarthria?

A

cerebellum or cerebellar control circuits / pathways

29
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

normal size, strength, symmetry, and reflexes; slow, irregular jaw, face, and tongue movements during non-speech AMR tasks

A

ataxic dysarthria

30
Q

name of the type of dysarthria characterized by the following speech symptoms:

accelerated speech, hypophonia, arctic errors due to reduced range of motion, rapid (and “blurred”) speech AMRs

A

hypokinetic dysarthria

31
Q

lesions in which areas often lead to hypokinetic dysarthria?

A

basal ganglia control circuit (when diseased); frequent in persons with Parkinson’s disease

32
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

expressionless face even during social interaction; tremors in the jaw, face, or tongue at rest; reduced range of motion of the jaw, face, and tongue during speech AMRs

A

hypokinetic dysarthria

33
Q

the following are two subtypes of which kind of dysarthria?

  1. quick or slow, rhythmic or arrhythmic, involuntary movements that interrupt, distort, or slow speech movements
  2. affect respiration, phonation, resonance, and articulation - often, prominent affects on prosody
A

hyperkinetic dysarthria

34
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

rhythmic, quavering waxing, and waning vocal character; possibly abrupt voice arrests and slowed speech rates

A

tremor

35
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

quick, unsustained, and unpredictable movements where abnormal speech characteristics depend on the structures (jaw, face, tongue, palate, larynx, respiratory system) affected

A

chorea

36
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

quick, involuntary adductor or abductor movements; voice arrests with strained quality or transient breathiness; hyper nasality and nasal emissions; irregular articulatory breakdowns; prosodic abnormalities; irregular AMRs

A

chorea

37
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

slow and sustained speech movements; slow, adventitious movements of lips, tongue, or jaw; can be confined to muscles for speed hand swallowing and triggered only by the act of speaking

A

dystonia

38
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

__ductor spasmodic dysphonia : waxing / waning strained-harsh voice quality :: __ductor spasmodic dysphonia: breathy / aphonic segments of speech

A

layngeal dystonia;

[fill-ins] ad, ab

39
Q

name of the kind of hyperkinetic dysarthria characterized by the following speech symptoms:

hypernasality, significantly impaired articulation, abnormalities of prosody

A

dystonia

40
Q

lesions in which area often lead to hypokinetic dysarthria?

A

basal ganglia control circuits

41
Q

name of the type of dysarthria characterized by the following non-speech oral mechanism findings:

normal size, strength, and symmetry; no hyper or hyporeflexia; involuntary movements only observed during the oral motor exam

A

hyperkinetic dysarthria

42
Q

name of the category of motor speech syndromes characterized by disorders in motor planning

A

apraxia

43
Q

a disorder of learned movement

A

apraxia

44
Q

true or false: apraxia is caused by paralysis, weakness, or incoordination and is accounted for by sensory loss, comprehension deficits, or inattention to commands

A

false;

“disorder of learned movement, NOT caused by paralysis, weakness, or incoordination and CANNOT be accounted for by sensory loss, comprehension deficits, or inattention to commands”

45
Q

name of the kind of apraxia characterized by the following speech symptoms:

difficulty carrying out volitional, oral non-speech movements (not due to weakness, incoordination, sensory, or cognitive-linguistis impairment)

A

oral apraxia; also called nonverbal oral apraxia (NVOA)

46
Q

name of the kind of apraxia characterized by the following speech symptoms:

imprecise / distorted articulation (SODA); slow speech rate; prolonged consonants and vowels; syllabic production of speech

A

apraxia of speech (AOS)

47
Q

lesions in which areas often lead to apraxia of speech (AOS)?

A

middle cerebral artery, posterior portions of the frontal lobe (Broca’s area), parietal lobe, sometimes basal ganglia

*note: rarely seen in isolation; usually paired with aphasia and / or a unilateral UMN dysarthria

48
Q

___ is a function of the dominant hemisphere, and apraxia of speech is associated with left (___) hemisphere damage

A

praxis, dominant

49
Q

name of the type of apraxia characterized by the following non-speech oral mechanism findings:

right lower facial and tongue weakness due to involvement of the nearby corticobulbar pathway; co-occurance of nonverbal oral apraxia (but may also occur independently)

A

apraxia of speech (AOS)

50
Q

given that a patient has basal ganglia lesions, they will likely have a ___

hypokinetic : little excitation :: hyperkinetic : excess excitation

A

dysarthria

51
Q

UUMN (unilateral upper motor neuron) dysarthria is often ___ with lesions in the ___

A

mild; internal capsule

558 Midterm 2a (4 decks)

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