Lecture 6 Flashcards
Spastic dysarthria is due to what type of damage?
UMN
What are the underlying characteristics underlying spastic dysarthria?
spasticity and weakness (reduces range and force of movement)
spastic dysarthria is caused by unilateral or bilateral damage? And this is damage to what?
- Bilateral
- Direct and indirect pathways of the CNS
Spastic dysarthria may manifest in what components of speech?
- respiratory, phonatory, resonatory, and articulatory.
Which is milder UUMN or spastic dysarthria?
UUMN
Unilateral or Bilateral Damage:
Spastic dysarthria is due to?
UUMN is due to?
- Bilateral damage
- Unilateral damage
What is the main difference in damage when comparing UUMN to spastic dysarthria?
UUMN is unilateral UMN damage
Spastic dysarthria is bilateral UMN damage
Motor impairment after an internal capsule lesion can be significant. Why?
Because descending fibers are closely packed at this level.
Spasticity is believed to be due damage to _______ that travel alongside the _____ and ______ _____
- Indirect activation pathways
- corticobulbar and corticospinal tracts
cranial nerve nuclei is aka
LMN
Indirect Pathways:
Where do they originate?
Where do they synapse?
where do they terminate?
- in the cortex
- on nuclei in the brainstem
- cranial nerve nuclei (LMN)
What are the functions of indirect activation pathways?
regulates reflexes and maintains posture and muscle tone
Damage to Indirect pathways result in what?
What are the effect of damage?
- Spastic dysarthria or UUMN
- hyperreflexia and spasticity
What are the confirmatory signs of spastic dysarthria? (4)
- spasticity
- hyperreflexia
- pathological oral reflexes
- emotional lability (continuous change or breakdown)
What speech subsystems tend to be involved in spastic dysarthria?
All of them
In left hemisphere lesions, what disorders may mask the presence of UUMN dysarthria?
Aphasia and Apraxia of speech
What are the confirmatory non-speech signs of spastic dysarthria?
- unilateral lower facial weakness
- unilateral tongue weakness
What are the distinctive speech characteristics of spastic dysarthria?
slowness of speech and strained-harsh vocal quality
What are the characteristic speech signs in UUMN dysarthria?
mildness of deficits and articulation imprecision
Ataxic dysarthria is due to damage to what?
Cerebellum or cerebellar control circuits
Speech characteristics in ataxic dysarthria are primarily due to what?
Impaired coordination
What would you expect on an oral motor exam with an individual with ataxic dysarthria?
They may have a normal oral mech exam
Cerebellar symptoms are unilateral, contralateral, or ipsilateral?
Ipsilateral
What are the key speech characteristics of ataxic dysarthria?
irregular articulatory and prosodic errors
Cerebellar lesions result in
- hypotonocity
- Errors in force, speed, timing, range and direction of movement
- intention/kinetic tremor
Hypokinetic dysarthria is due damage to what?
the basal ganglia and/or basal ganglia control circuits
Damage to the basal ganglia generally results in what?
reduction of movement or dyskinesias
What is the most common cause of hypokinetic dysarthria?
Parkinson’s disease
Parkinson’s disease is the result of what and in what location?
degeneration of the dopamine producing neurons in the substantia nigra
Parkinson’s is characterized by what? (4)
- rigidity
- reduced range of motion
- difficulty initiating movements
- resting tremors
What are the non-speech signs of hypokinetic dysarthria?
- mask-like, expressionless face
- tremor/tremulousness of the lips
- tongue and jaw at rest
- normal strength
What are the characteristic speech impairments with hypokinetic dysarthria?
- hypophonia
- reduced loudness
- mono-loudness
- fast speech rate
Hyperkinetic dysarthria is due to damage to what?
the basal ganglia
Hyperkinesia refers to what type of movement?
abnormal extra involuntary movements. They can be quickly or slowly produced
What underlies or is the cause of speech impairments in hyperkinetic dysarthria?
hyperkinesias
How are dyskinesias usually classified?
fast or slow
What does an oral mechanism exam look like with someone with hyperkinetic dysarthria?
normal except for the presence of involuntary movements
Hyperkinetic dysarthria dyskinesias: Tremor
Tremor can affect all the muscles of speech production, but most commonly affects what?
voice
Huntington’s disease is characterized by what?
quick, choreic movements
The speech of individuals with Huntington’s disease is characterized by what>
- sudden voice arrests with with strained quality
- irregular articulatory breakdowns
- prosodic abnormalities
Hyperkinetic dysarthria dyskinesias: dystonia
dystonic movements are what?
And what speech subsystems are affected?
- slow and sustained
- can affect any speech subsystem
There are dysarthrias that are due to a laryngeal dyskinesia. Which dyskinesia?
Dystonia
What is adductor spasmodic dysphonia?
Intermittent strained vocal quality
What is abductor spasmodic dysphonia?
Intermittent breathiness
