Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Motor Speech Disorders Exams 1 + 2 > Mixed Dysarthria > Flashcards

Mixed Dysarthria Flashcards

1
Q

Mixed dysarthrias are common because…

A

the damage that causes dysarthia often affects more than one area or system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F

Mixed dysarthria is a combination of just 2 disarthrias

A

False

Can be 2 OR MORE (typically no more than 3 types)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is the mixed dysarthria named?

A

The component that dominates is the first name given, such as flaccid-spastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is it important to determine the types of mixed dysarthrias, the components,

A

because it may help rule out or confirm neurological diagnoses
e.g. flaccid-spastic usually = ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common type of dysarthria?

A

Mixed (Figure 1-3 shows it to be the most frequently occurring dysarthria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiologies:

A
  • Commonly caused by more than one event, i.e. multiple strokes, combination of neurological or degenerative diseases such as PD and stroke, chorea and stroke.
  • Often seen in degenerative diseases (e.g. ALS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ALS is usually…

A

flaccid-spastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of mixed dysarthrias and percentages in Duffy’s practice:

A
  • Flaccid-spastic – 42%
  • Hyperkinetic-hypokinetic – 35%
  • Ataxic-spastic – 23%
  • Other mixes – 19%
  • Hypokinetic-spastic - 7%
  • Ataxic-flaccid-spastic – 6%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which is the most common type of mixed dysarthria?

A

Flaccid-spastic (42%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which is the least common type of mixed dysarthria?

A

Ataxic-flaccid-spastic (6%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ETIOLOGIES: Specific diseases associated with mixed dysarthrias (6):

A
  1. Degenerative diseases
  2. Toxic - metabolic conditions
  3. Vascular disorders
  4. Trauma
  5. Tumor
  6. Infections and autoimmune diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Degenerative diseases and mixed dysarthria:

A

These often affect several parts of the motor system thus produce mixed dysarthrias

This is the most common etiology of mixed dysarthrias.

e.g. Motor neuron disease - primarily affects upper or lower motor neurons or both.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common type of motor neuron degenerative disease that causes mixed dysarthria:

A

Amyotrophic lateral sclerosis (ALS)

  • Has both UMN and LMN involvement
  • Commonly has mixed spastic-flaccid or flaccid-spastic components
  • ALS occurs in 1% to 5 % per 100,000
  • More men affected than women. 5% is familial
  • Onset for most is between 40 to 70 years
  • Often hard to diagnose - Diagnosis confirmed by EMG findings of weakness
  • Nearly always fatal. Most die between 1 and 5 years after diagnosis. Some few live more than 12 years
  • Death usually due to respiratory failure – but person can be put on ventilator.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Onset of ALS between ages ___ to __ years old

A

40-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Patients with ALS usually die between __ and __ years after diagnosis

A

1-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Death with ALS is usually due to:

A

respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

2 types of ALS:

A

Bulbar or spinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Patients with bulbar ALS initially have troubles with (2):

A

speech and swallowing problems very early on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Patients with spinal ALS initially have troubles with (1):

A

problems with limbs first

20
Q

Motor neuron degenerative disease that causes mixed dysarthria (4):

A
  1. ALS
  2. Primary lateral sclerosis (PLS)
  3. Spinal muscle atrophies
  4. Progressive Bulbar Palsy
21
Q

Primary lateral sclerosis (PLS) (a motor neuron degenerative disease) and mixed dysarthria:

A

– affects UMN only
– may be hard to distinguish from ALS
- It typically produces spastic dysarthria but is hard to differentiate from ALS

22
Q

Spinal muscle atrophies (a motor neuron degenerative disease) and mixed dysarthria:

A

– affects LMN only
– progressive limb wasting and weakness
– may have some cranial nerve weakness as well
- It is a motor neuron disease but typically produces only flaccid dysarthria, not mixed

23
Q

Progressive Bulbar Palsy (a motor neuron degenerative disease) and mixed dysarthria:

A

– primarily has LMN weakness of cranial nerve muscles. - Dysarthria and dysphagia predominate

  • Similar to ALS without limb involvement
  • It is usually associated with flaccid dysarthria, not mixed.
24
Q

Multiple Sclerosis and mixed dysarthria:

A

– it is a demyelinating disease

– the myelination is attacked but the axon itself is not

  • Cause is unknown – may be related to autoimmune cause triggered by environmental and genetic interactions
  • Diagnosis is difficult – MRI often used for diagnosis.
  • Patient often exhibits problems with vision and other sensory difficulties and some cognitive deficits.
  • Dysphagia is not common.
25
Q

ALS affects more (men or women)

A

men

26
Q

MS affects more (men or women)

A

women

27
Q

What is the most common CNS disease affecting young and middle age adults?

A

MS

28
Q

Age of onset for MS

A

onset between 20 to 40 years of age

29
Q

Courses of disease for MS (4):

A
  1. Benign – only few episodes, then remission
  2. Relapsing-remitting – comes and goes
  3. Remitting-progressing - comes and goes but progressively gets worse
  4. Progressive – no remission
30
Q

Type of mixed dysarthria with MS:

A

Most common type of mixed dysarthria is ataxic-spastic but any combination can occur

The type of dysarthria is more unpredictable than with other diseases

31
Q

Frederich’s Ataxia and mixed dysarthria:

A
  • Is associated with cerebellar dysfunction but can also be associated with mixed spastic/ataxic dysarthria
32
Q

Progressive Supranuclear Palsy and mixed dysarthria:

A
  • neurodegenerative disease associated with multisystem involvement
  • May be confused with PD because it has similar symptoms such as bradykinesia
  • Dysphagia and dysarthria are common and are evidenced early on in the disease
  • Mixed dysarthrias seen in this disease are combinations of hypokinetic, spastic and ataxic
33
Q

Multiple Systems Atrophy and mixed dysarthria:

A
  • similar to PSP and PD - but doesn’t respond well to L-Dopa
  • Shy Drager Syndrome falls under this category of diseases
  • Types of mixed dysarthrias include hypokinetic, hyperkinetic, ataxic and spastic depending on the underlying pathologies
34
Q

Shy-Drager syndrome (type of Multiplle Systems Atrophy) and mixed dysarthrai:

A
  • progressive neurologic disease

– unknown etiology

  • First signs are usually blood pressure problems when standing, incontinence and decreased respiration and impotence
  • May also have problems with gait, dysarthria and dysphagia
  • Most common types of dysarthria associated with SDS are hypokinetic, ataxic, spastic and flaccid
35
Q

What characteristics distinguish ALS from the others (2)?

A
  1. Wet/gurgle voice

2. Vocal Flutter

36
Q

Corticobasal degeneration and mixed dysarthria:

A
  • It is rare and involved impairment of cortex and basal ganglia
  • presents most often with spastic-hypokinetic dysarthria, but can have ataxic and hyperkinetic components.

(Primary progressive aphasia is sometimes put under this category.)

37
Q

Degenerative diseases that cause mixed dysarthria (6):

A
  1. Motor Neuron Diseases (ALS, PLS, Spinal Muscle atrophies, Progressive Bulbar Palsy)
  2. Multiple Sclerosis
  3. Frederich’s Ataxia
  4. Progressive Supranuclear Palsy
  5. Multiple Systems Atrophy
    e. g. Shy-Drager syndrome
  6. Corticobasal degeneration
38
Q

Toxic - metabolic conditions that cause mixed dysarthria (2):

A
  • Effects tend to be diffuse and damage can impair several components, thus resulting in a mixed dysarthria.
    1. Wilson’s disease
    2. Hypoxic encephalopathy
39
Q

Wilson’s disease (a toxic - metabolic condition that causes mixed dysarthria):

A
  • It is a metabolic disorder leading to too much copper in brain, eyes and liver
  • It can be fatal
  • It often demonstrates brown rings around cornea of the eyes
  • Dysarthria is a predominant symptom - and typically involves two or more of these: hypokinetic, ataxic, and spastic
40
Q

Hypoxic encephalopathy (a toxic - metabolic condition that causes mixed dysarthria):

A
  • Due to lack of oxygen to brain because of heart and lung problems
  • With loss of oxygen, brain damage occurs
  • Mixed dysarthrias often occur involving hypokinetic, hyperkinetic and ataxic dysarthrias
41
Q

Vascular disorders and mixed dysarthria:

A
  • Multiple strokes often affect multiple systems and produce mixed dysarthrias of any combination
  • If strokes affect brainstem, dysarthria may include flaccid, spastic and ataxic due to close proximity of pyramidal and extrapyramidal fibers
42
Q

Trauma and mixed dysarthria:

A
  • TBI can produce any combination of dysarthrias

- Mixed dysarthia is more common with TBI than single dysarthrias due to the diffuse injuries associated with TBI

43
Q

Tumors and mixed dysarthrias:

A
  • Can affect various components of neurological system and produce various mixed dysarthrias
44
Q

Infections and autoimmune diseases and mixed dysarthria:

A
  • AIDS is a good example and can produce various mixed dysarthrias
  • The type of dysarthias depend on the condition that is presenting with AIDs as various conditions can result
45
Q

SPEECH PATHOLOGY and ALS

A
  • Dysarthria is often the first sign.
  • The majority are unintelligble by the time death occurs.
  • Most need AAC intervention within approximately 3 years of diagnosis and use them about 2 years before death.
  • Dysarthria may not be mixed throughout the entire disease.
  • Dysarthria has components of both flaccid and spastic when it is mixed and either of those can predominate.
  • Symptoms of each of those types can occur, i.e. with spasticity - pathological reflexes and pseudobulbar effect can occur; with flaccidity - fasiculations and atrophy can occur.
  • Intelligibility can be severely affected due to hypernasality, reduced ability to build up intraoral air pressure and weakness of tongue.
46
Q

Other symptoms that occur with ALS that aren’t seen with single dysarthrias (2):

A

 tremor or “flutter” in voice is commonly seen, especially in vowel prolongation. (The cause is not known.)

 wet or gurgly voice - due to turbulence in voice from saliva that builds up in pyriform sinuses and on vocal folds due to reduced swallowing and clearing of secretions

Motor Speech Disorders Exams 1 + 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions