Motor Speech

Question 1

Flaccid Dysarthria

Answer 1

Damage to lower motor neurons (LMN)
Main characteristics
- Muscle weakness
- Imprecise consonants
- Breathy phonation
- Diplophonia
- Rapid deterioration of speech (recovery with rest)
- Hypernasality
- Abnormal prosody

Question 2

Myasthenia Gravis

Answer 2

Rapid fatigue of muscular contractions over a short time, with recovery occurring at rest

Question 3

Guillain-Barré Syndrome

Answer 3

Body’s immune system attacks the peripheral nerves and can cause weakness, numbness or paralysis; characterized by rapid progression (develops over a period of a few days or weeks)

Question 4

Polio

Answer 4

Infectious viral disease that attacks cell bodies of LMNs (affects brain and spinal cord)

Question 5

Muscular Dystrophy

Answer 5

group of diseases that cause progressive weakness and loss of muscle mass (mutation in genes)

Question 6

Progressive Bulbar Palsy

Answer 6

primarily affects LMNs controlling the muscles of the face, tongue, throat, and larynx (often progresses to ALS)

Question 7

Spastic Dysarthria

Answer 7

Damage to bilateral upper motor neurons (UMN)
Main characteristics
- Strained/ harsh voice
- Pitch breaks
- Slow and regular AMRs
- Hypertonia
- Slow rate and effortful speech
- Pseudobublar affect: Uncontrollable crying or laughing
- Drooling

Question 8

Unilateral UMN Dysarthria

Answer 8

Unilateral damage to upper motor neurons (UMN)
Main characteristics
- Slow rate
- Reduced loudness
- Imprecise articulation
- Strained voice quality
- Irregular articulatory breakdowns
- May have nonverbal oral apraxia

Question 9

Ataxic Dysarthria

Answer 9

• Damage to cerebellum
  Main characteristics
• “Drunken” quality of speech
• Distorted vowels
• Irregular AMRs
• Excessive loudness variation
• Slurring syllables
• Irregular articulatory breakdowns
• Dysmetria (lack of coordination)
• “Scanning speech”

Question 10

Hypokinetic Dysarthria

Answer 10

Reduction of dopamine in BG- Parkinson’s Disease (rigid & restricted movements)
Main characteristics
- Reduction in range and speech of speech movements
- Monopitch and monoloudness
- Reduced stress and loudness/ loudness decay
- Tendency for rapid speech rate
- Palilalia (automatic repetition of own words)
- Inappropriate silences
- Rapid AMRs
- Masked facial expression
- Resting tremor

Question 11

Hyperkinetic Dysarthria

Answer 11

Damage to BG- Huntington’s Disease (rapid, dancelike involuntary movements)
Main characteristics
- Involuntary movements interfering with speech production
- Sudden forced inspiration or expiration
- Vocal strain/ hoarseness
- Myoclonic vowel prolongation (tremor like “beats”)
- Slow and irregular AMRs
- Myoclonus (sudden jerking)
- Inappropriate vocal noises

Question 12

Mixed Dysarthria

Answer 12

Neurologic damage that extends to more than one portion of the motor system

Question 13

Apraxia of Speech

Answer 13

Inability to sequence movement of articulators for voluntary speech production
Distorted articulation and prosody
Damage to CNS

Question 14

Ideational Apraxia

Answer 14

Ex- ask patient to blow out a birthday candle, patient says “I don’t know how to do that task”
Understand directions mostly, but maybe can’t remember what a birthday candle is/ looks like

Question 15

Ideomotor Apraxia

Answer 15

Asking someone to carry out the plan
Ex: asking someone to brush their teeth, person puts toothbrush in their mouth and unsure how to properly brush teeth (sequence of movements impaired)

Question 16

5 components of speech production

Answer 16

Respiration
Phonation
Resonance
Articulation
Prosody

Question 17

Respiration

Answer 17

Our breath, provides air pressure to make VF vibrate

Question 18

Phonation

Answer 18

Production of voiced phonemes through VF vibrations

Question 19

Resonance

Answer 19

Placement of oral or nasal tonality onto phonemes during speech
- Assess velopharyngeal function (hyper/ hyponasality)

Question 20

Articulation

Answer 20

Shaping of vocal air stream into phonemes

Question 21

Prosody

Answer 21

Melody of speech (stress and intonation)

Question 22

Vagus Nerve Braches

Answer 22

Pharyngeal Branch
External Superior Laryngeal Branch
Recurrent Nerve Branch

Question 23

Pharyngeal Branch

Answer 23

affects movement of the velum

Question 24

External superior laryngeal branch

Answer 24

controlling vocal pitch

Question 25

Recurrent nerve branch

Answer 25

phonation= breathy and hoarse

Question 26

Palatal lift

Answer 26

prosthetic treatment that is essentially a dental retainer to help push upward on the velum

Question 27

Central Nervous System structures

Answer 27

Brain - Cerebrum (and 4 lobes) - Brainstem (midbrain, pons, medulla) - Cerebellum Spinal Cord

Question 28

PNS

Answer 28

12 cranial nerves 31 spinal nerves

Question 29

Basal Ganglia

Answer 29

Acts as a filler to prevent unwanted movements Compromise: - Huntington’s Disease - Parkinson’s Disease

Question 30

Cerebellum

Answer 30

Attached to back of brainstem, just below occipital lobe - Helps regulate muscle tone, maintain balance, and coordinate skilled motor movements

Question 31

Cerebellum damage

Answer 31

- Ataxia: Disturbance to speed, range, and direction and movements

Question 32

Thalamus

Answer 32

- Sits on top of midbrain - Receives neural inputs of planned motor movements from basal ganglia and cerebellum

Question 33

Thalamus damage

Answer 33

Thalamic Pain Syndrome Hypersomia Thalamic Aphasi

Question 34

Upper motor neurons

Answer 34

- All the descending motor fibers coursing through the CNS - Damage: Spastic Dysarthria

Question 35

Lower Motor Neurons

Answer 35

- Motor neurons in cranial and spinal nerves (PNS) - Damage: Flaccid dysarthria