Motor Speech Disorders Final Flashcards
Motor Speech Disorders Vary Along a Number of Dimensions
- Age of Onset
- Course of Disorder
- Site of Lesion
- Neurological diagnosis
- Pathophysiology
Classifying Dysarthria Categories
Flaccid
Hypokinetic
Spastic
Hyperkinetic
Ataxic
UMN
(mixed)
Classifying Dysarthria: Etiology and Course
Dysarthria Grouped by Cause/Etiology
- Developmental
- Recovering (stroke)
- Stable (long term post stroke)
- Exacerbating (multiple sclerosis)
Dysarthria Grouped by Course
- Non-progressive
- Chronic
- Degenerative
Nonprogressive Dysarthria
CVS
Hypokinetic Dysarthria is associated with the _____ _______ control circuit
Basal Ganglia
Hypokinetic Dysarthria is most evident in ________, _________, and _________.
Voice, Articulation Prosody
Interconnections Control Circuit 1
- Cortical - crucial cortical input coming from frontal lobe premotor cortex
- Thalamic
- Substantial Nigra
Neurotransmitter imbalance is responsible for many movement disorders associated with ____ ______ control.
Basal Ganglia
Which neurotransmitter is most importantly impacted with Parkinson’s Disease?
Dopamine
Common Non-Speech Characteristics of Hypokinetic Dysarthria?
- Resting Tremor
- Rigidity
- Bradykinesia (appears to have super fast movements)
- Hypokinesia
- Akinesia
- Postural Abnormalities
- Reduced eye blink
- Swallow infrequently (drooling because of this)
- Rapid tremulous jaw and lips
- Flat affect (facial expressions)
Speech Characteristics of Hypokinetic Dysarthria
- Aberrant range or speed of movement
- Deficits are mainly seen in phonatory, articulatory and prosody
- speech movements and timing are generally accurate
- Individual movements are slow
- repetitive movements are fast (tongue and force are reduced)
- Excessive muscle tone
- Reduced ROM maybe more significant in underlying neuromuscular deficit related to speech
What Causes Hypokinetic Dysathria Etiology?
- Extra pyramidal tract degenerative disease
- Vascular conditions usually in the brain
- Toxic-metabolic conditions
- Trauma
- Infectious conditions
What reflexes are lost with Hypokinetic Dysarthria?
Postural Reflexes
Perceptual respiration symptoms of Hypokinetic Dysarthria?
- Decreased breath support resulting in
- short rushes of speech
- decreased loudness
Perceptual phonation symptoms of Hypokinetic Dysarthria?
- Hoarseness
- Breathiness
- Tremor
- Decreased loudness
- Monoloudness
- Monopitch
- Reduced utterance length
Perceptual resonance symptoms of Hypokinetic Dysarthria?
Mild hyper nasality
Perceptual articulation symptoms of Hypokinetic Dysarthria?
- Sounds slushy
- Imprecise
- rapid-repeated
- blurred
- Irregular AMR
Perceptual prosody symptoms of Hypokinetic Dysarthria?
- Increased rate in segments
- Increased overall rate
- Monotone
- Monoloudness
- Short rushes of speech
- Phrase or syllable repetitions
- Palilalia with excessive pauses
- Reduced stress
- Variable rate
Physiological Symptoms of non speech oral motor function of Hypokinetic Dysarthria?
Causes of MSDs (VITAMIN-D)
o Vascular accident
o Infectious disease
o Trauma
o Allergic or anoxic conditions
o Metabolic disorder
o Idiopathic
o Neoplasm
o Degenerative and/or demyelinating disease
Parkinson’s Disease (PD)
o High prevalence of dysarthria
o Can affect laryngeal and velopharyngeal function, oral articulation, and intelligibility
o PD due to a loss of neurons in basal ganglia that produce dopamine, the substantia nigra, which is related to the BG and the brain stem.
Progressive Supranuclear Palsy (PSP)
o An extrapyramidal syndrome
o Symptoms include ophthalmoplegia (paralysis of eye muscles), rigidity of neck, pseudobulbar palsy, and a severe spastic dysarthria.
Dyskinesias
o General term that describes abnormal involuntary movements typically associated with BG pathology
o Most familiar with tardive dyskinesia (TD)
o Medications often cause dyskinesias
Dystonia
o Characterized by abnormal involuntary movements and postures
o Form of hyperkinesia
o Involuntary movements (spasms) are usually associated with voluntary motor activity
