Motor Speech Disorders L1 Flashcards
Dysarthria - Lecture 1
How many subsystems of speech are there?
Five
Name the subsystems of speech.
Respiration
Phonation
Articulation
Resonance
Prosody
What is phonation also know as?
Voicing
What are suprasegmental aspects of speech?
Prosody
- Intonation
- Tone
- Pitch
Rhythm
What are the Segmental features of speech?
Consonants and vowels (phonemes)
Dysarthrias affect an individual’s ability to…..
Dysarthria ‘RATTSSS
Control and execute speech
- neuromuscular execution
Apraxias affect an individual’s ability to….
Plan and program speech
motor speech planning, programming and control
MSD is an umbrella term for…?
Apraxia’s and Dysarthria’s
Is apraxia cognitive or neurological?
- Apraxia will be revisited later on. Prepare to edit
Cognitive
- it’s not about damage to peripheral nerves, rather a reduced capacity of the brain to plan.
- the person and brain still know what they should be doing and how they should be doing it
Symptoms vs Signs
Sign - what the clinician observes and identifies, characteristics.
Symptoms - what the patient feels/notes
Dysarthria affects muscle movement. List 7 symptoms/signs of these impacts.
Changes in:
Tone
Speed
Strength
Steadiness
Range
Timing
Accuracy
What does RATTSSS mean as Dysarthric signs/symptoms?
A change in
Range
Accuracy
Timing
Tone
Speed
Strength
Steadiness
What does intelligibility mean?
How does it differ to comprehensibility?
Intelligibility - ‘the degree to which the acoustic signal is understood by a listener’’ (Yorkston, Kennedy & Strand, 1996, p.56)Comprehensibility - how language and gestures are understood
What are Dysarthrias?
Neurologically based speech disorders that affect RATTSSS due to disordered muscle movements.
This affects the 5 subsystems of speech PARRP
What are PARRPs?
The 5 subsystems of speech
Phonation
Articulation
Resonance
Respiration
Prosody
Incidence vs Prevalence
Incidence - how many onsets
Prevalence - how many cases at a time
What are the 3 models of the dysathrias?
Social
Medical
Mayo Clinic
Explain the Medical Model of Dysarthrias
Looks at presentation and cause
What are the two key groups, the two key classifications, of the medical model of Dysarthrias?
Acute onset (3)
Progressive (2)
What are the three acute onsets of dysathria?
TIA
Improving (stroke/TBI
Chronic/stable (long term
What are the two forms of Progressive Dysarthrias?
Parkinson’s, Huntingson’s
- continual decline
MS
- remitting + relapsing
How many key clusters of Dysarthria has the Mayo Clinic identified?
eight
HAHFUUMS
What is HHAFUUMS
The key clusters of dysarthrias identified by the mayo clinic.
Hypokinetic
Hyperkinetic
Ataxic
Flaccid
Spastic
Mixed
Unilateral Upper Motor
Undetermined
Give the 8 key clusters identified by the Mayo Clinic
Hyperkinetic
Hypokinetic
Ataxic
Flaccid
Spastic
Mixed
Unilateral Upper Motor
Undetermined
What is Ataxic Dysarthria?
Damage to the cerebellum causing incoordination.
Is Parkinson’s Hypo or Hyper-kinetic?
Hypo
Is Huntingson’s Hypo or Hyper kinetic?
Hyper
Which two assessments, used in the UK on dysarthria, are based on the Mayo Clinic key clusters?
Of the two, which is the most used?
Frenchay Dysarthria Assessment
Robertson Dysarthria Profile
Frenchay (FDA)
Which two Dysarthrias identified by the Mayo Clinic, are extrapyramidal and formed from damage to the basal ganglia?
Hypo and Hyper kinetic
What structure of the basal ganglia controls movement?
Substantia Nigra
Where in the brain in the basal ganglia located?
Midbrain
The Pars Reticula and Pars Compacta are areas of which structure?
What role(s) do they have?
Substantia Nigra
Compacta - produces dopamine to control movement
Reticula - regulates unwanted movement
What is the Neuromotor effect of Hypokinetic Dysarthria?
Rigidity/reduced movement
What is the Neuromotor effect of Hyperkinetic Dysarthria?
Abnormal movements
Dystonia and Choreiform are signs of which Dysarthria?
Hyperkinetic
Dystonia vs Choreiform
Dystonia (prolonged muscle contractions - typically seen as turning limbs inwards [ThisTrippyHippy]
Choreiform - random and unpredictable movements
Why does damage to upper motor neurons cause spasticity?
These neurons leave the brain, enter the spinal cord and synapse with lower motor neurons which exit the spinal cord.
These neurons don’t cause muscle movement directly, but initiate it.
If they don’t work, the lower motor neurons have unregulated movements.
If an individual has Flaccid Dysarthria, what is the neuromotor effect, and what structures(s) has been damaged?
Effect - weakness
Lower motor neurons are damaged - no signals reaching effector muscles
Motor Speech Disorders are the result of damage to….
The central and/or peripheral nervous system.
(Cranial/spinal nerves)
Is Dysarthria a MSD where neuromuscular execution is impacted (control and execution) or where motor speech planning, programming and control is impacted (planning and programming?)
Neuromuscular execution
‘Motor speech processes’ is a general term for which combined processes of speech?
speech motor planning, programming, control and execution
Does aprosodia affect both comprehension and expression of prosody?
Yes
What are MSDs?
Speech disorders due to neurologic impairment affecting planning, programming, execution and control of speech.
