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Motor Speech Exam 3 Flashcards

1
Q

What is the neurological basis for ataxic dysarthria?

A

cerebellar damage or it’s pathway

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2
Q

ataxia

A

a lack of coordination

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3
Q

cerebellum

A

coordinates timing and force of muscular contractions

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4
Q

symptoms of cerebellar ataxia

A

disequilibrium, nystagmus, intention tremor, hypotonia, problems with motor learning

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5
Q

what are the etiologies of ataxic dysarthria

A

degenerative diseases, stroke, toxic conditions, TBI, tumors

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6
Q

what is a degenerative disease for ataxic dysarthria

A

friedreich’s ataxia

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7
Q

what are the characteristics of friedreich’s ataxia

A

progressive, hereditary, symptoms appear in the late 20s

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8
Q

what are the components of the etiology of a stroke in ataxic dysarthria

A

occlusions, ruptured aneurysms, and cerebellar arteries

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9
Q

what are the components of the etiology of toxic conditions in ataxic dysarthria

A

lead, mercury, cyanide with history of ethanol, phenytoin, and metabolic conditions such as vitamin deficiencies and hypothyroidism

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10
Q

what are the components of the etiology of a TBI in ataxic dysarthria

A

cerebellum and cerebellar control circuit

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11
Q

ataxic dysarthria speech characteristics

A

movements of speech mechanisms are poorly coordinated, timing and force of muscular contractions for clearly articulated speech, “drunken speech”, and “scanning speech”

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12
Q

ataxic dysarthria articulation

A

imprecise consonants and vowel distortions

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13
Q

what are the type of imprecise consonants for ataxic dysarthria

A

slurred, irregular, and inconsistent errors

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14
Q

ataxic dysarthria prosody

A

equal and excess stress, prolonged phonemes, prolonged intervals between phonemes, slow speech rate with increased pause time/articulation time and “choppy speech”, monopitch, and monoloudness

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15
Q

ataxic dysarthria phonation

A

harsh voice quality with decreased muscle tone in laryngeal and respiratory structures

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16
Q

ataxic dysarthria respiration

A

exaggerated or paradoxical movements including excessive loudness variations, reduced vital capacity, speaking on residual air, decreased loudness, and harsh voice quality

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17
Q

what are the key evaluation tasks for ataxic dysarthria

A

AMRs, conversational speech and reading, and sentence repetition

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18
Q

how do you treat respiration for those with ataxic dysarthria

A

speak immediately on exhalation with visi-pitch for visual feedback, stop phonation early, optimal breath group

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19
Q

how do you treat prosody for those with ataxic dysarthria

A

pitch range exercises, intonation profiles, contrastive stress drills, and chunking utterances into syntactic units

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20
Q

what is intonation profiles

A

written sentences and protocol on visi-pitch

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21
Q

how do you treat articulation for those with ataxic dysarthria

A

over articulation of consonants and minimal contrast pairs

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22
Q

is hypokinesis the same as hypotonia?

A

no

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23
Q

hypokinesis

A

less movement, but more muscle tone

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24
Q

the vast majority of cases of hypokinetic dysarthria are due to

A

parkinsonism

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25
parkinsonism
umbrella term for brain conditions that cause slow movements, rigidity and tremors
26
Parkinsonism neurologists's diagnosis is based on
TRAP - tremor, rigidity, akinesia, postural instability
27
parkinson's disease is an idiopathic (unknown cause) form of
parkinsonism
28
parkinson's disease have a high prevalence of
speech deficits 60-80%
29
WHO: wrote an account of his patients in 1817, described a "shaking palsy", not all PD patients have a tremor, tremor dominant or rigid dominate, speech symptoms clearly resembled what is known today as hypokinetic dysarthria
James Parkinson
30
medical treatment for parkinson's disease is usually
treated pharmacologically, deep brain stimulation to send current to thalamus, and surgeries
31
what are the two types of surgeries for medical treatment of parkinson's
thalamotomy and pallidotomy
32
thalamotomy surgery
lesion on thalamus, less input from basal ganglia goes through
33
pallidotomy
lesion in globus pallidus - terrific for tremor and akinesia
34
what is the second most common form of parkinsonism
neuroleptic-induced parkinsonism
35
what are the side effects of antipsychotic drugs in neuroleptic-induced parkinsonism
chlorpromazine and schizophrenia; (tardive diskenesia - weird jerking movements after years of drugs)
36
schizophrenia is often associated with
excess dopamine
37
post encephalic parkinsonism
caused by viral encephalitis and can also affect children
38
traumatic brain injury
cerebral anoxia (if it affects BG), "punch drunk" encephalopathy (pugilism - caused by fighting)
39
CVA when it affects
basal ganglia, substantia nigra, BG control circuit
40
hypokinetic dysarthria prosody
monopitch, reduced stress, mono loudness, inappropriate silences, short rushes of speech, variable speech rate
41
hypokinetic dysarthria articulation
imprecise consonants, repeated phonemes, and palilalia
42
what are the characteristics of imprecise consonants in hypokinetic dysarthria
reduced ROM, distortions, spirantization, articulatory undershoot
43
hypokinetic dysarthria phonation
harsh voice, breathy, reduced vocal loudness
44
hypokinetic dysarthria respiration
faster breathing rates, paradoxical movements (when the agonist and antagonist are co-contracting - tug of war), reduced ROM, may result in shallow breath support, poorly controlled exhalations, short breathing cycles, short rushes, breathy
45
what are the key evaluation tasks in hypokinetic dysarthria
conversational speech, AMRs, and vowel prolongation
46
what are the conversational speech/reading tasks in hypokinetic dysarthria
rate problems and intelligibility
47
what are the AMR tasks in hypokinetic dysarthria
imprecise consonants, variable rate, and "blurring" of syllables
48
what are the vowel prolongations in hypokinetic dysarthria
breathy voice quality
49
treatment of hypokinetic dysarthria for rate reduction
can improve articulation, give articulators more time to reach target positions, give listener more processing time
50
treatment of hypokientic dysarthria for DAF
speech is amplified, delayed, then "fed back" to the speaker's ears, speech prolongs syllable until the delayed signal is perceived, then begins next syllable, and slow, fluent speech with prolonged vowels, connected syllables
51
DAF and normal speakers
delay indicated that speech sound has not completed, repetition or prolongations of syllables, "artificial stuttering" (lee 1951), responses vary with attention paid to delayed signal and helps to explain variability in responding
52
frequency - altered feedback (FAF)
shifts pitch up or down, might increase activity in left auditory cortex, alter pitch change VF tension, increase/decrease VF tension
53
increase VF tension is better for
Parkinson's
54
decrease VF tension is better for
person who stutters
55
what are the ways to asses phonation
pushing/pulling, HGA, instrumental biofeedback, LSVT, and SpeakOut
56
LSVT (think Loud)
the voice issues were caused by Parkinson's by a lack of respiratory effect
57
what are the procedures of LSVT
daily AHs
58
Speak Out (Parkinson's Voice Project)
Samantha Elandary saying with "intent" and "throw the sound over my head"
59
Speak Out is based on
"intent" - Dr. Daniel Boone
60
what are the components of Speak Out
1. warm up: MAY ME MY MOE MOO 2. Sustained "ah" 3. Glides 4. Counting 5. Reading activities 6. Cognitive activities
61
Masking auditory feedback
applies lombard effect, kayPentax facilitator, speechvive
62
hyperkinesis
excessive involuntary movements
63
what are the two neurological basis for those with hyperkinetic dysarthria
damage to basal ganglia and imbalance of dopamine and ACH
64
____ and ____ smooth and coordinate rough motor impulses from the associated cortex then send them to the PMC via the thalamus
basal ganglia and cerebellum
65
what are the three parts of the basal ganglia
caudate nucleus, putamen, globus pallidus
66
what are the subdivisions of the basal ganglia
striatum, lenticular nucleus, and pallidus
67
striatum is made up of
caudate and putamen
68
lenticular nucleus is made up of
putamen and globus pallidus
69
pallidum is made up of
globus pallidus
70
substantial nigra contains
dopaminergic neurons
71
reduced dopamine in stratum leads to
TRAP and hypokinetic dysarthria
72
TRAP
tremor, rigidity, akinesia, postural instability
73
loss of neurons in the striatum leads to
involuntary movements and hyperkinetic dysarthria
74
chorea
rapid, dance-like involuntary movements
75
chorea effects
limbs, trunk, head and neck
76
sydenham's chorea
rare, idiopathic, childhood
77
huntington's diease
progressive degeneration of basal ganglia and cerebral cortex, onset in middle age
78
hemiballism
contralateral to the lesion
79
stroke
rarely causes chorea, basal ganglia or nearby structures, hemiballism
80
hyperkinetic dysarthria prosody
prolonged intervals, variable speech rate, mono-itch, inappropriate silences, monoloudness
81
hyperkinetic dysarthria articulation
imprecise consonants, distorted vowels, prolonged phonemes
82
hyperkinetic dysarthria phonation
harsh voice quality, excess loudness variations, strained-struggled voice, breathy voice, voice stoppages
83
hyperkinetic dysarthria respiration
unexpected inhalations and exhalations
84
hyperkinetic dysarthria resonance
intermittent hyper nasality in some patients
85
essential (organic) tremor
idiopathic, faster than tremor in parkinson's, action/intention tremor, no other neurological signs, essential voice tremor
86
essential voice tremor
contractions of laryngeal muscles
87
dystonic
disorder of muscle tone, slow, sustained, "waxing and waning", can by constant or fixed
88
spasmodic dysphonia
many features of a focal dystonia, involuntary VF movements during phonation, contractions are vigorous and active
89
AD spasmodic dysphonia
most common type -strained-strangled
90
AB spasmodic dysphonia
breathy and aphonia
91
key evaluation tasks for hyperkinetic dysarthria
vowel prolongation, AMRs, conversational speech/reading, observation of involuntary movements
92
medical treatment for hyperkinetic dysarthria
usually pharmacological to suppress involuntary movements and botox
93
botox interferes with
ACH transmission
94
treatments for hyperkinetic dysarthria
voice therapy for SD, sensory tricks, and bite blocks
95
treatments for spasmodic dystonia
counseling, /h/ onset (AD type) and continuous voicing (AB type)

Motor Speech Disorders (2 decks)

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