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Cognitive & Motor > MSD - Quiz 2 > Flashcards

MSD - Quiz 2 Flashcards

1
Q

What is a motor speech disorder?

A

Defined as speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech.

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2
Q

What is dysarthria?

A

Neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production.

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3
Q

What is apraxia of speech?

A

Neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech

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4
Q

What part of the brain is hypokinetic dysarthria associated with?

A

basal ganglia control circuit

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5
Q

The characterisitics of hypokinectic dysarthria are most evident in:

A

voice, articulation, prosody

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6
Q

Hypokinetic dysarthria physiologic characteristics include:

A

rigidity, reduced force and range of movement, and slow individual but sometimes fast repetitive movements on speech

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7
Q

What are the basal ganglia activities strongly association with?

A

The actions of the indirect activation pathway or extrapyramidal system

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8
Q

What complex interconnections make up the basal ganglia control circuit?

  1. cortical, _______, and substantia nigra input to the striatum, with crucial cortical input incoming from the _____ lobe premotor cortex.
  2. _____ input to the substantia nigra and globus pallidus
  3. globus pallidus to the _____, subthalamic nucleus, red nucleus, and ____ formation in the brainstem.
A
  1. thalamic, frontal
  2. striatum
  3. thalamus, reticular
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9
Q

What are the functions of the basal ganglia circuit?

A

regulate muscle tone,
control postural adjustments during skills movements,
regulate movements that support goal-directed activities,
scale the force, amplitude, and duration of movements,
adjust movements to the environment,
assist in the learning, preparation and initiation of movements

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10
Q

What part of the brain is UUMN dysarthria associated with?

A

Upper motor neuron pathways

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11
Q

UUMN dysarthria reflects effects in:

A

Weakness, but sometimes spasticity and incoordination

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12
Q

UUMN dysarthria can be caused by a: tumor, _____, unilateral stroke (most common), and small _____ also called lacunes or lacunar

A

Trauma; infarcts

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13
Q

What are frequent patient complaints of UUMN dysarthria?

A
  • Drooling
  • Heaviness on affected side of the face or corner of mouth
  • Heaviness /thickness in the tongue
  • Chewing & swallowing difficulties are not uncommon
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14
Q

Patient complaints in severe cases:

A

slurred/thick/slow speech with deteriorates due to fatigue or psychological stress

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15
Q

What does a UUMN oral mech look like?

A
  • Unilateral weakness: at rest and during movement
  • Palatal weakness: velopharyngeal function assumed to be normal
  • Dysphagia: discomfort/difficulty swallowing
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16
Q

Speech characteristics for UUMN dysarthria include:

A
  • Articulatory inaccuracy: imprecise consonants, irregular artic. breakdowns, irregular/imprecise AMRs
  • Mild hypernasality
  • Mild rate and prosodic abnormalities
  • Mild to moderate phonation/reduced loudness
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17
Q

UUMN dysarthria results in ____ respiratory drive.

A

-reduced/weakened

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18
Q

T/F: Laryngeal function in UUMN dysarthria can either increase or decrease.

A

True

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19
Q

T/F: Patients with UUMN dysarthria experience increased nasal airflow.

A

True

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20
Q

Patients with UUMN dysarthria experience reduced: Speech rate, _____ rates, jaw movement, and strength/endurance/speech of tongue and _____ movement

A

AMR; lip

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21
Q

What part of the brain is Ataxic dysarthria associated with?

A

Damage to the cerebellar control circuit

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22
Q

Ataxic dysarthria reflects effects in:

A

Motor control (not neuromuscular execution)

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23
Q

T/F: Ataxic dysarthria can be a problem of poor timing, control, and/or coordination.

A

True

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24
Q

What are the main structures/pathways/functions in the cerebellar control circuit?

A
  • The vermis: forms the midportion of the anterior and posterior cerebellar lobes
  • Purkinje cells: inhibitory; output neurons of the cerebellar nuclei
  • The motor system: reciprocal connections, auditory and proprioceptive feedback from muscles/tendons/joints,
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25
Q

Ataxic dysarthria can be caused by a:

A
  • Degenerative diseases (ALS, PSP, frontotemporal dementia, etc.)
  • Vascular (stroke)
  • Trauma: postoperative (tumor or deep brain stimulation) or TBI
  • Tumor
  • Toxic/Metabolic/Endocrine (drug toxicity or alcohol-related)
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26
Q

What are typical complaints from patients with Ataxic dysarthria?

A
  • Slurred/drunken speech
  • Dramatic deterioration in speech (with limited alcohol intake)
  • Inability to coordinate their breathing and speaking
  • May bite their cheek or tongue while talking/eating
  • Stumble over words (mild dysarthria)
  • Fatigued speech
27
Q

An Ataxic oral mech show:

  1. structures and movements are ____ at rest, sustained posture, and during emotional expression.
  2. ____ nonspeech AMRs.
A

normal; irregular

28
Q

What are the 3 different types of clusters in Ataxic dysarthria?

A
  • Articulatory inaccuracy: imprecise consonants, vowel distortions, irregular arctic. breakdown
  • Prosodic excess: excess and equal dress, prolonged phonemes, prolonged intervals, slow rate
  • Phonatory-prosodic insufficiency: harshness, monopitch, and monoloudness
29
Q

What is the most common cause of hypokinetic dysarthria?

A

Parkinsonism

30
Q

What are the 5 common nonspeech clinical signs of parkinsonism?

A 
resting tremor
rigidity
bradykinesia/hypokinesia
akinesia
postural abnormalities
31
Q

The underactivity of ______ is reflected in a masked or expressionless and unblinking facial expression

A

hypokinesia

32
Q

What diseases can cause hypokinetic dysarthria?

A 
degenerative 
vascular
traumatic
infectious
inflammatory
neoplastic
toxic-metabolic
33
Q

T/F: Hypokinetic dysarthria is THE dysarthria of PD.

A

True

34
Q

What is the most common neurologic movement disorder?

A

Parkinson’s disease; affects about 2-3% of the population over the age of 65

35
Q

Medications used to treat PD often have what side effects?

A

dystonia and dyskinesias, and on-off effects

36
Q

What kind of vascular conditions can be associated with parkinsonis and features of hypokinetic dysarthria?

A

diffuse frontal lobe white matter lesions
basal ganglia vascular lesions
midbrain and bilateral thalamic strokes
cerebral hypoxia

(not common)

37
Q

Parkinsonism develops in 10-20% of people treated with medications known as _____ ______

A

dopamine antagonists (antipsychotic and antiemetic)

38
Q

_____ is a rhythmic tremor of the body/head that can occur in a cerebellar disease.

A

Titubation

39
Q

Hypotonia in a patient with a cerebellar disease can be described as:

A

Abnormally low level of muscle tone in ones extremities

40
Q

What is dysmetria?

A

A disturbance in the trajectory of a moving body part or an inability to control movement range.

41
Q

What is dysdiadochokinesis?

A

A manifestation of decomposition of movement due to errors in timing and speed causing poor coordination

42
Q

What are the 4 characteristics of a cerebellar lesion and Ataxia?
_____, hypotonia, _____, and dysdiadochokinesis.

A

Titubation; dysmetria

*dysmetria and dysdiadochokinesis are the cause of Ataxia specifically

43
Q

T/F: In UUMN dysarthria, lesions appear more often on the RIGHT.

A

False; lesions are usually on the left

44
Q

T/F: UUMN lesions are supratentorial.

A

True

45
Q

Individuals with UUMN dysarthria experience _____ or_____-_____ severity levels.

A

mild or mild-moderate

46
Q

What are the (3) primary speech characteristics of UUMN dysarthria?

A
  • Articulation
  • Phonation
  • Prosody
47
Q

Which dysarthria reflect problems in the final common pathway? Where is it localizaed?

A

Flaccid dysarthria; lower motor neuron

48
Q

T/F: Flaccid dysarthria affects reflexive, automatic and voluntary movements.

A

True

49
Q

Hypernasality, imprecise consonants, breathiness, monopitch, nasal emission, audible inspiration, harsh (or hoarsee) voice quality, short phrases, and monoloudness describe what type of dysarthria?

A

Flaccid dysarthria

50
Q

T/F: The clinical characteristics for spastic dysarthria include weakness, hypotonia & reduced reflexes, atrophy, fasciculations & fibrillations, and progressive weakness with use.

A

False; flaccid dysarthria

51
Q

Etiologies for flaccid dysarthria can be uncertain. Which etiologies are common known causes?

A

Degenerative disease and surgical trauma

52
Q

Bilateral upper motor neuron (within the direct and indirect activation pathways) describes the localization for which dysarthria?

A

Spastic

53
Q

The direct activation pathway involves __ tracts or __ __ system

A

pyramidal; direct motor

54
Q

The indirect activation pathway involves __ tracts

A

extrapyramidal

55
Q

There are two tracts the direct and indirect activation pathways include. What are they?

A

Corticobulbar tracts and corticospinal tracts

56
Q

___ tracts influence cranial nerves

A

Corticobulbar

57
Q

__ tracts influence spinal nerves

A

Corticospinal

58
Q

T/F: Damage to two pathways is uncommon.

A

False; one.

59
Q

Loss of fine, skilled movement; hypotonia; weakness; absent abdominal reflexes; positive Babinski sign, hyporeflexia describes damage to which pathway?

A

DAP (pyramidal tract)

60
Q

Increased muscle tone, spasticity, clonus, decorticate or decrebrate posture, hyperactive stretch reflexes, and hyperactive gag reflexes describes damage to which pathway?

A

IAP (extrapyramidal tracts)

61
Q

T/F: The clinical signs of flaccid dysarthria include weakness, loss of skilled movement, spasticity, hyperactive reflexes and pathologic reflexes.

A

False; spastic

62
Q

T/F: The salient effects of upper motor neuron lesions on speech movements (for spastic dysarthria) include spasticity, weakness, reduced range of movement, and slowness of movement

A

True

63
Q

Where are the substantia nigra and subthalamic nuclei located?

A

midbrain

Cognitive & Motor (4 decks)

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