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Motor Speech > quiz 4 > Flashcards

quiz 4 Flashcards

1
Q

spastic dysarthria effects which subsystems

A

any or all

not confined to a single component

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2
Q

SD is predominantly a problem of

A
  • neuromuscular execution

- not planning programming or control

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3
Q

clinical features of SD

A

excessive muscle tone and weakness (resistance to movement)

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4
Q

direct activiation pathways also known as

A

pyramidal and extra pyramidal

-form part of the UMN system

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5
Q

direct pathways consist of

A

corticobulbar and corticospinal tracts

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6
Q

direct pathways are

A
  • bilateral

- facilitatory (impulses sent through them tend to lead to movement which are SKILLED AND DISCRETE MOVEMENTS)

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7
Q

etiologies of SD

A
  • degenerative (ALS, motor neuron disease)
  • vascular (stroke, anoxic encephalopathy)
  • congenital (CP)
  • demylinating (MS)
  • undetermined
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8
Q

Spasticity and weakness affect

A

-speed
-range
-force
of movement

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9
Q

ataxic dyarthria predominantly reflects..

A

problems with motor CONTROL

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10
Q

ataxic dysarthria can affect which subsystems

A

and or all

-MOST EVIDENT IN ARTIC AND PROSODY

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11
Q

etiologies of ataxic dysarthria

A

AND process that damages the cerebellum or cerebellar control circuit
-degenerative, demyelinating, vascular, tumor, traumatic, toxic/metabolic/endocrine, undertermined, multiple, other

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12
Q

clinical features of ataxic dysarthria

A
  • incoordination and reduced muscle tone appear responsible for slowness of movement and inaccuracy in force, range, timing, and direction of speech movements
  • people often complain of slurred, drunken speech
  • complaints of dysphagia and drooling are infrequent
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13
Q

most distinctive cues of ataxic dysarthria

A
  • irregular articulatory breakdowns
  • irregular speech AMRs (alternating motion rates)
  • excessive and equal stress
  • distorted vowels
  • excess loudness variation
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14
Q

hypokinetic dysarthria manifests in which subsystems

A

any or all

MOST EVIDENT IN VOICE, ARTIC, AND PROSODY

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15
Q

hypoK dysarthria reflects effects of…

A
  • rigidity
  • reduced force and range of movement
  • slow individual and sometimes repetitive movements of speech
  • DECREASED RANGE OF MOVEMENT
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16
Q

hypoK dysarthria results from..

A

damage to the basal ganglia control circuit pathway

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17
Q

hypoK dysarthria etiologies

A

-degenerative, vascular, traumatic, infectious, inflammatory, neoplastic, toxic and metabolic diseases

MOST COMMON CAUSE IS PD

(go back and read more about hypoK)

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18
Q

hyperkinetic dysarthria manifests in which subsystems

A

-any or all

MOST EVIDENT IN PROSODY AND RATE

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19
Q

Hyperkinetic dysarthria results from

A
  • damage to basal ganglia control circuit
  • destruction of sub thalamic nucleus causes reduced inhibitory output from BG which results in increased thalamic and subsequent cortical firing
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20
Q

hyperkinesia

A

abnormal or excessive involuntary movements

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21
Q

hyperkinetic dysarthria deviant speech characteristics

A

-abnormal rhythmic or irregular and unpredictable, relic or slow involuntary movements

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22
Q

hyper

A

EXTRA

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23
Q

dyskinesias

A

abnormal involuntary movements regardless of etiology

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24
Q

orofacial dyskinesias

A

involuntary orofacial movements that can occur without hyperkinesias elsewhere in the body

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25
Q

myoclonus

A

involuntary single or repetitive brief lightening-like jerks of a body part
QUICK AND REPETITIVE
-cannot be inhibited willfully
-can be induced by various stimuli or spontaneously
-associated with epilepsy

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26
Q

action myoclonus (AM)

A

-induced by volitional muscle activity and is less generalized than other forms

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27
Q

palatopharyngolaryngeal myoclonus (PM)

A

-abrupt, rhythmic, or semi rhythmic uni or bilateral movements of the sort palate, pharyngeal walls and laryngeal muscles

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28
Q

chorea

A

full limb jerking movements

  • non repetitive
  • involuntary
  • can be response to drugs or during pregnancy
  • degenerative (huntington’s chorea)
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29
Q

dystonia

A

-involuntary abnormal postures resulting from excessive cocontraction of agonist and antagonist muscles

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30
Q

dystonia results from

A

-abnormailities in the basal ganglia, cerebellum, and dopaminergic system

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31
Q

dystonia reflects impaired inhibition resulting from…

A

-abnormalities of somatosensory processing and integration

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32
Q

cervical dystonia (spasmodic torticollis)

A
  • segmental dystonia characterized by tonic or clones spasms of the neck muscles especially in sternocleidomastoid and trapezius
  • BG disorder
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33
Q

tonic spasm

A

prolonged or continuous

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34
Q

clonic spasms

A

repetitive, rapid in onset and brief in duration

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35
Q

most common involuntary movement

A

tremor

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36
Q

tremor involves..

A

-rhythmic/periodic movements of a body part

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37
Q

resting tremor

A

occurs when the body part is in repose (rest)

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38
Q

postural tremor

A

occurs when the body part is maintained against gravity

39
Q

action tremor

A

during movement

40
Q

terminal tremor

A

as the body part nears the target

41
Q

essential tremor

A

occurs with sustained posture and action and commonly affects the upper limbs, head or voice

  • reduced by alcohol
  • linked to cerebellar dysfunction
42
Q

cerebellar tremor

A

occurs during sustained postures and action and terminally

43
Q

essential voice tremor

A

onset is gradual and worsens with fatigue and psychological stress and improve with alcohol intake
-can be isolated or cooccur with head or extremity tremor

44
Q

most common abnormal movements

A

chorea, dystonia, athetosis. spasmodic tortocollis, myoclonus, tics and tremor

45
Q

unilateral upper motor neuron (UUMN) mainifests in which subsystems

A

-articulation phonation and prosody

any or all

46
Q

deviant characteristics of UUMN

A

weakness, sometimes spasticity and incoordination

47
Q

UUMN label

A

is ANATOMIC rather than PATHOPHYSIOLOGIC

48
Q

UMN direct pathway impulses are crutial for

A

-impulses traveling the direct pathway appear crutial for finely coordinated skilled movements

49
Q

UMN indirect pathway impulses are crutial for

A

-regulating reflexes and controlling posture and tone upon which skilled movements are superimprosed

50
Q

most common cause of UUMN

A

STROKE

51
Q

lacunes or lacunar infarcts

A

occur in brainstem, cortical, or subcortical areas the cerebral hemispheres

  • result of occlusion of small penetrating branches of large cerebral arteries
  • primarily motor or sensorimotor
52
Q

most common sites of lacunes

A

BG, thalamus, internal capsule, brainstem

53
Q

flaccid dysarthria results from damage to..

A

one or more cranial or spinal nerves
-reflect problems in the nuclei, axons, or neuromuscular junctions that make up the motor unit of the final common pathway

54
Q

flaccid manifests in which speech subsystems

A

respiratory
artic
phonatory
resonatory

55
Q

primary deviant speech characteristics flaccid

A

muscle weakness and reduced muscle tone

effect speed range and accuracy of speech movements

56
Q

how are subtypes of flaccid recognized

A

-distinct abnormalities attributable to unilateral or bilateral damage to a specific cranial or spinal nerve or a combo

57
Q

all flaccid dysarthrias are considered to be a problem of..

A

neuromuscular execution NOT planning programming or control

58
Q

flaccid-paralysis affects…

A

reflexive, automatic, and voluntary movements

  • weakness hypotonia, diminished reflexes
  • atrophy, fasiculations
59
Q

flaccid-weakness affects

A

muscles ability to contract is reduced or lost because motor units are inactivated
-results in paralysis or paresis

60
Q

flaccid-hypotonia or reduced reflexes

A
  • floppiness of muscle tissue and reduced resistance to passive movement
  • reduced or absent normal reflexes

-reduced because components of the stretch reflex is activated by the final common pathway

61
Q

flaccid-atrophy

A

muscles loose bulk

-always associated with weakness

62
Q

fasiculations

A

visible, arrhythmic isolated twiches in resting muscle that result from spontaneous motor unit discharges in response to nerve degeneration or irritation

63
Q

fibrillations

A

invisible spontaneous independent contractions of individual muscle fibers that reflect slow repetitive action potentials

can be detected on EMG within about 1-3 wks after a muscle is deprived of motor nerve supply

64
Q

flaccid-progressive weakness with use

A

myasthenia gravis

-rapid weakening and recovery with rest are prominent in neuromuscular junctions disease

65
Q

neuropathy

A

disease of nerve usually of nonimflmmatory etiology

66
Q

neuritis

A

an imflammatory disorder of nerve

67
Q

peripheral neuropathy

A

any disorder of nerve in the peripheral nervous system

can affect motor sensory or autonomic fibers

can be demyelinating, axonal or mixed in their effects

68
Q

pure motor hemiparesis

A

purely motor stroke involving the face, arm, and leg on one side

69
Q

clinical features present with UUMN dys

A

lower facial weakness and hemiparesis

contralateral lingual weakness

drooling and dysphagia

recovery is GOOD

70
Q

most common deviant speech characteristics UUMN

A

imprecise arctic, slow rate, slow and irregular AMRs, harsh-strained or harsh -breathy vocal quality, reduced loudness

71
Q

most common mixed dys

A

FLACCID-SPASTIC

72
Q

mixed dys is more common than any other single dys?

A

YES

73
Q

Spinal muscle atrophies

A

affect LMNs only

flaccid

74
Q

progressive bulbar palsy

A

associated with flaccid

lmn weakness of cranial nerve mms

75
Q

PLS

A

affects UMNs only
bulbar mms affected
without LMN involvement is spastic only

76
Q

ALS

A

most common motor neuron disease
UMN and LMN signs
common associated with mixed spastic-flaccid dys

-dysphasia and airways problems pose major threat to life

77
Q

FA

A

inherited degenerative disease
spinocerebellar
mixed ataxic-spastic dys

78
Q

Progressive suprenuclear palsy

A

neurodegenerative disease multi system

mixed dysarthria occurs in form of various combos of hyperkinetic, spastic, and ataxic

79
Q

multi system atrophy

A

sporadic neurodegenerative condition with combos of PD, ataxia, spasticity, and autonomic dysfunction

MSA-P: (PD) hypo kinetic type most often but when seen in combo is seen with spastic or ataxic

MSA-D: (cerebellar) ataxic type most often but when mixed seen with hypo kinetic and spastic

80
Q

MS

A

when present, dysarthria may reflect nearly and single type or combo of single types

spastic-ataxic is most common

81
Q

vascular disorders

A

combos of spastic, ataxic, and flaccid are common in brainstem strokes

-hyperkinetic resulting from PM myoclonus can occur

82
Q

corticobasal degeneration

A

spastic and hypo kinetic types most common

hyperkinetic and ataxic types can occur

83
Q

toxic-metabolic conditions

A

commonly a mixed dysarthria

84
Q

wilson’s disease

A

hypokinetic, ataxic, spastic cardinal features

85
Q

hypoxic encephalopathy

A

presence of at least hypo kinetic and hyperkinetic and ataxic forms

86
Q

mutism

A

absence of speech

87
Q

causes of mutism

A

maybe organic but non neurologic

  • profound congenital hearing loss
  • peripheral structural loss
  • deliberate
  • psychiatric disturbances
88
Q

neurogenic mutism can result from

A

severe dysarthria, AOS, aphasia, nonaphasic congitive affective conditions
-post seizures, surgical resection of corpus callosum

89
Q

anarthria

A

specchlessness due to severe lossof neuromuscular control of speech
-dysarthria in most severe form

90
Q

locked in syndrome

A

when anarthria is accompanied by quadriplegia and total body immobility except for vertical eye movements and blinking

91
Q

coma

A

state of unarousable unresponsiveness and absence of sleep/wake on EEG

92
Q

speech arrest

A

most commonly associated with parietal seizures speech is halted

93
Q

palalalia

A

compulsive repetition of words and phrases, often in context of increasing rate and decreasing loudness

normal voice…then repeated in whisper

associated with hypo kinetic dys

94
Q

echolalia

A

motorically normal unsolicited repetition of another’s utterances

limited processing of meaning

Motor Speech (4 decks)

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