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spastic dysarthria Flashcards

1
Q

spastic dysarthria is what type of lesion

A

bilateral upper motor lesion

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2
Q

3 main characteristics of spastic dysarthria

A
  • imprecise articulation
  • monotonous pitch and loudness
  • poor prosody
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3
Q

how are the muscles in spastic dysarthria

A

stiff and move sluggishly through a limited range

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4
Q

in spastic, speech is ? and words may be ?

A

speech is labored and words may be prolonged

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5
Q

spastic also includes

A
  • spastic paralysis or paresis of the involved muscles (stiffness in the muscles)
  • hyperreflexia (hyperactive jaw reflex)
  • little or no muscle atrophy (vs flaccid has atrophy)
  • presence of pathological reflexes (sucking reflex)
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6
Q

prevalence of spastic

A

7.3% of MSD cases at mayo

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7
Q

descending motor tracts are divided into

A

pyramidal and extrapyramidal system

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8
Q

pyramidal system carries impulses that control

A

voluntary, fine motor movements

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9
Q

pyramidal system works at a _ level

A

conscious level

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10
Q

pyramidal is a direct or indirect activation system

A

direct

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11
Q

two components of the pyramidal system

A

corticospinal and corticobulbar tracts

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12
Q

origin of the pyramidal system

A

cortex

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13
Q

ending of the pyramidal system

A

brainstem or spinal cord

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14
Q

the extrapyramidal system carries impulses that control

A

postural support needed by fine motor movements

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15
Q

extrapyramidal system works at a __ level

A

unconscious (automatic)

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16
Q

extrapyramidal system is direct or indirect activation system

A

indirect

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17
Q

tracts of the extrapyramidal system

A
  • rubospinal tract
  • reticulospinal tract
  • vestibulospinal tract
  • testospinal tract
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18
Q

origin of the extrapyramidal system

A

brainstem, ending with synapsing with peripheral nerves

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19
Q

damage to the pyramidal system can result in

A
  • weak/slow skilled movements
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20
Q

damage to the extrapyramidal system results in

A
  • weakness
  • increased muscle tone (spasticity)
  • abnormal reflexes
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21
Q

causes of spastic dys

A
  • stroke
  • degenerative diseases
  • traumatic head injury
  • infections of brain tissue
  • tumors
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22
Q

a stroke will result in spastic dysarthria only when

A
  • two or more cerebral strokes
  • one brainstem stroke
23
Q

Amyotrophic lateral sclerosis (ALS)

A
  • a degenerative (progressive) neurologic disease of unknown cause
  • causes spastic when UMN involvement is predominant
24
Q

Traumatic head injury

A
  • stretched and torn axons, lacerated brain tissue, and blood vessel hemorrhage in numerous parts of the brain
  • can produce widespread injury to the brain causing bilateral damage to pyramidal and extrapyramidal systems
  • can result in mixed dysarthria given extensive damage that occurs in this type of trauma
25
multiple sclerosis
- a suspected immunologic disorder resulting in inflammation or complete destruction of the myelin sheath covering axons (cerebral hemispheres, cerebellum, brainstem, and spinal cord) - with bilateral involvement to UMN, it can result in spastic dysarthria
26
other causes of spastic
- brainstem tumor - cerebral anoxia - viral infection in cerebral tissue - bacterial infection in cerebral tissue
27
speech errors in spastic
- spasticity - slowness - weaknesses in vocal tract muscles
28
articulation in spastic
very common in spastic - imprecise consonant production - vowel distortions
29
imprecise consonant production is a result of
abnormally short voice onset time for voiceless consonants, incomplete articulatory contact, incomplete consent clusters
30
phonation in spastic
- harsh vocal quality (most prominent) - strained-strangled vocal quality - low pitch
31
which laryngeal muscles helps with pitch change
cricothyroid
32
resonance in spastic
- hypernasality
33
they hypernasality in spastic is caused by what
spasticity in velar muscles, which slows and reduces the range of soft palate movement and results in con complete velopharyngeal closure during non nasal speech sounds
34
prosody in spastic
- monopitch - monoloudness - short phrases - short rate of speech
35
why is there mono pitch in spastic
caused by the overall tenseness or laryngeal muscles, resulting in reduced ability to contract/relax to vary pitch
36
why is there mono loudness in spastic
caused by overall increased muscle tone in laryngeal muscles
37
why is there short phrases in spastic
natural consequence of speaking through abnormally tight larynx, making it difficult to use long utterances
38
what is the slow rate of speech caused by
reduced speed and range of movement
39
respiration in spastic
doesn't play a great role in spastic (compared to flaccid)
40
what problems are more likely to be a result of hypperadduction of the vocal folds
phonation and prosody
41
additional characteristics of spastic
- pseudo bulbar affect - drooling
42
how could you treat drooling
cueing the pt to consciously swallow and pharmaceutical treatments that reduce saliva production
43
key evaluation tasks for spastic
- conversational speech and reading - alternate motion rate - vowel prolongation
44
treatment of phonation in spastic
- head and neck relaxation - easy onset of phonation - yawn-sigh exercises
45
treatment of articulation
- tongue-stretching - lip-stretching - traditional articulation exercises
46
what are traditional articulation treatments
- intelligibility drills - phonetic placement - exaggerating consonants - minimal contrast drills
47
treatment of prosody
- pitch range exercises - intonation profiles - contrastive stress drills - chunking utterances into syntactic units
48
what is the overall reason for treating prosody?
to increase intelligibility
49
treatment of resonance in spastic
- hypernasality - surgical and prosthetic treatments - behavioral-based treatments
50
what is the hypernasality caused by
slowness and reduced range of movement (result of increased muscle tone in the velum)
51
what are surgical and prosthetic treatments for spastic
- pharyngeal flap procedure - teflon injections - palatal lift
52
behavioral-based treatments
- visual feedback - reduced rate of speech - increase loudness
53
summary
- caused by any process resulting in bilateral damage to pyramidal and extrapyramidal systems - results in muscle weakness and slowness of articulators during speech (bilateral pyramidal damage) and increase muscle tone (spasticity) in articulators (bilateral damage to extrapyramidal system)

Motor Speech (2 decks)

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