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Motor Speech > spastic dysarthria > Flashcards

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
Q

multiple sclerosis

A
  • 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
Q

other causes of spastic

A
  • brainstem tumor
  • cerebral anoxia
  • viral infection in cerebral tissue
  • bacterial infection in cerebral tissue
27
Q

speech errors in spastic

A
  • spasticity
  • slowness
  • weaknesses in vocal tract muscles
28
Q

articulation in spastic

A

very common in spastic
- imprecise consonant production
- vowel distortions

29
Q

imprecise consonant production is a result of

A

abnormally short voice onset time for voiceless consonants, incomplete articulatory contact, incomplete consent clusters

30
Q

phonation in spastic

A
  • harsh vocal quality (most prominent)
  • strained-strangled vocal quality
  • low pitch
31
Q

which laryngeal muscles helps with pitch change

A

cricothyroid

32
Q

resonance in spastic

A
  • hypernasality
33
Q

they hypernasality in spastic is caused by what

A

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
Q

prosody in spastic

A
  • monopitch
  • monoloudness
  • short phrases
  • short rate of speech
35
Q

why is there mono pitch in spastic

A

caused by the overall tenseness or laryngeal muscles, resulting in reduced ability to contract/relax to vary pitch

36
Q

why is there mono loudness in spastic

A

caused by overall increased muscle tone in laryngeal muscles

37
Q

why is there short phrases in spastic

A

natural consequence of speaking through abnormally tight larynx, making it difficult to use long utterances

38
Q

what is the slow rate of speech caused by

A

reduced speed and range of movement

39
Q

respiration in spastic

A

doesn’t play a great role in spastic (compared to flaccid)

40
Q

what problems are more likely to be a result of hypperadduction of the vocal folds

A

phonation and prosody

41
Q

additional characteristics of spastic

A
  • pseudo bulbar affect
  • drooling
42
Q

how could you treat drooling

A

cueing the pt to consciously swallow and pharmaceutical treatments that reduce saliva production

43
Q

key evaluation tasks for spastic

A
  • conversational speech and reading
  • alternate motion rate
  • vowel prolongation
44
Q

treatment of phonation in spastic

A
  • head and neck relaxation
  • easy onset of phonation
  • yawn-sigh exercises
45
Q

treatment of articulation

A
  • tongue-stretching
  • lip-stretching
  • traditional articulation exercises
46
Q

what are traditional articulation treatments

A
  • intelligibility drills
  • phonetic placement
  • exaggerating consonants
  • minimal contrast drills
47
Q

treatment of prosody

A
  • pitch range exercises
  • intonation profiles
  • contrastive stress drills
  • chunking utterances into syntactic units
48
Q

what is the overall reason for treating prosody?

A

to increase intelligibility

49
Q

treatment of resonance in spastic

A
  • hypernasality
  • surgical and prosthetic treatments
  • behavioral-based treatments
50
Q

what is the hypernasality caused by

A

slowness and reduced range of movement (result of increased muscle tone in the velum)

51
Q

what are surgical and prosthetic treatments for spastic

A
  • pharyngeal flap procedure
  • teflon injections
  • palatal lift
52
Q

behavioral-based treatments

A
  • visual feedback
  • reduced rate of speech
  • increase loudness
53
Q

summary

A
  • 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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