test 2 uumn Flashcards
T/F In most cases, you can have dysarthria with unilateral UMN damage
False: In SOME cases you can have dysarthria from uumn damage:
*MOST cases will be from BILATERAL UMN damage
T/F: UUMN is heavily studied
Falso: Very little studied
T/F: UUMN is one of the most rare dysarthrias
Falso: Is may be the most commonly occurring dysarthria
When uumn dysarthria occurs in the left hemisphere, _____ and ____ often co-occurs
Apraxia and aphasia
What generally happens when dysarthria occurs in the right hemisphere?
cognitive and other speech deficits may occur, this will overwhelm and mask the dysarthric symptoms.
T/F: UUMN dysarthria tends to be chronic
Falso: the symptoms tend to be transient
What is a common etiology of UUMN?
stroke
Other than determining a course of treatment, what is another important reason to identify UUMN?
It may be the most apparent symptom of neurological problems, so it helps with diagnosis– the neurological scans dont always catch everything
T/F: UUMN dysarthrias are consistantly the same throughout patients
Falso: there is considerable variability among cases of UUMN
UUMN dsyarthrias tend to be:
a) mild
b) severe
c) moderate
d) There is too much variability to determine
a) mild
UUMN Dsy primarily effects:
a) prosody
b) coordination
c) respiration and prosody
d) articulation
d) articulation
Speech probs with UUMN are due mainly to weakness of the _______ and ________
face and tongue
T/F: You can see inccordination with with UUMN dysarthria
True
T/F: the extrapyramidal tract deccusates at the pyramids
False: the extrapyramdial tract does not cross through the pryamids
Be able to decribe the pathways of the UMN system
:) last test
How many tracts does the direct UMN pathway have?
2; cortico bulbar/ cortico spinal
The indirect pathway has ____same/diferent_____ origins as the direct pathway of the UMN
same
List the extra stops that the xtra pyramidal pathway takes:
basal ganglia, cerebellum, red nucleolus, reticular formation
which bulbar speech muscles have unilateral innervation?
lower face and part of the tongue
what does the term “central facial weakness refer to? which part of the face does it involve?
weakness caused by central nervous system damage. Lower part of the face
T/F: you usually only see either direct or indirect pathway lesions
False: you usually see a combination of direct and indirect lesions
You typically see _______ and _______ in the limbs/organs effected
weakness and spasticity
T/F: In UUMN lesion, Spacity and hyperfelexity are always present
False: Initially, weakness, hypotonia and hyporeflexia are seen, and spacity comes in time
Define decerebrate posturing
stiff, rigid posture (when primarily cerebrum is removed)
T/F: Degenerative, inflammatory, toxic-metabolic diseases can easily cause UUMN disorders
False: Only things that cause Unilateral damage.
What can cause UUMN damage?
Some trauma, tumors, strokes
Distinctive characteristics of UUMN dysarthia:
No single clear distinguishing features; Look for a cluster or group of characteristics - unilat central face/tounge weakness - Mild to moderate artic problems - mild irregular artic breakdowns - slow rate - strained/hoarse voice quality - reduced loudness
What does the Pt. complain of with UUMN?
- usually aware of the problem
- c/o thick tongue or thick, slurred speech
- speech deteriorates with fatigue (not of sharply as with MG)
- words dont come out right-difficulty with pronunciation
- drooling or mild dysphagia
- occasionally have inappropriate laughing or crying
What are some nonspeech clinical findings?
- hemiplegia or hemiparesis
- May of sensory deficits
List the speech findings for UUMN
- Imprecise consonants *most common
- Slow rate
- Irregular AMRs (usually mild)
- Slow AMRS
- Hoarse/harshness
- hypernasality rare
- seems similar to spastic dysarthria
- reduced loudness
- intelligibility is mildly affected
- therapy not usually needed
Why is it strange that irregular AMRs are seen in UUMN? What is the reason for this?
It is usually associated with cerebellar issues. could be due to damage to crerbellocortical fibers that intermingle with UMN fibers
what are the oral mech findings for UUMN
Unilat. lower facial weakness (central weakness) in rest and movement *this is great for dysarthria in stroke patients
Unilat. tongue weakness
Dysphagia may occur
Unilat palatal weakness
Jaw usually normal -weakness is possible
- Unilat. tongue weakness best indicator– test this by diviation during tongue protrusion
When dysarthria is the only sign of a stroke, what is the most common cause of UUMN?
Lacunar infarcts
T/F: Lacunar infarcts commonly lead to aphasia
False
Describe the severity of UUMN
- Most UUMN dysarthria is reported to be mild or mild to moderate.
- However, there are some cases reported for moderate to severe UUMN dysarthria.
- UUMN dysarthria is usually transient.
- However,UUMN dysarthria can persist in some cases.
strokes in what parts of the brain lead to UUMN?
Left carotid art or left MCA *middle cerebral artery
Right Carotid art or right MCA
Unilat strokes in the posterior cerebral basilar and anterior cerebral arteries
Which stroke would lead to aphasia and apraxia and UUMN?
Left carotid art or left MCA
which stroke would lead to neglect and cognitive issues?
right carotid art or right MCA
Duffy’s % of leison locations
95% - supratentorial
61% - left hemisphere
34% - right hemisphere
T/F: Lacunar infarcts can occur in the basal gangila.
True- causes senorimotor deficits + dysarthria
What is a possible reason that maority of Duffy’s clients had left cerebrum leisons? – what does this mean?
the aphasia and speech deficits that would acompany them would be more obvious, yet there in enough data that left and right hemesphere stroke can cause UUMN dsarthrisa
