Types of Dysarthria

Question 1

Flaccid Dysarthria results from a lesion to the

Answer 1

Lower motor neuron

Question 2

T or F. Flaccid dysarthria is only associated with progressive processes.

Answer 2

F. Flaccid dysarthria is associated with progressive AND nonprogressive processes

Question 3

weakness, loss of tone in the effected muscle, and impairment of individual muscles rather than the movement best describes

Answer 3

flaccid dysarthria

Question 4

List Clinical Characteristics of Flaccid Dysarthria

Answer 4

weakness of oral musculature, hypotonia, atrophy, fasiculations, progressive weakness with use

Question 5

myasthenia gravis is what type of dysarthria?

Answer 5

flaccid dysarthria

Question 6

Etiologies associated with flaccid dysarthria include

Answer 6

any process that damages the motor unit: degenerative (ALS), infection (meningitis, Bell’s Palsy), toxic (botulism), neoplastic (tumor), traumatic (surgery, TBI), vascular (CVA), other (XRT=radiation), cranial nerve damage

Question 7

T or F. Flaccid Dysarthria can result from isolated cranial nerve damage or multiple cranial nerve damage.

Answer 7

T

Question 8

Name the dysarthria that is characterized by the following clusters of deviant speech:
phonatory incompetence (breathy voice, audible inspiration, short phrases)
resonatory incompetence (hypernasality, nasal, emission, imprecise consonants, short phrases)
phonatory-prosodic insufficiency (harsh voice, mono pitch & loudness)

Answer 8

flaccid dysarthria

Question 9

may be manifest in any/all systems of speech, combined weakness & spasticity leading to slow movement and reduced range & force

Answer 9

spastic dysarthria

Question 10

Spastic dysarthria is the result of

Answer 10

bilateral upper motor neuron damage (or unilateral brainstem lesion above synapse)

Question 11

Confirmatory signs of spastic dysarthria are

Answer 11

+ babinski, suck, snout, and jaw reflexes

Question 12

Patient complaints of spastic dysarthria

Answer 12

slow effortful speech, speaking against resistance, fatigue, nasal speech, need to speak slowly to be understood, dysphagia, difficulty controlling emotions

Question 13

Clinical findings of Spastic Dysarthria

Answer 13

dysphagia, drooling, flattened nasolabial fold, pathologic laughing/crying, + reflexes, slow BUT regular AMRs, harsh vocal quality during ‘ah’

Question 14

Name the dysarthria that is characterized by the following clusters of deviant speech:
prosodic excess (excess and equal stress, slow rate), articulatory-resonatory incompetence (imprecise consonants, distorted vowels, hypernasality), prosodic insufficiency (monpitch and loudness, reduced stress, short phrases), phonatory stenosis (low pitch harshness, strained-vocal quality)

Answer 14

Spastic dysarthria

Question 15

Confirmatory signs of Ataxic Dysarthria

Answer 15

difficulty standing & walking, broad based gait, titubation (staggering), nystagmus (quick movements of eyes), dysmetria (overshoot or undershoot intended position)

Question 16

Salient features of Ataxic Dysarthria

Answer 16

irregular AMRs, normal oral motor exam, drunken sounding speech

Question 17

Name the dysarthria that is characterized by the following clusters of deviant speech: articulatory inaccuracy (imprecise consonants, irregular articulatory breakdowns, distorted vowels), prosodic excess (excess and equal stress, prolonged phonemes, prolonged intervals, slow rate), phonatory-prosodic insufficiency (harshness, monopitch & loudness)

Answer 17

ataxic dysarthria

Question 18

Dysarthria as a result of a lesion in the basal ganglia control circuit resulting in lack of dopamine

Answer 18

hypokinetic dysarthria

Question 19

the only dysarthria associated with fast rate

Answer 19

hypokinetic dysarthria

Question 20

Parkinson’s disease is associated with what kind of dysarthria

Answer 20

hypokinetic dysarthria

Question 21

Confirmatory signs of hypokinetic dysarthria

Answer 21

resting tremor, rigidity, bradykinesia (slow initiation and speed of movements), postural abnormalities, mask like face

Question 22

Salient features of hypokinetic dysarthria

Answer 22

infrequent swallowing, drooling, tremor of jaw/lips at rest, AMRs slow to initiat then increase in rate, rushes of speech, limited range of movement of articulators, excessive muscle tone

Question 23

Name the dysarthria that is characterized by the following clusters of deviant speech: prosodic insuffiency (monopitch, monoloudness, reduced stress, short phrases, variable rate, short rushes of speech, imprecise consonants)

Answer 23

hypokinetic dysarthria

Question 24

disease of the basal ganglia control circuit, speech characteristics are the result of abnormal, rhythmic or irregular rapid of slow INVOLUNTARY movements, perceptually distinguishable & visually distinguishable

Answer 24

hyperkinetic dysarthria

Question 25

Possible movement patterns secondary to basal ganglia damage are called

Answer 25

dyskinesia (involuntary muscles movements)

Question 26

types of dyskinesia

Answer 26

myoclonus (spamodic jerky contraction of groups of muscles)
tics (habitual spasmodic contration of muscles)
chorea( jerky involuntary movements)
ballism (twisting, shaking, jerking motions)
dystonia (abnormal muscle tone resulting in muscular spasm and abnormal posture)
spasm (sudden involuntary muscular contration or convulsive movement)

Question 27

disease processes associated with hyperkinetic dysarthria

Answer 27

degenerative disease (huntington’s chorea), toxic-metabolic conditions (tardive dyskinesia), vascular (not common, but possible–infarct of BG), neoplasm (tumor of BG or thalamus), infectious processes (sydenham’s chorea), other (Tourette’s syndrome, chorea gravidarum)

Question 28

Sydenham’s chorea is rar and seen in what age population

Answer 28

children

Question 29

Chorea gravidarum is only seen in what population

Answer 29

pregnant women

Question 30

Characteristics of chorea

Answer 30

oral motoar exam wnl, occassional drooling, dysphagia, motor unsteadiness

Question 31

patient complaints of chorea

Answer 31

effortful speech, inability to get speech out, involuntary orofacial movements, chewing/swallowing problems

Question 32

Speech characteristics of chorea

Answer 32

imprecise consonants, prolonged intervals, variable rate, monopitch, harsh vocal quality, inappropriate silence, distorted vowels, excess loudness variation

Question 33

Name the dysarthria that is characterized by the following clusters of deviant speech: prosodic excess (prolonged intervals & phonmemes, inappropriate silences, excess & equal stress), prosodic insufficiency (monopitch & loudness, reduced stress, short phrases)

Answer 33

hyperkinetic (chorea)

Question 34

oral motor exam often normal, drooling, chewing & swallowing difficulties, difficulty with attempts to maintain orofacial posture, facial grimacing, slower movements than chorea, and sensory tricks to inhibit movement are characteristic of

Answer 34

dystonia (hyperkinetic dysarthria)

Question 35

Patients with dystonia complain of

Answer 35

effortful speech, involuntary orofacial movements, tricks temporarily improve speech, chewing/swallowing problems, food sticking in throat

Question 36

Speech characteristics of dystonia are

Answer 36

voice stoppages, strainged-harsh vocal quality, excess loudness variations, hypernasality, irregular breakdown of consonants, variable rate, slow/irregular AMRs

Question 37

What kind of dysarthria isgenerally mild and temporary, primarily effects articulation, often co-occurs with aphasia, apraxia, & cognitive disorders

Answer 37

unilateral upper motor neuron

dysarthria

Question 38

UUMN is manifested as weakness/incoordination of the ____side

Answer 38

contralateral

Question 39

What is a common site for a lesion that causes UUMN?

Answer 39

internal capsule

Question 40

hemiplegia, impairment of fine motor skills, Babinski on affected side, hyporeflexia, central facial weakness, & lingual weakness are signs of…

Answer 40

direct motor system lesions of

unilateral upper motor neuron

Question 41

increased muscle tone, spasticity, clonus (muscle spasm involving repeated, rhythmic, contractions), hyperactive stretch reflexes, central facial weakness during emotional expression are signs of

Answer 41

indirect damage of unilateral upper motor neuron

Question 42

Etiologies associated with UUMN dysarthria are

Answer 42

tumor, trauma, CVA (most common)

Question 43

Speech characteristics of UUMN are

Answer 43

imprecise artic, irregular articulatory breakdowns, slow AMRs, strained harsh vocal quality, mildly slowed rate, possible reduced loudness, possible hypernasality

Question 44

Patient Complaints of UUMN

Answer 44

thick tongue, heavy lower face, difficulty with pronunciation, mild dysphagia, improvment daily, usually pt aware of speech difficulty

Question 45

Approximately 35% of all dysathrias (very common), any combo of 2 or more, often difficult to tease out

Answer 45

Mixed Dysarthria

Question 46

Common degenerative disease associated with etiologies of mixed dysarthria

Answer 46

ALS, MS, Friedreich’s ataxia, PSP, Shy-Drager syndrome, Olivopontocerebellar atrophy

Question 47

Other etiologies of mixed dysarthria (other than degenerative disease)

Answer 47

toxic metobolic condition (Wilson’s disease), Vascular disorders (multiple infarcts), trauma (diffuse lesions associated w/ TBI), Tumor (generally brainstem), Infectious disease (AIDS)

Question 48

Common Types of Mixed Dysarthrias

Answer 48

Flaccid-Spastic 42%
Ataxic-spastic 23%
Hypokinetic spastic 7%
Ataxic flaccid spastic 6%
Hyper-hypo 3%
other 19%