UNIT 2 Flashcards
Main word for flaccid dysarthria
weakness
causes of flaccid dysarthria
impairments of lower motor neurons in cranial or spinal nerves
characteristics of flaccid dysarthria
slow labored articulation, hypernasality, hoarse-breathy phonation, air is escaping
caused by any disorder that _____
disrupts flow of neural impulses along lower motor neurons that innervate muscles of respiration, phonation, articulation, prosody, or resonance
what are the 6 pairs of nerves that play a vital role in speech production
5, 7, 9, 10, 11,12
damage involved in flaccid dysarthria
brainstem stroke, growing tumor, viral or bacterial infection, physical trauma, surgical accidents
3 main branches of trigeminal nerve (5)
opthalmic, maxillary, mandibular
damage to trigeminal nerve can be ___
unilateral or bilateral
facial nerve (7)
branches from brainstem just below trigeminal nerve, dividing it into cerviofacial and temporofacial branch
damage to facial nerve….
can cause weakness or paralysis in all muscles on the same side of the face (drooping of eyelid, mouth, cheek, and other structures)
glossopharyngeal cranial nerve 9 2 main components
tongue and pharynx
innervation of glossopharyngeal nerve
stylopharyngeus and superior pharyngeal constrictor muscles
3 branches of cranial nerve
pharyngeal branch, external superior laryngeal branch, recurrent nerve branch
2 parts of accessory cranial nerve 11
neck and shoulders
where does accessory nerve originate from
in the medulla, just below vagus nerve
what does accessory nerve help innervate
intrinsic muscles of velum, pharynx, and larynx
damage to cranial components of access nerve…..
will affect vagus nerve and vice versa
where does hypoglossal nerve originate from
medulla
what does the hypoglossal nerve innervate
innervations all intrinsic and most extrinsic muslces of the tongue
damage to hypoglossal nerve results in,,,
weakness of tongue or paralysis
primary characteristic of hypoglossal nerve damage
imprecise articulation, phoneme distortion, or slow lingual movements
how many pairs of spinal nerves
31 pairs
one of the most important spinal nerve of respiration
phrenic nerve
causes of flaccid dysarthria
disrupts the flow of motor impulses along cranial or spinal nerves that innervate muscles of speech production
CONDITIONS THAT DAMAGE LOWER MOTOR NEURONS
physical trauma, brainstem stroke, myasthenia gravis, guillain-barre syndrome, polio
physical trauma to cause flaccid dysarthria
surgical trauma w accidential cut of cranial nerve, head and neck injury
brainstem stroke to cause flaccid dysarthria
occurs w interruption of blood flow to brain as artery breaks or is blocked, affects cranial nerves directly, possible for single brainstem stroke to damage more than 1 cranial nerve
myasthenia gravis to cause flaccid dyasthria
affects neuromusclar junction, caused by antibodies that block/damage muscle tissue
temporary treatment of mysathenia gravis for flaccid dysarthria
injection of edrophonium chloride
what is myasthenia gravis
autoimmue disorder, where any voluntary muscles are affected, eyesm mouth, laryngeal structures
symptoms of myasthenia gravis
rapid fatigue of muscular contractions over time
assessment of myasthenia gravis
stress test, asking patient to count from 1-100 or to read lengthy paragraph
guillian-bare syndrome
results in demyelization, occurs after certain kinds of infections and immunizations
symptoms of gullian barre
flaccid dysarthria, dysphagia
recovery of gullian barre
high recovery rate, lasting weeks or months, 5% die in acute stages
polio
infectious viral disease that attacks cell bodies of lower motor neurons, most frequently affecting cervical and thoracic spinal nerves that cause labored inhalation during speech; shortened speech phrases; speaking on residual air; decreased loudness
other causes of flaccid dysarthria
tumors growing in/near brainstem, muscular dystrophy, progressive bulbar palsy
resonance and flaccid dysarthria
hypernasality, nasal emission, weak pressure consonants, shortened phrases
articulation and flaccid dyasthria
imprecise consonant production, difficulty elevating jaw sufficiently to bring articulators into contact w each other
phonation and flaccid dysarthria
phonatory incompetence, breathy quality,
COMBINED PRESENCE OF ____
hypernasality and phonatory incompetence is strongest confirmatory sign of flaccid dysarthria
most commonly affected speech mechanisms of flaccid dysarthria
resonance, articulation, phonation
respiration and flaccid dysarthria
may or may not be a component, if it is present then it would be monoloudness and monopitch
prosody and flaccid dysarthria
monopitch, monoloudness
key evaluation tasks for flaccid dysarthria
conversational speech and reading, alternate motion rate, prolonged vowel, speech stress test
traditional approach to treat motor speech disorders it to…
use assessment data to identify deficits, begin working with patients using appropriate treatment goals, increase complexity of tasks as patients improve, work toward generalization of improvements
Rosenbek 6 additional recommendations
help patients recognize differences in speech, help patients have a willingness to change their speech, work closely with patients when setting goals of treatment, increasingly insist that patients are talking therapeutically in their sessions, ensure patients are learning to listen, evulate, and self correct, be sure to progressivley add congitive linguistic load
treatment to improve strength
treatment is presented according to which cranial nerve or combination of nerves are damage, needs and abilities vary,
damage to trigeminal nerve
unilateral (small effect on speech production) bilateral damage (rare, can leave jaw muscles very weak)
damage to vagus nerve 10
affects glossopharyngeal and accessory cranial nerves
treatment for resonsance
velar-strength training procedure
what is velar strength training procedure
coughing, blow out through a straw, yawning, puff out cheeks, sucking in small amount of liquid, humming
additional treatments for resonance
modification of speech, reduce rate, more open mouth position during speech, increase loudness
treatments for phonation
pushing and pull procedure, holding breath, hard glottal attack, head turning and sideways pressure on the larynx
treatment for prosodic deficits
pitch range exercises, intonation profile, contrastive stress drills, chunking utterances into syntactic units
damage to facial nerve and hypoglossal cranial nerves
affects speech production primarily by decreasing lip strength and range of movement, traditional articulation drills often recommended, correct posture, compensatory prosthetic devices, speaking immediately on exhalation, cueing for complete inhalation
MAIN WORDS FOR FLACCID
WEAKNESS!!!! SLOW- LABORED ARTICULATION, WEAKNESS/HYPONASALITY, BREATHY VOICE, AMR IS SLOW AND IRREGULAR, DAMAGE TO LOWER MOTOR NEURON
