Week 5 Flashcards
hyperkinetic dysarthria etiology
-chorea
-dystonia
-essential voice tremor (more rhythmic, shaky vocal quality)
spasmodic dysphonia
chorea
brief, abrupt and unpredictable movements
dystonia
involuntary, sustained painful muscle contractions causing twisting and abnormal postures
spasmodic dysphonia
-phonation is affected
-sudden spasm in abductor or adductor vocal cord movement
LCA: adductor
PCA: abuctor
-involuntary movement of limbs or group of muscles
hyperkinetic dysarthria lesion site
basal ganglia (result of imbalance of dopamine and ach)
motor signs of hyperkinetic dysarthria
excessive involuntary movement
hyperkinetic dysarthria speech signs
association between movement disorder
ex: spasm leading to voice stoppage
hypokinetic dysarthria etiology
Parkinsonism
hypokinetic dysarthria lesion site
reduction of dopamine in striatum
hyperkinetic dysarthria motor signs
hypokinesis
TRAP (tremor, rigidity, akinesia, and postural instability)
hypokinetic dysarthria speech signs
reduced movement of speech muscles resulting from muscular rigidity
-monopitch (PD), monoloudness
-imprecise consonants
-atypical silence
-short rushes of speech
-harsh vocal quality
-continuous breathy voice
-fast speech (only dysarthria you will see)
why do patients with hypokinetic dysarthria have fast speech
range of motion of their structures decreases resulting in using fast speech as a compensatory approach to catch up to their speech
UMN Dysarthria etiology
focal lesion
stroke
UMN Dysarthria lesion site
unilateral damage to UMNs
-left hemi: may co-occur with aphasia, AOS
-right hemi: may co-occur with RHD
UMN Dysarthria motor signs
reduced ROM and control of muscles of the contralateral lower face and tongue
UMN Dysarthria speech signs
imprecise consonants
slow and imprecise AMRs
slow speech rate
these two groups of patients with dysarthria may complain of effortful speech
spastic and hyperkinetic
3 parameters to evaluate an exercise
static or dynamic
task specific
overload
static or dynamic
static, isometric (greater strength, involves one structure)
dynamic, isotonic (increases speech of contraction, involves more than one structure)
speech is dynamic so more effective
isometric
length of muscles does not change but tension increases to improve strength
isotonic
tension of muscle is fixed but length of muscle changes
task specific
does the specific exercise correlate with the task you are wanting to work on
Ex: work on improving speech intelligibilty work on speech
overload
muscle stimulated above threshold level (increasing strength and endurance)
neuroplasticity
brain’s ability to remodel itself