Week Two

Question 1

Where does damage occur for a person to have flaccid dysarthria?

Answer 1

In the cranial and spinal nerves

Somewhere between the brainstem/spinal cord and muscles of speech

A lower motor neuron lesion

Question 2

Where does damage occur for a person to have spastic dysarthria?

Answer 2

Cerebral cortex

A bilateral upper motor neuron lesion

Damage to the upper motor neuron causes an imbalance between the pyramidal and extrapyramidal tract.

This causes an imbalance between excitatory and inhibitory input.

Question 3

Where does damage occur for a person to have unilateral upper motor neuron dysarthria?

Answer 3

Unilateral upper motor neuron damage

Question 4

What are some key speech characteristics of flaccid dysarthria?

Answer 4

• Muscle weakness
• Flaccid/hypotonic muscles (reduced muscle tone)
• Loss or reduction of muscle reflexes

Question 5

Where on the lower motor neuron can lesions occur for flaccid dysarthria and what may cause these lesions?

Answer 5

Cell Body
- Brainstem stroke
- Tumour
- Motor neuron disease

Axon
- Bell’s Palsy

Neuromuscular Junction
- Myasthenia Gravis

Question 6

What may result from a lesion of the intercostal and phrenic nerve?

Answer 6

Respiration
- Can’t get enough air = shorter sentences

Question 7

What is the most severe form of flaccid dysarthria?

Answer 7

• Bulbar Palsy
• Occurs when several cranial nerves are effected
• Speech: impaired consonant production, hypernasality, breathiness, monopitch, monoloudness and audible inhalation

Question 8

What is Myasthenia Gravis?

Answer 8

• An autoimmune disease that effected the neuromuscular junction resulting in flaccid dysarthria
• Characterized by muscle weakness with increased use, but recovers with rest. Note when count 1 - 50
• Weakness of all facial muscles common

Question 9

What are some key characteristics of spastic dysarthria?

Answer 9

• Decreased muscle tone when at rest
• Increased muscle tone when moving
• Spasticity and hyperactive reflexes
• Reduced range of movement
• Slowness of movement
• Speech: strained, slow, short, monoloudness, monotone, strained, hypernasality

Some additional symptoms:
- Bilateral facial palsy
- Bilateral hemiparesis
- Pathological reflexes present (babinski, grasp, sucking)
- Emotional lability
- drooling
- Dysphagia
- Fatigue when speaking

Question 10

What are some key characteristics of unilateral upper motor neuron dysphagia?

Answer 10

• Physical signs and symptoms present on the side opposite damage
• Generally mild effects on speech: imprecise consonants, slow AMRs, harsh vocal quailty