Motor speech: assessing dysarthria Flashcards
1
Q
Primary function of respiration for speech? If there is damages, what does it affect?
A
- Provides subglottic air pressure for phonation
- Nerve damage leads to weak muscles w/difficulties moving air in and out of lungs→ short phrases, reduced loundness, and breathy voice
2
Q
Primary function of phonation for speech production? If there is damage, what does it affect?
A
- Normal phonation= complete adduction of VFs and sufficient subglottic air pressure
- Neuromotor damage to the nerve that innervates VF→ flaccid dysarthria, spastic dysarthria, neuromotor damage to laryngeal muscles
3
Q
Primary function of resonance for speech productions? If there is damage, what does it affect?
A
- Proper placement of oral or nasal tonality onto phonemes during speech accomplished by raising and lowering of velum
- Oral resonance- velum is raised and closes off nasal cavity
- Nasal resonance- velum is lowered and oral cavity is blocked by tongue and lips
- Damage to nerves innervating velar muscles may cause hypernasal quality
4
Q
Primary function for articulation for speech production? If there is damage, what will it affect?
A
- Shapes the vocal air stream into phonemes
- Neuromotor damage to articulators may affect lips, tongue, jaw, velum, or vocal folds and results in articulation errors (imprecise consonants or distorted vowels)
5
Q
Primary function of prosody for speech production? If there is damage, what will it affect?
A
- Melody of speech, using stress, and intonation to convey meaning
- Neuromotor damage can affect prosody→ monopitch, and monoloudness; involuntary movements can result in irregular pitch variations, loudness, and prolonged intervals
6
Q
Standardized test for apraxia
A
Apraxia battery for adults-second edition
7
Q
Standardized test for dysarthria
A
- Frenchay Dysarthria Assessment-2
- Assessment of intelligibility of Dysarthric speech
- Speech intelligibility test for windows
8
Q
What 6 salient features should we assess?
A
- Muscle strength
- Speech of movement
- Range of motion
- Accuracy of movement
- Motor steadiness
- Muscle tone
9
Q
Muscle strength
A
- Typical speech- requires adequate strength to perform speech production tasks
- Decreased muscle strength- can affect respiration, articulation, resonance, phonation, prosody
- Assessed by- asking the patient to press the tongue against tongue blade
10
Q
Speed of movement
A
- Typical speech- requires very rapid muscle movements of tongue and vocal folds
- Reduced speech movement is a characteristic of most dysarthrias except hypokinetic dysarthria
- Assessed by- alternate motion rates (AMR) and sequential motion rates (SMR)
11
Q
Range of movement
A
- Typical speech- requires range of movement of articulators
- Reduced ROM- may cause inability to open jar or completely adduct vocal folds
- Assessed by- asking patient to extend or hold articulators in various position
12
Q
Accuracy of movement
A
- Typical speech- requires accurate movements of articulators
- Reduced accuracy of movement may cause- distorted consonants; hypernasality
- Assessed by- conversational speech; spoken paragraph reading
13
Q
Motor steadiness
A
- Typical speech- ability to hold articulators still
- Reduced motor steadiness- tremors and large, inovoluntary movements
- Assessed by- asking patient to hold position of prolonged vowel
14
Q
Muscle tone
A
- Typical speech- requires muscle ready for quick movements
- Reduced muscle tone may cause- weakness or paralysis; spasticity or rigidity
- Assessed by- listening to speech, looking at affected body parts
15
Q
Specific tasks during oral mech exam
A
- face and jaw muscles at rest/during movement
- tongue at rest/during movement
- velum and pharynx at rest/during movement
- laryngeal function
- auditory perceptual evaluation
- phonatory respiratory system
- resonation system
- combined systems
- stress test
