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Motor Speech Exam 2 > Ataxic Dysarthria > Flashcards

Ataxic Dysarthria Flashcards

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1
Q

T/F:For Ataxic Dysarthria (AD) it is beneficial to work on oral motor strengthening exercises.

A

False.

-AD is a problem of coordination so it is NOT beneficial to work on strengthening exercises.

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2
Q

AD primarily affects __ & ___.

A
  • articulation

- prosody

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3
Q

T/F: AD is a cerebellar control circuit dysfunction.

A

TRUE

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4
Q

The cerebellum receives input primarily from (1) and provides output to (2) and then to (3).

A

The cerebellum receives input primarily from MOTOR CORTEX and provides output to CORTEX (THROUGH THALAMUS) and then to PERIPHERAL SYSTEM.

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5
Q

Cerebellum’s major function is?

A

Error control

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6
Q

The cerebellum imposes control on?

A

posture and movement initiated elsewhere.

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7
Q

Explain how the cerebellum coordinates: posture, locomotion, and coordinated activities.

A

By adjusting activities of the indirect and direct motor systems and through them, the activities of the LMN system.

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8
Q

Lesions in the cerebellum cause..

A
  • Hypotonia

- Errors in: force, speed, timing, range, direction of movements (e.g. INCOORDINATION)

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9
Q

T/F: Reduced m. tone and incoordination cause fast rate of speech and inaccuracy in speech movements.

A

FALSE: causes SLOW rate of speech and inaccuracy in speech movements.

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10
Q

In AD, does the role of the cerebellum breakdown in motor control and organization?

A

YES

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11
Q

T/F: In AD, speech reflects the weakness seen in other dysarthrias.

A

FALSE: It DOES NOT reflect the weakness seen in other dysarthrias, BUT RATHER, POORLY CONTROLLED AND INCOORDINATED SPEECH.

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12
Q

List the 3 lobes of the cerebellum.

A
  • Anterior
  • Posterior
  • Flocculonodular
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13
Q

What does the anterior lobe consist of and what is it important for?

A
  • Most of the vermis
  • Anterior aspect of the cerebellar hemispheres

Important in regulating:

  • posture
  • gait
  • m. tone of the trunk of the body
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14
Q

What does the posterior lobe make up and where is it located?

A
  • Makes up: greater part of the cerebellum

- Located: between the anterior lobe and the flocculonodular lobe

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15
Q

What is the posterior lobe important for?

A

For coordinating:

  • Skilled, voluntary muscle activity
  • M. tone
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16
Q

The flocculonodular lobe includes?

A

inferior part of the vermis and the attached flocculi

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17
Q

Explain flocculi.

A

Small appendages in the posterior inferior region.

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18
Q

What is the vermis?

A

The middle of the cerebellum

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19
Q

There are 2 hemispheres to each side of the vermis which are both connected to?

A
  • opposite thalamus

- opposite cerebral hemispheres

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20
Q

T/F: Hemispheres in the cerebellum control function on the contralateral side of the body.

A

FALSE: ipsilateral

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21
Q

T/F: Left side of the cerebellum controls the left side of the body and connects to the right cerebral hemisphere.

A

TRUE

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22
Q

T/F: The right side of the body is controlled by the right cerebral hemisphere and the left cerebellar hemisphere.

A

FALSE:

Right side of the body is controlled by the LEFT cerebral hemisphere and the RIGHT cerebellar hemisphere.

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23
Q

Where are Purkinje cells found and about how many are there?

A

Found in: cortex of the cerebellum

How many: 15 million

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24
Q

Purkinje cells connect to other nuclei deep in the cerebellum and information is passed through these connections.
Name the nuclei important in speech control and explain why.

A

Denate nucleus- aids in initiating movement and regulating posture.

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25
3 structures where tracts of nerve fibers enter and leave the cerebellum through.
(1) inferior cerebellar peduncle (2) middle cerebellar peduncle (3) superior cerebellar peduncle
26
T/F: Each cerebellar hemisphere connects to the rest of the nervous system through 3 bundles of nerve fibers: superior, middle, inferior peduncles.
TRUE
27
Inferior peduncle coordinates info between the __ and __. It is mainly (afferent or efferent) pathway.
- Coord info between MEDULLA & CEREBELLUM. | - EFFERENT pathway
28
T/F: Superior peduncle is a bridge between brainstem and cerebrum.
FALSE: Midbrain & Cerebellum
29
T/F: Middle peduncle is a bridge between the pons and cerebellum. It is afferent.
TRUE
30
T/F: Superior peduncle= afferent
FALSE: efferent
31
Cerebellar lesions causing speech problems are usually (unilateral or bilateral).
-Bilateral or in the vermis (midline) or generalized. | BUT, it can be due to a more focal lesion.
32
What is Frederich's ataxia?
- Symptoms shown in childhood & progress over time - Hereditary - Due to autosomal recessive pattern - Ends in death after about 20 yrs - Ataxic Dys is common but usually not first sign
33
Multiple Sclerosis?
- May result in cerebellar lesions & Ataxic Dys | - Lesions aren't just in the cerebellum
34
T/F: Lesions in the vascular system cannot impact cerebellar function and cannot cause AD.
FALSE: they CAN imapct cerebellar function and cause AD.
35
Vascular diseases that affect the cerebellum are usually caused by:
- aneurysms - arteriovenous malformations (AVM) - cerebellar hemorrhage
36
T/F: 75% of metastatic brain tumors develop in the cerebellum.
FALSE: 25%
37
T/F: TBI often results in ataxic dysarthria and limb ataxia.
TRUE
38
Boxers who have sustained hits to the head may develop dementia pugilistica or ______ which involves cerebellar dysfunction.
"punch-drunk encepalopathy"
39
Boxers who develop "punch-drunk encepalopathy" may also develop ___.
Ataxic Dysarthria
40
T/F: Acute alcohol abuse produces AD permanently.
FALSE: usually isn't permanent
41
Does AD, as a result of chronic alcoholism, develop due to the effect of alcohol or due to nutritional problems?
Nutritional problems.
42
Can severe malnutrition w/ vitamin deficiencies result in cerebellar damage & AD?
YES
43
Neurotoxic levels of certain drugs may result in cerebellar symptoms. List 3 examples of harmful drugs.
(1) Lithium (2) Dilantin (3) Valium
44
What is hypothyroidism?
Endocrine imbalance caused by not enough secretion of thyroxin by thyroid glands.
45
Can hypothyroidism ALWAYS lead to AD?
No. Only when severe.
46
When a pt has AD caused by severe hypothyroidism, their voice may be..
- Hoarse - Gravely - Excessively low pitched
47
T/F: Normal pressure hydrocephalus (NPH) often results in AD.
TRUE | *Ventricles may be enlarges but CSF pressure is normal.
48
What are some complaints a pt with AD might have?
- slurred speech - stumble over words - bite cheek when eating - can't coordinate breathing w/ speaking - difficulty swallowing (not very often)
49
T/F: For a pt with AD, limited alcohol intake results in improvement of speech.
FALSE: results in QUICK DETERIORATION of speech
50
T/F: Pts with AD complain about swallowing less often than pts with flaccid or spastic dys.
TRUE
51
What helps pts with AD improve their intelligibility?
Slowing their speech
52
List general clinical characteristics of Ataxia.
- Problems standing or walking (most prominent signs) - Broad based gait - Titubation - Abnormal eye movement - Hypotonia - Dysmetria - Dysdiadochokinesis
53
Explain titubation.
Rhythmic tremors of body or head- looks like a rocking motion of trunk or head. Can be rocking side to side or forward & back or in a rotary motion.
54
What are the two types of abnormal eye movements seen in pts with AD..
(1) Nysgtagmus- jerking back and forth of eyes at rest | (2) Oculodysmetria- rapid eye movements as the pt tries to fix eyes on a visual target.
55
T/F: Hypotonia is also found in LMN disorders.
True
56
What are the most prominent signs of Ataxia?
- Problems standing and walking. - Broad based gait (feet far apart)- to counter imbalance. - May lift legs too high when walking
57
What is a common sign of cerebellar problems where the person is not able to control range of movement and is seen typically over or undershooting a target?
Dysmetria
58
What is dysdiadochokinesis?
Decomposition of movement occurring in cerebellar problems. Results in error in sequence and speech of the component parts of a movement-produces incoordination.
59
How would you assess dysdiadochokinesis?
- side to side tongue wiggling | - patting floor with the ball of the foot
60
Ataxia is the product of:
- dysmetria | - dysdiadochokinesis
61
Describe ataxic movements.
- halting - imprecise - jerky - poorly coordinated - lacking in speed & fluidity
62
Cerebellar disorders are often seen with __ or ___ tremor.
Intention or kinetic tremor | -Seen in movement but sometimes in sustained postures.
63
T/F: Tremor (intention or kinetic) usually worsens the closer one gets to the target.
TRUE
64
T/F: In AD, the gag reflex is usually abnormal.
FALSE-normal
65
T/F: In AD, there are NO pathological reflexes.
TRUE
66
T/F: AD primarily has problems with articulation and resonance.
FALSE: - articulation - prosody
67
T/F: In AD, sometimes (rarely) you may see hyponasality due to improper timing of VP function and articulatory gestures for nasal consonants.
TRUE
68
For AD, how/what would you assess?
Assess: - conversational speech - reading - AMRs Have pt repeat sentences with multisyllabic words such as "The municipal judge sentenced the criminal".
69
Having the pt repeat sentences with multisyllabic words may result in:
Distinctive irregular articulatory breakdowns
70
According to Duffy, a pt with AD is going to have regular or irregular AMRs?
Irregular | **AMRs are one of the most important distinguishing characteristics of AD.**
71
Best distinguishing features of AD (according to Duffy)
- Irregular AMRs - Irregular & transient articulatory breakdowns - Telescoping - Excess & equal stress - Excess loudness variations - Dysprosody - Vowel distortions

Motor Speech Exam 2 (3 decks)

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