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SPP310 - NSMD > Dysarthria > Flashcards

Dysarthria Flashcards

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1
Q

Define the concept ‘acquired’.

A

Sudden onset. Damage to an already established or developed system.

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2
Q

What does ‘motor’ refer to?

A

Muscle tone, movement, planning, coordination and execution. Sensorimotor relates to feedback from the sensory system in terms of movement.

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3
Q

Speech

A

A mode of communication. The final output of wanting to express a message verbally. Include segmental and suprasegmental characteristics. Segmental: Respiration, phonation, resonance, articulation, VOT. Suprasegmentals: Duration, rate/rhythm, juncture, stress, intonation, voice quality.

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4
Q

Dysarthria

A

Insult or injury to the nervous system resulting in no or reduced, atypical innervation of muscles resulting in constant speech distortions, a pattern exists distortions are consistent. Motor programming and execution (speech) is impacted.

Thus, respiration, resonance, phonation and articulation are impacted. Damage to the NS may lead to paralysis, paresis, involuntary movement or poor coordination.

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5
Q

Apraxia

A

Motor planning difficulty due to damage to the nervous system and impacts the movement required to produce target sounds. Errors vary and are not predictable, but motor planning is worsened by increase in word difficulty.

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6
Q

Two differences between dysarthria and apraxia

A

Dysarthria: Injury to NS that impacts motor execution of speech sounds. Distortions are constant and predictable.
Apraxia: Injury to NS that impacts motor planning of target sounds. Errors vary and increase as word complexity does.

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7
Q

Difference between speech and language.

A

Language - a symbol system used to represent thoughts, concepts, ideas etc. Rule governed.
Speech - final output and is a verbal mode to express language and convey a message.

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8
Q

Speech model

A 
Respiration
Phonation
Resonance
Articulation
VOT
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9
Q

FLF of speech sensorimotor control

A

(intent to communicate verbally)
Symbolic linguistic planning
Motor planning (spatial and temporal for specific phonemes)
Motor programming (planned sequence of movements)
Motor execution

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10
Q

Aphasia

A

Disorder relating to linguistic symbolisation. Difficulty expressing (Broca’s) and receiving (Wernicke’s) language.

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11
Q

Lesion: temporal parietal

A

Ability affected: Linguistic symbolic comprehension

Disorder: Receptive aphasia

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12
Q

Lesion: temporal parietal, Broca’s and adjacent

A

Ability affected: Linguistic symbolic planning (syntax and morphology)
Disorder: Broca’s aphasia, phonemic paraphasia of Wernicke’s and conduction aphasia

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13
Q

Lesion: Broca’s and motor cortex

A

Ability affected: Motor planning

Disorder: Aphasia

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14
Q

Lesion: Basal ganglia, cerebellum, motor cortex, lower motor neurones

A

Ability affected: Motor programming and execution

Disorder: Dysarthria

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15
Q

Closed head injury

A

Ability affected: Cognition, memory, attention

Disorder: Variety, symptoms of TBI

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16
Q

UMN

A

Convey impulses for voluntary movement from brain to LMN. Fibres crossover, have contralateral and ipsilateral innervation. Synapse with LMN.

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17
Q

LMN

A

Transmit signal to motor end plates in muscles through cranial and spinal nerves and muscle responds accordingly.

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18
Q

Neurophysiological approach

A

Consider MSD as a result of a lesion, specific symptoms can be seen when a lesion is in a particular area.

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19
Q

Neuro-evolutional approach

A

Consider MSD as a breakdown in the development of movement. Maturation of motor system and more voluntary control. More differentiation of movement (gross to fine).

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20
Q

We use a combined approach

A

For better level of functioning, use in ax and tx. Establishes where to start and what to work towards, from simple to complex movements.

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21
Q

Bilateral central representation

A

Ipsilateral and contralateral innervation.

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22
Q

Symptoms of UMN lesion

A

Loss of voluntary movement in 1/2 body (limbs) on opposite side of lesion. No atrophy (muscle mass loss). No tremors or fasciculations

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23
Q

Symptoms of bilateral UMN lesion

A

Both sides of body affected; quadriplegia. E.g. pseudobulbar (CN 9, 10, 11 affected with weakness and spasticity)

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24
Q

Symptoms of unilateral UMN lesion

A

Opposite limbs are affected as well us lower 1/4 of face and 1/2 of tongue on opposite side, eye and eyebrow unaffected.

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25
Spasticity
Symptom of UMN lesion. Pathological reflexes can occur, leading to increased tone.
26
Essential factors for normal functioning of movement
- Stimulus - Motor program - Postural adjustment - Activation of synergists - Inhibition of antagonists - Activation of primary movement muscle groups - Postural adjustment & equilibrium reactions during execution of movement - Sensory feedback
27
Basal ganglia lesions
Hypokinetic - hypertonic Hyperkinetic - hypotonic Leads to disorders in programming and execution
28
Hypokinetic dysarthria
Low movement, therefore increased tone (spasticity/rigidity), hypertonic. Basal ganglia fall out, associated with Parkinson's. Monopitch, monoloudness
29
Hyperkinetic dysarthria
High movement, therefore flaccid, reduced tone, hypotonic
30
Symptoms of basal ganglia lesions
Chorea | Athetosis
31
3 areas of the cerebellum
Archicerebellum (balance) Palleocerebellum (control of tone and posture) Neocerebellum (planning of movements)
32
Impact of cerebellar damage
Temporal control of speech production, difficulty planning and coordinating movements. Difficulty with DDK and rhythm
33
Symptoms of injury to archicerebellum
Ataxia Nystagmus Vertigo
34
Symptoms of injury to palleocerebellum
Ataxia
35
Symptoms of injury to neocerebellum
Hypotonia | Dyssenergia
36
Ataxia symptoms
Cerebellar fall out. Sound drunk, wide gait, difficulty with balance, poor coordination. Difficulty with stress or intonation. Excess loudness of speech, slow rate
37
Symptoms of LMN lesions
Flaccid dysarthria, hypotonia, atrophy, fasciculations. Cranial nerves affected, sensory difficulties
38
Symptoms of unilateral LMN lesion
1/2 of face on same side as lesion,
39
Symptoms of bilateral LMN lesion
Whole face affected
40
Mixed dysarthria
Neuromuscular pathology such as myasthenia gravis or MND/ALS. Degenerative decline in muscle fiber. Impact more than one area of the brain.
41
Describe why the stages of processing language and speech is important and list them.
``` A concept needs to be transformed into a meaningful linguistic message and then into a motor plan in order for us to verbally convey a message. Different neural parts are involved in different stages of this processing. Linguistic symbolic planning Motor planning Motor programming Motor execution ```
42
Linguistic symbolic planning
Related to language and not motor aspects of speech planning, programming or production. Pertains to constructing a message using the rules of a language. Fall out on this level results in aphasia.
43
What does motor planning entail?
Spacial and temporal aspects of the movements needed to produce a specific phoneme, articulator specific. Core motor plans (CMP) are constructed or recalled. Goals for each CMP are identified. Internal feedback. Fall out on this level results in apraxia of speech.
44
Which areas of the brain control motor programming and execution?
BG, cerebellum, UMN, LMN. Fall out on this level results in dysarthria.
45
Which speech subsystems are impacted by apraxia?
Phonation Resonance Articulation
46
What's the difference between dysarthria and apraxia of speech?
Apraxia - not due to muscle weakness. Distortions are inconsistent. Relate to the temporal and spatial aspects of articulators to produce a specific phoneme. Occurs at the level of motor planning. Dysarthria - due to insult of the NS resulting in distorted speech impacting motor programming and motor execution as a result of muscle weakness. Distortions are consistent.
47
Which speech subsystems are impacted by dysarthria?
Respiration Resonance Phonation Articulation
48
List some speech characteristics of dysarthria
slow or rapid motor movements Decrease in strength and range of movements Poor directionality and timing of movements
49
What are reflexes?
It is the simplest form of movement and is involuntary. Most infantile reflexes are inhibited unless needed for survival, but may reappear after TBI. They are processed either in the brain or spinal cord.
50
What is a reflex arc?
A stimuli triggers the receptors in the skin, sending a signal to the brainstem or spinal cord along an afferent pathway, a signal is then sent via the efferent pathway to the effector organ for muscle to respond accordingly. It occurs below the level of conscious control and is predictable. Can be autonomic or somatic.
51
Autonomic reflexes
Unconscious reflexes that regulate bodily functions and smooth muscle
52
Somatic reflexes
Skeletal muscle contraction
53
Name the four groups of reflexes
Superficial Deep Visceral Pathological
54
Name four types of muscle groups
Agonist - contracts while another relaxes Antagonist - opposes the action of another Synergistic - stabilises the the joint around which movement is occurring Fixation - stabilises the origin of the agonist
55
What is the effect of longitudinal muscle contraction of the tongue?
The tongue shortens and thickens. If the longitudinal muscles on one side are more active, tongue bends to that side.
56
What is the effect of transverse muscle contraction of the tongue?
Lengthens and thins the tongue
57
What is the effect of simultaneous contraction of the longitudinal and transverse muscles?
The tongue becomes rigid
58
What is tongue deviation?
Occurs due to damage in the motor cortex, affecting the hypoglossal nerve. Tongue will turn away from the midline when protruded and will deviate toward the side of the lesion.
59
Name the seven dimensions of movement that have to be controlled - (my mom makes such amazing roast turkey)
1) Muscle strength, must be graded 2) Speed of movement 3) Range of movement - boundaries of equivalence: limited spatial range for a sound to perceived correctly, stay within the boundary for accurate perception 4) Accuracy 5) Motor steadiness 6) Timing 7) Muscle tone
60
Name three persistent reflexes
Gag (superficial) Palatal (superficial) Mandibular (deep)
61
What do motor programs specify?
Muscle tone, movement direction, speed, force, range, mechanical stiffness of joints; dimensions of movement
62
What happens at the motor execution level?
Programs are transformed into reflexes. At this level adjustments are not possible as it is reflexive.
63
Flaccid dysarthria
Execution only. Due to LMN lesion. Breathiness, hypernasality. Audible inspiration, loudness variation.
64
Which types of dysarthria are programming-execution types?
Hyperkinetic Hypokinetic (eg Parkinsons) Ataxic
65
Spastic dysarthria
Result of UMN lesion. strained voice, reduced ROM, very imprecise articulation.
66
What are the goals of assessment? | 4
Describe the perceptual characteristics Describe the speech subsystems affected Identify any other systems or processes affected Ax impact on speech intelligibility
67
List the components of the assessment. | 7
``` Case history Non-speech examination Speech production Language and cognitive communication Swallowing ability Linguistic and cultural considerations Differential diagnosis ```

SPP310 - NSMD (1 decks)

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