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Dysarthria Flashcards

(61 cards)

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1
Q

What is the definition of dysarthria from the literature?

A

“a group of neurogenic speech disorders resulting from abnormalities in the strength, speed, range, steadiness, tone or accuracy of movement required for the control of [different aspects] of speech production”

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2
Q

Who wrote the definition of dysarthria?

A

Murdoch, 2013

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3
Q

what is dysarthria made up of?

A
  • several different types corresponding to damage to particular parts of the nervous system
  • each type has different auditory perceptual characteristics
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4
Q

what is the lesion site for flaccid dysarthria?

A

lower motor neurons (LMN)

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5
Q

what is the lesion site for spastic dysarthria?

A

upper motor neurons (UMN)

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6
Q

what is the lesion site for hypokinetic & hyperkinetic dysarthria?

A

basal ganglia & associated brain stem nuclei

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7
Q

what is the lesion site for ataxic dysarthria?

A

cerebellum and/or its connections

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8
Q

what is the lesion site for unilateral UMN dysarthria?

A

unilateral upper motor neurons

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9
Q

what is the lesion site for mixed dysarthria?

A

both lower motor neurons and upper motor neurons

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10
Q

what parts of the central nervous system revolve around motor planning and control?

A

basal ganglia & cerebellum

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11
Q

what parts of the CNS & the PNS revolve around motor execution?

A
  • UMN pathways such as the pyramidal system & extrapyramidal system
  • LMN pathways such as the cranial and spinal nerves
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12
Q

what is the pyramidal system?

A

the network of nerve fibers that controls voluntary movement in the body

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13
Q

what is the extrapyramidal system?

A

controls involuntary actions, maintains posture and regulates muscle tone

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14
Q

what nerves control respiration in speech?

A

spinal-phrenic nerve and spinal intercostals

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15
Q

what nerve controls phonation in speech?

A

vagus (X)

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16
Q

what nerves control resonance in speech?

A

vagus (X), glossopharyngeal (IX), spinal accessory (XI)

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17
Q

what nerves control articulation in speech?

A

trigeminal (V), facial (VII) and hypoglossal (XII)

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18
Q

what are some characteristics of flaccid dysarthria?

A
  • voluntary control of muscles lost
  • muscles become flaccid (atrophy) which affects speed, range and accuracy
  • diminished reflexes
  • fasciculations (spontaneous twitches)
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19
Q

what are some conditions associated with flaccid dysarthria?

A
  • myasthemia gravis (condition that causes muscle weakness)
  • brain stem strokes
  • brain stem tumours
  • damage to the cranial nerves
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20
Q

in flaccid dysarthria, if the trigeminal nerve (V) is effected, what signs will show?

A
  • jaw deviating to weak side on opening
  • jaw hangs open at rest
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21
Q

in flaccid dysarthria, if the tongue’s nerve (XII) is effected, what signs will show?

A
  • tongue deviates to weak side on protrusion
  • fasciculations and atrophy
  • distorted alveolar and velar sounds
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22
Q

in flaccid dysarthria, if the facial nerve (VII) is effected, what signs will show?

A
  • facial droop
  • reduced lip seal
  • distorted bilabial and labiodental sounds
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23
Q

in flaccid dysarthria, if the laryngeal nerve (X) is effected, what signs will show?

A
  • weak cough
  • stridor on inhalation
  • monopitch
  • monoloudness
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24
Q

in flaccid dysarthria, if a velopharyngeal nerve (X, IX, XI) is effected, what signs will show?

A
  • hangs lower on weak side at rest
  • elevates towards normal side on phonation
  • reduced gag reflex
    hypernasality
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25
what is the 3 most common distinctive features for flaccid dysarthria?
- hypernasality - imprecise consonants - breathless (constant)
26
what are some conditions associated with spastic dysarthria?
- progressive supra nuclear palsy (PSP) - like parkinson’s but affects balance and movement more - traumatic brain injury - bilateral brain stem strokes
27
what do upper motor neurons do?
- convey impulses from motor areas of the cerebral cortex to the lower motor neurons
28
what are some characteristics of spastic dysarthria?
- reflects combined effects of direct and indirect motor system involvement - results in spasticity (causes muscle stiffness), weakness, reduced range of movement and slowness of movement
29
what are some respiratory/laryngeal characteristics of spastic dysarthria?
- strained/strangled voice - harshness - pitch and loudness variability - pitch breaks
30
what is the resonance characteristic of spastic dysarthria?
- hypernasality
31
what are some articulation characteristics of spastic dysarthria?
- imprecise articulation - vowels distorted (most common)
32
what are some prosody characteristics of spastic dysarthria?
- reduced rate - excess stress - prolonged phonemes
33
what is the cerebellar system responsible for?
- imposing control on movement - coordinating timing and sequencing of movements - maintaining steadiness
34
what are some conditions associated with ataxic dysarthria?
- multi systems atrophy (MSA) - spinal cerebellar atrophy (genetic) - multiple sclerosis
35
what are some characteristics for ataxic dysarthria?
- incoordination -> errors in force, speech, timing, range and direction of movements - hypotonicity -> lack of muscle tone
36
what are some respiratory/laryngeal characteristics of ataxic dysarthria?
- monopitch - monoloudness - harsh voice
37
what is the resonance characteristic of ataxic dysarthria?
- normal to variable - including hyponasality
38
what are the articulation characteristics of ataxic dysarthria?
- imprecise articulation - vowels distorted - irregular breakdowns
39
what are the prosody characteristics of ataxic dysarthria?
- slow rate - equal/excess stress - prolonged phonemes - inappropriate silences
40
what is hypokinetic dysarthria?
- not enough dopamine = too little movement
41
what are some conditions associated with hypokinetic dysarthria?
- parkinson’s disease - parkinsonism - progressive supranuclear palsy (PSP)
42
what are some characteristics of hypokinetic dysarthria?
- slow individual movements - fast or slow repetitive movements - reduced range of movement - reduced force - excessive tone (rigidity)
43
what are the respiratory/laryngeal characteristics of hypokinetic dysarthria?
- breathiness - short phrases - reduced volume
44
what is the resonance characteristic of hypokinetic dysarthria?
- hypernasality (hpk answer)
45
what is the articulation characteristic of hypokinetic dysarthria?
- imprecise articulation
46
what are the prosody characteristics of hypokinetic dysarthria?
- monopitch - monoloudness - short phrases - variable rate - reduced stress
47
what is hyperkinetic dysarthria?
- too much dopamine = too much movement
48
what are some conditions associated with hyperkinetic dysarthria?
- 70% have unknown diagnosis - Huntington’s disease - stroke
49
what are some characteristics of hyperkinetic dysarthria?
- action myodonus - episodes of involuntary muscle jerking - chorea - causes involuntary, irregular & unpredictable muscle movements - top of mouth uncontrollable movement
50
in what areas does hyperkinetic dysarthria affect?
- all areas
51
what is the dominant speech characteristic that hyperkinetic dysarthria affects?
- prosody - patterns of stress and intonation
52
what are some specific difficulties hyperkinetic dysarthria can cause, in terms of speech?
- prolonged intervals - imprecise consonants - distorted vowels - monopitch
53
what types of stroke can cause unilateral UMN dysarthria?
- frontal lobe - corona radiata - internal capsule - brainstem
54
what conditions are associated with unilateral UMN dysarthria?
- 90% stroke related - traumatic brain injury - tumour
55
what are some characteristics for unilateral UMN dysarthria?
- weaknesses - incoordination - spasticity
56
what are some speech characteristics for unilateral UMN dysarthria?
- imprecise articulation - hoarseness - slow & irregular AMRs - reduced loudness
57
what mixed dysarthria is associated with MND?
- flaccid-spastic
58
what mixed dysarthria is associated with brainstem stroke, multiple sclerosis and traumatic brain injury?
- ataxic-spastic
59
what mixed dysarthria is associated with Parkinsonism and CBD?
- hypokinetic-spastic
60
what mixed dysarthria is associated with Parkinsonism and CBD?
- hypokinetic-spastic
61
what mixed dysarthria is associated with Parkinson’s disease?
- hypokinetic-hyperkinetic

Acquired motor speech (5 decks)

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