Exam 2 Flashcards
(73 cards)
1
Q
- rate and rhythm control approach to treating AOS
- speech produced in time to a metronome
- usually about 1 syllable per beat
- rate initially slow, gradually increased
A
metronome pacing
2
Q
- Due to damage to cerebellum
- Impairment affects:
- coordination
- decreased muscle tone
- Impairment results in slowness and inaccuracy of aspects of movement
A
Ataxic dysarthria
3
Q
- articulatory and kinematic approach to treating AOS
- client consciously focuses on production in a word s/he can say
- clinician tries to generalize this correct production to other words
A
key word approach
4
Q
vascular problems that could cause spastic dysarthria
A
- stroke- most likely brainstem, not unilateral cerebral
- vascular dementia
5
Q
True or false apraxia of speech rarely occurs without an accompanying aphasia
A
True
6
Q
Unilateral Upper Motor Neuron Dysarthria
Clinical characteristics (4)
A
- hemiplegia or hemiparesis
- early-weakness, hyporeflexia, hypotonia
- later- spasticity, hypertonia
- contralatral lower face weakness
7
Q
- inflammatory demyelinating disease
- destruction of white matter in brain or spinal cord
- possible etiology of spastic dysarthria
A
leukoencephalitis
8
Q
Unilateral Upper Motor Neuron Dysarthria
Etiologies (3)
A
- stroke- most common
- tumors
- trauma
9
Q
- prolonged or continuous spasms
A
tonic spasm
10
Q
Types of Neuromotor speech disorders (2)
A
- dysarthria
- apraxia of speech
11
Q
Etiologies of Hyperkinetic dysarthria (5)
A
- toxic- metabolic conditions
- degenerative diseases
- infectious disease
- stroke
- tumors
12
Q
errors in sequence and speed of parts of movement
A
decomposition of movement
13
Q
How many types of dysarthria?
A
7
14
Q
rhythmic tremor of body or head
A
titubation
15
Q
Ways to evaluate speech (3)
A
- perceptually
- acoustically
- physiologically
16
Q
neuromotor speech disorders management goals (2)
A
- restore lost function
- promote the use of residual function
- reduce the need for lost function
17
Q
- rapid, stereotyped movements
- often irresistible urge to make the movements
A
tics
18
Q
- most often due to impairment of basal ganglia indirect pathway
- often prominent effects on prosody
- different kinds of involuntary movements cause hyperkinetic dysarthrias
- orofacial dyskinesia
- tardive dyskinesia
- myoclonus
- tics
- chorea
- ballismus
- athetosis
- dystonia
- spasm
- tremor
A
Hyperkinetic dysarthrias
19
Q
- rate and rhythm control approach to treating AOS
- model two syllable words, accenting the stressed syllable, client imitates
- gradually increase word length
A
stress patterning
20
Q
- a combination of two or more types of dysarthria
- more common than single dysarthrias
A
mixed dysarthrias
21
Q
Hypokinetic dysarthria impairment produces: (4)
A
- rigidity
- reduced force
- reduced range
- slow individual, but sometimes fast repetitive movements
22
Q
- repetitive and brief spasms
A
clonic spasm
23
Q
- biofeedback
- mirror under the nose
- nasal flow transucer (if available)
- resistance treatment during speech continuous positive airway pressure (CPAP)
- produce words containing pressure sounds with nares pinched closed
- modification of speaking (over articulation)
- no evidence for NSOMEs
- no evidence for inhibition techniques
A
treating velopharyngeal dysfunction associated with dysarthria
24
Q
distrubance in trajectory or inability to control range
A
dysmetria
25
* electrodes surgically implanted, most often in subthalamic nucleus
* may be unilateral or bilateral
* electrical impulses sent to electrodes via stiumulator implanted implanted under the skin
* stimulator connected to electrodes via wires
* electrical impulses disrupt tremors and other motor problems
* limb movement problems respond better to drugs and DBS than speech problems
* speech may worsen with drugs or DBS
Deep brain stimulation (DBS)
26
* most often due to impairment of basal ganglia indirect pathway
hyperkinetic dysarthrias
27
* Impairment affects
* muscle strength
* muscle tone
* speed, range, and accuracy
flaccid dysarthria
28
Formal perceptual assessments for speech (4)
* Frenchay Dysarthria Assessment
* Assessment of Intelligibility in Dysarthric Speech (AIDS)
* Speech Intelligibility Test (SIT)
* Apraxia Battery for Adults
29
Clinical characteristics of ataxic dysarthria (8)
* problems in standing and walking
* titubation
* nystagmus
* dysmetria
* dysdiadochokinesis
* decomposition of movement
* possible intention tremor
* cognitive disturbances
30
* traditional approaches
* phonetic placement
* phonetic derivation
* integral stimulation-watch and listen tasks
* rate modification-slowing
* exaggeration of articulation
treatment of articulatory dysfunction associated with dysarthria
31
* articulatory and kinematic approach to treating AOS
* tactile cues are used to facilitate correct production
* requires extensive training to learn cues
PROMPT
32
face looks like they're wearing a mask, lacks facial expression
masked facies/ hypomimia
33
degenerative diseases that are possible etiologies of mixed dysarthria (4)
* progressive bulbar palsy
* pseudobulbar palsy
* ALS
* MS
34
## Footnote
rate and rhythm control approaches to treating Apraxia of Speech (2)
* metronome pacing
* stress patterning
35
What is the most common cuase of hypokinetic dysarthria?
Parkinson's Disease
36
Due to bilateral impairments of direct and/or indirect activation pathways
spastic dysarthria
37
* Parkinson's Disease
* Parkinson-plus or atypical parkinsonism
* dementing diseases (Lewy body, Pick's)
* Toxic/metabolic conditions
* trauma
* Infections
Etiologies of Hypokinetic Dysarthria (6)
38
What is the type of dysarthria based on?
the site of the lesion
39
* used to increase loudness
* think "loud and big"
* increase effort
* intensive treatment (4xs a week for 4 weeks)
* certification required
* work from short (single words) to longer material
* use of objective measures to monitor loudness (e.g., sound level meter)
* provide home practice materials (1 hour/day, 5 days)
* provide a lot of trials (15/item)
Lee Silverman Voice Therapy (LSVT)
40
Informal perceptual tools for speech assessment
* Mayo tests of motor programming
* Motor Speech Examination (Wertz et al. 1984)
41
* most common involuntary movement
*
tremor
42
Prosthetic options for neuromotor speech disorders (2)
* palatal lift prosthesis
* voice amplifier
43
What are the types of dysarthria? (7)
* flaccid
* spastic
* ataxic
* hypokinetic
* hyperkinetic
* unilateral upper motor neuron
* mixed
44
Assessments of non-speech movements (2)
* cranial nerve exam
* Duffy's (2013) examination
45
Impairment of basal ganglia direct pathway
hypokinetic dysarthria
46
* postural adjustments
* try to incorporate respiration activities into speech tasks
* sustaining phonation with feedback (e.g. Visipitch)
* some non-speech tasks may be beneficial for improving respiratory support
* maximum inhalation and exhalation tasks
* breathing against resistance (masked or pused lips)
treatment for respiratory dysfunction associated with dysarthria
47
* involuntary single repetitive brief jerks
* may be rhythmic or non-rhythmic
* palatal or palatopharyngeal
myoclonus
48
Clinical characteristics Flaccid dysarthria (6)
* weakness
* hypotonia
* diminished reflexes
* fasiculations
* atrophy
* progressive weakness with use
49
* may affect a single muscle group
* may affect only one speech subgroup
* subtypes based on site of lesion
Flaccid dysarthria
50
Etiologies of flaccid dysarthria (7)
* trauma
* degenerative diseases
* muscle disease
* neuromuscular junction
* brainstem stroke
* demyelinating disease
* infectious diseases
51
parts of a case history (7)
* basic data
* onset and course of the problem
* associated deficits
* patient's perception
* consequences
* management
* patient awareness of medical diagnosis and prognosis
52
* Due to impairment of the final common pathway (lower motor neuron)
Flaccid dysarthria
53
treatments that have supporting evidence for treating AOS (2)
* eight step continuum/integral stimulation
* PROMPT
54
slow initiation of movements
brodykinesia
55
Degenerative diseases that could cause flaccid dysarthria (2)
* amyotrophic lateral sclerosis (ALS)
* Progressive bulbar palsy
56
* for hypoadduction-effort closure techniques
* LSVT
* Resonant Voice Exercies
* Sirening
treatment of phonatory dysfunction associated with dysarthria
57
slow, writhing movements
athetosis
58
involuntary orofacial movements
orofacial dyskinesia
59
Neuromotor speech disorders
approaches to management (4)
* medical intervention
* prosthetic
* behavior management- patient and significant other(s)
* speech management
60
Articulatory and kinematic approaches (3)
* phonetic placement/derivation
* key word approach
* PROMPT
61
* due to damage to UMNs that innervate cranial or spinal nerves important for speech
* often mild and short lived
Unilateral Upper Motor Neuron Dysarthria
62
forceful, sustained closure of the eyes
blepharospasm
63
flailing movements
ballismus
64
* involuntary rapid, random, purposeless movements
* can be subtle or very obvious
chorea
65
* idiopathic and hereditary forms
* progressive loss of cells in the substantia nigra
* decreased dopamine the basal ganglia
* imbalance between ACh and dopamine in the basal ganglia
* treated with drugs that increase dopamine
* when drugs fail, may be treated with deep brain stimulation (DBS)
Parkinson's Disease
66
short, rapid, shuffling steps
festination
67
intermittant freezing
akinesia
68
* resting tremor (about 3-8 Hz)
* brodykinesia
* intermittent freezing
* pill-rolling movement
* masked facies (hypomimia)
* reduced arm swing
* micrographic writing
* festination
* impaired sensory function
Clinical Characteristics Parkinsonism (9)
69
FAST
Face, Arm, Speech, Time
70
* degenerative motor neuron disease
* corticobulbar, corticospinal signs
* if dysphagia and dysarthria major components, it is called progressive pseudobulbar palsy
* possible etiology of spastic dysarthria
primary lateral sclerosis
71
Neuromuscular junction diseases that could cause flaccid dysarthria (2)
* myasthenia gravis
* botulinum toxin exposure (botulism)
71
clinical characteristics of spastic dysarthria (4)
* spasticity
* weakness (especially distal)
* reduced range of movement
* slow movement
71
Etiologies of spastic dysarthria
* vascular problems
* primary lateral sclerosis
* leukoencephalitis
