Exam 3 - Hypokinetic Dysarthria

Question 1

neurological basis of hypokinetic dysarthria

Answer 1

basal ganglia

Question 2

common speech characteristics of hypokinetic dysarthria

Answer 2

harsh or breathy vocal quality
reduced vocal loudness
abnormal speaking rates

Question 3

hypokinetic dysarthria most evident in these subsystems:

Answer 3

phonation
articulation
prosody

Question 4

hypokinetic dysarthria is unique bc only dysarthria with:

Answer 4

INCREASED rate of speech
mainly one cause: parkinsonism

Question 5

mainly one cause of hypokinetic dysarthria

Answer 5

parkinsonism

Question 6

hypokinetic means

Answer 6

less motion

Question 7

hypokinetic dysarthria has reduced movement, but NOT

Answer 7

reduced tone

Question 8

reduced movement includes

Answer 8

shuffling gate
masked facies
reduced eye blinking

Question 9

role of basal ganglia

Answer 9

smooth/refine + postural support

Question 10

primary characteristics of parkinsonism

Answer 10

resting tremor
brady kinesia
rigidity
spasticity
akinesia
disturbances of postural reflexes

Question 11

bradykinesia

Answer 11

slow + reduced movement (shuffling gate, micrographia)

Question 12

akinesia

Answer 12

delay/pause before response

Question 13

causes of parkinsonism

Answer 13

dysfunction in basal ganglia
***imbalance in dopamine and acetylcholine

Question 14

reduction in dopamine causes

Answer 14

too much acetylcholine

Question 15

decreased dopamine levels result in

Answer 15

spasticity and rigidity of muscles

Question 16

inhibitory neurotransmitter

Answer 16

dopamine

Question 17

excitatory neurotransmitter

Answer 17

acetylcholine

Question 18

major causes of hypokinetic dysarthria

Answer 18

idiopathic parkinson’s disease
neuroleptic-induced parkinsonism (psych-med induced)
postencephalitic parkinsonism (viral)

Question 19

less common causes of hypokinetic dysarthria

Answer 19

traumatic head injury
toxic metal poisoning
stroke

Question 20

hypokinetic dysarthria non-speech symptoms

Answer 20

tremor
bradykinesia
rigidity
akinesia
disturbed postural reflexes

Question 21

prosody of hypokinetic dysarthria

Answer 21

monopitch
reduced stress
monoloudness
short phrases
rushed-sounding speech

Question 22

articulation of hypokinetic dysarthria

Answer 22

imprecise consonants
repeated phonemes
palilalia

Question 23

phonation of hypokinetic dysarthria

Answer 23

harsh/breathy
aphonia
low pitch

Question 24

respiration of hypokinetic dysarthria

Answer 24

sometimes noted

Question 25

resonance of hypokinetic dysarthria

Answer 25

if present, mild hypernasality

Question 26

eval for hypokinetic dysarthria

Answer 26

oral mech exam vowel prolongations DDKs conversation speech and reading

Question 27

Pharmacologic Tx of hypokinetic dysarthria

Answer 27

L-Dopa (levodopa) - precursor of dopamine anticholinergic drugs - decrease acetylcholine activity

Question 28

surgical Tx of hypokinetic dysarthria

Answer 28

deep brain stimulation stem cell implantation - more research needed

Question 29

behavioral Tx of hypokinetic dysarthria

Answer 29

Speech therapy

Question 30

behavioral Tx for parkinsonism

Answer 30

behavior/instrumentation based tasks important part of clinical treatment plan articulation phonation respiration prosody

Question 31

most common articulation deficit of parkinsonism

Answer 31

imprecise consonants d/t reduced range of motion in articulators *can be compounded by increased rate

Question 32

articulation Tx of parkinsonism

Answer 32

rate reduction stretching traditional articulation tasks

Question 33

phonation Tx of parkinsonism

Answer 33

pushing/pulling procedure (increase force) hard glottal attack voice amplifiers instrumental biofeedback LSVT Speak out

Question 34

why harsh/breathy vocal quality w hypokinetic dysarthria

Answer 34

vocal folds adduct only partially + possible poor respiratory support

Question 35

respiration Tx of parkinsonism

Answer 35

speaking immediately on exhalation cueing for complete inhalation slow and controlled exhalation stop phonation early optimal breath group respiratory muscle strength training (RMST)

Question 36

prosody Tx of parkinsonism

Answer 36

slowing rate intonation profiles contrastive stress drills chunking utterances into syntactic units

Question 37

hypokinetic dysarthria is closely associated with

Answer 37

parkinsonism

Question 38

most common cause of hypokinetic dysarthria

Answer 38

idiopathic parkinson's disease

Question 39

SUMMARY: hypokinetic dysarthria Tx involves targeting:

Answer 39

articulatory precision increasing phonatory effort promoting more natural prosody rate control tasks