Flaccid Flashcards

(51 cards)

1
Q

flaccid dysarthria is cased by damage to what

A

lower motor neurons

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2
Q

lower motor neurons include what

A

cranial nerves and spinal nerves

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3
Q

flaccid characteristics

A
  • slow labored articulation
  • marked degrees of hyper nasal resonance
  • hoarse-breathy phonation
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4
Q

last and only “road” neural impulses from upper motor neurons travel to reach muscles

A

final common pathway

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5
Q

the six pairs of cranial nerves that play a role in speech production

A
  • trigeminal
  • facial
  • glossopharyngeal
  • vagus, accessory
  • hypoglossal
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6
Q

specific causes of damage to your lower motor neurons

A
  • physical trauma
  • brainstem stroke
  • myasthenia gravis
  • Guillain-Barre syndrome
  • polio
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7
Q

flaccid dysarthria is caused by anything that …

A

disrupts the flow of motor impulses along cranial or spinal nerves that innervate muscles of speech production

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8
Q

what nerve is one of the most important nerves of respiration (and motor speech production) that come out of C3, C4, and C5

A

phrenic nerve

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9
Q

damage to the phrenic nerve can cause

A
  • paralyzed diaphragm
  • decreased loudness
  • shortened, breathy, or strained vocal quality
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10
Q

physical trauma can include

A
  • surgical trauma
  • head and neck injury
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11
Q

a brainstem stroke is also known as a

A

cerebrovascular accident (CVA)

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12
Q

damage from a CVA depends on what

A

the amount of lower motor neurons that are lost and don’t receive blood flow from that stroke

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13
Q

what does Myasthenia Gravis affect

A

the neuromuscular junction

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14
Q

symptoms of Myasthenia Gravis

A
  • rapid fatigue of muscular contractions over a short time with recovery after rest
  • hyper nasality
  • decreased loudness
  • breathy voice quality
  • decreased articulatory precision
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15
Q

how would you assess Myasthenia Gravis

A

with a stress tess

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16
Q

what is a stress test

A

counting from 1 to 100 or to read a lengthy paragraph

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17
Q

Guillain-Barre Syndrome results in

A

demyelination (depletion of the myelin sheath on the neuron)

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18
Q

Guillain-Barre frequently occurs when?

A

after certain kinds of infections and immunizations

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19
Q

symptoms of Guillian-Barre

A
  • flaccid dysarthria
  • dysphagia
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20
Q

recovery of Gillian-barre syndrome

A
  • high recovery rate, lasting weeks or months
  • 5% die in acute stages
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21
Q

polio is what

A

an infectious viral disease that attacks cell bodies of lower motor neurons

22
Q

what does polio most frequently affect

A

cervical and thoracic spinal nerves

23
Q

polio causes

A
  • labored inhalation during speech
  • shortened speech phrases
  • speaking on residual air
  • decreased loudness
24
Q

Can polio also affect spinal nerves?

25
Others causes of flaccid dysarthria
- tumors (growing in or near the brainstem) - muscular dystrophy (progressive degeneration of muscle tissue) - progressive bulbar palsy (often only present in LMN but can he in the UMN as well)
26
Main word or flaccid characteristic
weaknesses
27
resonance in flaccid
- hypernasality (most noticeable voice quality error) - nasal emission - weak pressure consonants - shortened phrases
28
articulation in flaccid dysarthria
- imprecise consonant production
29
damage to the trigeminal nerve affects articulation in that
they would have difficulty in elevating the jaw sufficiently to bring articulators into contact with each other
30
intervention for problems with jaw movement
use your hand to elevate the jaw or use a jaw sling
31
phonation in flaccid dysarthria
phonatory incompetence (incomplete adducting of the vocal folds during phonation)
32
incomplete adduction of the vocal folds during phonation results in
- breathy voice quality or whisper - weak or paralyzed adductor and abductor muscles
33
what is the strongest confirmatory sign of flaccid dysarthria
hypernasality and phonatory incompetence
34
respiration in flaccid dysarthria
weakened respiration (decreased inhalation of impaired control of exhalation) may be present
35
respiration symptoms in flaccid dysarthria
- reduced loudness - shortened phrase length - strained vocal quality if speaking on residual air to prolong phrase length - monoloudness * - monopitch * - may inhale frequently (affects prosody)
36
prosody in flaccid dysarthria
weakened laryngeal muscles that are unable to make many fine vocal-fold adjustments necessary for normal pitch and loudness variations
37
prosodic symptoms
- monopitch - monoloudness
38
is prosody a definite diagnostic marker for flaccid dysarthria?
nope!
39
key evaluation tasks for flaccid
- conversational speech and reading - alternate motion rate (AMR) - prolonged vowel - speech stress test
40
what is the primary task for evaluating flaccid
conversational speech and reading
41
conversational speech and reading can evoke errors of what
- resonance (hypernasality) - articulation (imprecise consonants) - respiration (shortened phrase length) - prosody (mono pitch, mono loudness)
42
what will AMR highlight in flaccid dysarthria
a slow rate of phoneme production (showing the weak articulation movement)
43
what will a prolonged vowel evoke in flaccid
- helpful in seeing the breathy voice quality heard in phonatory incompetence - useful in observing respiratory weakness
44
why is a speech stress test necessary in flaccid
for myasthenia gravis (to show the tired)
45
the traditional approach to treating motor speech disorders is to
- use assessment data to identify deficits - begin working with patients use appropriate treatment goals - increase complexity of tasks as patients improve - work toward generalization of improvements
46
Rosenbek made 6 additional recommendations
- help pts recognize differences in their speech - help pts have a willingness to change their speech for the better - work closely with pts when setting goals for treatment - insist that pts are talking therapeutically in their sessions even in small talk - ensure pts are learning to list, evaluate, and self-correct their speech - progressively add cognitive-linguistic load to treatment tasks to ensure pts are working toward generalization
47
treatment for flaccid are presented according to what
which cranial nerve or combination of nerves are damaged
48
respiration treatment for flalccid
- correct posture - compensatory prosthetic devices - speaking immediately on exhalation - cueing for complete inhalation
49
phonation treatment for flaccid
- pushing and pulling procedures - holding breath - hard glottal attack - head turning - sideways pressure on the larynx
50
articulation treatment for flaccid
traditional articulation drills
51
resonance treatment for flaccid
- velar strength-training procedure - modification of speech - reduced rate - more open-position mouth during speech - increase loudness