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Neurogenic & Motor disorders > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Body Functions and Structures

A

Underlying impairments of or change to anatomical structures or physiologic functions physiologic functions.

In dysarthria impairments are often described at the level of muscle or nerve impairment (e.g. weakness ) or at the level of subsystem of voice)

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2
Q

Activity and participation

A

Describes the impact of health conditions, impairments, and contextual factors on performance of and participation in functional activities.

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3
Q

Contextual Factors
Personal Factor

A

Personal Factor
-Age
-Life experiences
-Personality
-co-morbidities

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4
Q

Contextual Factors
Environmental Factors

A

-Technology
-Geography
-Support and relationships
-Attitudes
-Services
-Systems and policies

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5
Q

Flaccid Dysarthria
Definition—- weakness where ?
4 characteristics

A

 Weakness in speech or respiratory
musculature
 Causes a variety of symptoms:
Slow-labored articulation
Hypernasal resonance
Breathy phonation
Hoarse voice

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6
Q

FLACCID DYSARTHRIA
 Caused
What 5 muscles are innervated?

A

 Caused by damage to lower motor neurons
(part of PNS)
 neural impulses are transferred from upper motor
neurons to reach muscles
 Caused by a damage preventing neural impulses
descending by lower motor neurons innervating
muscles of:
 respiration
 phonation
 articulation
 prosody
 resonance

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7
Q

CRANIAL NERVES important for speech
What lower motor neurons do ?

A

 Six pairs of cranial nerves are crucial for
speech production
 Trigeminal
 facial
 glossopharyngeal
 vagus
 accessory
 hypoglossal
 Lower motor neurons of these nerves transmit
neural impulses from upper motor neurons to
muscles for speech.

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8
Q

CRANIAL NERVES
 Damaged causes

A

 Damaged nerves result in specific symptoms:
 Causes:
 Brainstem stroke
 Tumor
 Viral or bacterial infections
 Trauma
 Surgical accidents
Freed, 2020

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9
Q

Trigeminal Nerve V
Where is in the brainstem?
What are the branches and what do they do ?
What kind of damage can be?

A

 Attached to brainstem at level of pons, divided into
three main branches (ophthalmic, maxillary, and
mandibular)
 Mandibular branch innervates muscles of lower jaw and
velum
 Damage to trigeminal nerve can be unilateral or
bilateral

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10
Q

Facial Nerve VII
Where is it In the brainstem?
What if damage?

A

 Branches out from brainstem just below trigeminal
nerve.
 Damage to facial nerve:
 weakness or paralysis in all muscles on same side of face
 drooping of the eyelid
 mouth
 cheek
Freed, 2020

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11
Q

Glossopharyngeal Cranial IX
Where in the brainstem?
Where does it travel and what does it do?

A

 Originates in brainstem at medulla, traveling to
pharynx
 speech resonance
 phonation
 creating pharynx positions for producing various
phonemes
Freed, 2020

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12
Q

Vagus Nerve X
Branches and what do they do?

A

 Three branches
 Pharyngeal branch
 movement of velum, resonance

 External superior laryngeal nerve branch
 pitch

 Recurrent nerve branch
 breathy phonation
Freed, 2020

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13
Q

Accessory Cranial Nerve
Where in the brainstem?
What other cranial nerve does it work with to innervate what 3?

A

 Originates in medulla below vagus nerve
 Works with vagus nerve, innervating muscles of
 velum, pharynx, and larynx
 Damage to accessory nerve will affect vagus
nerve and vice versa

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14
Q

Hypoglossal Cranial Nerve

A

 Innervates muscles of tongue
 Damage results in weakness or paralysis
of tongue
 Imprecise articulation
 phoneme distortion
 slow lingual movements
Freed, 2020

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15
Q

Spinal nerves
What does it assist and what is damaged?

A

 Assist motor speech production
 Phrenic nerve for respiration
 Injury impairs respiration
 paralyzed diaphragm
 decreased loudness
 breathy or strained vocal quality
Freed, 2020

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16
Q

CAUSES OF FLACCID
DYSARTHRIA

A

 Injury in cranial or spinal nerves innervating
muscles of speech
 trauma
 brainstem stroke
 myasthenia gravis
 Guillain-Barré syndrome
 and polio
 Tumor
 muscular dystrophy
 progressive bulbar palsy
Freed, 2020

17
Q

Physical trauma

A

Physical trauma
 Surgical trauma with the accidental cut of
cranial nerve
 Surgery
 Removal of head and neck tumors
 Dental surgery
 Head and neck injury
 Motor vehicle accidents
 Falls Freed, 2020

18
Q

BRAINSTEM STROKE

A

 Cerebrovascular accident (CVA)
 blood flow interruption to brain due to artery
breaks or is blocked
 Lower motor neurons are lost
 Brainstem stroke damages more than one
cranial nerve
Freed, 2020

19
Q

MYASTHENIA GRAVIS
What it is? How does it happen ? And any treatment ?

A

 Affects neuromuscular junction
 Caused by antibodies that damage muscle
tissue
 Temporary relief
 Injection of edrophonium chloride (Tensilon)
Freed, 2020

20
Q

MYASTHENIA GRAVIS (CONT’D.)
 Symptoms and assessment

A

 Symptoms
 Rapid fatigue of muscular contractions with
recovery after short rest
 Hypernasality
 decreased loudness
 breathy voice quality
 decreased articulatory precision

 Assessment
 Stress test involving asking patient to count from 1
to 100 or to read lengthy paragraph

21
Q

GUILLAIN-BARRÉ SYNDROME
What is it and why it happens ?
Symptoms and recovery rates

A

 Results in demyelization
 After infections and immunizations

 Symptoms
 Flaccid dysarthria
 dysphagia

 Recovery is frequent
 High recovery rate
 lasts weeks or months
 5% die in acute stages
Freed, 2020

22
Q

POLIO
What it is and characteristics

A

 A viral disease affecting cell bodies of lower
motor neurons
 Cervical and thoracic spinal nerves damage
 labored inhalation during speech
 shortened speech phrases
 speaking on residual air
 decreased loudness
 cranial nerves can be affected as well

23
Q

OTHER CAUSES OF FLACCID
DYSARTHRIA

A

 Tumors growing in or near brainstem

 Muscular dystrophy
 Causes progressive degeneration of muscle tissue
 Can result in weakness in many muscles served
by cranial nerves
Freed, 2020

24
Q

Progressive bulbar palsy

A

 Progressive bulbar palsy
 Affects upper and lower motor neurons
 With lower motor neuron damage, causes flaccid
dysarthria
Freed, 2020

25
Q

SPEECH CHARACTERISTICS OF
FLACCID DYSARTHRIA

A

 Not all individuals demonstrate deficits and
severity of symptoms in all areas
 Clusters of symptoms play a role in
diagnosing various types of dysarthria
Freed, 2020

26
Q

Resonance
Reflects on what?
Characteristics

A

 Reflects bilateral damage to pharyngeal
branch of Vagus
 Innervates muscles of velum
 Hypernasality: most noticeable error
 Nasal emission: weak velopharyngeal closure
 Weak pressure consonants: decreased intraoral air
pressure
 Shortened phrases: wasted air that escapes through nasal
cavity during speech
Freed, 2020

27
Q

Articulation
How damaged to the cranial nerves affect it?

A

ARTICULATION
 Imprecise consonant production

 Damage to facial and hypoglossal nerves
 Bilateral damage to facial nerve
 From mild distortion to unintelligibility

 Damage to trigeminal nerve
 Difficulty elevating jaw sufficiently to bring articulators into contact
with each other
Freed, 2020

28
Q

Phonation
How damage to the CN and what branches affect it ?and why does it happen ?

A

 Phonatory incompetence
 Abnormal adduction of vocal folds during phonation

 Caused by damage to recurrent branch of vagus
 weak or paralyzed adductor and abductor muscles
 breathy voice quality or whisper

 Confirmatory sign of flaccid dysarthria:
 Combined presence of hypernasality and phonatory
incompetence

29
Q

Respiration

A

 Weakened respiration
 Damage to cervical and thoracic spinal
nerves
 abnormal innervation of diaphragm and intercostal muscles
 Decreased inhalation
 impaired control of exhalation during speech

30
Q

Respiration
 Symptoms

A

 Symptoms
 Reduced loudness
 shortened phrase length
 strained vocal quality
 if speaking on residual air to prolong phrase length
 monoloudness
 monopitch
 May inhale frequently while speaking
 adversely affects prosody
 difficult to determine:
 poor laryngeal valving or
 weak respiration
Freed, 2020

31
Q

Prosody

A

 Weakened laryngeal muscles
 unable to make fine vocal-fold adjustments for normal pitch and
loudness variations
 monopitch, monoloudness
 Not unique to flaccid dysarthria

Neurogenic & Motor disorders (5 decks)

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