Lecture 2 Flashcards
(31 cards)
Body Functions and Structures
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)
Activity and participation
Describes the impact of health conditions, impairments, and contextual factors on performance of and participation in functional activities.
Contextual Factors
Personal Factor
Personal Factor
-Age
-Life experiences
-Personality
-co-morbidities
Contextual Factors
Environmental Factors
-Technology
-Geography
-Support and relationships
-Attitudes
-Services
-Systems and policies
Flaccid Dysarthria
Definition—- weakness where ?
4 characteristics
Weakness in speech or respiratory
musculature
Causes a variety of symptoms:
Slow-labored articulation
Hypernasal resonance
Breathy phonation
Hoarse voice
FLACCID DYSARTHRIA
Caused
What 5 muscles are innervated?
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
CRANIAL NERVES important for speech
What lower motor neurons do ?
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.
CRANIAL NERVES
Damaged causes
Damaged nerves result in specific symptoms:
Causes:
Brainstem stroke
Tumor
Viral or bacterial infections
Trauma
Surgical accidents
Freed, 2020
Trigeminal Nerve V
Where is in the brainstem?
What are the branches and what do they do ?
What kind of damage can be?
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
Facial Nerve VII
Where is it In the brainstem?
What if damage?
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
Glossopharyngeal Cranial IX
Where in the brainstem?
Where does it travel and what does it do?
Originates in brainstem at medulla, traveling to
pharynx
speech resonance
phonation
creating pharynx positions for producing various
phonemes
Freed, 2020
Vagus Nerve X
Branches and what do they do?
Three branches
Pharyngeal branch
movement of velum, resonance
External superior laryngeal nerve branch
pitch
Recurrent nerve branch
breathy phonation
Freed, 2020
Accessory Cranial Nerve
Where in the brainstem?
What other cranial nerve does it work with to innervate what 3?
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
Hypoglossal Cranial Nerve
Innervates muscles of tongue
Damage results in weakness or paralysis
of tongue
Imprecise articulation
phoneme distortion
slow lingual movements
Freed, 2020
Spinal nerves
What does it assist and what is damaged?
Assist motor speech production
Phrenic nerve for respiration
Injury impairs respiration
paralyzed diaphragm
decreased loudness
breathy or strained vocal quality
Freed, 2020
CAUSES OF FLACCID
DYSARTHRIA
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
Physical trauma
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
BRAINSTEM STROKE
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
MYASTHENIA GRAVIS
What it is? How does it happen ? And any treatment ?
Affects neuromuscular junction
Caused by antibodies that damage muscle
tissue
Temporary relief
Injection of edrophonium chloride (Tensilon)
Freed, 2020
MYASTHENIA GRAVIS (CONT’D.)
Symptoms and assessment
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
GUILLAIN-BARRÉ SYNDROME
What is it and why it happens ?
Symptoms and recovery rates
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
POLIO
What it is and characteristics
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
OTHER CAUSES OF FLACCID
DYSARTHRIA
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
Progressive bulbar palsy
Progressive bulbar palsy
Affects upper and lower motor neurons
With lower motor neuron damage, causes flaccid
dysarthria
Freed, 2020
