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Flashcards in Motor Exam 2 Deck (45)
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1

In UUMN dysarthria, the clinician might observe the following during an oral mechanism exam:

lower facial weakness and hemiparesis
drooling
contralateral lingual weakness

2

Individuals who are diagnosed with Multiple Sclerosis often have ________ dysarthria

ataxic

3

The three essential procedural components when assessing an individual for dysarthria are

review medical history, identify salient features, identify confirmatory signs

4

A weak or quiet voice, rapid rate of speech, difficulty initiating speech, drooling, and swallowing complaints are common with ______ dysarthria

hypokinetic

5

Flaccid dysarthria characterized by tongue weakness is due to damage to which cranial nerve?

XII

6

A 57 year old man was seen for evaluation. He had residual symptoms from a stroke 3 years earlier. The neurologist reported the patient had a "pure motor hemiparesis, almost like a capsular infarct." The speech evaluation revealed mild lower left face and tongue weakness. The patient's speech revealed mildly imprecise articulation and imprecise AMRs. Phonation and resonance were normal. What type of dysarthria does this patient have?

UUMN

7

Where does hypokinetic dysarthria localize to?

basal ganglia control circuit

8

What is the specific neuromuscular basis (or main problem) associated with spastic dysarthria?

spasticity

9

Where does spastic dysarthria localize to?

Bilateral UMNs

10

____ palsy occurs when several cranial nerves are affected.

Bulbar

11

What is the most common main/broad etiologic category of unilateral UMN dysarthria?

vascular/stroke

12

A patient who has problems that localize to the extrapyramidal system will have which type(s) of dysarthria?

hypokinetic
hyperkinetic

13

Deviant speech characteristics of hyperkinetic dysarthrias can be manifest in which levels of speech?

respiratory, phonatory, resonatory, and articulatory

14

A 72 year old man is referred to you for a speech evaluation by his neurologist. His medical history includes a left-side brainstem stroke 6 months ago, with no previous strokes. The are of his stroke suggests impairment of cranial nerves IX, X, and XI on the left. What type of dysarthria would you suspect?

flaccid

15

Perceptual attributes that are consistent with laryngeal muscle weakness and hypotonia are a result of lesions to which branch of the vagus nerve?

superior laryngeal and recurrent laryngeal

16

Phonatory and resonatory incompetence are commonly encountered distinguishing features of what type of dysarthria?

flaccid

17

Clinical characteristic of cerebellar lesions and ataxia include:

hypotonia
titubation

18

Hallmark speech characteristics of hypokinetic dysarthria include:

accelerated speech
monopitch
inappropriate silences

19

Reduced respiratory support for speech, reduced loudness, pitch variability, and reduced phrase length can be caused by lesions to?

spinal respiratory nerves

20

Where does flaccid dysarthria localize to?

LMNs

21

A 68 year old man presented with a 5 year history of difficulty getting into and out of chairs, stiffness during walking, and difficulty turning in bed. He had voice and handwriting difficulty. He presented with neck rigidity and diminished arm swing. Facial expression was masked. He reported he was uncertain if "words would come out." His spouse reported he was quieter and slower in the evening or following extended periods of speaking. His jaw, lips and tongue were mildly tremulous during sustained postures. Infrequent rapid repetitions, prolongations of initial phonemes, nasal emission (but did not sound hypernasal) were observed during the speech evaluation. Speech AMRs were normal and prolonged "ah" was breathy-hoarse. What type of dysarthria did this gentlemen have?

hypokinetic

22

A 73 year old woman presented with a 10 year history of voice difficulty that was present upon awakening one day. The problem progressed for a while by the patient had been stable for several years. Neurologic evaluation identified a head tremor, postural upper extremity tremor, and "spastic speech." The speech evaluation noted her speech was characterized by a tremor that consistently interrupted her voice and slowed her speech rate. Prolonged "ah" contained consistent, somewhat irregular, and strained voice interruptions were noted. Tremor fluctuations were not apparent during prolongation of voiceless fricatives. What type of dysarthria did this patient have?

hyperkinetic

23

Slurred speech and "drunken" sounding speech is one of the hallmark complaints of individuals with which type of dysarthria?

ataxic

24

What is the specific neuromuscular basis (or main problem) associated with hyperkinetic dysarthria?

involuntary movements

25

A 63 year old female was hospitalized for evaluation and treatment of cardiovascular problems. Three weeks before admission, she suddenly developed speech and gait difficulty. She had no difficulties with language, chewing, or swallowing. A CT scan of the head identified a 2-cm area of low attenuation in the right cerebellar hemisphere consistent with a stroke. The speech pathologist was consulted. Speech-language evaluation results noted: normal oral mechanism exam; speech difficulties included irregular articulatory breakdowns, irregular speech AMRs, and unsteady vowel prolongation. The SLP reported intelligibility was normal. With what motor speech disorder would you diagnose her?

Ataxic

26

Movement disorders associated with hyperkinetic dysarthria are:

dystonia
chorea
tremor
tics

ALL?

27

The dysarthria types differ in:

oral mechanism findings
anatomic and vascular localization
speech characteristics
etiologic distributions

28

Monopitch, monoloudness, reduced stress, and short phrases are speech characteristics that can be attributed to which cluster of deviant dimensions?

prosodic insufficiency

29

What is the specific neuromuscular basis associated with hypokinetic dysarthria?

rigidity and reduced range of movement

30

Spasticity, weakness, reduced range of movement, slowness of movement are salient effects of what type of lesions?

UMN