Flashcards in MSD - Quiz 2 Deck (63)
What is a motor speech disorder?
Defined as speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech.
What is dysarthria?
Neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production.
What is apraxia of speech?
Neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech
What part of the brain is hypokinetic dysarthria associated with?
basal ganglia control circuit
The characterisitics of hypokinectic dysarthria are most evident in:
voice, articulation, prosody
Hypokinetic dysarthria physiologic characteristics include:
rigidity, reduced force and range of movement, and slow individual but sometimes fast repetitive movements on speech
What are the basal ganglia activities strongly association with?
The actions of the indirect activation pathway or extrapyramidal system
What complex interconnections make up the basal ganglia control circuit?
1. cortical, _______, and substantia nigra input to the striatum, with crucial cortical input incoming from the _____ lobe premotor cortex.
2. _____ input to the substantia nigra and globus pallidus
3. globus pallidus to the _____, subthalamic nucleus, red nucleus, and ____ formation in the brainstem.
1. thalamic, frontal
3. thalamus, reticular
What are the functions of the basal ganglia circuit?
regulate muscle tone,
control postural adjustments during skills movements,
regulate movements that support goal-directed activities,
scale the force, amplitude, and duration of movements,
adjust movements to the environment,
assist in the learning, preparation and initiation of movements
What part of the brain is UUMN dysarthria associated with?
Upper motor neuron pathways
UUMN dysarthria reflects effects in:
Weakness, but sometimes spasticity and incoordination
UUMN dysarthria can be caused by a: tumor, _____, unilateral stroke (most common), and small _____ also called lacunes or lacunar
What are frequent patient complaints of UUMN dysarthria?
-Heaviness on affected side of the face or corner of mouth
-Heaviness /thickness in the tongue
-Chewing & swallowing difficulties are not uncommon
Patient complaints in severe cases:
slurred/thick/slow speech with deteriorates due to fatigue or psychological stress
What does a UUMN oral mech look like?
-Unilateral weakness: at rest and during movement
-Palatal weakness: velopharyngeal function assumed to be normal
-Dysphagia: discomfort/difficulty swallowing
Speech characteristics for UUMN dysarthria include:
-Articulatory inaccuracy: imprecise consonants, irregular artic. breakdowns, irregular/imprecise AMRs
-Mild rate and prosodic abnormalities
-Mild to moderate phonation/reduced loudness
UUMN dysarthria results in ____ respiratory drive.
T/F: Laryngeal function in UUMN dysarthria can either increase or decrease.
T/F: Patients with UUMN dysarthria experience increased nasal airflow.
Patients with UUMN dysarthria experience reduced: Speech rate, _____ rates, jaw movement, and strength/endurance/speech of tongue and _____ movement
What part of the brain is Ataxic dysarthria associated with?
Damage to the cerebellar control circuit
Ataxic dysarthria reflects effects in:
Motor control (not neuromuscular execution)
T/F: Ataxic dysarthria can be a problem of poor timing, control, and/or coordination.
What are the main structures/pathways/functions in the cerebellar control circuit?
-The vermis: forms the midportion of the anterior and posterior cerebellar lobes
-Purkinje cells: inhibitory; output neurons of the cerebellar nuclei
-The motor system: reciprocal connections, auditory and proprioceptive feedback from muscles/tendons/joints,
Ataxic dysarthria can be caused by a:
-Degenerative diseases (ALS, PSP, frontotemporal dementia, etc.)
-Trauma: postoperative (tumor or deep brain stimulation) or TBI
-Toxic/Metabolic/Endocrine (drug toxicity or alcohol-related)
What are typical complaints from patients with Ataxic dysarthria?
-Dramatic deterioration in speech (with limited alcohol intake)
-Inability to coordinate their breathing and speaking
-May bite their cheek or tongue while talking/eating
-Stumble over words (mild dysarthria)
An Ataxic oral mech show:
1. structures and movements are ____ at rest, sustained posture, and during emotional expression.
2. ____ nonspeech AMRs.
What are the 3 different types of clusters in Ataxic dysarthria?
-Articulatory inaccuracy: imprecise consonants, vowel distortions, irregular arctic. breakdown
-Prosodic excess: excess and equal dress, prolonged phonemes, prolonged intervals, slow rate
-Phonatory-prosodic insufficiency: harshness, monopitch, and monoloudness
What is the most common cause of hypokinetic dysarthria?