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32 Cards in this Set
- Front
- Back
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Damage to what cortical control circuit causes hypokinetic dysarthria
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the Basal Ganglia
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The basal ganglia are comprised of
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caudate nucleus
putamen nucleus accumbens globus pallidus substantia nigra subthalamic nucleus |
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lenticular nucleus =
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GP + Putamen
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Striatum=
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caudate nucl + putamen + middle of nucl accumbens
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The receptive portion of the BG is:
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the striatum (projections from frontal cortex, thalamic nuclei and substantia nigra)
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Magor efferent pathways of the BG originate in ____ and go to the ___ to be
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the globus pallidus
ventrolateral thalamic nucleus relayed back to the cortex |
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Neurotransmitters seen in the BG
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Acetylcholine
Dopamine Gama-aminobutyric acid (GABA) |
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Input from the GP to the thalamus is ___
Input from the thalamus to the cortex is ___ |
inhibatory
excitatory |
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Input from the striatum to the GP is
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either inhibatory or excitatory
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Damage to BG can affect movements in 2 ways:
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hypokinesia or reduced mobility
hyperkinesia or involuntary movements |
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As a group, functions of BG components are important for (5)
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regulating muscle tone
maintaining normal posture maintaining static muscle contraction upon which voluntary, skilled movements are superimposed iregulating amplitude, velocity and possible initiation of movement motor learning? |
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Abnormal involuntary movements are those that occur ___
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when motor steadiness is expected
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Hypkinetic dysarthria results when a lesion to the _____ results in ______ resulting in impaired output to the ____ motor system.
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substantia nigra
a deficiency of dopamine extrapyramidal |
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Etiologies
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Degenerative neurological (parkinson's, supranuclear palsy, shy-drager)
Vascular Iatrogenic Metabolic |
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Neurological Characterisitics
Tremor: type and describe |
resting
rate 3-5 cps subsides with movement usually in extremity may also be postural or vocal tremor |
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Neurological Characteristics
Flexibility? |
Rigidity
may be smooth or intermittent |
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Neurological Characteristics
Movement may be characterized by |
bradykinesia, which is reduced speed, amplitude and kinesthesia of movemetnn of a muscle through its ROM
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Neurological Characteristics
Postural reflexes |
are reduced, resulting in stooped posture, festination of gait and reduced balance that often causes frequent falls
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Neurological Characteristics
Oral/facial features |
masked facies
reduced eye blinking (and reduced upward gaze and convergence) reduced ROM of lips/tongue |
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Neurological Characteristics
AMR/SMR |
reduced ROM evident
reduced differentiation between syllables ("humming") increased rate |
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Neurological Characteristics
Handwriting is characterized by ___ |
micrographia
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Neurological Characteristics
Dementia? |
in 30-50% of patients, risk increases with longevity
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Neurological Characteristics
Dysphonia? |
yep
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Neurological Characteristics
Dysphagia |
yep, often
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Speech Characteristics
Vocal Quality |
hoarse, rough, breathy with vocal tremor (reduced laryngeal competence from bowing of vocal folds and/or reduced glottal adduction)
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Speech Characteristics
Pitch |
higher than normal
restricted pitch range |
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Speech Characteristics
Loudness |
reduced level
restricted range patient may eventually only whisper |
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Speech Characteristics
Articulation |
manner affected more than place
articulatory undershoot |
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Speech Characteristics
Resonance |
normal
hypernasality is infrequent |
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Speech Characteristics
Respiration |
reduced VC (due to posture?)
irregular breathing patterns |
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Speech Characteristics
Prosody |
fast speaking rate
pallilalia monotone speech soft and hurried |
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What differentiates hypokinetic dysarthria from other types of dysarthria?
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voice changes (hypofunctional), including reduced intensity, monopitch and monoloudness, harshe and breathy vocal quality
Increased rate of speaking with short rushes of speech articulatory undershoot & pallilalia prosody characterized by reduced stress, inappropriate silences, monopitch and monoloudness |
