Motor Speech Disorders

Front 1

Flaccid Dysarthria

Back 1

- A group of motor disorders produced by injury or
malfunction of one or more of the cranial or spinal
nerves
- Problems in the nuclei, axons, or neuromuscular
junctions that make up motor units of the FCP
- Weakness, hypotonia, and diminished reflexes are the
primary characteristics
- Can be caused by degenerative inflammatory, toxic,
metabolic, neoplastic, traumatic, and vascular
diseases

Front 2

Spastic Dysarthria

Back 2

- Produce by bilateral damage to the direct and indirect
activation pathways of the central nervous system
- May be manifest in any or all of the respiratory,
phonatory, resonatory, and articulatory components
of speech
- Spasticity is a hallmark of upper motor neuron disease
- Signs that accompany spastic dysarthria include
weakness, loss of skilled movement, spasticity,
hyperactive reflexes, and pathologic reflexes
- Speech is slow and effortful and deteriorates with
fatigue are also common

Front 3

Ataxic Dysarthria

Back 3

Associated with damage to the cerebellar control circuit
- Characteristics are most evident in articulation and
prosody
- Reflects the effects of incoordination and reduced
muscle tone
- Individuals with ataxic dysarthria, complain of slurred
speech , dysphagia, and drooling

Front 4

Hypokinetic Dysarthria

Back 4

- Associated with the basal ganglia control circuit
- Characteristics most evident in voice, articulation, and
prosody
- Reflects the effects of rigidity, reduced force and range
of movement, and slow individual and sometimes
fast repetitive movements

Front 5

Hyperkinetic Dysarthria

Back 5

- Associated with diseases of the basal ganglia control
circuit
- Often have prominent effects on prosody
- Speech characteristics include abnormal, rhythmic or
irregular and unpredictable, rapid or slow
involuntary movements
- Frequent known causes include toxic and metabolic
conditions
-Tongue, jaw, and face are often affected

Front 6

Unilateral Upper Motor Neuron Dysarthria (

Back 6

- Associated with damage to the upper motor neuron
pathways that carry impulses to the cranial and spinal
nerves
- Stroke is the most common cause of UUMN
- Lower facial weakness and hemiparesis often
accompany UUMN
- UUMN is often mild to moderate in severity with good
recovery
- Speech characteristics are imprecise articulation and
less frequently, irregular articulatory breakdowns

Front 7

Mixed Dysarthrias

Back 7

- Various combinations of individual dysarthria types
- Can be caused by conditions that damage more than
one portion of the nervous system
- Associated with ALS
- Spastic dysarthria is the most frequently occurring
type of dysarthria within mixed dysarthrias
- Flaccid and ataxic dysarthrias occur frequently
- Intelligibility is often affected

Front 8

Apraxia of Speech

Back 8

- A disturbance in the planning or programming of
movements for speech
- Result of pathology in the left cerebral hemisphere
- Caused by stroke and sometimes tumor or trauma
- Can occur in association with dysarthria, UUMN, or
spastic dysarthria
- Speech characteristics include articulation, rate,
prosody, and fluency

Front 9

Perceptual Speech Characteristics

Back 9

-vowel prolongation for sustained phonation
-AMR (alternating motion rates)
-SMR (sequential motion rates
-contextual speech
-stress testing
-motor speech planning or programming capacity

Front 10

Factors that influence comprehensibility

Back 10

1. physical environment (e.g., noise level, lightning)
2. syntactic environment (e.g., sentence structure)
3. semantic content (e.g., giving the listener a topic to predict the words that come next)
4. gesture (hand movements)
5. orthographic cues (alphabet board or writing the word)

Front 11

Amyotrophic Lateral Sclerosis

Back 11

-most common motor neuron disease
-characterized by degeneration of the motor neurons in the corticospinal tract, brainstem motor nuclei, and the anterior horn cells of the spinal cord relentless upper and lower motor dysfunction
-manifests as a mixed dysarthria (spastic and flaccid dysarthrias)

Front 12

Nonspeech Oral Mechanism

Back 12

-reduced blink and swallow frequency
- drooling
- masked facies
- tremor of jaw/lips at rest or sustained posture
- nonspeech AMRs slowly initiated/completed or rapid and restricted ROM

Front 13

Speech findings

Back 13

-monopitch
-reduced stress
-monoloudness
-imprecise consonants
-inappropriate silences
-harsh voice quality
-breathy voice
-low pitch

Front 14

Types of Hyperkinetic Movements

Back 14

-Dykinesias
-Myoclonus
-Tics
-Chorea
-Ballismus
-Athetosis
-Dystonia
-Spasm
-Tremor

Front 15

Speech Motor System

Back 15

1. final common pathway
2. direct activation pathway
3. indirect activation pathway
4. control circuit

Front 16

Direct Activation Pathway

Back 16

-Corticobulbar tract
- Corticospinal tract
Voluntary, skilled movements-finely controlled and discrete, often rapid movements

Front 17

Indirect Activation Pathway

Back 17

-Reticular formation
-Vestibular Nuclei
-Red nucleus

Front 18

Paired cranial nerves which stimulate muscles for phonation, resonance, articulation, and prosody

Back 18

-Trigeminal nerve-X
-Facial nerve-VII
-Glassopharyngeal nerve-IX
-Vagus nerve-X
-Accessory nerve-XI
-Hypoglossal nerve-XII

Front 19

Extrapyramidal System

Back 19

-Controls unconscious movement, muscle contractions for posture
-Damage to basal ganglia can cause dystonia
-Parkinson's Disease
- Athetosis-fluctuating tone
- Ballismus-flailing movements
-Chorea-large, uncontrollable movements

Front 20

Pyramidal System (Corticobulbar Tract)

Back 20

-Controls conscious, volitional fine movements
-Made up of 2 neurons (Upper motor neuron-UMN and Lower Motor Neuron-LMN)
-Travels to brainstem