Motor Speech Disorders Part 1

Front 1

Oral communication requires what 4 things?

Back 1

- cognitive linguistic processes
- motor speech programming
- neuromuscular execution
- combination "motor speech processes"

Front 2

__ may be the first system affected by a neurological problem.

Back 2

speech

Front 3

Effects of neurologic disease are often __, __, __, and __.

Back 3

lawful, predictable, clinically unique, recognizable

Front 4

Those characteristics observed by others

Back 4

signs

Front 5

Those characteristics perceived by the disordered individuals themselves

Back 5

symptoms

Front 6

Motor speech disorders are disorders of __ resulting from __ impairment affecting the __ or __ execution of speech.

Back 6

speech; neurologic; motor programming; neuromuscular

Front 7

Motor speech disorders encompass what two things?

Back 7

dysarthrias and apraxia of speech

Front 8

Dysarthria, in medical literature, is any disturbance of __ of speech, any __ disturbance of speech or language, and severity is correlated with __ or __ processes.

Back 8

articulation; neurogenic; illness; disease

Front 9

Dysarthria implies __ in origin

Back 9

neurologic

Front 10

Dysarthria is a disorder of movement related to __, __, __, __, __ of speech movements

Back 10

strength, speed, range, timing, or accuracy

Front 11

__ is often not recognized as a clinical entity outside speech pathology literature.

Back 11

apraxia

Front 12

Normal variations in speech production involve __ and __.

Back 12

age, style

Front 13

Three methods for studying and categorizing motor speech disorders

Back 13

perceptual, acoustic, physiolocgic

Front 14

Non-neurogenic speech disturbances (3)

Back 14

musculoskeletal defects; non-neurogenic/non-psychogenic voice disorders; psychogenic disorders

Front 15

When characterizing motor speech disorders what to take into account? (3)

Back 15

age of onset, course, site of lesion

Front 16

What causes flaccid dysarthria? Injury or malformation at level of CN nucleus in __ or somewhere along __ to periphery or neuromuscular junction

Back 16

brainstem; axon

Front 17

__ dysarthria can result from CNS or PNS lesions/damage. All other dysarthria types will result from CNS lesions.

Back 17

flaccid

Front 18

Flaccid dysarthria etiologies: neuromuscular junction disease (3)

Back 18

myasthenia gravis; botulism; Eaton Lambert Syndrome

Front 19

Flaccid dysarthria etiologies: vascular disorders (1)

Back 19

brainstem stroke

Front 20

Flaccid dysarthria etiologies: infectious processes (2)

Back 20

herpes zoster; polio (post-polio syndrome)

Front 21

Flaccid dysarthria etiologies: demyelinating disease (2)

Back 21

Gillain-Barre; chronic demyelinating neuritis

Front 22

Flaccid dysarthria etiologies: muscular disease (1)

Back 22

muscular dystrophy

Front 23

Flaccid dysarthria etiologies: degenerative disease (2)

Back 23

Progressive bulbar palsy; ALS

Front 24

Flaccid dysarthria etiologies: anatomic (1)

Back 24

Arnold Chiari Malformation

Front 25

A developmental abnormality characterized by elongated cavities lined by glia close to the central canal of the spinal cord

Back 25

Synringomyelia

Front 26

Disease of the facial nerve; unilateral; sudden onset; recovery fairly complete within 1-2 months; symptoms depend on location of lesion but tend to be cosmetic complaints to imprecise consonants

Back 26

Bell's palsy

Front 27

Cranial nerves related to speech production (4)

Back 27

Trigeminal (V), Facial (VII), Vagus (X), Hypoglossal (XII)

Front 28

Nerves involved in respiration that are spread from the cervical through thoracic divisions of the spinal cord

Back 28

phrenic nerves

Front 29

Injuries above __ can isolate respiratory muscles from brainstem resulting in __ paralysis.

Back 29

C3; respiratory

Front 30

(4) things that interrupt innervation to respiration resulting in a weakening

Back 30

Myasthenia Gravis, Amyotrophic Lateral Sclerosis, Guillain-Barre, and spinal cord injuries

Front 31

Clinical characteristics of flaccid dysarthria (7)

Back 31

weakness (paralysis/paresis), hypotonia, diminished reflexes, atrophy, fasciculation, fibrillations, fatigue (rapid weakening followed by recovery)

Front 32

Perceptual characteristics of flaccid dysarthria (9)

Back 32

hypernasality, imprecise consonants, breathiness (continuous), monopitch, nasal emission, audible inspiration, harsh voice quality, short phrases, monoloudness

Front 33

3 clusters of impairment with flaccid dysarthria

Back 33

phonatory incompetence, resonatory incompetence, phonatory-prosodic insufficiency

Front 34

What causes spastic dysarthria? __ damage to direct and indirect __ of CNS.

Back 34

bilateral; activation pathways

Front 35

UMN- pyramidal/direct pathways consists of __ and __ tracts.

Back 35

corticobulbar and corticospinal

Front 36

Most corticobulbar tracts travel through the __ and __.

Back 36

cornea radiata; internal capsule

Front 37

UMN-pyramidal pathways generally facilitate __

Back 37

movement

Front 38

Lesions to the pyramidal pathways include (4)

Back 38

weakness, loss of skilled movements, increased tone, Babinski sign

Front 39

Extrapyramidal pathways involve major contributions from __ and make crucial connections with (5)

Back 39

premotor areas; basal ganglia, cerebellum, reticular formation, vestibular nuclei, red nucleus

Front 40

Extrapyramidal pathways are generally __ and regulates reflexes for maintaining __ and __.

Back 40

inhibitory; posture, tone

Front 41

Lesions to the extrapyramidal pathways cause (3)

Back 41

spasticity, increased reflexes, weakness

Front 42

Resistance to passive stretch

Back 42

spasticity

Front 43

__ is the hallmark sign of UMN damage

Back 43

spasticity

Front 44

Term related to spasticity in which UMN damage leads to loss of inhibition and LMN damage means more excitable and responds more to smaller inputs

Back 44

"release phenomena"

Front 45

Damage almost always involves both pyramidal and extrapyramidal systems resulting in (6)

Back 45

paralysis/paresis; loss of skilled movement; spasticity, increased reflexes, pathological reflexes, no atrophy

Front 46

Genearlly, paralysis/paresis and loss of skilled movement is due to __ damage

Back 46

pyramidal tract

Front 47

__ signs (spasticity, increased or pathological reflexes) is due to __ damage- disinhibition

Back 47

positive; extrapyramidal

Front 48

__ are still working but getting impaired input from __

Back 48

LMN; UMN

Front 49

Etiologies of spastic dysarthria (6)

Back 49

degenerative, inflammatory, toxic, metabolic, traumatic, vascular diseases

Front 50

__ involve infarcts of internal carotid and middle and posterior cerebral arteries.

Back 50

vascular disorders

Front 51

__ is the inflammation of white matter of brain or spinal cord. It involves the necrosis of blood vessels and surrounding brain tissue

Back 51

Leukoencephalitis

Front 52

Degenerative diseases involve __, which is a subcategory of ALS, cotricobulbar and corticospinal sings, and no LMN involvement

Back 52

primary lateral sclerosis

Front 53

Clinical characteristics of spastic dysarthria (4)

Back 53

spasticity, weakness, reduced ROM, slowness of movement

Front 54

Clinical observations of spastic dysarthria: most effected (2), rarely effected (3), and reduced ability to produce __.

Back 54

lower face, tongue; jaw, velopharynx, larynx; fine, discrete movements

Front 55

Nonspeech clinical findings for spastic dysarthria (5)

Back 55

dysphagia, drooling, facial posture fixed, excessive facial expressions (slow to appear), pathological laughing and crying

Front 56

Speech clinical findings for spastic dysarthria (3)

Back 56

slowness and reduced range of individual and repetitive movements; reduced force of movement; excessive muscle tone or spasticity

Front 57

14 deviant speech dimensions

Back 57

imprecise consonants, monopitch, reduced stress, harshness, monoloudness, low pitch, slow rate, hypernasality, strained-strangled quality, short phrases, distorted vowels, pitch breaks, breathy voice (continuous), excess and equal stress

Front 58

4 clusters of impairment for spastic dysarthria

Back 58

prosodic excess, articulatory-resonatory incompetence, prosodic insufficiency, phonatory stenosis

Front 59

Patient complaints about speech (7)

Back 59

slow, effortful, fatigue, nasal, dysphagia, drooling, difficulty controlling expression of emotion

Front 60

5 other neurogenic speech disturbances

Back 60

acquired neurogenic stuttering-like behavior- palilalia, echolalia, certain types of mutism, pseudo-foreign dialect, sensory deficits

Front 61

The __ is placed strategically for getting input from the body and the cortex and is part of the indirect pathway to LMNs

Back 61

cerebellum

Front 62

The cerebellum is known as a __, which receives proprioceptive input from joints and muscles

Back 62

error controller

Front 63

The cerebellum controls what 3 things?

Back 63

speed, background muscle activity, range of muscular movements

Front 64

Etiologies of ataxic dysarthria (6)

Back 64

degenerative diseases, vascular diseases, neoplastic disorders, trauma, toxic/metabolic conditions, other

Front 65

__ is a (degenerative) spinocerebelar disease that usually begins in adolescence and brings death over a course of 20 years

Back 65

Friedreich's Ataxia

Front 66

__ is a (degenerative) disorder of gradual destruction of myelin sheathes.

Back 66

Multiple Sclerosis (MS)

Front 67

Lesions in vascular disorders are most commonly caused by (4)

Back 67

aneurysms, arteriovenous malformations, cerebellar hemorrhage, occlusion of vertebral-basilar system

Front 68

__ disorders involve tumors/growths

Back 68

neoplastic

Front 69

__% of metastatc brain tumors develop in the cerebellum

Back 69

25%

Front 70

__ tumors involve multiple cranial nerves

Back 70

cerebellopontine angle

Front 71

Damage to the __ during a TBI is fairly common

Back 71

cerebellum

Front 72

Damage to cerebellum can result from __ during a TBI

Back 72

anoxia

Front 73

Term associated with boxers who have repeated brain injuries and may sustain cerebellar injuries

Back 73

punch drunk

Front 74

Toxic/metabolic conditions results from __ or __ deficiency

Back 74

malnutrition; vitamin

Front 75

Deficient production of thyroid hormone

Back 75

hypothyroidism

Front 76

Signs of hypothyroidism (7)

Back 76

fatigue, swelling, stiffness, depression, slow heart rate, thinning of hair, weight gain

Front 77

__ involves enlarged ventricles but normal cerebrospinal fluid pressure

Back 77

normal pressure hydrocephalus

Front 78

__ results from cerebellar control circuit dysfunction

Back 78

ataxia

Front 79

Ataxia involves slowness and inaccuracy in what 4 things, which equals difficulty with coordination of movement

Back 79

force, range, timing, direction

Front 80

8 signs of cerebellar lesions

Back 80

hypotonia, slow voluntary movements, jerky movements, wide-based gait, intention tremor, terminal tremor, truncal titubation (tremor), dysmetria

Front 81

Lesions to cerebellum can cause (5)

Back 81

mild weakness, tremors, paucity of movement, muscular incoordination, impairments of equilibrium

Front 82

Ataxia speech presentation involves irregular and transient __ breakdowns, irregular __ distortions, excess and equal __, excess __, __ (lack of melody), and irregular __.

Back 82

articulatory; vowel; stress; loudness; dysprosody; altered motion rates

Front 83

Symptoms of ataxic dysarthria (5)

Back 83

"drunk speech," stumbling over words, biting tongue/cheek when speaking/eating, speech deteriorates with alcohol consumption, poor respiratory coordination during speech

Front 84

Cerebellar lesions causing ataxic dysarthria are usually __ and occur in the __.

Back 84

bilateral;; vermis

Front 85

Ataxic speech involve errors of __ (4) which translate into difficulty with coordination of movement

Back 85

force, speed, timing, range

Front 86

Oral communication requires:
- Organization of __ and their __ formulation and expression

- Externalization of __ in speech through concurrent functions of (5)

-The programming of these __ skills into their volitional production of individual sounds and their combination into sequences to form __.

Back 86

-concepts; symbolic

-thought; respiration, phonation, resonance, articulation, prosody

-volitional; words

Front 87

Apraxia is often buried under __ or generic heading of __.

Back 87

aphasia; dysarthria

Front 88

When characterizing motor speech disorders, course includes (5)

Back 88

congenital, chronic/stationary, improving, progressive/degenerative, exacerbating-remitting

Front 89

We characterize motor speech disorders by (2)

Back 89

neurologic diagnosis; pathophysiology

Front 90

3 specific speech characteristics

Back 90

speech components involved; severity; perceptual characteristics

Front 91

List the 9 major types of motor speech disorders

Back 91

1) flaccid
2) spastic
3) ataxic
4) hypokinetic
5) hyperkinetic
6) UUMN
7) Mixed
8) Undetermined
9) Apraxia of speech

Front 92

What is the location of flaccid dysarthria

Back 92

LMN (brainstem/spinal cord and muscles of speech)

Front 93

The diaphragm covers the 3-5th __ segments.

Back 93

cervical

Front 94

Three things clustered as phonatory incompetence

Back 94

breathiness, short phrases, audible inspiration

Front 95

Four things clustered as resonatory incompetence

Back 95

hypernasality, imprecise consonants, nasal emission, short phrases

Front 96

Three things clustered as phonatory-prosodic insufficiency

Back 96

harsh voice, monoloudness, monopitch