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43 Cards in this Set

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what is spastic dysarthria?
a type of speech disorder resulting from bilateral damage to UMN
Spastic Dysarthria results in (3)
stiff muscles moving sluggishly through a limited range (a lot of resistance)

slow and labored speech (similar to flaccid)

Prolonged words
UMNs are part of the...
originate in the...and the...
are grouped into the...system and the... system
- are part of the CNS
- originate in the cortex and brainstem
- are grouped into the pyramidal and extrapyramidal systems
spasitc dysarthria is caused by bilateral damage to both the...and the... neural pathways
pyramidal and extrapyramidal
UMNs of the pyramidal system originate in the....

course down to the....which then innervate the muscles
originate in the motro areas of hte cortex

course down tot he LMNs
UMN pyramidal tracts are divided into
corticobulbar tract and corticospinal tract
UMNs of the pyramidal system are responsible for
transmitting neural impulses for discrete skilled movements to the LMNs
Damage to the UMNs of the pyramidal system results in (2)
weakness
slowness of the speech musculatrue (discrete skilled movement)
the UMNs of the extrapyramidal system originate in the ....and the...
cortex and brainstem (more)
the extrapyramidal system has how many interconnections thorughout the brain?
numerous
UMNs of the extrapyramidal system eventually synapse with the LMNs of the
cranial and spinal nerves
Damage to the extrapyramidal system can result in(3)
- weakness
- increased muscle tone
- abnormal muscle reflexes
most salient features of disordered movement in bilateral UMN lesions:
- spasticity (indirect)
- abnormal reflexes (indirect)
- weakness (direct and indirect)
- slowness of movement (direct) (most obvious in tongue movement)
Nurological Basis: To have spastic dysarthria, what three factors need to be in place?
-damage to UMN
- bilateral damage
- both the extrapyramidal and pyramidal tracts will be affected

(if damage is only unilateral, the result is UUMN dysarthria)
what are 6 possible etiologies of spastic dysarthria?
- Stroke
- ALS
- TBI
- MS
- Brainstem tumor
- cerebral anoxia
what is the most common cause of spastic dysarthria?
stroke
since the definition of spastic dysarthria is bilateral damage...where does the stroke need to occur (2)
- brainstem
- two strokes in the cerebral hemisphere (not as likely)
ALS results in progressive degeneration of the
umns and lmns
after onset of ALS average life expectancy is
22 months
How does the course of ALS vary across individuals (3)
- some first present with LMN involvement ex: flaccid dysarthria, atrophy
- others primarily have UMN invovement ex. spastic dysarthria, hyperactive gag reflex and jaw reflexes
- eventually both UMNs and LMNs are affected resulting in a MIxed dysarthria
TBI can cause bilateral damage to the pyramidal and extrapyramidal systems due to (2)
- widespread damage to cortical, subcortical, and brainstem structures
- damage can be extensive due to brain shifting in the cranium causing damage to axons, braintissue, and hemorrhaging
people with TBI are likely to exhibit ......... as well as spastic dysarthria
mixed dysarthria
what is MS
immunologic disorder resulting in inflammation or complete destruction of hte myelin covering the axons
MS can result in spastic dysarthria because
is can affect myelin anywhere in the CNS

NOT OFTEN TO CAUSE SP DYS
what is cerebral anoxia and what is it capable of?
it is when you dont' breath for a while

capabel of widespread neural damage extending to the UMNs bilaterally
Articulation characteristics of person with Spastic dysarthria
see packet
what are the three characteristics of phonation with person with spas. dys.
-harsh vocal quality (friction of air quality)
- strainted-strangled vocal quality
- low pitch
what ist he harsh vocal quality caused by?
cause by purposeful partial abduction of VFs. by keeping VFs partially abducted, the spa patient is able to prevent the spastic muscle tone from closing the glottis too tightly
whta is strained-strangled vocal quality characterized by?.....due to??
-characterized by subglottic air being forced throug a tight contriction
- due to spasticity of the laryngeal muscles
describe the resonance of person with spa dys.

what has reduced range of movement resulting in...

as noticable as flaccid?

nasal emission?
velar movement was slow with a reduced range of movement

resulting in hypernasality
- however, not as noticable as in flaccid
- no nasal emission
what are the four characteristics of prosody in spa dys?
- monopitch intonation in connected speech
- monoloudness
- short phrases
- slow rate
monopitch intonation in connected speech is caused by
overall spasticity of the laryngeal muscles: VFs have reduced ability to contract and relax
monoloudness:
also due to spasticity of the laryngeal muscles, thus, diff controling/ regulating subglottic pressure for loudness
short phrases:
natural sequence of an abnormally tight larynx
slow rate of speech is due to
reduced speed and ROM (range of movement) of the articulators
what are two non-speech (contirmatory signs) of spas dys?
- pseudobulbar affect
- drooling
what are two characteristics of pseudobulbar affect/
- uncontrollable crying or laughing due to damage of areas needed for inhibiting emotions
- emotion displayed can be independent of emotions felt.
are pharmaceutical therapies effective?
nobeen very effective, but patient's recovery progress may be of benefit
regularity of occurance with this disorder?
not all patients with spas dys disply this affect, but it occurs more frequently in this type of dysarthria than with others
drooling can occur in other dysarthrias....but most predominant in
spastic dysarthria
due to impairment of.....
oral control of saliva and less frequent swallowing
can drooling be treated?
yes, with cueing to swallow as well as pharmaceutical treatments
2 other confirmatory signs of spastic dysarthria

what will some deny??
dysphagia, chewing is more effortful, some patients will deny difficulty with swallowing and chewing.