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55 Cards in this Set

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ataxic dysarthria results in damage to
the cerebellum
the most noticeable characteristics of ataxic dysarthria are in
- articulation
- prosody
speech characteristics reflect a breakdown in (2)
- motor organization
- control

sounds slurred


(not a weakness)- different from other types
ataxia means
lack of order (widespread incoordination)
cerebellum coordinates.....and.....of muscular movements
timing and force

- skilled, voluntary movements are appropriate for an intended task
cerebellum processes.....from all over the body and.....that information into....... of a movement
sensory information
integrates
execution
what are the 3 peduncles of the cerebellum
1. inferior peduncle
2. middle peduncle
3. superior peduncle
what is the function of the peduncles
the cerebellum communicates with the CNS via three bundles of neural tracts (cerebellar peduncles)
the inferior peduncle (first neural pathway)
- receives ....... information from the entire body regarding .......


-monitors ....
- receives sensory information from the entire body regarding position of body parts before, during and after a movment


- the timing and force of movements while being performed (how execute movement) (online adjustments, while doing something)
middle peduncle (second pathway) receives.....information from..... regarding.....

- the cerebellum coordinates these planned movements by


- info is sent back to the cortex via the
- receives preliminary information from the cortex regarding planned movements

- integrating the sensory info-> refined, smoothed according to current condition of the body

- thalamus
the superior peduncle (third pathway)
- is the......to the rest of the CNS

- sends its......to the .....completing...
- the main output channel to the rest of the CNS


-sends its processed motor impulses to the motor areas of the cortex, thus, completing the corticocerebellar control circuit
additional tracts travel out of the......that connect the cerebellum directly to
travel out of the superior peduncle....connect to neurons of the extrapyramidal tract
Not sure how the cerebellum influence speech, 2 probable ways the cerebellum influences speech:
1. planned, motor impulses of a planned speech act are sent from the cortex to the cerebellum
- cerebellum then coordinates and refines these preliminary speech movements via sensory information
- sent to thalamus for additional refinement->motor cortex

2. the cerebellum could influence speech movements through its connections to the extrapyramidal system
- the cerebellum can make rapid adjustments in the timing and force of movements to compensate for unexpeced change in the circumstances of a movement
in summary, cerebellums dual ability :
to corrdinate and modify planned and ongoing speech movemetns -> important part of the motor speech system
clinical characteristics of cerbellar lesions: cerebellar ataxia:
1. movement deficits of timing, force, range, and direction
2. disordered stance and gait
- broad-based
- truncal instability
3. intention tremors (as you get closer to a target)
4. ocular motor abnormalities
5. hypotonia
6. problem with motor learning (learning to ride a bike would be very diff)
ataxic dysarthria generally results from ..... or..... damage to the....


when lesions are focal, damage to the following areas are implicated (3)
**bilateral or generalized damage to the cerbellum


- the area of the superior peduncle
- the lateral hemispheres or paraveral regions

(could possible cause ataxic)
what are 5 etiologies of ataxic dysarthria?
1. degenerative diseases
2. stroke- vascular disorders
3. toxic and metabolic conditions
4. TBI
5. neoplastic disorders
Friedreich's ataxia is ...
- prevalence
- symptoms appear when person is in there...years....
-progressive hereditary spinocerebellar disease
- prevalence is 2 per 100,000
- symptoms appear when person is in their 20s
4 symptoms of friedreich's ataxia
1. cerebellar ataxia affecting gait and manual dexterity
2. LMN weakness
3. extrapyramidal signs such as spasticity
4. dysarthria (often mixed type+spastic)
less common symptom of friedreich's ataxia is
dementia and sensorineural deafness
life span of someone with friedreich's ataxia is
in the 40s
Olivopontocerebellar atrophy (OPCA) is

- results in
-mulisystem atrophy
-hereditary progressive cerebellar disorder

-results in atrophy of the middle cerebellar peduncle, much of the cerebellum and parts of the pons
symptoms of olivopontocerebellar atrophy are (3)
1. cerbellar ataxia (movement disorders)
2. parkinsonism
3. dementia
Stroke as a cause of ataxic dysarthria

lesions are most commonly caused by (4)
1. ischemic
2. ruptured aneurysms
3. arteriovenous malformation (AVMs)
4. cerebellar hemorrhage
a cerebellar stroke will result in (4)
1. sudden onset of limb ataxia
2. problems with balance
3. visual deficits
4. ataxic dysarthria
toxic conditions that cause ataxic dysarthria (4)
1. acute and chronic alcohol consumption
2. lead and mercury poisoning
3. exposure to certain chemicals
4. treatable and reversible (depending how long)

reversible when toxin is lowered
metabolic condition that causes ataxic dysarthria
1. prolonged vitamin E or B12 deficiency
neurotoxic levels of several drugs (1)
1. anticonvulsants
3 characteristics of TBI
1. diffuse damage
2. cerebellar peduncles are vulnerable to the twisting and rotational forces of a TBI
3. boxers cna suffer from sustaining repeated cerebral injuries and pathologic changes to the cerebellum and other areas of the CNS
neoplastic disorders:
tumors within or exerting mass effects on the cerebellum can lead to cerebellar signs
nonspeech characteristics of a person with apraxic dysarthria
normal oral mechanism exam except:
nonspeech AMRs of jaw, lips, and tongue may be irregular
- most apparent in wiggling of the tongue or retraction and pursing of lips
what are 7 complaints heard from patients with apraxic dysarthria
1. complains of slurred speech with "drunken" quality
2. dramatic deterioration in speech with little alcohol intake
3. occasional complaint of difficulty coorinating breathing with speaking
4. patients with mild severity: speech is normal until they suddenly "stumble over words"
5. intelligibility improves with decreased rate
6. may bite their cheeks or tongue while talking or eating
7. swallowing difficulties infrequent
what are 3 articulation deficits
1. imprecise consonants
2. distorted vowels
3. irregular articulatory breakdowns
what are the articulatory distortions caused by
cerebellar damage that disrupts timing, force, range, and direction of movements required for speech.
what are three characteristics of articulatory breakdowns seen in patients with ataxic dysarthrai?
1. articulation errors vary from utterance to utterance
2. intermittent breakdowns, especially in multisyllabic words
3. breakdowns can sound like syllables are being compressed
what characteristic of speech is very obviuos and different from other dysarthria types?
prosody
what are the 4 areas of prosody talked about regarding ataxic dysarthrai
1. stress
2. prolongations
3. monopitch
4. scanning speech
what are three prosody characteristics seen regarding stress
1. tendency to put equal stress on syllables or words that have varied stress patterns
2. excessive stress on unstressed syllables and words
3. each syllable sounds as if it is being produced separately
prolongations in speech of ataxic dysarthria could be caused by
decreased muscle tone, which results in general slowness in the contractions of the speech muscles ->slow rate
what is scanning speech
slow deliberate production of syllables
what are three components of speech that are not a big issue in people with ataxic dysarthra
1. phonation- harshness may be observed
- possibly caused by decreased tone of the laryngeal and respiratory muscles
- may observe voice tremor

2. resonance is typically normal
- intermittent hyponasality possible

3. respiration
- uncoorinated movements in the respiratory muscles-> can contribute to some of the prosodic abnormalities (waste a lot of air- speak on residual air- vocal fry)
what are 5 primary distinguishing speech characteristics
**1. irregular articulatory breakdowns
**2. irregular rythm speech AMRs
3. excess and equal stress
4. distorted vowels
5. prolonged phonemes
what 2 key evaluative tasks are used
1. speech AMRs- pay attention to rate and rhythm
2. conversational speech, reading and repeating sentences containing multisyllabic words- look for irregular articulatory breakdowns and prosodic abnormalities.
what are 4 treatment techniques for respriation with someone with ataxic dysarthria
1. patients need to work on coordination rather than strenthening
2. slow and controlled exhalation
3. speak immediately on exhalation
4. stop phonation early/ optimal breath group
what is meant by slow and controlled exhalation? how make it more difficult?
- inhale fully and exhale slowly and steadily
- increase difficulty of task by having patients exhale for 3 seconds, stop for 1 second, then continue to exhale (work up to 3 sequences within one breath)
Speak immedately on exhalation
- make sure phonation occurs...
- have patient place...
- the moment hand...
- make sure phonation occurs the moment the patient begins exhalation
- have patient place hand on abdomen
- the moment the hand goes in on exhalation, the patient is cued to begin phonation
stop phonation early/ optimal breath group
- time when to take breath to....
- calculate...
-as coordination improves...
- time when to take a breath to avoid speaking on isufficient air supply
- calculate optimal breath groups
-as coordination improves, increase lenght
what is the key to improving prosody
rate control
what are three ways to rate control
1. reciting syllables to a metronome
2. finger or hand tapping
3. cued reading material
intelligibility generally improves with
decreased rate
what are three characteristics of reciting syllables to a metronome
1. one syllable is produced for each beat.
2. this is ONLY used to get the patient to a more acceptable rate
3. once this is achieved, the patient works on keeping their rate down independently
finger or hand tapping..can be sued instead of.....
metronome, where the clinician sets the rate by tapping his/her finger
what are three ways of cuing reading material
1. clinician points to words at the desired speaking rate
2. slash marks are used to indicate where to pause
3. chunking utterances in syntactic units
what are three ways to address stress and intonation
1. contrastive stress drills
- bob hit bill? WHO hit Bill? BOB hit bill.
2. pitch range exerciese
3. intonation profiles
what are four ways to address articulation
1. intelligibility drills
2. phonetic placement
3. exaggerating consonants
4. minimal contrast drills