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59 Cards in this Set
- Front
- Back
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What domain and possible disorders are associated with the function of an idea?
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-domain: cognition
-possible disorders: dementia, confusion, ADD |
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What domain and possible disorders are associated with the function of sounds, words, and grammar?
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-domain: language
-possible disorders: aphasia, language delay |
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What domain and possible disorders are associated with the function of motor plan?
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-domain: motor planning
-possible disorders: acquired apraxia, developmental apraxia |
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What domain and possible disorders are associated with the function of speech movements?
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-domain: speech execution
-possible disorders: dysarthria |
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What is the definition of motor speech disorders?
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-resulting from neurological impairments
-affecting the motor programming or neuromuscular execution of speech -apraxia of speech/ dysarthria |
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What does motor programming mean? AND what is a disruption of this process result in?
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-selection and organization of already existing movement sequences to express an intended verbal message
-results in apraxia of speech (can also have oral apraxia) |
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What does neuromuscular execution mean? AND what is a disruption of this process result in?
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-neural transmission of movement sequences cause muscle contraction and movements of articulators to produce speech sounds
-results in dysarthria |
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What muscle groups does speech production involve?
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-respiratory, phonatory, resonatory, and articulatory muscles
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What are some etiologies of motor speech disorders?
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-TBI (MVA, shotgun wound, fall, sports injury)
-CVA (hemorrhage, ischemia) -progressive neuromuscular disease (ALS, Parkinsons, Myasthenia Gravis, MS) -tumor (malign, benign) -infections (viral, encephalitis, meningitis) |
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Define dysarthria.
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-a collective name for a group of speech disorders resulting from damage of the CNS or PNS.
-problems due to paralysis, weakness, or incoordination of the speech musculature |
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Name the types of dysarthria.
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-flaccid
-spastic -ataxic -hyperkinetic -hypokinetic -mixed -unilateral UMN |
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True or false: Apraxia is much more common than dysarthria for people with a primary diagnosis of neurogenic motor speech disorders.
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False: Apraxia - 9%, different types of dysarthria - at least 55%
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What type of damage causes flaccid dysarthria?
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-LMN damage
-damage to the motor units of cranial, cranial nerves, or spinal nerves that serve the speech muscles -can be isolated to lesions of single cranial or spinal nerves |
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What are the most common speech characteristics of flaccid dysarthria?
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weakness and hypotonia
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What are the important cranial nerves that can be effected by flaccid dysarthria?
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V, VII, IX, X, XII
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What are common diagnoses of flaccid dysarthria?
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-surgical traumatic injuries of cranial nerves (27%) (carotid endarterectomy, thyroid surgery, left upper lobectomy for lung carcinoma, chest and cardiac surgery)
-myasthenia gravis -ALS (mixed dysarthria) -muscular dystrophy |
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What are the speech characteristics of flaccid dysarthria?
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-decreased intelligibility
-breathy vocal quality -reduced loudness and pitch range -reduced lingual force for speech production -hypernasality |
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What damage causes spastic dysarthria?
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damage to the UMNs bilaterally
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What accounts for the speech characteristics of spastic dysarthria?
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combined effects of spasticity and weakness
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What are the salient effects of bilateral UMN lesions?
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-spasticity
-weakness (not due to flaccid muscle) -reduced range of movement -slowness of movement |
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What are the common diagnoses of spastic dysarthria?
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-degenerative (30%) (ALS, Progressive Supranuclear Palsy[PSP-damage to only UMN], MS)
-TBI (10%) -tumor (14%) |
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What are the speech characteristics associated with spastic dysarthria?
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-slow speech rate
-effortful speech movements -deterioration of speech movements with fatigue -strained-strangled voice -decreased intelligibility |
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Where is the damage located for ataxic dysarthria?
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damage to cerebellum
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Describe ataxic dysarthria.
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incoordination and reduced muscle tone may account for slowness and inaccuracy of speech movements
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What are the salient effects of cerebellar dysfunction (ataxia)?
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-incoordination of movements
-reduced muscle tone -inaccuracy of force, range, timing, and direction of movement (overshooting and undershooting targets) -"drunken" quality of movements |
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What are the common dianoses of ataxic dysarthria?
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-cerebellar degeneration (also in combo with brainstem degeneration - friedreich's ataxia)
-demyelization (MS) -toxic/ metabolic etiology (alcohol/ drug abuse, anoxic encephalopathy due to drug overdose) -TBI -tumor (cerebellopontine angle tumor) |
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What are the common speech characteristics associated with ataxic dysarthria?
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-articulatory inaccuracy
-increased variability of speech rate, loudness, fundamental frequency -impression of "drunken" quality of speech -decreased intelligibility |
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What causes hyperkinetic dysarthria?
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dysfunction in the basal ganglia or extrapyramidal system
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What is hyperkinetic dysarthria?
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abnormal rhythmic or irregular and unpredictable, rapid or slow involuntary movements account for speech characteristics
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What are the variety of abnormal and involuntary movements of motor dysfunctions of the extrapyramidal system?
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-palatopharyngeal myoclonus
-tics -chorea (extra movements) -athetosis (writhing) -dyskinesia -dystonia (tics or muscle contractions) -spasmodic dysphonia (hyperabducting of VFs) -tremor of the jaw, lip, tongue, VFs |
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What are the common diagnoses of hyperkinetic dysarthria?
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-unknown etiologies (59%!)
-degenerative diseases (huntington's chorea) -tourette's syndrome |
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What are the speech characteristics associated with hyperkinetic dysarthria?
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-decreased intelligibility
-tremor of jaw, lips, tongue, and palate during speech -voice tremor, vocal spasms -slow speech rate -involuntary, jerky or shaky speech movements |
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Where is damage located for hypokinetic dysarthria?
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damage to the basal ganglia
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What type of dysarthria is parkinson's typically associated with?
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hypokinetic dysarthria
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What are the salient effects of dysfunction in the basal ganglia (hypokinetic dysarthria)?
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-rigidity
-difficulty with initiation of movements -dysfluency (slowness and fast repetitions) -imprecision of movements |
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What are the common diagnoses of hypokinetic dysarthria?
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-degenerative (75%!) (parkinson's, PSP)
-vascular (stroke) |
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What are the speech characteristics associated with hypokinetic dysarthria?
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-decreased intelligibility
-reduced loudness -monotone voice -short, rushed speech -masked facial expressions -tremors in jaw, lip, and tongue -difficulty initiating speech |
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What is mixed dysarthria?
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damage to more than one component of the speech motor system
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True or false: Mixed dysarthria occurs less frequently than any single dysarthria.
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False: more frequently
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What are the common diseases associated with mixed dysarthria?
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-degenerative (63%!) (ALS)
-vascular (multiple strokes) -demyelination (MS) |
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What are the speech characteristics associated with mixed dysarthria?
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-decreased intelligibility
-combination of characteristics of flaccid, spastic, ataxic, hyper- and/or hypokinetic dysarthrias |
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Where is the damage located for unilateral upper motor neuron dysarthria?
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unilateral damage to the upper motoneuron pathway
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What does unilateral UMN dysarthria look like?
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weakness and incoordination of the tongue and lower face may account for the characteristic speech movements
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What are the common diagnoses of unilateral UMN dysarthria?
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-focal lesion of the brain: infarct, trauma (i.e., shotgun wound), tumor
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What are the speech characteristics associated with unilateral UMN dysarthria?
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-imprecise consonants
-slow and imprecise fast repetitive movements (puh, tuh, kuh) -in general only mild to moderate dysarthria ratings -good prognosis of recovery |
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What is acquired apraxia of speech?
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impairment of the capacity to program commands for volitional speech movements
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Acquired apraxia of speech is nearly always due to damage in what cerebral hemisphere?
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dominant (left) cerebral hemisphere
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True or false: Acquired apraxia of speech does not have significant weakness or neuromuscular slowness.
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True
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What are the speech characteristics associated with apraxia of speech?
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-substitutions, distortions, omissions, additions, and repetitions of sounds
-variability of errors -lack of consistency in error patterns |
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Apraxia or dysarthria?--primarily articulation and prosody affected
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apraxia
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Apraxia or dysarthria?--automatic speech better
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apraxia
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Apraxia or dysarthria?--errors inconsistent
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apraxia
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Apraxia or dysarthria?--groping for correct articulatory movements
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apraxia
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Apraxia or dysarthria?--attempts to correct error
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apraxia
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Apraxia or dysarthria?--more often in combination with aphasia
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apraxia
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Apraxia or dysarthria?--respiration, phonation, resonance, articulation, and prosody affected
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dysarthria
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Apraxia or dysarthria?--errors are consistent
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dysarthria
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Apraxia or dysarthria?--errors are often distortions of simplifications of speech movements (consonant clusters)
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dysarthria
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Apraxia or dysarthria?--infrequently combined with aphasia
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dysarthria
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