Spastic Dysarthria

Front 1

Most common cause of spastic dysarthria?

Back 1

stroke

Front 2

LMN or UMN damage?

Back 2

bilateral UMN, of course!

Front 3

Etiologies (9)

TAD'S TIMID

Back 3

Trauma
Anoxia
Degenerative Disease
Stroke
Tumor
Infection
Multiple causes (tumor w/ radiation)
Inflammation
Demyelinating

Front 4

Given its association with bilateral, multifocal and diffuse CNS diseases, patients with spastic dysarthria are likely to have ____

Back 4

cognitive disturbances

Front 5

Lesion site?

Back 5

UMN lesion to DAPs and IAPs

Front 6

Lesions to DAP cause

Back 6

weakness, loss of skilled movements, decreased tone, hyperreflexia (babinski sign)

Front 7

Fibers in UMN tracts typically innervate ____. However for speech this is true only for ______ and ______

Back 7

unilaterally
the lower face
to a lesser extent the tongue

Front 8

The DAP is responsible fore

Back 8

skilled discrete quick or phasic movements

Front 9

The result of hyperactivity of stretch reflexes is defined as:

Back 9

spasticity

Front 10

Selective damage to only one pathway (IAP or DAP) is ____ because why?

Back 10

highly unusual
arise adjacently in cortex and travel in close proximity on way to LMNs

Front 11

Spasticity reults in resistance to movement that is ____

Back 11

generally more pronounced at the beginning of the movement or in response to quick movement.

Front 12

True or False

Decreased tone is associated with spasticity

Back 12

false: increased

Front 13

Pts with UMN lesions may exhibit ____, which is a _____ that occurs when a muscle is kept under tension

Back 13

clonus
repetitive reflex contraction response

Front 14

Spasticity
Lower extremity bias for
Upper extremity bias for

Back 14

Lower: extension
Upper: flexion

Front 15

True or False

Spastic hemiplegia is not normally seen in speech systems but in other motor systems. If so, why? If not, why not?

Back 15

True
bilateral innervation

Front 16

First presenting symptoms?

Back 16

speech symptoms, pathologic oral reflexes (hyperreflexia), dysphagia, pseudobulbar affect

Front 17

Why are pts with spastic dysarthria sometimes misdiagnosed as having a psych disorder?

Back 17

Pseudobulbar affect (outbursts of crying/laughing unrelated to feeling or emotion.

Front 18

General characteristics

Weakness:

Back 18

diffuse
patterns of movements, not just individual muscles

Front 19

General Characteristics

Hypertonia

Back 19

aka spasticity
seen/felt when muscle is palpated and stretched (resistance slowly decreases as muscle pulled through range)
Most affected in arms and legs (difficulty bending legs (extensors and extending arms(flexors))

Front 20

Hyperreflexia indicates a lesion to the ___

Back 20

DAP

Front 21

How do you procure a babinski sign

Back 21

pressur with sharp point on sole from heel to little tow and across big toe.
Positive response is expansion and fanning of toes

Front 22

General Characteristics

Voluntary movement

Back 22

limited ROM and slowed rate

Front 23

True or False

A unilateral UMN lesion affecting the tongue will cause the tongue to deviate on protrusion as well as fasciculations and atrophy

Back 23

FALSE.

No fasciculations or atrophy unless damage is to LMN lesion, tongue deviates (contralateral to lesion) but does looks fairly normal sitting in the mouth

Front 24

General Characteristics

AMR rates

Back 24

slow but relatively rhythmic

Front 25

General Characteristics

Facial expression

Back 25

expressionless face
reflexive or emotional response may be slowly emergent but then may become excessive.

Front 26

General Characteristics

Confirmatory signs

Back 26

spastic paralysis
hyperactive reflexes
pseudobulbar affect

Front 27

General Characteristics

ROM

Back 27

severely impaired

tongue protrudes only to lips
limited smile/pucker
drooling
limited soft palate on speech, normal on reflex

Front 28

General Characteristics

Strength

Back 28

jaw normal
lips reduced
face weak bilaterally
tongue may be weak.

Front 29

True or False

Drooling is more common with this type of dysarthria than other types.

Back 29

True

Front 30

Speech Characteristics

Respiration

Back 30

not a lot known
hyperadduction of ln makes it hard to determine
May be similar to CP breathing (shallow, reduced inhalatory/exhalatory volumes, paradoxical breathing, reduced VC)

Front 31

Speech Characteristics

Articulation

Back 31

imprecise consonants (NOT a distinguishing feature)
some vowel distortions
reduced rate of speech (slow and labored)
voiceless sounds may be VOICED due to poor timing of voice onset/offset

Front 32

Speech Characteristics

Phonation

Back 32

strained strangled quality
effortful grunts
harsh quality that may get progressively worse
low pitch with limited variation
limited loudness variation
can be breathy (not really typical)
voicing stops gradually at end of utterance (decreasing amplitude)

Front 33

Speech Characteristics

Resonance

Back 33

hypernasality common (WITHOUT nasal emission)
incomplete symmetrical palatal movement on sustained phonation of a
VP moves slowly (opens soon/closes late)
not as severe as in flaccid

Front 34

Speech Characteristics

Prosody

Back 34

Short phrasing bec. phonotory/resonatory/articulatory systems are inefficient
monopitch
monoloudness
reduced stress variation
stress stimes excessive and equal

Front 35

partial or total loss of articulate speech resulting from lesions of the CNS is called

Back 35

anarthria

Front 36

Differentiating characteristics

Back 36

slow rate of speech
strained-strangled and harsh voice quality
slow but regular AMRs & SMRs
reduced variability of pitch and loutness.