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23 Cards in this Set
- Front
- Back
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•Mostcommon movement disorder
•More frequently in extremities ( hands and limbs •Most common with advanced age •Varying etiology but centrally driven •Worsened by anxiety, fatigue and excitement |
essential voice tremor
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•Audible and rhythmic cycles of the tremor occurring every 4-6 Hz during vowel prolongation
•Pitch breaks and voice breaks associated with large amplitude tremors of the larynx •Laryngeal electromyography can help differentiate from ADSD by defining the rhythmic nature of essential tremor •Acoustic analysis also shows the rhythmic wavePerceptual |
essential voice tremor
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•Laryngeal examination reveals bilateral tremor of the true vocal folds
•Accompanying tremor can be present in soft palate, tongue, pharyngeal wall and false vocal folds •Larynx moves both at rest and tremor increases with phonation •Differential diagnosis from ADSD: with ADSD spasm are not seen at restFeatures |
essential voice tremor
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Pharmacologic management:
beta-blockers propranolol and metoprolol Anticonulsants Botox are all ways to manage.... |
essential voice tremor
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Caused by reductions in the peripheral nervous system neurotransmitter (acetocholine) through an autoimmune mechanism
•Results in severe decline in a muscle’s ability to contract •Hallmark symptom is weakness •Onset between third and sixth decade of lifeDescription |
myasthenia gravis
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As activity increases, muscle weakness exhibits
•Weakness in the suprlaryngeal and laryngeal muscles causes a dysarthria that is characterized as weak and breathy •After a period of rest muscle force production returnsPerceptual |
myasthenia gravis
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Videostroboscopy reveals fluctuating vocal fold mobility either unilateral or bilateral with reductions in phase closure and vibratory amplitudeFeatures
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myasthenia gravis
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Pharmacologic treatments that act as anticholinesteraseagents
Imunosuppressivedrugs Thymectomy Removal of the thymus gland are management techniques for... |
myasthenia gravis
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Neurodegenerative disease of the extrapyramidalsystem
•Genetic and environmental factorsDescription |
hyphophonia associated with pd
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Hypokinetic dysarthria
•Decreased vocal pitch and loudness range •Breathiness, roughness, hoarseness and vocal tremor |
hypophonia associated with pd
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Varies with age and duration and severity of the disease
•Visual laryngeal examination the vocal folds appear normal during phonation and other times appear bowed due to muscle atrophy |
hypophonia associated with pd
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Difficult to treat due to the range of symptoms
LSVT (chapter 7) Expiratory muscle strength training (EMST) |
hypophonia associated with pd
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•Autoimmune and inflammatory disease of neurologic origin within the white and gray matter of the central nervous system (Swejgaard2008).
•Symptoms: fatigue, numbness, difficulty walking and balance •Speech, voice and swallowing later in the disease •DX: evidence of damage to at least two separate areas of the central nervous system and evidence that damage occurred at least one month apart |
multiple sclerosis
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•Spastic, ataxic or mixed dysarthria
•Abnormally long pauses between word or individual syllables of words, and words that are hyper nasal or slurred •Difficulty raising loudness due to insufficient expiratory muscle force •Weak phonation characterized by hatshnessand disturbances of the respiratory cycle |
multiple sclerosis
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Reduced vocal fold closure
•Stroboscopy shows a posterior glottal chink •Muscle weakness impairs closure for coughing and other functions like swallowing |
multiple sclerosis
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Broad Range
Pharmacologic therapies Immune modulating drugs Corticosteroids Diet and lifestyle modifications are managment techniques of what? |
multiple sclerosis
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Motor neuron disease
•Fatally attacks the neurons responsible for controlling voluntary muscle contraction |
ALS
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•First motor symptoms tend to be in the leg
•Symptoms may start off in the corticobulbar system for 25% of cases (involving voice, speech and swallowing) •Respiratory muscles •Mixed Dysarthria: characterized by weak voice, hoarseness, roughness, and strained voice. Some hyper nasality, decreased speech intelligibility, slow rate of speech. |
ALS
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Augmentative communication devices
Feeding Tubes Clinical Trials: riluzole are management techniques of what? |
ALS
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•Inherited autosomal dominant disorder
•Mutation on chromosome 4 •Neuronal destruction targeted to the basal ganglia and cerebral cortex |
Huntington's
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A group of speech disorders attributed to weakness, slowness, or incoordination affecting the multiple systems involved in communication such as the respiratory, laryngeal or supralaryngealsystems
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dysarthria
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Voice Quality:
Breathy voice Audible inspiration Hypernasality Nasal emission Laryngeal Function: Muscle weakness Hypotonia Effects speed, range, and accuracy of speech movements are all characteristics of what type of dysarthria |
flaccid
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Voice Quality:
Harshness Strained-strangled voice Laryngeal Function: Hyper adduction of the VF Normal appearing vocal folds at rest are all characteristics of what type of dysarthria |
spastic
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