Adv Artic Disorders Test 1

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ggarriott
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Adv Artic Disorders Test 1
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2012-09-20 01:01:50
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Motor Speech Disorders
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Adv Artic Disorders Test 1
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  1. Thoughts are converted to verbal symbols
    Cognitive-Linguistic Processes
  2. Selection and sequencing of sensorimotor programs that activate speech muscles
    Motor Speech Planning and Programming
  3. Innervations of the respiratory, phonatory, resonatory & articulatory muscles
    Neuromuscular Execution
  4. Combined processes of speech motor planning, programming, and neuromuscular execution
    Motor Speech Processes
  5. Changes in speech may announce the presence of...
    Neurologic disease
  6. The effects of neurologic disease on speech are often what 4 things?
    • Lawful
    • Predictable
    • Clinically unique
    • Recognizable
  7. What are the 4 reasons to understand neurophysiologic bases of speech disturbances?
    • Nervous system organization for speech control
    • Differential dx and localization of neuro disease
    • Prevalence
    • Management
  8. There's usually a direct correlation bet/ __________ and the symptoms/speech deficits that go along with it.
    Sites of lesion
  9. Neurologic disorders are common/uncommon?
    Common
  10. Few neurologic disorders are _______.
    Curable
  11. Neurologic disorders are a major cause of _________.
    Disability
  12. Neurologic speech disorders represent a significant proportion of _________ communication disorders.
    Aquired
  13. Neurologic speech disorders will increase in prevalence because of __________.
    Increased Survival Rates
  14. Understanding the underlying ___________ can help in planning treatment.
    Neuropathology
  15. Group of neurologic SPEECH disorders resulting from abnormalities in strength, speed, range, steadiness, tone, or accuracy of movements req. for control of the respiratory, phonatory, resonatory, articulatory, and prosodic aspects of speech production.
    Dysarthria
  16. The responsible pathophysiologic disturbances of dysarthria are due to _______ or _______ abnormalities.
    • CNS
    • PNS
  17. What are possible symptoms of dyarthria?
    • Weakness
    • Spasticity
    • Incoordination
    • Involuntary movements
    • Muscle tone (excessive, reduced, or variable)
  18. What are the characteristics of dysarthria?
    • Neurologic
    • Movement disorder
    • Categorized differently by auditory-perceptual characteristics and neuropathology
  19. Neurologic speech disorder reflecting an impaired capacity to plan or program (SEQUENCE) sensorimotor commands necessary for directing articulatory movements in voluntary speech production that result in phonetically and prosodically normal speech.
    Apraxia of speech
  20. What can occur in the absence of physiologic disturbances assoc. w/ dysarthria and in the absence of disturbance in any component of language such as aphasia?
    Apraxia of speech
  21. The __________ of apraxia of speech is different than that for most dysarthria types, and its ____________ is different from that for dysarthria and aphasia.
    • Localization
    • Management
  22. Speech disorders resulting from neurologic impairments affecting the motor planning, programming, neuromuscular control, or execution of speech (including dysarthrias and apraxia).
    Motor Speech Disorders (MSDs)
  23. Acquired neurologic stuttering, Palilalia, Echolalia, some Mutism, Pseudoforeign dialect, and Aprosodia are known as ________________.
    Other Neurologic Speech Disturbances that are NOT defined as Motor Speech Disorders
  24. Aprosodia is associated with _______ hemisphere dysfunction.
    Right
  25. Changes in speech resulting from _______ and _______ deficits sometimes are difficult to distinguish from MSDs bec/ they often co-occur w/ them making dx difficult and are categorized as ______________disturbances.
    • Cognitive
    • Language
    • Cognitive, Linguistic, & Cognitive-Linguistic disturbances
  26. What are the sensorimotor disturbances implicated in certain MSDs?
    • Tactile
    • Kinesthetic
    • Proprioceptive
  27. What are the NON-neurologic disturbances on speech that are localized outsid of nervous system and are neither neuromotor nor cognitive-linguistic in character?
    • Musculoskeletal defects (laryngectomy, cleft, etc.)
    • Voice Disorders (that are nonneurologic/nonpyschogenic)
    • Psychogenic (& related nonorganic disorders)
  28. ___________ associated with hormones, neoplasms, or vocal abuse can be the effect of a nonneurologic/nonpsychogenic voice disorder.
    Dysphonias
  29. What are some examples of abnormal psychologic states that can result in changes in speech?
    • Schizophrenia
    • Depression
    • Conversion disorder
  30. What are the 3 classifications of Normal Variations in speech production?
    • Age-related
    • Gender
    • Style variations (personality, emotion, roles)
  31. Identification of deviant speech indicative of dysarthria often requires an awareness of the ____________ for the patient's age and general physical condition.
    Range of Normal
  32. Approximately _____% of noncomatose people who have had strokes suffer from some kind of speech or language impairment.
    60%
  33. Dysarthria occurs in
    ____% w/ Lacunar (small) strokes
    ____% w/ TBI
    • 25%-Lacunar strokes
    • 33%-TBI
  34. Dysarthria is present in _____% of people w/ Parkinson's w/ increased prevalence as the disease progresses.
    60%
  35. Dysarthria sometimes is a presenting sign for what disease and often emerges during the disease's course?
    Amyotrophic Lateral Sclerosis (ALS)
  36. What method for studying motor speech disorders is primarity based on the "ears" and is considered the gold standard for clinical differential dx, severity, mgmt, & assessment of funtional change?
    Perceptual method
  37. What are the 3 Instrumental methods for studying motor speech disorders?
    • Acoustic (speech lab)
    • Physiologic (electromyography, aerodynamic, etc)
    • Visual Imaging (videofluoroscopy, naso/laryngo/video)
  38. What are the 8 components of characterizing motor speech disorders?
    • Age of Onset
    • Course of disorder
    • Lesion site
    • Neuro dx
    • Pathophysiology (what we hear w/our ears)
    • Speech Components involved
    • Severity
    • Perceptual Characteristics
  39. CP is an example of a/an ________ MSD 
    Parkinson's is an example of a/an __________ MSD.
    • Congenital/Developmental--CP
    • Acquired--Parkinson's
  40. The following are are categories of what component of characterizing MSDs?
    -Congenital
    -Chronic/Stationary
    -Improving
    -Progressive/Degenerative
    -Exacerbaing-Remitting
    Course
  41. What's the primary goal of neurologic evaluation, one to which differential dx of MSDs can contribute, and can predict certain speech deficits?
    Lesion site establishment
  42. What can raise doubts about presumed localization or suggest the presence of additional lesions or even different diseases?
    Incompatibility of speech findings w/ lesion site
  43. By itself, a MSD usually isn't ________ of a particular neurologic etiology or specific disease.
    Diagnostic
  44. Because diseases can affect ________________, it's NOT useful to classify MSDs by disease.
    Multiple/Variable portions of nervous system
  45. When Parkinson's causes dysarthria, its type is always _________.
    Hypokinetic
  46. When Myasthenia Gravis causes dysarthria, its type is always ________.
    Flaccid
  47. The underlying pathophysiology (weakness, spasticity) determines the unique _________________ of speech in MSDs.
    Deviant Perceptual Features
  48. MSDs can be categorized according to the speech ________ that are affected.
    Subsystems
  49. What 5 speech components that may be impaired can contribute to speech dx & often has impact on mgmt decisions?
    • Respiration
    • Phonation
    • Resonance
    • Articulation
    • Prosody
  50. What component of a speech disorder is ALWAYS relevant to management decisions?
    Severity (short/long term or improve speech/develop AAC)
  51. What scheme of Darley, Aronson, & Brown (DAB) forms the framework around which MSDs are discussed?
    Percecptually-based classification scheme
  52. What are the 8 types of dyarthria?
    • Flaccid
    • Spastic
    • Ataxic
    • Hypokinetic
    • Hyperkinetic
    • Mixed
    • UUMN
    • Type undetermined
  53. -Controls voluntary movements
    -Thought into movement
    -Conscious and unconscious
    -If damaged, result is debilitating movement disorder
    -Dependent on location/extent of damage
    Motor System
  54. PNS consists of :
    ____ pairs of cranial nerves
    ____ pairs of spinal nerves
    • 12-cranial
    • 31-spinal
  55. What's the largest division of the brain?
    Cerebrum
  56. Nerve cells located in this gyrus immediately in fron of central sulcus play an important role in controlling voluntary movements of the body.
    Precentral Gyrus (Primary Motor Cortex or Motor Strip)
  57. __________ damage can cause significant deficits in the performance of both gross & fine motor actions such as walking, writing, & speech.
    Cerebellar
  58. What's the most common type of neuron?
    Interneuron (links neurons w/ other neurons & important role in controlling movement)
  59. What are 2 important neurotransmitters in the motor system?
    • Acetylcholine
    • Dopamine
  60. In the motor system, an imbalance bet/ _______________ may be a cause of spasticity.
    Exitatory & Inhibitory Neurotransmitters
  61. Most planning for movement does NOT originate in the primary motor cortex.  The initial planning of a movement is formulated primarily in the ______________.
    Association Cortex
  62. Area of the cortex that is distributed over 4 areas of the cortex that makes sense of the sensory impulses that have been initally analyzed by the primary cortex.
    • Association cortex
    • (temporal, frontal, parietal, & visual)
  63. Where is the neurotransmitter dopamine produced?
    Substantia Nigra neural tract to striatum
  64. What are the 2 reasons dopamine is decreased?
    • Disease (Parkinson's)
    • Antisychotic drugs (block the production)
  65. Motor speech disorder caused by damage to the basal ganglia associated with Parkinson's
    Hypokinetic dysarthria
  66. Motor speech disorder caused by damage to the basal ganglia associated with Huntington's
    Hyperkinetic dysarthria
  67. Fatal, inherited disease that results in progressive loss of neurons in striatum and other areas of the brain.  Symptoms include rapid, involuntary movements of extremities face, & tongue.
    Huntington's disease
  68. Disease with decreased dopamine in striatum.  Symptoms include muscular rigidity, tremor, gait disturbances, & difficulty initiating movement.
    Parkinson's disease
  69. Because of its many ______________ with diverse parts of the nervous system, damage to the cerebellum can result in a variety of disorders.
    Afferent & Efferent connections
  70. Disturbance in speed, range, and direction of movements.
    Ataxia
  71. Muscle groups near the ______ & _______ in particular may be affected by ataxia.  Gait is wide-based, lurching, & stumbling.
    • Shoulders
    • Pelvis
  72. Tremor caused my lesions in the cerebellum and is observed only during the performance of voluntary movements & is not present at rest.
    Intention Tremor
  73. Other than drunken gait and intention tremor, what are some other symptoms of cerebellar damage?
    • Nystagmus
    • Muscle tone increase or decrease
    • Equilibrium disturbance
  74. What's the MSD usually associated with cerebellar lesions?
    Ataxic dysarthria
  75. Doorway located behind basal ganglia through which subcortical systems of nervous system communicate with cerebral cortex.
    Thalamus
  76. Practically every sensory impulse from the body passes through the _______ on its way to the cortex; this sensory info is used to further refine motor impulses from basal ganglia & cerebellum.
    Thalamus
  77. Neurons in primary motor cortex have axons among longest that extend from cortex to lower spinal cord.  These axons make up much of the descending motor tract called the _______________.
    Pyramidal System
  78. Primary motor cortex is NOT the designer of ___________ movements.
    • Purposeful
    • Sequenced
  79. Principal role of the primary cortex is to take _________ movement patterns that are formulated elsewhere and to transmit them to the ____________ via a tract of motor neurons called the pyramidal system.
    • Voluntary
    • Cranial or Spinal Nerves
  80. The pyramidal system is responsible for carrying impulses that control _____________ movements.
    Voluntary, Fine Motor
  81. The extrapyramidal system transmits impulses that control the _____________ needed by fine motor movements.
    Postural Support
  82. What symptoms result from damage to the pyramidal system?
    • Muscle Weakness
    • Rapid Fatigue
    • Decreased Mental Concentration
  83. In the motor speech mechanism, unilateral damage to the pyramidal system results in loss of fine motor movement in the articulators known as...
    Unilateral Upper Motor Neuron dysarthria (UUMN)
  84. Damage that affects the __________ tract almost always will affect other neural tracts as well with results that complicate the clinical picture.
    Pyramidal tract
  85. Spastic dysarthria is the result of _____________ damage and causing _________.
    • Bilateral UMN damage
    • Spasticity
  86. Flaccid dysarthria is the result of damage to the __________ in cranial nerves that innervate muscles of speech production causing ____________.
    • LMNs
    • Muscle paralysis or Paresis (weakness)
  87. Name the 5 purposes of the Motor Speech Examination.
    • Description
    • Dx Possibilities (neurologic,organic,acquired, MSD type)
    • Dx (differential)
    • Localization implications
    • Severity
  88. What are the 2 characteristics of EVERY dysarthria that can make it difficult to distinguish among types?
    • Imprecise Consonants
    • Harsh Vocal Quality
  89. Successful eval of MSDs require clinicians to match what they hear in pt's speech w/ what they know about the functioning of ____________.
    Human Motor System
  90. What are the 7 questions asked in motor speech eval designed to lead to correct dx?
    • Speech problem
    • Describe it
    • Neurologic?
    • Onset (sudden or slow?)
    • Strictly speech prod.?
    • Phoneme sequencing? (apraxia)
    • Speech error charac & assoc. motor probs (dysarthria)
  91. Dysarthria results from _________ damage to the ________ or _________.
    • Neuromotor
    • CNS or PNS
  92. Dysarthria is strictly a SPEECH disorder caused by neuromotor damage; it is NOT...
    • Language
    • Cognitive
    • Anatomical
    • Sensory
    • Psychological
  93. The sequencing problem in apraxia of speech is NOT the result of ...
    • Muscle weakness
    • ROM reduction
    • Slowness
    • Cognition disorder
  94. Apraxia of speech is nearly always associated with damage to the ______ hemisphere of the brain.
    Dysarthria can be caused by damage to ___________.
    • Left hemisphere
    • Many parts of the nervous system
  95. Respiration provides the ______________ that's needed to set the vocal folds into vibration.
    Subglottic air pressure
  96. Respiratory muscle innervation damage means less air for speech production which results in...
    • Ability to speak in only short phrases
    • Reduced loudness
    • Breathy voice quality
  97. Production of voiced phonemes through vocal fold vibrations in the larynx.
    Phonation
  98. Normal phonation is dependent on the complete ________ of the folds and enough __________ to set the VFs into vibration.
    • Adduction
    • Subglottic Air Pressure
  99. Neuromotor damage to the nerves that innervate the ____________ muscles can have several effects on speech production
    Vocal Fold Adductor muscles
  100. In flaccid dysarthria, the damage causes adduction to be __________ resulting in phonations that have ___________ quality.
    • Weak or incomplete
    • Breathy or Harsh
  101. In spastic dysarthria, adduction is _________ which causes phonation to have a ____________ quality.
    • Too tight
    • Strained/Strangled
  102. Neuromotor damage to laryngeal muscles reduces the ability to change ______ or _______ during phonation.
    • Pitch
    • Loudness
  103. Proper placement of oral/nasal tonality into phonemes during speech accomplished by raising/lowering velum.
    Resonance
  104. Shaping of vocal airstream into phonemes.
    Articulation
  105. What articulation errors can be heard after neuromotor damage?
    • Imprecise consonants
    • Distorted vowels
    • Inappropriate silences
    • Irregulatory articulatory breakdowns
  106. Prosody is the melody of speech and conveys meaning within an utterance through the use of ________ & ________.
    • Stress
    • Intonation
  107. Stress is accomplished by changing the _______, _______, & _________ of syllables within words to give them added importance or clarify meaning.
    • Pitch
    • Loudness
    • Duration
  108. Use of pitch changes and stress to communicate for example whether an utterance is a question, assertion, or exclamation.
    Intonation
  109. If neuromotor damage causes weakness or slowness the resulting speech may have a ______ & ________ quality.
    • Monopitch
    • Monoloud
  110. If neuromotor damage casus involuntary movements of vocal muscles, the resulting speech may have ________, __________, & ____________.
    • Irregular pitch variations
    • Sudden increases/decreases in loudness
    • Prolonged intervals bet/syllables or words
  111. What are the 6 "salient features" that are the neuromuscular processes and should be constantly assessed as the MSD eval is administered?
    • Muscle strength
    • Speed of movement
    • Range of motion
    • Accuracy of movement
    • Motor steadiness
    • Muscle tone
  112. Tasks that move articulators through a single series of rapid back and forth movements, such as repeating "puh, puh, puh" or "tuh, tuh, tuh" as rapidly as possible.  Helpful in differential dysarthria dx.
    Alternate Motion Rates (AMR)
  113. Tasks that move the articulators repeatedly through a quick sequence of movements, such as repeating "puh, tuh, kuh" on one breath of air.  Helpful in apraxia dx.
    Sequential Motion Rates (SMR)
  114. ___________ speed of movement is a common characteristic of most dysarthrias?
    Reduced
  115. In what dysarthria may there be an increased speed of movement?
    Hypokinetic dysarthria
  116. What speech component can especially be affected by reduced range of movement in the articulators?
    Prosody
  117. An accurate movement is one in which what features are precisely coordinated?
    • Strength
    • Speed
    • Range
    • Direction
    • Timing
  118. What tasks are good for assessing the accuracy of movement?
    • AMR tasks
    • SMR tasks
    • Conversational speech
    • Spoken paragraph reading
  119. Involuntary contractions that can affect the laryngeal musculature
    • Tremor
    • can lead to a tremulous vocal quality during speech
  120. How is motor steadiness assessed?
    • Holding an articulatory position
    • Prolonging a vowel (say "ahhh" and sustain)
  121. Small, constant amt of muscle contraction that's always present even at rest and maintains a muscle in a "ready to move" condition and allows for quick movement when necessary.
    Normal Muscle Tone
  122. Decreased muscle tone is associated with...
    • Weakness
    • Paralysis
  123. Increased muscle tone is associated with...
    • Spasticity
    • Rigidity
  124. What cranial nerve is being assessed on tasks that provide motor innervations to the facial muscles.
    Facial Cranial Nerve (VII)
  125. What cranial nerve is being assessed during the tasks that require jaw movements?
    Trigeminal Cranial Nerve (V)
  126. What are some specific tasks to assess cranial nerves for face and jaw?
    • Mouth/smile symmetry
    • Force lips open
    • Flat affect
    • Forehead wrinkling both halves
    • Lip pucker
    • Puff/hold air
    • Jaw hang/deviate/right-left/keep closed/keep open
  127. What cranial nerve is being assessed during tasks for tongue and rest and during movements?
    Hypoglossal Cranial Nerve (XII)
  128. What section of the MSD eval should be done if groping tongue movements are noted?
    Apraxia section
  129. What are some specific tasks that test the tongue at rest and during movement?
    • Size/Symmetry
    • Fasciculations
    • Steadiness
    • Protrusion
    • Keep midline
    • Touch upper lip
    • Keep pressed to inside cheek
    • Move side to side
  130. What cranial nerve is being assessed during the section of the evaluation that looks at the structure/function of the velum and pharynx?
    Vagus Cranial Nerve (X)
  131. What are specific tasks to assess velum and pharynx at rest and during movement?
    • Velum rise symmetrically during /a/?
    • Gag reflex when back wall of pharynx touched?
  132. What are direct ways to observe the actions of the larynx?
    • Laryngeal mirror
    • Flexible Nasoendoscope
  133. What are 3 tasks to indirectly assess laryngeal function?
    • Able to produce sharp cough?
    • Produce sharp glottal stop?
    • Inhalatory stridor present?
  134. One should listen crtically to what 3 characteristics of the patient's phonation because each can provide useful dx info?
    • Quality
    • Pitch
    • Loudness
  135. What are some examples of the quality of phonations?
    • Hypernasality
    • Breathiness
    • Harshness
    • Diplophonia
    • Tremor
  136. What are examples of the pitch of phonations?
    • Low pitch
    • Pitch breaks
  137. What are examples of the loudness of phonations?
    • Excessive loudness variations
    • Decreased loudness
  138. Hypernasality is most frequently a symptom of which 3 dysarthrias?
    • Flaccid
    • Spastic
    • Hypokinetic
  139. What is rarely present in the speech of individuals with dyarthria or apraxia of speech?
    Hyponasality
  140. What's a specific task testing resonance?
    Sustain /u/ then with squeezed nares
  141. What's another name for Alternate Motion Rate (AMR)?
    • Diadochokinetic Rate
    • ability to move articulators rapidly, smoothly in repetitive motion
  142. _______s are very important in motor speech eval bec/people w/ diff types of dysarthria perform differently on this task.
    AMRs
  143. What kind of AMRs do people with flaccid & spastic dysarthria have?
    Slow & Regular
  144. What kind of AMRs do people w/ ataxic & hyperkinetic dysarthria have?
    Slow and Irregular
  145. Some w/ ___________ dysarthria have AMRs that are more rapid than normal; said so quickly that articulation of phonemes is blurred.
    Hypokinetic
  146. It's not unusual for people w/ _________ to complete AMR successfully but be unable to even attempt SMR sequence.
    Apraxia
  147. Task that screens for myasthenia gravis; count quickly from 1 to 100.  Typical to have rapid deterioration and recovery after rest only to have performance decline again.
    Stress Testing
  148. Disorder that causes rapid fatigue of muscles during sustained motor activity.
    Myasthenia Gravis
  149. Vegatative movements such as smiling, puckering, tongue protrusion, lip biting, hesitations, groping, & revisions are examples of what type of apraxia?
    Nonverbal Oral apraxia
  150. MSD produced by any process that damages motor unit.  Injury/malformation of cranial/spinal nerves reflecting probs in nuclei, axons, or neruomuscular junctions making up motor units of the final common pathway.
    Flaccid dysarthrias
  151. All of __________ dysarthrias share a lesion somewhere between the brainstem/spinal cord and muscles of speech.
    Flaccid dysarthrias
  152. What are the 3 primary characteristics of flaccid dysarthrias?
    • Weakness
    • Hypotonia
    • Reflex reduction
  153. What characteristics often accompany the primary characteristics of flaccid dysarthria?
    • Atrophy
    • Fasciculations
    • Fibrillations
    • Progressive Weakness
  154. What are the 9 main headings for diseases/conditions that cause flaccid dysarthria?
    • Trauma
    • Degenerative disease
    • Muscle disease
    • Neuromuscular Junction disease
    • Vascular disorders
    • Anatomic anomalies
    • Demyelinating disease
    • Infection
    • Other
  155. -ALS
    -Progressive Bulbar Palsy
    -Spinal Muscle Atrophies (progressive)
    -Kennedy's disease (men only)
    Degenerative diseases causing flaccid dysarthria
  156. -Muscular Dystrophy
    -Polymyositis
    Muscle diseases causing flaccid dysarthria
  157. -Myasthenia Gravis
    -Lambert-Eaton Myastenic Syndrome
    -Botulism
    Neuromuscular Junction diseases causing flaccid dysarthria
  158. -Brainstem Stroke
    -Wallenberg's Lateral Medullary Syndrome
    -Collet-Sicard Syndrome
    -Medial Medullary Syndrome
    Vascular disorders causing flaccid dysarthria
  159. Anatomic Anomalies:  just know that...
    Babies can be born with diseases that cause flaccid dysarthria
  160. -Guillain-Barre Syndrome
    -Chronic Demyelinating Polyneuritis
    Demyelinating diseases causing flaccid dysarthria
  161. -Polio
    -Herpes Zoster
    -Sarcoidosis
    -AIDS
    Infectious Processes causing flaccid dysarthria
  162. -Skull Base Tumors
    -Radiation Therapy
    OTHER causes for flaccid dysarthria
  163. Surgical trauma to the laryngeal branches of the ________ nerve is a frequent cause of flaccid dysarthria.
    Vagus
  164. What are the clusters of deviant speech dimensions for flaccid dysarthria?
    • Phonatory Incompetence (breathy, audible, short phrases=inadequate VF adduction)
    • Resonatory Incompetence (hypernasal, emission, consonants, short phrases=VP valve weakness)
    • Phonatory-Prosodic Insufficiency (harsh, monopitch, monoloud=hypotonia of laryngeal muscles)
  165. Which dyarthria is produced by bilateral damage to the direct (pyramidal) and indirect (extrapyramidal) activation pathways?
    Spastic
  166. Most salient features of disordered movementin pts w/spastic dysarthria
    • Spasticity
    • Weakness
    • Reduced ROM
    • Slow movement
  167. Spasticity is a hallmark of ___________ disease.
    Upper Motor Neuron (UMN) disease
  168. Direct activation pathway (pyramidal tract) is predominantly _________ tending to lead to movement.
    Facilitatory
  169. In the indirect activation pathway (extrapyramidal tract) many of its activities are _________.
    Inhibitory
  170. -Fine/skilled movement loss
    -Hypotonia
    -Weakness
    -Babinski sign
    -Hyporeflexia (weak/nonexistent)
    Pyramidal tract damage
  171. -Muscle tone increase
    -Spasticity
    -Clonus (repetitive reflex under tension)
    -Stretch reflex hyperactive (too strong/sensitive)
    -Gag reflex hyperactive
    Extrapyramidal tract damage
  172. ___________ disorders are more frequently associated with spastic dysarthria than most other types.
    Vascular
  173. Lesions in _____________ are required to produce the bilateral UMN damage usually associated with spastic dysartria.
    Both Left & Right hemispheres
  174. What 2 vascular disorders are usually associated with hypertension?
    • Lacunar Strokes
    • Vascular Dementia
  175. Primary Lateral Sclerosis (PLS) is a _________ disease similar to ALS that can cause spastic dysarthria.
    Degenerative
  176. Leukoencephalitis is an ___________ disease that affects the white matter of the brain or spinal cord that can lead to spastic dysarthria.
    Inflammatory Demyelinating disease
  177. What % of spastic dysarthria cases are caused by degenerative & vascular disease?
    70%
  178. _____________ strokes accounted for most of the vascular causes.
    Nonhemorrhagic
  179. What are some patient perceptions & complaints w/spastic dysarthria?
    • FATIGUE*
    • Slow/effortful speech
    • Speaking against resistance
    • Swallowing
    • Gagging/drooling
    • Laughing/Crying uncontrollably*
  180. What's a telltale sign of spastic dysarthria that is rare in other dysarthria types?
    Laughing/Crying uncontrollably (lability/affect)
  181. Dysarthria is common and sometimes severe in ________ dysarthria.
    Spastic
  182. Spastic dysarthria is associated with impaired ___________ rather than weakness of individual muscles.
    Movement Patterns
  183. ____________ dysarthria is associated w/ deficits of all the speech valves and for all components of the speech system.
    Spastic
  184. What are the distinguishable features of spastic dysarthria?
    • Strained-Harsh voice*  (found in no other dysarthria)
    • Slow rate
    • Slow & REGULAR AMRs
  185. What's respiration like in spastic dysarthria?
    • Shallow/paradoxical breathing
    • Vital Capacity reduced
  186. Ataxic dysarthria affects which 2 speech components most?
    • Articulation
    • Prosody
  187. Dyarthria associated with damage to the cerebellum
    Ataxic
  188. Common sign of cerebellar disease resulting in the over/undershooting of targets.
    Dysmetria
  189. Tremor occurring during movement or sustained postures and is most obvious as a target is approximated.
    Intention/terminal tremor
  190. -Friedreich's Ataxia (incapacitation/death) 
    -Multiple Sclerosis (demylinating)
    Dengenerative diseases associated with ataxic dysarthria
  191. -Aneurysms
    -Arteriovenous malformations
    -Cerbellar Hemorrhage
    -Strokes
    Vascular disorders associated with ataxic dysarthria
  192. Tumors within/outside cerebellum (16% of metastatic brain tumors)
    Neoplastic disorders associated with ataxic dysarthria
  193. TBI
    Punch Drunk Encephalopathy (Mahammad Ali)
    Trauma associated with ataxic dysarthria
  194. -Chronic Alcoholism
    -Lithium/Valium
    -Malnutrition/Vitamin Deficiency
    Toxic or Metabolic Conditions associated w/ ataxic dysarthria
  195. -Severe Hypothyroidism
    -Hydrocephalus
    -Heat Stroke
    -Infections (rubella, Creutzfeldt-Jacof, Lyme, CNS tuberculosis)
    OTHER causes of ataxic dysarthria
  196. Degenerative, Demyelinating, & Vascular diseases account for more than ____% of cases of ataxic dysarthria
    65%
  197. ________ speech AMRs are a distinguishing characteristic of ataxic dysarthria.
    Irregular
  198. Prosodic Excess/Scanning speech using slow word-by-word cadence with equal emphasis on each syllable or word is associated with what dysarthria?
    Ataxic dysarthria
  199. Although uncommon, intermittent hyponasality is more frequently encountered in ________ dysarthria than any other type.
    Ataxic
  200. What are distinguishing features of ataxic dysarthria?
    • Articulatory breakdowns
    • IRREGULAR AMRs*
    • Excess/equal Stress
    • Excess Loudness
    • Vowels distorted*

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