What is caused by damage to the upper motor neuron pathways that carry impulses to the cranial and spinal nerces that supply the speech muscles?
Unilateral Upper Motor Neuron dysarthria (UUMN)
UUMN dysarthria may be manifest in any component of speech but most often is apparent in ____________,___________, and _________.
articulation, phonation, and prosody
What dysrthria has been considered a mild and temporary problem?
UUMN dysarthria often occurs simultaneously with aphasia or apraxia of speech when the lesion is in the ______ hemisphere and with cognitive or nondysarthriac speech deficits when the lesion is in the ________ hemisphere.
We know the least about UUMN dysarthria because it is often _________ by more severe speech problems.
UUMN dysarthria occurs frequently a _________ diagnosis for people with aphasia, apraxia of speech, or nonaphasic cognitive-communication deficits.
UUMN dysarthria nearly always reflects the effects of unilateral UMN weakness in the ______ and __________, and sometimes other levels of the speech system.
face and tongue
UUMN system is ____________ half originating in the right hemisphere and half in the left hemisphere.
The direct activation pathway of the UMN system is crucial for __________ ____________ _________ ___________.
finely coordinated skilled movements.
The inderect activation pathway of the UMN system is crucial for regulating _______ and controlling _________ and ___________, upon which skilled movements are superimposed.
reflexes, posture and tone
Most of the speech cranial nerces receive both ________ and ___________ innervation. This bilateral input provides a degree of redundancy that helps to preserve breathing, feeding, and motor speech functions when UMN lesions are confined to one side of the brain.
contralateral and ipsilateral
For UUMN dysarthria lesions are often associated with __________ hemiplegia or hemiparesis. A babinski reflex usually is present on the affected side.
____________ involvement is often manifest by varying degrees of contralateral lower facial weakness. This is typically called central or supranuclear facial wekness.
Peripheral cranial nerve 7 lesions usually affect the ___ and ________ face.
upper and lower
Degenerative, inflammatory, and toxic-metabollic diseases usually produce ________ effects so they are rarely associated with focal unilateral signs including UUMN dysarthria.
What is the most common cause of UUMN damage and dysarthria is a frequent consequence occuring in 29% of patients associated with hemiparesis.
What are the most common causes of strokes leading to UMN deficits that also are accompanied by aphasia or apraxia of speech?
Left carotid or middle cerebral artery occlusions
What are the most common cause of strokes leading to UMN deficits that also are accompanied by neglect and cognitive disturbances characteristic or right hemisphere pathology.
Right carotid or middle cerebral artery occlusion
What is the most frequent caose of UUMN dysarthria when dysarthria is a relatively isolated sign of stroke?
____________ __________ are small infarcts that occur in the brainstem or cortical or subcortical areas of the cerebral hemispheres as the result of occlusion of the small penetrating branches of the large cerebral arteries.
________ dysarthria almost always is due to stroke, tumor, or neurosurgery, and stroke is the overwhelming predominant cause.
UUMN dysarthria can result from lesions on ________ side of the brain
Patients with UUMN dysarthria describe their speech as _______, ___________, or __________
slurred, thick, or slow
Patient with UUMN dysarthria complain of _____ or heavy feeling on the affected side of the face or corner of the mouth and sometimes of heaviness or thickness of the tongue when speaking.
Most patients with UUMN dysarthria have unilateral central _______ weakness.
Unilateral lingual weakness appears to be a good predicdtor or ________ and a farly good predictor of ________ in people with acute stroke.
For UUMN dysarthria the most pervasive speech deficit is __________ ___________ due to unilateral lower facial and tongue weakness.
The second most prominent deviant speech feature is ____ _________.
Many patients with UUMN dysarthria have phonatory abnormalities, including _________, ______, or ____________ dysphonia due to weakness, spasticity or both.