Neuromotor Lecture 2

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jacwill
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251768
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Neuromotor Lecture 2
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2013-12-08 19:02:51
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  1. what is dysarthria
    impairment in the nerves/muscles of articulation
  2. what are the 6 types of dysarthria
    • flaccid
    • spastic
    • ataxic
    • hyperkinetic
    • hypokinetic
    • mixed
  3. flaccid dysarthria
    • results from impairment of the cranial or spinal motor units
    • patients have weakness or paralysis or reduced tone in the musculature of one or more speech subsystems
  4. flaccid dysarthria
    how speech subsystems may be affected
    • respiratory-
    •     -abnormal respiratory movements
    •         -struggle to inhale or exhale or put in extra work when breathing, taking in too much or not enough air
    •     -reduced respiratory capacity (don't have enough air to generate speech)
    •     -speak in short phrases
    • laryngeal-
    •     -damage to the vocal folds (thyroarytnoid)
    • articulatory/resonance-
    •     -weakness of oral musculature (obic oris)
    •     -reduced range of motion (movement of artics
    •     -weakness of the soft palate (velum)
    •     -asymmetry in speech musculature (onesided strength)
  5. flaccid dysarthria 
    etiologies
    • physical 
    • surgical trauma
    • muscle disease
    • neuromuscular junction disease (neuron meets muscle)
  6. spastic dysarthria
    • two forms:
    • mild-moderate-
    •     -unilateral upper motor neuron damage (cortical motor neurons are damaged)
    •     -may affect all speech subsystems
    •     -patients may have chewing/swallowing difficulty, slowed rate of speech, and or harsh vocal quality (due to forcefullness of vfs coming together)
    •     -may co-occur with aphasia, aparaxia (left hemi) or with cognitive or prosody deficits (right hemi)
    • severe-
    •    -bilateral upper motor neuron damage
    •    -direct and indirect motor systems may be involved
  7. spastic dysarthria
    speech characteristics of mild and severe
    • slow effortful jerky labored
    • harsh tense vocal quality
    • impercise consonants
  8. spastic dysarthria
    etiologies
    • CVA (unilateral or bilateral)
    • focal trauma ("")- tbi, physical accident
  9. ataxic dysarthria
    • results from damage or disease of cerebellum
    • produces in a breakdown in the timing, rhythm and regularity of speech
  10. ataxic dysarthria
    speech characteristics
    • imprecise articulation
    • dysprosody
    • breakdown of timing and sequencing of speech
    • note breakdown on tasks that require fast repetitions of sounds
  11. ataxic dysarthria
    etiologies
    • friedreich's ataxia
    • cerebral palsy
    • tumors
    • vascular damage
    • drug toxicity
    • malnutrition
  12. hyperkinetic dysarthria
    • unwanted movement, movement overexaggerated
    • results from damage/disease of basal gangliz components
    • patients exhibit too much movment
    • all speech subsystems may be affected
  13. hyperkinetic dysarthria
    symtoms/etiologies
    • tremors
    • tics-spastic, aperiodic, not expected
    • chorea-abnormal involuntary movement disorder, one of a group of neurological disorders call dyskinesias (may be gasping for air, hyperventilation), effortful, inability to get out, includes probs with phonation, resonance, artic, resp
    • dystonia-sustained hold muscle contractioncause twisting and repetitive movements or abnormal postures, movement is abnormal and can be applied to any subsystem, sustaining the contraction of the "o" from an extended period of time
  14. hyperkinetic dysarthria
    speech characteristics
    • impaired articulation-all
    • impaired prosody-all rhythm of speech
    • inappropriate/prolonged pauses (blockages of speech)-like dystonia
  15. hypokinetic dysarthria
    • also associated with damage to basal ganglia circuit
    • can occur in any/all speech subsystems
    • sometimes due to imbalance between neurotranmitters (may be that the signal is rejected because of some sort of blockage)
    • bradykinesia-slow execution of movement
    • tremors of the lips, head, tongue, limbs
    • intermittent freezing of movement (for longer period of time)
    • masked facies (deals with parkinson', blank motionless face
  16. hypokinetic dysarthria
    etiologies
    • degenerative disease
    • shy-drager sysndrome
    • drug toxicity
    • repeated head trauma
  17. hypokinetic dysarthria
    speech characteristics
    • reduced loudness-due to effected respiratory system
    • imprecise consonants that are blurred of repeated-articulatory system
    • monotone
    • rushes of speech output
  18. mixed dysarthrias
    • diseases of multiple neurological systems
    • typically an other category formed by a combination of +1 of the other dysarthrias (eg flaccid-spastic woudl have strained harsh vocal quality, hypernasality, labored slow rate etc
  19. mixed dysarthrias
    etiologies
    • motor neuron disease
    • multiple sclerosis
    • cerebral palsy
    • multiple strokes of single brainstem stroke
    • tumors near brainstem
    • closed head injury wth multiple focal lesions or diffuse brain injury
  20. mixed dysarthrias
    cerebral palsy
    • spastic-caused by reduced blood flow to the brain durning development results in hypernasality, imprecise consonants
    • athetosis-caused by blood incompatibility between mother and child results in reduced muscle tone, dysphagia, strained voice, monotone

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