Motor speech exam 1: Spastic dysarthria

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janessamarie
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284437
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Motor speech exam 1: Spastic dysarthria
Updated:
2014-09-29 22:08:03
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spastic dysarthria motor speech
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Description:
Spastic dysarthria and characteristics
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  1. Spastic dysarthria is d/t bilateral damage to ____. The ___ ___ pathway affects movement. Damage results in:
    The ___ ___ pathway regulates reflexes and also maintains ___ and ___. There are 2 primary components to spastic dysarthria:
    • UMN
    • Direct activation¬†
    • Weakness, hypertonia, hyperreflexia, Babinski's sign
    • indirect activation; posture, tone
    • weakness, resistance to movement
  2. What are pathologic reflexes associated with spastic dysarthria?
    • Babinski's
    • Snout, suck
    • Jaw jerk, clonus, hyperactive gag
  3. What are clinical features of spastic dysarthria?
    Dysarthria, dysphagia, oral mech problems (drooling), emotional lability
  4. During the exam, what might you observe?
    Some weakness, slow non-speech movements, reduced ROM w/ normal rhythm, hyperactive gag, coup and cough
  5. What are causes of spastic dysarthria?
    degenerative, inflammatory, toxic, metabolic, traumatic, vascular disease
  6. Speech characteristics (clusters)
    prosodic stress
    artic-resonatory incompetence
    prosodic insufficiency
    phonatory stenosis
    • excess & equal stress, slow rate
    • imprecise consonants, distorted vowels, hypernasality
    • monopitch, monoloudness, short phrases, reduced stress
    • low pitch, harshness, strained voice, pitch breaks, short phrases, slow rate
  7. What other systems might spastic dysarthria affect?
    Respiratory, laryngeal, slow VP movement
  8. Distinguishing characteristics of spastic dysarthria
    Patient complaints?
    • slow rate, strained/harsh quality, slow AMR's, oral mech (drooling, pathologic reflexes, weak face/tongue, pseudo bulbar affect)
    • Slow rate, increased effort, difficulty chewing/swallowing, fatigue, emotional lability, tongue feels 'thick'
  9. if patient reports difficulty with chewing,
    ask about solids/liquids; change of diet, ask about moving food to back of mouth, pocketing, how long it takes to eat (changes)
  10. Intelligibility?
    Affected; continued voicing, slow movements
  11. Signed of spastic dysarthria
    • Hypertonia-Increased tone leads to reduced range and speed of movement¬†
    • Hyperreflexia- Primitive signs evident
  12. Strokes and spastic dysarthria
    • # of CVA's
    • associated with bilateral involvement; pseudo bulbar palsy
  13. How to LMN relay information to muscles with psedobulbar palsy?
    Bilateral involvement, affects corticobulbar tract that innervates cranial nerves, muscles may be weak as in bulbar palsy, but signs of spasticity
  14. Problems associated with pseudo bulbar palsy
    • Speech (hyper nasality, slow, strained, reduced stress, mono pitch, voice quality probs)
    • Dysphagia
    • Affect & cognition (lability, dementia)
  15. Overview of spastic dysarthria
    Reflects impaired movement patterns rather than weakness of individual muscles. Reflected in all speech systems (to some degree). What are hallmarks?
    Slowness, reduced range of movement, reduced force (strength), excessive muscle tone (especially larynx)

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