what is a group of speech disorders caused by paralysis, weakness, slowness, incoordination affecting speech processes, and is NOT a language disturbance?
Damage to the upper motor neurons (usually bilaterally)
Damage to lower motor neurons?
Damage to the cerebellar system?
Damage to the Extrapyramidal System that is usually Parkinson's disease?
Damage to the Extrapyramidal System that includes chorea and dystonia?
Damage to multiple motor systems?
Classification that includes Upper Motor Neuron Damage, spasticity, hyperreflexia, hypertonia, and Babinski sign?
Classification that includes Lower Motor Neuron Damage, flaccidiy, fasciculations, and atrophy?
Classification that deals with the Extrapyramidal System, Hypokinesis (rigidity), and Hyperkinese (athetosis)?
Classification that deasl with cerebellar damage, ataxia, and atonia?
Effects on speech typically result from bilateral lesions, must differentiate between two separate injuries (bilateral) and one injury which affects both ipsi- and contralateral tracts as they converge.
Upper motor neuron damage
Damage to neurons in the motor cortex that connect to motor nulcei in the brain stem?
Unilateral damage to the upper motor neurons
Damage to fivers that connect cortical motor neurons to motor nuclei in the brain stem?
Unilater damage to coricobulbar tract UMN
This kind of damage usually only causes transitory weakness because most of the speech muscles receive input from the morot cortex in BOTH brain hemispheres.
Unilateral damage to the Upper Motor Neurons
Which type of dysarthria has slow and limited movement that is effortful, is slow to reach targets, slow rate (due to extra effort), and has a strained-strangled-harsh vocal quality?
Bilateral Upper Motor Neuron Damage can also be called?
Refers to symptoms which results from from bilater damage?
Bilateral UMN damage/Spastic Dysarthria
Lesions occur separately on two sides?
Bilateral UMN Damage/Spastic Dysarthria
The first lesion is "silent", "invisible" due to bilateral innervation?
Bilateral UMN Damage/Spastic Dysarthria
Second lesion "unmasks" the damage, may initially appear to resemble damage to UMN at the level of the bulb?
Bilateral UMN Damage/Spastic Dysarthria
Bilateral UMN damage normally results in what kind of effects?
1.usually spastic paralysis/paresis of facial muscles
2. Usually contralateral to the second lesion
3. Usually accompanied by contralateral hemiplegia/paresis
May accompany "pseudobulbar palsy" due to proximity to corticobulbar tract at higher levels and their will be hyperreflexia/hypertonia of affected limbs/structures on side contralteral to the insult.
UMN Corticospinal tract lesion
Damage characterized by flaccidity/fasciculations/atrophy?
Lower Motor Neuron Damage
Lesions of cranial nerves/nuclei?
Lower Motor Neuron Damage
When damage is to the cranial nerves only, what occurs?
1. Ipsilateral muscles served are flaccid
2. No affect on limbs
Damage to cranial nerve nucleus only, what occurs?
1. Ipsilateral "speech"muscles flaccid
2. contralateral limbs spastic- lesion that destroys cranial nerve nucleus often destroys proximal pyramidal tract fibers for arm/leg prior to their decussation
Damage to the trigeminal V cranial nerve results in?
Weakened movement of the jaw
Damage to the Facial VII cranial nerve results in?
Motor- weakness and flaccidity of ipsilateral face, eyelids and muscles of expression
Sensory- loss of taste in anterior 2/3rds of the tongue
Damage to the Glossopharyngeal XI cranial nerve results in?
1. loss of gag reflex
2. weakened elevation of palate, larynx
3. constriction of pharynx may be weakened (hypernasality)
* sensation for posterior pharyngeal wall
Damage to the Vagus X results in?
Ipsilateral paralysis/weakness of soft palate and recurrent laryngeal branch=unilateral vocal fold paralysis
Damage to the Accessory XI results in?
Weakened muscles in neck/shoulders and weakened respiration and head droop may affect respiration and phonation
Damage to the Hypoglossal XII results in?
Ipsilateral weakness of the tongue/poor lateral movement, tongue deviates to the weak side/pushed across midline by the strong side, and some swallowing difficulties
Degeneration of ____ ____ ____ causes symptoms typical of lower motor neuron disease-flaccid paralysis, fasciculations of muscles, and eventual muscle atrophy.
Anterior Horn Cells
Inflammatory spinal nerve disease, such as ____ ____, usually affect the longest nerve fibers first.
The results of this disease include acute idiopathic polyneuritis, simultaneous inflammation of a large number of spinal nerves, paralysis, pain, and atrophy.
Spinal Nerve Diseases such as Guillain-Barre Syndrome
What is Characterized by abnormalities in the neurotransmitters responsible for transmission of nerve impulses across synapse.
Diseases of the Neuromuscular Junction
Abnormalities are related to deficiency or excess of neurotransmitters or to alterations in the sensitivity of receptor cells to the neurotransmitters.
Disease of the Neuromuscular Junction
What is the most common of the neuromuscular transmission diseases?
What is caused by an autoimmune-mediated damage to the acetylcholine receptors on muscle cells, which interferes with neuromuscular transmission.
Symptoms include generalized but fluctuating muscle weakness, rapid muscle fatigue, and quick recovery of strength when muscles are rested.
This often causes unique flaccid dysarthria syndrome in which the patient's speech intelligibilty deteriorates as the patient talks.
What is the adult form of muscular dystrophy causing progressive weakening of muscles?
An acquired inflammatory muscle disease, usually does not affect speech but may affect respiratory muscles and sometimes produces swallowing problems?
Disintegration of coordination; jerky, segmented?
Range and force of movements are distorted?
Initial acceleratioin and final termination ("breaking") of movements is slowed causing overshoot of the target. (Too abruptly and too forcefully)
Rhythmic/Repetitive movements affected by distorted timing?
Loss of background muscle tone due to damaged gamma system, disordered equilibrium and gait (wide stance), intentional tremor may be present?
Involvement of basal ganglia and regulation of background adjustments, posture, integration of component movements (synergy), inhibition of unplanned, involuntary movements?
This type of damage causes dyskinesias - abnormal movement disorders
What are the neuro-muscular effects for Hyperkinetic Quick Dysarthria?
From the Greek word "dance", involuntary movements, sometimes forceful, abrup, at rest the muscles may appear hypotonic?
Choreas (Hyperkinetic Quick)
This is an extreme form of chorea, violent flailing?
Ballisms (Hyperkinetic Quick)
Sporadic, irregular contractions of the body, sudden abrupt movements as when drifting off to sleep. May also include Torettes.
Myoclonus (Hyperkinetic Quick)
What 2 diseases are associated with Hyperkinetic Quick dysarthria?
2. Huntington's Chorea
What are the neuro-muscular effects for Hyperkinetic Slow Dysarthria? 1,2
Slow, writhing, sinuous movements, that usually affects arms, face, and tongue, overflow of movements exaggerated by attempts at voluntary movements.
Athetosis (Hyperkinetic Slow)
Excessive muscle tone in selected body parts, usually affects trunk, neck, and proximal parts of limbs.
Dystonia (Hyperkinetic Slow)
Diminished range of movement?
"Rigidty" results from extrapyramidal activation of both extensors and flexors?
Parkinson's disease is part of which dysarthria group?
Artiosclerotic changes in basal ganglia (substantia nigra) causing a deficiency in "dopamine" neural transmitter substance?
Parkinson's Disease (Hypokinetic Dysarthria)
Elicited in passive movement, involuntary contraction of the muscle being stretched; results in extensors vs. flexors?
Two types of Rigidity
1. smooth (stiff, difficult to bend)
2. intermittent (stepwise, bit by bit)
Resting tremor (hypokinetic dysarthria)
Rigit facial expression (face is a mask)
Masked facies (hypokinetic dysarthria)
Short, stiff, shuffling steps?
Festinating gait (hypokinetic dysarthria)
Disorder of the nervous system characterized by an inability to perform purposeful movements?
The disruption of the concepts or ideas needed to understand the use of objects?
The disruption of the motor plans needed to demonstrate volitional actions - disruptions that cannot be accounted for by weakness, paralysis, sensory loss, or incoordination of the muscles required to perform the actions?
Disruption of the ideas needed to demonstrate the use of objects - especially apparent "on command"?
Unable to carry out movement sequences - even when provided with the relevant object (toothbrush)? (ex. putting a key in the lock)
Disruption of the plans needed to demonstrate the use of objects?
May demonstrate individual motor gestures that comprise an action (ex brushing ones teeth), but is unable to assemble them into the proper sequence?
Which Apraxia, Ideational or Ideomotor, is more common and less severe?
Damage to the left parietal lobe is expected to result in which apraxia?
Damage in the frontal lobe, especially the premotor cortex, is expected to result in which apraxia?
There are 3 types of Ideomotor apraxia?
1.buccofacial-whistling, using a straw, blowing feathers
2. limb-toothbrusthing, using a door key (hands and arms)
3. speech-formulation of sounds and sound sequences
Due to damage to the cortical center for "praxis" - or planning sequences of movements would be unable to perform whether requests are presented verbally or non-verbally?
Due to damage which disconnects the left hemisphere auditory comprehension areas from areas for planning would be able to perform requests that are present non-verbally (through gestures) - bypasses the auditory comprehension area.
Disconnection Apraxia (between ares that should be attached)
This dysarthria has slow and limited movement that is very effortful. Slow to reach artic targets and have a slow rate of speech, also they have a strained-strangled harsh quality?
Spastic dysarthria-Upper Motor Neurons
This dysarthria can be caused by myasthenia gravis, has the inability to reach target articulation, and a breathy quality?
Flaccid Dysarthria-Lower Motor Neurons
This dysarthria is going to deal with incoordination, inaccruate movements, tremors, iregular articulatory breakdown, abrupt changes in loudness and pitch, unequal stress, and can be unpredictable?
This dysarthria is going to have a tremor, may be caused by Parkinson's, going to have rapid articulation movement with reduced amplitude, may also have excessive movements?
This dysarthria deals with chorea's, ballisms. jerks and tics, and myoclonic, as well as excessive involuntary movements, and variable loudness?
Hyperkinetic Quick-Extrapyramidal/basal ganglia
This dysarthria deals with athetosis and dystonia, may have involuntary movements, as well as monopitch, and monoloudness?