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Flashcards in Types of dysarthria Deck (61)
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1
Q

Name the 6 different types of dysarthria.

A
Flaccid
Spastic
Ataxic
Hypokinetic
Hyperkietic
Mixed.
2
Q

Flaccid Dysarthrias.

Loacalisation.

A

Lower Motor Neuron damage.

3
Q

Flaccid Dysarthrias.

Examples of conditions.

A

TBI
myasthenia gravis
multi-system atrophy.

4
Q

Flaacid Dysarthrias.

Key Feature.

A

Weakness.

5
Q

What is flaccid dyarthria caused by?

A

the lower motor neuron lesion of one or more cranial or spinal nerves.

6
Q

What can flaccid dysarthrias affect?

A

It may only affect one component of speech or only one muscle group e.g. tongue.
It can also affect multiple components of speech in various combinations, giving rise to subtypes (hence flaccid dsyarthriaS).

7
Q

What do bilateral lower motor neurons give rise to?

A

A collection of symptoms known as bulbar palsy (flaccid dyarthria).

8
Q

Flaccid dysarthrias can affect…

A

any of the components of speech- respiration, phonation, articulation, resonance and prosody.

9
Q

What are the priamry distingushimg characteristics of flaccid dysarthrias?

A

Weakness

Reduced tone

10
Q

What is the consequent impact of weakness and reduced tone (flaacid dysarthrias)?

A

reduced speed
reduced range
reduced accuracy of speech movements.

11
Q

What are the features of flaccid dysarthria?

A
  • Weakness
  • Hypotonia
  • Absent or Reduced reflexes
  • Atrophy
  • Fasciculation (twitches in resting muscle)
  • Progressive weakness with use
12
Q

Flaccid dysarthrias.

What might you see in an oromotor exam?

A
this can be unilateral or bilateral :)
jaw deviates to weak side/both sides.
facial droop one side/both sides
weakness evident on one side or both sides e.g. lip pusing and puffing cheeks
mild or more severe articulatory distortions
cough can be weak
weak or absent gag reflex
Tongue atrophy on or both sides.
Fasiculations on weak side or both sides
tongue may also deviate to weak side.
13
Q

Bilateral lower motor neuron lesions result in more…

A

serious consequences e.g. more distorted articulation etc.

14
Q

Name the distinctive speech characteristics of flaccid dysarthria.

A
Short Phrases
Hypernasality
Nasal Emission
Continuous breathiness
Audible inspiration.
15
Q

Spastic dsyarthria.

Localisation.

A

Upper Motor Neuron Damage.

16
Q

Spastic dysarthria.

Examples of conditions.

A

TBI

Cerebral Palsy.

17
Q

Spastic dysarthria.

Key Feature.

A

Spasticity.

18
Q

What is spastic dysarthria caused by?

A

bilateral upper motor neuron lesions.

19
Q

Spastic dysarthria can affect…

A

Any of the components of speech (respiration, phonation, articulation, resonance and prosody). BUT ALWAYS MORE THAN ONE :)

20
Q

What term is associated with spastic dysarthria?

Define this.

A

Pseudobulbar palsy- this is emotional lability- sudden laughter or crying not necessarily related to what the individual feels.

21
Q

Spastic Dysarthria.

What are the primary distinguishing chracteristics of speech?

A

Weakness combined with excessive muscle tone (hypertonia), reduced range of movement and slowness of movement.

22
Q

What is also present with spastic dysarthria?

A

Dysphagia.

Abnormal reflexes.

23
Q

Spastic Dysarthria.

What’s observable on an oromotor exam?

A

jaw clonus (tremor) when relaxed.
normal jaw strength
bilateral face weakness
limited lip retraction and pursing (but not as bad LMN lesions lol)
gag reflecx may be hyperactive
range of tongue movement may be limited snd strength decreased.

24
Q

Spastic Dysarthria.

Key Speech Characteristics.

A
  • Slow rate
  • Reduced pitch
  • Strained-strangled voice quality.
25
Q

Ataxic Dysarthria.

Localisation.

A

Cerebellum.

26
Q

Ataxic Dysarthria.

Examples of conditions.

A

Fredreich’s Ataxia.

27
Q

Ataxic Dysarthria.

Key feature.

A

Inco-ordination.

28
Q

What is ataxic dysarthria associated with?

A

Damage to the cerebellar control unit.

29
Q

What components of speech can ataxic dysarthria manifest in?

A

Any of the components of speech, but its characteristics are most evident on articulation and prosody.

30
Q

Ataxic dysarthria.

What are the primary distinguishing characteristics of speech?

A

Inccoordination
Reduced muscle tone (hypotonia)

This causes slowness and inaccuracy in the force, range, timing and direction of speech movements.

31
Q

Ataxic dysarthria is associated with impaired..

rather than…

A

impaired cooordination and control of movement patters rather than individual speech muscles.

32
Q

Ataxic dysarthria.

Where will difficulties be more evident?

A

Difficulties will be more evident in speech tasks - particularly in multi-syllabic words or utterances of greater than length.

Rather than oromotor exam (assessment of cranical nerves).

33
Q

Name the key characteristics of Ataxic Dysarthria.

A
Excess and equal stress
Irregular articulatory breakdowns
Distorted vowels
prolonged Phonemes
Excess loudness variations.
34
Q

In ataxic dysarthria, why is speech particularly hard to understand?

A

Due to distorted vowels.

35
Q

Hypokinetic Dysarthria.

Localisation.

A

Basal Ganglia (extrapyramidal)

36
Q

Hypokinetic Dysarthria.

Examples of conditions.

A

Parkinson’s Disease.

37
Q

Hypokinetic Dysarthria.

Key feature.

A

Rigidity.

38
Q

What is hypokinetic dyarthria associated with?

A

Damage in the basal ganglia.

39
Q

What components of speech does hypokinetic dysarthria affect?

A

It can be in any or all components of speech but must noticeable in phonation, articulation and prosody.

40
Q

What is hypokinetic dysarthria due to?

A

Rigidity, reduced force and range of movement, and slow individual movements but then sometime fast repetitive movements. (slow then rush).

41
Q

What does hypokinetic dysarthria often give the impression of?

A

It gives the impression that the underlying speech movements are there but have been reduced in range or amplitude, and reduced in flexibility and speed.

42
Q

What may be present, in hypokinetic dysarthria?

A

Dyspahgia.

43
Q

What else may be evident in hypokinetic dysarthria?

A

Drooling may be evident due to reduced swallowing frequency.

44
Q

Hypokinetic Dysarthria.

Observable on oromotor exam.

A

Tremor at rest of jaw opening.
Masked facial expression and reduced blinking.
Lips (particularly upper) may appear tight or immobile.
Range or strength may be normal on OME but may contrast with speech tasks.
Dyshonia (hoarse) vooce is common.
Tongue tremor at rest or on protrusion.

45
Q

Hypokinetic Dysarthria.

Key speech features.

A
Reduced stress
Inappropriate silences
Increased rate in segments
Increase rate overall
Short rushes of speech
Repeated phonemes
Monoptich and monoloudness.
46
Q

Hyperkinetic Dysarthrias.

Localisation.

A

Basal Ganglia (extrapyramidal).

47
Q

Hyperkinetic Dysarthrias.

Examples of conditions.

A

Huntington’s disease.

48
Q

Hyperkinetic Dysarthrias.

Key Feature.

A

Involuntary Movements.

49
Q

Hyperkinetic dysarthria is associated with damage in the …

A

Basal Ganglia.

50
Q

What components of speech can hyperkinetic speech be in?

A

Any or all of the components of speech but is most often noticeable in prosody and rate.

51
Q

In what way is hyperkinetic dysarthria similar to flaccid dysarthria?

A

It too can be as a result of abnormalities at one level of speech and to only a few muscles of that level.

52
Q

Hyperkinetic Dysarthria.

What do deviant speech characteristics result form?

A

Abnormal, rhythmic or irregular and unpredictable voluntary movements.

53
Q

Why the plural hyperkinetic dysarthriaS?

A

There are subgroups relating to the type of involuntary movement.

54
Q

Name some involuntary movements.

A

Myoclonus- lightening jerk, single, rapid, brief.
Dyskinesia- involuntary movement
Chorea- rapid, random, purposeless movements
Tics- rapid, coordinated or patterned, partially controlled.
Tremor- rhymic periodic movement. at rest or action :)
Dystonia- slow and sustained abnormal movement.
Athetosis- slow, writhing, purposeless movements.

55
Q

Hyperkinetic dysarthria.

Key Speech Features.

A
Prolonged intervals.
Variable Rate.
Innappropriate silences.
Prolonged phonemes.
Excess loudness variations.
Voice stoppages.
Transient breathiness.
56
Q

Mixed Dysarthria.

Localisation.

A

More than one localisation :)

57
Q

Mixed Dysarthria.

Examples of conditions.

A

Motor Neuron Disease.

Multiple Sclerosis.

58
Q

Mixed Dysarthria.

Key feature?

A

That there’s more than one key feature lol.

59
Q

Mixed Dysarthria.

Info.

A

In reality, neurologic disease doesn’t fit into neat compartments.

Dysarthria is often mixed; reflecting 2 or more types of dysarthria.

60
Q

What is dysarthria often indicative of?

A

Damage to multiple areas of the nervous system.

61
Q

In mixed dysarthria, what combinations are possible?

A

Any combination of dysarthrias are possible ;)