Learn: motor exam 2 | Quizlet

What are the seven dysarthria types?

Flaccid; Spastic; Ataxic; Hypokinetic; Hyperkinetic; Mixed; Unilateral Upper Motor Neuron (UUMN)

What lesion causes Flaccid Dysarthria?

Lower Motor Neuron (LMN) damage affecting cranial nerves or spinal nerves

Hallmark characteristics of Flaccid Dysarthria

Weakness, hypotonia, breathiness, hypernasality, nasal emission, short phrases, imprecise consonants

Primary physiologic deficit in Flaccid Dysarthria

Weakness and reduced muscle tone (hypotonia)

Common confirmatory signs of Flaccid Dysarthria

Atrophy, fasciculations, hyporeflexia, weakness

Common treatment goals for Flaccid Dysarthria

Improve VP closure, articulation, tongue strength (CN XII), reduce nasal emission, palatal lift/speech bulb, traditional speech exercises

Which cranial nerve controls jaw movement?

CN V (Trigeminal)

Damage to bilateral CN V causes what speech problems?

Imprecise articulation due to reduced jaw strength and slow rate

Which cranial nerve controls facial muscles?

CN VII (Facial)

Damage to CN VII causes what speech problems?

Labial distortions, reduced lip seal, reduced lip rounding, consonant distortions

Which cranial nerve controls the palate and pharynx?

CN X (Vagus)

Pharyngeal branch of CN X controls what?

Velopharyngeal closure, resonance, swallowing

Superior laryngeal branch (SLN) controls what?

Pitch control through the cricothyroid muscle

Recurrent laryngeal branch (RLN) controls what?

Vocal fold movement and voice quality

Damage to CN XII causes what?

Lingual imprecision, vowel distortions, slow speech rate

What lesion causes Spastic Dysarthria?

Bilateral Upper Motor Neuron (UMN) damage

Hallmark feature of Spastic Dysarthria

Strained-strangled voice quality

Common speech characteristics of Spastic Dysarthria

Slow rate, monopitch, monoloudness, hypernasality, imprecise consonants, reduced stress

Primary physiologic deficit in Spastic Dysarthria

Hypertonia and hyperreflexia

Confirmatory signs of Spastic Dysarthria

Pathologic reflexes, emotional lability, drooling, spasticity

Treatment goals for Spastic Dysarthria

Relaxation, stretching, easy onset, yawn-sigh, articulation therapy, stress drills

What lesion causes Ataxic Dysarthria?

Cerebellar damage

Primary physiologic deficit in Ataxic Dysarthria

Incoordination

Hallmark speech characteristics of Ataxic Dysarthria

Irregular AMRs, excess and equal stress, scanning speech, irregular articulatory breakdowns

Common physical signs of Ataxic Dysarthria

Dysmetria, dysdiadochokinesis, nystagmus, poor balance, wide-based gait

Treatment goals for Ataxic Dysarthria

Rate control, breath control, metronome, finger tapping, improve articulation and prosody

What lesion causes Hypokinetic Dysarthria?

Basal ganglia control circuit

Hallmark characteristics of Hypokinetic Dysarthria

Reduced loudness, monopitch, monoloudness, rapid speech, short rushes, blurred AMRs

Common physical signs of Hypokinetic Dysarthria

Resting tremor, rigidity, bradykinesia, hypokinesia, masked facies, micrographia

Treatment goals for Hypokinetic Dysarthria

LSVT LOUD, Speak OUT!, EMST, rate reduction, improve respiratory support

What lesion causes Hyperkinetic Dysarthria?

Basal ganglia control circuit

Primary physiologic deficit in Hyperkinetic Dysarthria

Involuntary movements

Hallmark speech characteristics of Hyperkinetic Dysarthria

Voice stoppages, variable loudness, prolonged phonemes, inappropriate silences, irregular articulatory breakdowns

Treatment goals for Hyperkinetic Dysarthria

Reduce involuntary movements, improve intelligibility, compensatory speech strategies

What lesion causes Mixed Dysarthria?

Damage to multiple motor systems (UMN + LMN or multiple CNS structures)

Most common cause of Mixed Dysarthria

ALS and Multiple Sclerosis

What lesion causes UUMN Dysarthria?

Unilateral corticobulbar tract damage

Characteristics of UUMN Dysarthria

Mild dysarthria, imprecise consonants, unilateral weakness, slow rate

Which dysarthria is associated with LMN damage?

Flaccid

Which dysarthria is associated with bilateral UMN damage?

Spastic

Which dysarthria is associated with cerebellar damage?

Ataxic

Which dysarthria is associated with basal ganglia damage and reduced movement?

Hypokinetic

Which dysarthria is associated with basal ganglia damage and excessive involuntary movement?

Hyperkinetic

Which dysarthria is associated with multiple lesion sites?

Mixed

Myasthenia Gravis is associated with which dysarthria?

Flaccid Dysarthria

Cause of Myasthenia Gravis

Autoimmune destruction of acetylcholine receptors at the neuromuscular junction

Hallmark sign of Myasthenia Gravis

Fatigability (speech worsens with use and improves with rest)

Guillain-Barré Syndrome is associated with which dysarthria?

Flaccid Dysarthria

Progressive Bulbar Palsy is associated with which dysarthria?

Flaccid Dysarthria

Muscular Dystrophy is associated with which dysarthria?

Flaccid Dysarthria

Progressive Pseudobulbar Palsy is associated with which dysarthria?

Spastic Dysarthria

Multiple Sclerosis (MS) most commonly produces which dysarthria?

Mixed Dysarthria

Why does MS commonly produce Mixed Dysarthria?

It causes lesions in multiple areas of the CNS

Can MS also produce Spastic or Ataxic Dysarthria?

Yes

Friedreich's Ataxia is associated with which dysarthria?

Ataxic Dysarthria

Alcohol intoxication resembles which dysarthria?

Ataxic Dysarthria

Cerebellar stroke is associated with which dysarthria?

Ataxic Dysarthria

Parkinson's Disease is associated with which dysarthria?

Hypokinetic Dysarthria

Primary pathology in Parkinson's Disease

Loss of dopamine-producing neurons in the substantia nigra

Classic signs of Parkinson's Disease

Resting tremor, rigidity, bradykinesia, hypokinesia

Most common speech treatment for Parkinson's Disease

LSVT LOUD

What is Parkinsonism?

A group of disorders with Parkinson-like symptoms

Drug-induced Parkinsonism is caused by what?

Antipsychotic (neuroleptic) medications

Huntington Disease is associated with which dysarthria?

Hyperkinetic Dysarthria (Chorea)

Cause of Huntington Disease

Autosomal dominant degeneration of the caudate nucleus and putamen

Hallmark movement in Huntington Disease

Chorea

Tardive Dyskinesia is associated with which dysarthria?

Hyperkinetic Dysarthria

Cause of Tardive Dyskinesia

Long-term dopamine-blocking medications

Spasmodic Dysphonia is what type of movement disorder?

Laryngeal dystonia (Hyperkinetic Dysarthria)

Types of Spasmodic Dysphonia

Adductor, Abductor, Mixed

Essential Tremor belongs to which dysarthria category?

Hyperkinetic Dysarthria

ALS damages which motor neurons?

Both Upper and Lower Motor Neurons

What dysarthria is most common in ALS?

Mixed (Spastic-Flaccid)

Why does ALS produce Mixed Dysarthria?

It damages both UMNs and LMNs

Which dysarthria has the most severe hypernasality?

Flaccid Dysarthria

Which dysarthria has strained-strangled voice?

Spastic Dysarthria

Which dysarthria has irregular articulatory breakdowns?

Ataxic and Hyperkinetic

Which dysarthria has scanning speech?

Ataxic Dysarthria

Which dysarthria has rapid blurred AMRs?

Hypokinetic Dysarthria

Which dysarthria has involuntary movements?

Hyperkinetic Dysarthria

Which dysarthria has weakness?

Flaccid Dysarthria

Which dysarthria has hypertonia?

Spastic Dysarthria

Which dysarthria has incoordination?

Ataxic Dysarthria

Which dysarthria has rigidity?

Hypokinetic Dysarthria

Which dysarthria has chorea or dystonia?

Hyperkinetic Dysarthria

Which dysarthria commonly requires a palatal lift?

Flaccid Dysarthria

Which dysarthria commonly uses relaxation techniques?

Spastic Dysarthria

Which dysarthria commonly uses metronome pacing?

Ataxic Dysarthria

Which dysarthria commonly uses LSVT LOUD?

Hypokinetic Dysarthria

Which dysarthria varies depending on the specific movement disorder?

Hyperkinetic Dysarthria