Motor Speech Disorders Test #1

Motor Speech Disorders

neurologic origin, affecting planning, programming, control, or execution of speech

What is dysarthria?

A group of neurologic speech disorders.

What are the characteristics of dysarthria?

Abnormal strength, speed, range, steadiness, tone, or accuracy of movements required for respiration.

What are the characteristics for dysarthria?

weakness, spasticity, incoordination, involuntary movements, muscle tone abnormalities

Respiration

breathing air into and out of the lungs

Phonation

vibration of the vocal folds

Resonance

nasality

Articulation

accuracy of speech

Prosody

rate, pitch, loudness, stress, tone, and pausing

Apraxia of Speech

neurologic speech disorder affecting planning or programming of sensiormotor system, resulting in phonetic and prosodic abnormalities

__________________ results in phonetic and prosodic speech abnormalities

Apraxia of Speech (AOS)

________________ and _______________ are impacted when diagnosed with apraxia of speech (AOS)

articulation and prosody

Examples of Neurological Speech Disorders (NOT MSDs)

Acquired neurogenic stuttering

Palilalia (repetition of someone's own words)

Echolalia (repetition of someone else's words)

Foreign Accent Syndrome

Aprosodia (w/ right hemisphere dysfunction)

Mutism

Neurologic Speech Disturbances

Musculoskeletal defects, dysphonias, functional (psychogenic) and related nonorganic speech disorders

What are examples of neurologic speech disturbances?

Musculoskeletal defects, dysphonias, functional (psychogenic) and related nonorganic speech disorders

Normal variations in speech production

Normal aging, Gender, Style

How does aging change speech production?

change in pitch, voice quality and stability, loudness, speech breathing patterns, rate, fluency, prosodic variations, and fine motor control

Gender changes speech production by ______ and _______

pitch and rate

because of the mass and length of the vocal folds

Style changes speech production by ___________, ______________, and ____________

personality, emotional state, and speaking role

Dysarthria affects _______% of people with a small stroke

25%

People with Parkinson's disease most likely have what kind of dysarthria?

hypokinetic dysarthria

_____% of Parkinson's disease patients have dysarthria?

90%

One of the first symptoms in _____% of individuals with amyotrophic lateral sclerosis (ALS) is dysarthria

25%

______% of individuals with multiple sclerosis (MS) have dysarthria

50%

_____% of individuals with a TBI have dysarthria

33%

Up to ______% of individuals with cerebral palsy (CP) have dysarthria?

90%

Auditory Perceptual Analysis

clinician listens carefully to a person's speech or voice to evaluate quality, characteristics, and any abnormalities

What are salient features with auditory perceptual analysis?

visual, auditory, tactile observations

at rest, nonspeech movements, during speech

Why is auditory perceptual analysis important?

Can help inform what instrumental assessment to perform, HOWEVER, subject to unreliability among other clinicians

What instrumental analysis?

specialized tools and technology to assess and visualize swallowing, speech, or voice functions

What are the types of instrumental analysis?

acoustic, physiologic, and visual imaging

Examples of acoustic instrumental analysis are...

quantitative for speech rate, vocal quality, pitch, loudness, resonance, etc

How do you measure acoustic instrumental analysis?

VisiPitch, Nasometer, Praat

Examples of physiologic instrumental analysis are...

muscle movements and timing

How do you measure physiologic instrumental analysis?

electromyography, kinematic measures (electroglottography), aerodynamic measures (spirometry)

Examples of visual imaging instrumental analysis are...

videofluoroscopy, nasoendoscopy, laryngoscopy

What are the categories for MSDs (relevant to neurologic and etiologic perspectives)

age at onset, course, site of lesion, neurologic diagnosis, and pathophysiology

What are the categories for MSDs (relevant to speech disorders)

speech components, speech subsystems (speech breathing, phonation, resonance, and articulation)

where is flaccid dysarthria localized?

lower motor neuron (final common pathway)

where is spastic dysarthria localized?

bilateral upper motor neuron (direct and indirect activation pathways)

where is ataxic dysarthria localized?

cerebellum (cerebellar control circuit)

Where is Hypokinetic Dysarthria localized?

basal ganglia control circuit (extrapyramidal)

Where is hyperkinetic dysarthria localized?

basal ganglia control circuit

where is the unilateral upper motor neuron localized?

unilateral upper motor neuron

What hemisphere is AOS in?

Left (dominant) hemisphere

What is the neurologic sign for flaccid dysarthria

weakness

What is the neurologic sign for spastic dysarthria?

spasticity (muscle continuously tight or stiff)

What is the neurologic sign for ataxic dysarthria?

incoordination

What is the neurologic sign for hypokinetic dysarthria?

rigidity; reduced range of movement; scaling problems)

What is the neurologic sign for UUMN dysarthria?

UMN weakness, incoordination, or spasticity

What are the CNS meniges 3 layers

dura, arachnoid, pia mater

MSDs can occur in ________ and ____________.

meninges and meningeal spaces

What can cause MSDs in meninges and meningeal spaces?

infection, aneurysm, thrombosis

Acute

within minutes

Subacute

within days

Chronic

within days

transient

when symptoms resolve completely after onset

improving

when severity is reduced but symptoms are not resolved

progressive

when symptoms continue to progress or new symptoms appear

exacerbating / remitting

when symptoms develop, then resolve or improve, then reuse and worsen, and so on

Stationary (chronic)

when symptoms remain unchanged for an extended time

what are examples of degenerative diseases?

ALS, dementia, MS, parkinsons)

degenerative diseases are _________ and __________

gradual and progressive

inflammatory diseases

progressive and diffusely located

focal

toxic-matabolic diseases

diffuse effects

vitamin deficiencies, hypoatremia, hypoxia

Examples of neoplastic diseases

tumor, cancer

4 functional divisions of the basic motor symptoms

final common pathway

direct activation pathway

indirect activation pathway

control circuits

final common pathway is also called

lower motor neuron system

direct activation pathway is also called

upper motor neuron system

indirect activation pathway is also called

upper motor neuron system

control circuits is also called

cerelbellum, basal ganglia system