Term
| what causes flaccid dysarthria? |
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Definition
| damage to the lower motor neurons |
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Term
| what are some common clinical presentations of flaccid dysarthria? |
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Definition
| after surgery, injury, CVA, tumor, or myasthenia gravis |
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Term
| what is myasthenia gravis? how is it managed? |
|
Definition
| fatigue with extended use - it is medically managed |
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Term
| how does flaccid dysarthria affect the voice? |
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Definition
| the voice is breathy, hoarse, and there is diplophonia |
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Term
| how do we treat flaccid dysarthria? |
|
Definition
surgery or compensatory strategies
- bilateral is surgical
- unilateral is more SLP treated and we teach patients to try lifting, pushing, or pulling techniques |
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Term
| what is a disorder of motor execution? what symptoms do we see with this? |
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Definition
dysarthria: there is a problem with the transmission of the signal, but the original brain message is fine
-- we see low tone, paralysis, and weakness |
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Term
| what is a disorder of motor planning? |
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Definition
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Term
| what causes unilateral upper motor neuron dysarthria? |
|
Definition
| the most common cause is a stroke, then tumor or trauma |
|
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Term
| what does unilateral upper motor neuron dysarthria look like clinically? |
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Definition
|
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Term
| what are some common co-morbidities in unilateral upper motor neuron dysarthria? |
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Definition
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Term
| how does aphasia effect treatment for unilateral upper motor neuron dysarthria? |
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Definition
| Aphasia may interfere with the client not telling you what they need or follow your directions |
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Term
| how does apraxia effect treatment for unilateral upper motor neuron dysarthria? |
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Definition
| Apraxia will lead to inconsistent areas and groping behaviors |
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Term
| in which dysarthria do we get too much contraction so we get spasticity on one side? |
|
Definition
| unilateral upper motor neuron dysarthria |
|
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Term
| how are spastic dysarthria and UUMN dysarthria different? |
|
Definition
bilateral upper motor neuron damage: spastic
unilateral upper motor neuron damage: UUMN |
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Term
| How does spastic dysarthria affect the voice? |
|
Definition
-strained voice quality from over tightening of the folds
-harshness
-low pitch because of a greater degree of resistance to overcome so you have fewer cycles per second
-hypernasality |
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Term
| what are common co-morbidities of spastic dysarthria? |
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Definition
|
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Term
| How does a TBI affect treatment of spastic dysarthria? |
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Definition
| the SLP may have bigger things to deal with, such as walking, eating, etc. |
|
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Term
| how does lability affect spastic dysarthria treatment? |
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Definition
| the patient may have trouble with emotional regulation |
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Term
| what causes hypokinetic dysarthria? What's the usual diagnosis for patient's with this dx? |
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Definition
| problems in the basal ganglia with reduced dopamine - usual diagnosis is Parkinson's disease |
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Term
| what voice concerns do we encounter with hypokinetic dysarthria? |
|
Definition
- monopitch
- monoloudness
- breathy
- hoarse |
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|
Term
| what treatment options exist for hypokinetic dysarthria? |
|
Definition
| medication, surgery to correct bowing, and voice therapy (LSVT) |
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Term
| which dysarthria is the only dysarthria associated with an increased rate of speech and decreased volume? |
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Definition
|
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Term
| when patient's have been treated for a long time for Parkinson's disease, what can result from extended treatment? |
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Definition
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|
Term
| How do people with Parkinson's perceive their own voices? |
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Definition
| They perceive their own voices as normal, but in reality there is a bowing of the VFs which lets air escape and results in a breathy quality |
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Term
| what causes hyperkinetic dysarthria? |
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Definition
| it isn't completely understood, but there are problems in the basal ganglia |
|
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Term
| what voice-related problems does hyperkinetic dysarthria cause? |
|
Definition
-variable pitch
-variable loudness
-harshness |
|
|
Term
| how is hyperkinetic dysarthria managed? |
|
Definition
medication and voice therapy if appropriate
- in the early stages patients talk with a metronome, delayed auditory feedback, or use sensory tricks (touching finger to the jaw, etc.) |
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Term
|
Definition
| doctor or intervention caused - anytime a patient comes in for medical assistance and ends up with a problem they didn’t have before. |
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Term
|
Definition
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Term
| What answer choice should never be selected on the exam? |
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Definition
| ataxic dysarthria -- caused by the cerebellum and affects prosody/gait |
|
|
Term
| what causes mixed dysarthria? |
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Definition
|
|
Term
| which diagnoses cause voice-related problems? |
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Definition
|
|
Term
| how do we treat mixed dysarthria? |
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Definition
| always treat the respiration problems first, then resonation because it's hard to understand someone with awkward resonance. Work on prosody and articulation last. |
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Term
| CP usually results in a mix of what? |
|
Definition
| spastic and flaccid dysarthria |
|
|
Term
| when is onset of spasmodic dysphonia? |
|
Definition
|
|
Term
| what does spasmodic dysphonia affect? |
|
Definition
|
|
Term
| which subset of spasmodic dysphonia is most common? |
|
Definition
|
|
Term
| what is adductor spasmodic dysphonia? |
|
Definition
spasms of the adductor muscles - the person is talking and then they get a sudden burst of strained/strangled quality and the vocal folds close suddenly.
– This gives a harsh tone |
|
|
Term
| what is abductor spasmodic dysphonia? |
|
Definition
| get aphonic bursts where a person tries to phonate |
|
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Term
| what are causes of spasmodic dysphonia? |
|
Definition
focal dystonia
-focal: localized to one place
-dystonia: bad tone/something is going wrong from the brain to the muscle |
|
|
Term
| is spasmodic dysphonia a psychogenic disorder? |
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Definition
|
|
Term
| what are symptoms of spasmodic dysphonia? |
|
Definition
adductor: strangled voice quality
abductor: aphonic interruptions/breathiness |
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|
Term
| what are co-occurring symptoms of spasmodic dysphonia? |
|
Definition
blepharospasm- spasms of the eyelids
torticollis- twisted neck
graphospasm- spasm that effect the ability to write
oromandibular dystonia- bad muscle tone of the mouth and jaw |
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Term
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Definition
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|
Term
|
Definition
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|
Term
|
Definition
| Spasms that effect their ability to write (arm and hand) |
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|
Term
|
Definition
| Bad muscle tone of the mouth and jaw |
|
|
Term
| what are treatment options for spasmodic dysphonia? |
|
Definition
recurrent laryngeal nerve sectioning
botulinum toxin
voice therapy |
|
|
Term
| recurrent laryngeal nerve sectioning treatment for spasmodic dysphonia |
|
Definition
| current laryngeal nerve is cut to stop the impulses - but it's a temporary fix because it's not uncommon for the nerves to find their way back together |
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Term
| botulinum treatment for spasmodic dysphonia |
|
Definition
| injection of botox into the muscles of the larynx can damp down the overactive neural input and allow patients to produce more normal voice for a time |
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Term
| voice therapy treatment for spasmodic dysphonia |
|
Definition
| ONLY USEFUL IN ADJUNCT WITH BOTOX |
|
|
Term
| what is paradoxical vocal fold movement? |
|
Definition
| VFs don't move as directed - may close during breathing |
|
|
Term
| what is sometimes mistaken for asthma? |
|
Definition
|
|
Term
| what is treatment for paradoxical VF movement? |
|
Definition
| botox so the adductor muscles aren't closing off the airway - in severe cases the disorder may need a tracheostomy placement --- therapy can be helpful if we teach the patients how to relax the VFs |
|
|
Term
| what causes paradoxical VF movement? |
|
Definition
| maybe reflux, dystonia, or psychogenic? -- very unpredictable/triggered by exertion |
|
|
Term
| when can you identify paradoxical VF movement? |
|
Definition
| you can only identify during an attack |
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Term
| an essential tremor is considered a what? |
|
Definition
| hyperkinetic dysarthria - most common of the movement disorders |
|
|
Term
| what is the most common of the movement disorders? |
|
Definition
|
|
Term
| what is an essential tremor related to? |
|
Definition
|
|
Term
| is an essential tremor malignant or benign? |
|
Definition
|
|
Term
| what is treatment for an essential tremor? |
|
Definition
| there is no way to eliminate it - our therapy is focused on diversion (EG: teach patients how to shorten vowels, raise the pitch so there will be more tension in the VFs and the tremor will be less prominent, and to speak quieter with lower intensity) |
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