Muscular Dystrophy
Besides the global change of muscle mass reduction, muscular dystrophy is myotonic. What does this mean?
Delayed relaxation, prolonged contraction
What triggers Guillain-Barré to occur?
Infection (e.g. Zika virus)
If there is damage to the velopharyngeal branch of CN X, in which area will we see impairment? Name at least one symptom.
Velopharynx - decreased soft palate elevation
What is the etiology of myasthenia gravis?
Autoimmune neuromuscular disease - weakness due to antibodies blocking postsynaptic acetylcholine receptors at neuromuscular junctions
To provide support to reduce effort in the speech subsystems
T/F: An expressionless face is a symptom of muscular dystrophy.
True!
T/F: Guillain-Barré affects a single peripheral nerve.
False! Guillain-Barré involves an acute polyneuropathy of multiple peripheral nerves.
If there is damage to the laryngeal branch of CN X, in which area will we see impairment? Name at least one symptom.
Larynx - weak cough, weak glottal coup, VF paralysis
Name two global changes occurring as a result of myasthenia gravis.
- Progressive fatigue from activity that improves with rest
- Weakened chewing and inefficient swallowing
- Diminished facial expression
- Improvement with Tensilon
What are the three postural supports for flaccid dysarthria?
Respiratory prosthesis
Abdominal binder
Board with a paddle
Name one area of impairment/compromise for each of the subsystems of speech with muscular dystrophy.
Respiration: Short breath groups, fade at ends of sentences, reduced loudness
Phonation: Rough, breathy vocal quality
Resonance: Mild hypernasality due to weak VP port closure
Articulation: Placement errors in order to compensate for VP port air leakage
Does Guillain-Barré cause generalized flaccidity or spasticity?
Flaccidity
If there is damage to CN XII, in which area will we see impairment? Name at least one symptom.
Tongue! Atrophy, fasciculations, weak protrusion and/or lateralization, elevation, and resistance; difficulty licking lips
Name at least one symptom of myasthenia gravis for each of the following motor assessment areas: chest, larynx, velopharynx, lips, tongue, jaw
Chest: Rapid, shallow breathing
Larynx: Weak cough and glottal coup, weak glottal closure
Velopharynx: Reduced movement of soft palate and ineffective VP port closure
Lips: Limited strength and resistance
Tongue: Limited strength and resistance
Jaw: Limited and resistance
Name two compensatory strategies when addressing damage to CN V and VII.
Jaw bra
Hand support
Name at least one symptom of muscular dystrophy for each of the following motor assessment areas: chest, larynx, velopharynx, lips, tongue, jaw
Chest: Rapid, shallow breathing, reduced VC
Larynx: weak cough
Velopharynx: Decreased VP port closure
Lips: Weak labial seal
Tongue: Persistence of muscle contraction, weak resistance
Jaw: Persistence of muscle contraction, weak closure
Name one area of impairment/compromise for each of the subsystems of speech with Guillain-Barré.
Respiration: short breath groups, fade at end of sentence, speak on residual air
Phonation: breathy voice quality (or may be unable to speak due to tracheotomy)
Resonance: mild hypernasality due to weak VP port closure
Articulation: imprecise consonants, short phrases
From damage to which of the three branches of CN X will we see monotone speech/monovolume? (Velopharyngeal, recurrent laryngeal, or superior laryngeal?)
Superior laryngeal branch!
Name one area of impairment/compromise for each of the subsystems of speech with myasthenia gravis.
Respiration: Reduced loudness, short breath groups
Phonation: Weak, breathy vocal quality
Resonance: Mild hypernasality
Articulation: Imprecise consonants
Name three compensatory strategies when addressing damage to CN XII.
Increase awareness and reflexive movements
Thermal stimulation
Strength exercises (MUST be paired with speech)
What is the etiology of muscular dystrophy?
Genetic - an autosomal dominant pattern has been detected
Name at least one symptom of Guillain-Barré for each of the following motor assessment areas: chest, larynx, velopharynx, lips, tongue, jaw
Chest: Rapid, shallow breathing, reduced VC
Larynx: Weak VF adduction, weak cough and glottal coup
Velopharynx: Air leaking through nose due to weak VP port closure
Lips: Reduced labial seal
Tongue: Fasciculations, atrophy, weak resistance, limited ROM
Jaw: May sag open, limited resistance and strength
From damage to which of the three branches of CN X will we see diplophonia? (Velopharyngeal, recurrent laryngeal, or superior laryngeal?)
Recurrent laryngeal branch!
T/F: Tensilon can be used as a determiner as to whether or not an individual has myasthenia gravis.
True! If Tensilon does not improve an individual's state, there is something else causing their muscle weakness.
Name three compensatory strategies when addressing damage to CN X.
Turn head toward weak side
SOVT
Injections, implants
Thermal stimulation
Open mouth wider for oral resonance