Category 1
TRUE OR FALSE
Flaccid dysarthrias are commonly only associated with articulatory and/or phonatory components of speech.
FALSE - Flaccid dysarthrias commonly are associated with any combination of articulatory, phonatory, respiratory and resonatory components of speech.
TRUE OR FALSE
Flaccid dysarthria accounts for more than 20% of all dysarthrias.
FALSE - According to the Mayo Clinic Speech Pathology practice, flaccid dysarthria accounts for approximately 8% of all dysarthrias.
TRUE OR FALSE
The primary features of speech characteristics are related to muscle weakness and reduced muscle tone that affects the speed, range, and accuracy of speech movements.
TRUE - The primary features of speech characteristics are related to muscle weakness and reduced muscle tone that affects the speed, range, and accuracy of speech movements. The primary weakness identifies this subgroup as flaccid dysarthrias.
TRUE OR FALSE
The subgroup of dysarthrias known as the flaccid dysarthrias always involves multiple muscles and major subsystems.
FALSE - The subgroup of dysarthrias known as the flaccid dysarthrias may involve a single muscle group or subsystem or a variety of combinations.
Define a lesion.
Lesion - A region in an organ or tissue which has been damaged through the process of injury or disease.
Identify the common characteristic associated with the flaccid dysarthrias as either a problem of planning, neuromuscular execution, programming, control.
The common characteristic associated with the flaccid dysarthrias as neuromuscular execution due to weakness and reduced muscle tone.
Define a palsy.
Palsy - Paralysis, or the loss of the ability to move.
Identify the abnormal speech characteristics in flaccid dysarthrias related to phonatory incompetence.
The abnormal speech characteristics in flaccid dysarthrias related to phonatory incompetence include breathiness, short phrases, audible inspiration.
Identify the abnormal speech characteristics in flaccid dysarthrias related to resonatory incompetence.
The abnormal speech characteristics in flaccid dysarthrias related to resonatory incompetence include hypernasality imprecise consonants, nasal emission, short phrases.
Identify the abnormal speech characteristics in flaccid dysarthrias related to phonatory-prosodic insufficiency.
The abnormal speech characteristics in flaccid dysarthrias related to phonatory-prosodic insufficiency include harsh voice, monoloudness, and monopitch.
Define the flaccid dysarthrias.
The damage or dysfunction of the cranial or spinal nerve nuclei OR cranial or spinal nerves that subserve speech. They involve the lower motor neurons for speech.
Describe what happens to the signal to the muscles from the lower motor neurons.
There is an inability or a diminished ability of the muscles to contract. There is a disruption to the final common pathways.
List four key components used in the assessment process of an individual with suspected dysarthria.
1. Conversational speech and reading activities
2. AMRs
3. Sustained vowels
4. Speech stress test
Why are non-speech exercises not beneficial to individuals with flaccid dysarthrias when the primary characteristic is a weakness in one or more aspects of speech production?
Duffy (2005) determined that non-speech exercises do not positively impact motor speech movements. If the goal is to improve speech production, be sure to target exercises that include speech production. One does not need a great deal of strength to produce speech.
List effective compensatory speech strategies to facilitate with individuals with dysarthria.
Use a slower rate of speech
Take a breath that provides adequate breath support
Exaggerate speech sounds
What are the principles to take into account when developing a treatment program for individuals with flaccid dysarthria?
Individualize treatment plan based on assessment results
Provide a focus of treatment based on the severity of the symptoms
Allow for an individual to practice functional communication within a session
When providing intervention for someone with difficulties with prosody, describe an activity that would facilitate the individual's ability to improve this area.
Have the client place emphasis on each of the words of a sentence to change the meaning of the sentence.
"THAT ice cream was good."
"That ice cream was GOOD."
"That ice cream WAS good."
What type of etiology is most prevalent for the flaccid dysarthrias?
Degenerative conditions represented 40% of the Mayo Clinic's population of patients with flaccid dysarthria from 1999-2008.
List three or more of the bulbar systems affected by flaccid dysarthrias.
Cranial nerve V - Trigeminal
Cranial Nerve VII - Facial
Cranial nerve IX - Glossopharyngeal
Cranial nerve X - Vagus
Cranial nerve XI - Spinal accessory
Cranial nerve XII - Hypoglossal
What is one of the most crucial questions to ask an individual when completing an assessment with a suspected communication disorder?
Duffy (2013) identified that inquiring WHY someone is receiving an evaluation helps to drive patient-centered care. It is more often than not that we as SLPs arrive with our own agendas to drive a person's plan of care. The decisions should be made in conjunction with all individuals involved.
A 68-year-old male has a left hemispheric stroke affecting the contralateral side of his body. Identify the affected side as either the left side or the right side.
A contralateral lesion involves the opposite side of the body, therefore, the man's right side was affected.
A patient arrives at therapy with a right-sided facial palsy reporting significant difficulties drinking from a straw. What compensatory strategies or techniques might you try with this individual?
Due to the unilateral weakness, the individual may be experiencing anterior loss of liquids. Trialing placement of the straw on the non-affected side may facilitate the person's seal around the straw thereby eliminating any anterior loss of liquids. Additionally, the use of small-mouthed cups facilitates a better seal around the cup reducing the likelihood of anterior loss of liquids.
During an oral-motor examination, a patient is asked to smile and raise both eyebrows. The result is left eyebrow is raised and only the left side of the mouth raises for the smile. Identify which side of upper and/or lower motor neurons are affected.
This is an example of a right facial lower motor neuron lesion. Paralysis of the ipsilateral upper and lower facial musculature. The individual raises only the left eyebrow and has a unilaterally affected smile on the left.
Damage to the 3rd, 4th, or 5th cervical nerves result in impairment to which major muscle and which system of speech production?
The 3rd, 4th, or 5th cervical nerves result in impairment to the diaphragm thereby impacting the respiratory system.
During an oral-motor examination, a patient is asked to smile and raise both eyebrows. The result is BOTH eyebrows are raised, however, only the left side of the mouth raises for the smile. Identify which side of upper and/or lower motor neurons are affected.
This is an example of a left facial upper motor neuron lesion. Paralysis of the contralateral lower facial musculature. The individual raises both eyebrows, however, has a unilaterally affected smile.