Intro to Motor Speech
What is the most severe form of dysarthria?
Anarthria
What is the difference between indirect and direct observation?
indirect= case history information
direct= anything you see or assess
What are two additional names for Flaccid Dysarthria?
Lower motor neuron lesions
Bulbar Palsy
What does a neuron do? AND what are the components of a neuron (nerve)?
A neuron generates and conducts impulses.
Cell body
Dendrite
Axon
What are the phases of muscle contraction?
Latent Period
Contraction period
Relaxation Period
Dysarthria affects all movement for speech including _________?
Volitional
Spontaneous
Reflexive
What are the subsystems of speech?
Respiration, phonation, resonation, articulation
What is the Darly Arronson and Brown Classification System (DAB)?
framework for classification of our observations based on pathophysiology
Provides insight as to functionality of the patients speech. Gives an idea about making decisions
cervical nerves- 8 pair
Thoracic nerves-12 pair
Lumbar nerves-5 pair
Sacral nerves-5 pairs
Coccygeal nerves- 1 pair
What are the global changes of Flaccid Dysarthria?
Hypotonia
Lack of steadiness
Reduced Reflexes
Reduced Strength
What are the 4 parameters of the WHO model?
Give an example of each for an extra 300pts
1. Body function
2. Body structure
3. Activities and participation
4. Environmental Factors
What is pathophysiology? why is it important to understand the pathophysiology of a system?
it is what is going on on a physiology level & is important to know so that we can understand where the breakdown is.
Direct Damage Vs indirect damage
Direct damage leads to problems with having control over direct rapid movements (i.e articulation)
Indirect damage leads to problems with balance and posture & slower movements.
Cell body
Axon
Dendrite
Myoneural junction
Muscle fibers innervated by that cell body.
Damage to which nerve must be bilateral for symptoms to emerge?
Trigeminal nerve
What are the Big 8?
1. Symmetry 2. Steadiness 3. Tone
4. Strength 5.Range of Motion 6. Speed
7. Accuracy 8. Coordination
What is the difference between perceptual assessment and objective assessment?
Objective assessment is when you use a tool to test & you are taking data(numbers)
Perceptual assessment is what you see, hear and feel (i.e intelligibility, naturalness, prosody, respiration, phonation, resonance)
What does damage to the final common pathway affect?
individual muscles or muscle groups
Associated Diseases with breakdowns in the
Cell body , Axon, Myoneural Junction, muscle fibers innervated by that cell body, final common pathway
Damage to the cell body = ALS
Demyelinated Axon= Guillan Barre
Damage to Myonneural Junction = Myastenia Gravis
Damage to muscle fibers innervated by that cell body= Muscular dystrophy
Damage to the final common pathway= flaccid dysarthria
What are the two problems that can be seen with Vagus nerve damage?
Laryngeal branch : IMPACTS THE LARYNX: causes changes in phonation, AMR/SMR, short duration of vowels
Velopharyngeal branch: IMPACTS THE VELOPHARYNX: changes with resonance, AMR/S<R, short duration of vowels
What are the three systems to assess when looking at physiology
Motor control
Sensation
Reflexes
What are the two types of assessments that will be performed when looking at dysarthria?
1. Lower motor neuron level- will assess individual cranial nerves
2. Upper motor neuron , extrapyramidal, cerebellar and cortical levels- will assess each subsystem separately. (Respiration, phonation, resonation, articulation)
Damage to peripheral nerves is often _____ and impairs _____.
damage to the peripheral nerve is often UNILATERAL and impairs INDIVIDUAL MUSCLES.
T6-L1 is responsible for _________
C3-5 phrenic nerve is responsible for _________
T6-L1 is responsible for moving air
C3-5 phrenic nerve is responsible for innervating the diaphragm.
What are the most salient symptoms for:
Bell's Palsy,Guillan Barre ,Muscular Dystrophy Myasthenia Gravis
Bell's Palsy:unilateral facial nerve paralysis, imprecise articulation
Guillan Barre:Pervasive weakness across all structures.
Muscular Dystrophy: wasting of muscles causing emotionless face/weak structures.
Myasthenia Gravis:Rapid fatigue with rapid recovery