Quiz 3 Info For Motor Speech- Ataxic Dysarthria

Front 1

ataxic dysarthria results in damage to

Back 1

the cerebellum

Front 2

the most noticeable characteristics of ataxic dysarthria are in

Back 2

- articulation
- prosody

Front 3

speech characteristics reflect a breakdown in (2)

Back 3

- motor organization
- control

sounds slurred


(not a weakness)- different from other types

Front 4

ataxia means

Back 4

lack of order (widespread incoordination)

Front 5

cerebellum coordinates.....and.....of muscular movements

Back 5

timing and force

- skilled, voluntary movements are appropriate for an intended task

Front 6

cerebellum processes.....from all over the body and.....that information into....... of a movement

Back 6

sensory information
integrates
execution

Front 7

what are the 3 peduncles of the cerebellum

Back 7

1. inferior peduncle
2. middle peduncle
3. superior peduncle

Front 8

what is the function of the peduncles

Back 8

the cerebellum communicates with the CNS via three bundles of neural tracts (cerebellar peduncles)

Front 9

the inferior peduncle (first neural pathway)
- receives ....... information from the entire body regarding .......


-monitors ....

Back 9

- receives sensory information from the entire body regarding position of body parts before, during and after a movment


- the timing and force of movements while being performed (how execute movement) (online adjustments, while doing something)

Front 10

middle peduncle (second pathway) receives.....information from..... regarding.....

- the cerebellum coordinates these planned movements by


- info is sent back to the cortex via the

Back 10

- receives preliminary information from the cortex regarding planned movements

- integrating the sensory info-> refined, smoothed according to current condition of the body

- thalamus

Front 11

the superior peduncle (third pathway)
- is the......to the rest of the CNS

- sends its......to the .....completing...

Back 11

- the main output channel to the rest of the CNS


-sends its processed motor impulses to the motor areas of the cortex, thus, completing the corticocerebellar control circuit

Front 12

additional tracts travel out of the......that connect the cerebellum directly to

Back 12

travel out of the superior peduncle....connect to neurons of the extrapyramidal tract

Front 13

Not sure how the cerebellum influence speech, 2 probable ways the cerebellum influences speech:

Back 13

1. planned, motor impulses of a planned speech act are sent from the cortex to the cerebellum
- cerebellum then coordinates and refines these preliminary speech movements via sensory information
- sent to thalamus for additional refinement->motor cortex

2. the cerebellum could influence speech movements through its connections to the extrapyramidal system
- the cerebellum can make rapid adjustments in the timing and force of movements to compensate for unexpeced change in the circumstances of a movement

Front 14

in summary, cerebellums dual ability :

Back 14

to corrdinate and modify planned and ongoing speech movemetns -> important part of the motor speech system

Front 15

clinical characteristics of cerbellar lesions: cerebellar ataxia:

Back 15

1. movement deficits of timing, force, range, and direction
2. disordered stance and gait
- broad-based
- truncal instability
3. intention tremors (as you get closer to a target)
4. ocular motor abnormalities
5. hypotonia
6. problem with motor learning (learning to ride a bike would be very diff)

Front 16

ataxic dysarthria generally results from ..... or..... damage to the....


when lesions are focal, damage to the following areas are implicated (3)

Back 16

**bilateral or generalized damage to the cerbellum


- the area of the superior peduncle
- the lateral hemispheres or paraveral regions

(could possible cause ataxic)

Front 17

what are 5 etiologies of ataxic dysarthria?

Back 17

1. degenerative diseases
2. stroke- vascular disorders
3. toxic and metabolic conditions
4. TBI
5. neoplastic disorders

Front 18

Friedreich's ataxia is ...
- prevalence
- symptoms appear when person is in there...years....

Back 18

-progressive hereditary spinocerebellar disease
- prevalence is 2 per 100,000
- symptoms appear when person is in their 20s

Front 19

4 symptoms of friedreich's ataxia

Back 19

1. cerebellar ataxia affecting gait and manual dexterity
2. LMN weakness
3. extrapyramidal signs such as spasticity
4. dysarthria (often mixed type+spastic)

Front 20

less common symptom of friedreich's ataxia is

Back 20

dementia and sensorineural deafness

Front 21

life span of someone with friedreich's ataxia is

Back 21

in the 40s

Front 22

Olivopontocerebellar atrophy (OPCA) is

- results in

Back 22

-mulisystem atrophy
-hereditary progressive cerebellar disorder

-results in atrophy of the middle cerebellar peduncle, much of the cerebellum and parts of the pons

Front 23

symptoms of olivopontocerebellar atrophy are (3)

Back 23

1. cerbellar ataxia (movement disorders)
2. parkinsonism
3. dementia

Front 24

Stroke as a cause of ataxic dysarthria

lesions are most commonly caused by (4)

Back 24

1. ischemic
2. ruptured aneurysms
3. arteriovenous malformation (AVMs)
4. cerebellar hemorrhage

Front 25

a cerebellar stroke will result in (4)

Back 25

1. sudden onset of limb ataxia
2. problems with balance
3. visual deficits
4. ataxic dysarthria

Front 26

toxic conditions that cause ataxic dysarthria (4)

Back 26

1. acute and chronic alcohol consumption
2. lead and mercury poisoning
3. exposure to certain chemicals
4. treatable and reversible (depending how long)

reversible when toxin is lowered

Front 27

metabolic condition that causes ataxic dysarthria

Back 27

1. prolonged vitamin E or B12 deficiency

Front 28

neurotoxic levels of several drugs (1)

Back 28

1. anticonvulsants

Front 29

3 characteristics of TBI

Back 29

1. diffuse damage
2. cerebellar peduncles are vulnerable to the twisting and rotational forces of a TBI
3. boxers cna suffer from sustaining repeated cerebral injuries and pathologic changes to the cerebellum and other areas of the CNS

Front 30

neoplastic disorders:

Back 30

tumors within or exerting mass effects on the cerebellum can lead to cerebellar signs

Front 31

nonspeech characteristics of a person with apraxic dysarthria

Back 31

normal oral mechanism exam except:
nonspeech AMRs of jaw, lips, and tongue may be irregular
- most apparent in wiggling of the tongue or retraction and pursing of lips

Front 32

what are 7 complaints heard from patients with apraxic dysarthria

Back 32

1. complains of slurred speech with "drunken" quality
2. dramatic deterioration in speech with little alcohol intake
3. occasional complaint of difficulty coorinating breathing with speaking
4. patients with mild severity: speech is normal until they suddenly "stumble over words"
5. intelligibility improves with decreased rate
6. may bite their cheeks or tongue while talking or eating
7. swallowing difficulties infrequent

Front 33

what are 3 articulation deficits

Back 33

1. imprecise consonants
2. distorted vowels
3. irregular articulatory breakdowns

Front 34

what are the articulatory distortions caused by

Back 34

cerebellar damage that disrupts timing, force, range, and direction of movements required for speech.

Front 35

what are three characteristics of articulatory breakdowns seen in patients with ataxic dysarthrai?

Back 35

1. articulation errors vary from utterance to utterance
2. intermittent breakdowns, especially in multisyllabic words
3. breakdowns can sound like syllables are being compressed

Front 36

what characteristic of speech is very obviuos and different from other dysarthria types?

Back 36

prosody

Front 37

what are the 4 areas of prosody talked about regarding ataxic dysarthrai

Back 37

1. stress
2. prolongations
3. monopitch
4. scanning speech

Front 38

what are three prosody characteristics seen regarding stress

Back 38

1. tendency to put equal stress on syllables or words that have varied stress patterns
2. excessive stress on unstressed syllables and words
3. each syllable sounds as if it is being produced separately

Front 39

prolongations in speech of ataxic dysarthria could be caused by

Back 39

decreased muscle tone, which results in general slowness in the contractions of the speech muscles ->slow rate

Front 40

what is scanning speech

Back 40

slow deliberate production of syllables

Front 41

what are three components of speech that are not a big issue in people with ataxic dysarthra

Back 41

1. phonation- harshness may be observed
- possibly caused by decreased tone of the laryngeal and respiratory muscles
- may observe voice tremor

2. resonance is typically normal
- intermittent hyponasality possible

3. respiration
- uncoorinated movements in the respiratory muscles-> can contribute to some of the prosodic abnormalities (waste a lot of air- speak on residual air- vocal fry)

Front 42

what are 5 primary distinguishing speech characteristics

Back 42

**1. irregular articulatory breakdowns
**2. irregular rythm speech AMRs
3. excess and equal stress
4. distorted vowels
5. prolonged phonemes

Front 43

what 2 key evaluative tasks are used

Back 43

1. speech AMRs- pay attention to rate and rhythm
2. conversational speech, reading and repeating sentences containing multisyllabic words- look for irregular articulatory breakdowns and prosodic abnormalities.

Front 44

what are 4 treatment techniques for respriation with someone with ataxic dysarthria

Back 44

1. patients need to work on coordination rather than strenthening
2. slow and controlled exhalation
3. speak immediately on exhalation
4. stop phonation early/ optimal breath group

Front 45

what is meant by slow and controlled exhalation? how make it more difficult?

Back 45

- inhale fully and exhale slowly and steadily
- increase difficulty of task by having patients exhale for 3 seconds, stop for 1 second, then continue to exhale (work up to 3 sequences within one breath)

Front 46

Speak immedately on exhalation
- make sure phonation occurs...
- have patient place...
- the moment hand...

Back 46

- make sure phonation occurs the moment the patient begins exhalation
- have patient place hand on abdomen
- the moment the hand goes in on exhalation, the patient is cued to begin phonation

Front 47

stop phonation early/ optimal breath group
- time when to take breath to....
- calculate...
-as coordination improves...

Back 47

- time when to take a breath to avoid speaking on isufficient air supply
- calculate optimal breath groups
-as coordination improves, increase lenght

Front 48

what is the key to improving prosody

Back 48

rate control

Front 49

what are three ways to rate control

Back 49

1. reciting syllables to a metronome
2. finger or hand tapping
3. cued reading material

Front 50

intelligibility generally improves with

Back 50

decreased rate

Front 51

what are three characteristics of reciting syllables to a metronome

Back 51

1. one syllable is produced for each beat.
2. this is ONLY used to get the patient to a more acceptable rate
3. once this is achieved, the patient works on keeping their rate down independently

Front 52

finger or hand tapping..can be sued instead of.....

Back 52

metronome, where the clinician sets the rate by tapping his/her finger

Front 53

what are three ways of cuing reading material

Back 53

1. clinician points to words at the desired speaking rate
2. slash marks are used to indicate where to pause
3. chunking utterances in syntactic units

Front 54

what are three ways to address stress and intonation

Back 54

1. contrastive stress drills
- bob hit bill? WHO hit Bill? BOB hit bill.
2. pitch range exerciese
3. intonation profiles

Front 55

what are four ways to address articulation

Back 55

1. intelligibility drills
2. phonetic placement
3. exaggerating consonants
4. minimal contrast drills