CD 650: Motor Speech Final Exam study
set (weeks 9-15)
Hypokinetic dysarthria is associated with damage to what part of the nervous system? - correct answer
✔✔Basal ganglia control circuit
Basal Ganglia control circuit; Insufficient supply of dopamine (produced in the substantia nigra) leads to -
correct answer ✔✔an imbalance of neurotransmitters (dopamine and acetylcholine) important to
proper functioning of basal ganglia control circuit
What are the underlying neuromuscular features of hypokinetic dysarthria? - correct answer ✔✔•
Rigidity
• Reduced range of movement
• Increased rate of repetitive movement
about rigidity: if you were to feel the muscles of someone with rigidity - correct answer ✔✔they would
literally feel stiff; type of rigidity known as "cogwheel rigidity"
Depletion or insufficiency of what neurotransmitter is associated with hypokinetic dysarthria? - correct
answer ✔✔Dopamine, produced in the substantia nigra
What are the most distinctive features of speech in hypokinetic dysarthria? - correct answer ✔✔• Short
rushes of speech*
• Increasing rate*
• Monopitch and monoloudness
• Diminished stress patterning
• Palilalia
• Harsh/breathy voice Blurring of AMRs
*will help to identify
,How is a breathy voice in hypokinetic dysarthria different from a breathy voice in flaccid dysarthria? -
correct answer ✔✔Harsher with hypokinetic dysarthria
Discuss the confirmatory signs for hypokinetic dysarthria - correct answer ✔✔• Infrequent eyeblink and
swallowing
• Minimal facial expression
• Lips might appear tight
• Tremulousness of jaw and lips
• AMRs accelerate
• Lack of movements of that accompany speech
• Reduced chest wall movement during quiet breathing
How would you expect production of AMRs in hypokinetic dysarthria to differ from AMRs in any other
type of dysarthria? - correct answer ✔✔AMRs accelerate; can be so rapid they blur together = "blurring
of AMRs"
Name at least three typical complaints of patients with hypokinetic dysarthria. - correct answer ✔✔•
Weak/quiet voice
• Trouble getting started
• Rate of speech is too fast
• Speech gets worse with fatigue
• Upper lip feels stiff
What disease is the most frequent cause of hypokinetic dysarthria? - correct answer ✔✔Parkinson's
What do we mean by bradykinesia? Provide examples. - correct answer ✔✔Slowness of movement
• Delays/false starts
• Slowness once the movement has begun
• May be difficult to stop movements
• Repetitive movements decreased in amplitude and increased in speed
, • May be intermittent "freezing"
• *Thought not to be simply the result of rigidity or weakness
If a person has Parkinson's disease and dysarthria...what type of dysarthria would you expect it to be? -
correct answer ✔✔Hypokinetic
What are the four cardinal signs of Parkinson's disease? Be able to explain each. - correct answer
✔✔Resting tremor, rigidity, bradykinesia, loss/diminishment of postural reflexes
resting tremor - correct answer ✔✔often evident in hands, head, and feet; tremor lessens when
engaged in voluntary movement; pill-rolling movement in hands
rigidity: cogwheel rigidity during passive movement; leads to stooped posture and falling en bloc (if
someone falls - correct answer ✔✔they fall like a tree - all in one piece and can't break fall)
bradykinesia - correct answer ✔✔slowness of movement
loss/diminishment of postural reflexes - correct answer ✔✔tend to have involuntary flexion, body is
stooped over; can't "catch themselves" if they fall - (it's like a tree just falling over)
What do we mean by "cogwheel rigidity"? - correct answer ✔✔it's sort of a jerky-- any movement you
get-- as you're moving a limb, for example, passively through a range-- is a sort of jerky movement, as if
you were going over the cogs on a wheel.
Progressive Supranuclear Palsy (PSP) is - correct answer ✔✔a disease of unknown origin that is more
common in women over the age of 50. The average survival is 6 to 7 years. It results in cell loss in many
areas of the brain, but the cranial nerves and cerebral cortex (minus the frontal lobe) are usually spared.
Symptoms of PSP - correct answer ✔✔paralysis of vertical gaze, signs of parkinsonism, dysarthria and
dysphagia are common, and there are personality and cognitive changes (significant - as the frontal lobe
is damaged). PSP is not responsive to Parkinson's disease medications.
PSP syndromes include - correct answer ✔✔Diffuse Lewy body disease and Pick's disease.
set (weeks 9-15)
Hypokinetic dysarthria is associated with damage to what part of the nervous system? - correct answer
✔✔Basal ganglia control circuit
Basal Ganglia control circuit; Insufficient supply of dopamine (produced in the substantia nigra) leads to -
correct answer ✔✔an imbalance of neurotransmitters (dopamine and acetylcholine) important to
proper functioning of basal ganglia control circuit
What are the underlying neuromuscular features of hypokinetic dysarthria? - correct answer ✔✔•
Rigidity
• Reduced range of movement
• Increased rate of repetitive movement
about rigidity: if you were to feel the muscles of someone with rigidity - correct answer ✔✔they would
literally feel stiff; type of rigidity known as "cogwheel rigidity"
Depletion or insufficiency of what neurotransmitter is associated with hypokinetic dysarthria? - correct
answer ✔✔Dopamine, produced in the substantia nigra
What are the most distinctive features of speech in hypokinetic dysarthria? - correct answer ✔✔• Short
rushes of speech*
• Increasing rate*
• Monopitch and monoloudness
• Diminished stress patterning
• Palilalia
• Harsh/breathy voice Blurring of AMRs
*will help to identify
,How is a breathy voice in hypokinetic dysarthria different from a breathy voice in flaccid dysarthria? -
correct answer ✔✔Harsher with hypokinetic dysarthria
Discuss the confirmatory signs for hypokinetic dysarthria - correct answer ✔✔• Infrequent eyeblink and
swallowing
• Minimal facial expression
• Lips might appear tight
• Tremulousness of jaw and lips
• AMRs accelerate
• Lack of movements of that accompany speech
• Reduced chest wall movement during quiet breathing
How would you expect production of AMRs in hypokinetic dysarthria to differ from AMRs in any other
type of dysarthria? - correct answer ✔✔AMRs accelerate; can be so rapid they blur together = "blurring
of AMRs"
Name at least three typical complaints of patients with hypokinetic dysarthria. - correct answer ✔✔•
Weak/quiet voice
• Trouble getting started
• Rate of speech is too fast
• Speech gets worse with fatigue
• Upper lip feels stiff
What disease is the most frequent cause of hypokinetic dysarthria? - correct answer ✔✔Parkinson's
What do we mean by bradykinesia? Provide examples. - correct answer ✔✔Slowness of movement
• Delays/false starts
• Slowness once the movement has begun
• May be difficult to stop movements
• Repetitive movements decreased in amplitude and increased in speed
, • May be intermittent "freezing"
• *Thought not to be simply the result of rigidity or weakness
If a person has Parkinson's disease and dysarthria...what type of dysarthria would you expect it to be? -
correct answer ✔✔Hypokinetic
What are the four cardinal signs of Parkinson's disease? Be able to explain each. - correct answer
✔✔Resting tremor, rigidity, bradykinesia, loss/diminishment of postural reflexes
resting tremor - correct answer ✔✔often evident in hands, head, and feet; tremor lessens when
engaged in voluntary movement; pill-rolling movement in hands
rigidity: cogwheel rigidity during passive movement; leads to stooped posture and falling en bloc (if
someone falls - correct answer ✔✔they fall like a tree - all in one piece and can't break fall)
bradykinesia - correct answer ✔✔slowness of movement
loss/diminishment of postural reflexes - correct answer ✔✔tend to have involuntary flexion, body is
stooped over; can't "catch themselves" if they fall - (it's like a tree just falling over)
What do we mean by "cogwheel rigidity"? - correct answer ✔✔it's sort of a jerky-- any movement you
get-- as you're moving a limb, for example, passively through a range-- is a sort of jerky movement, as if
you were going over the cogs on a wheel.
Progressive Supranuclear Palsy (PSP) is - correct answer ✔✔a disease of unknown origin that is more
common in women over the age of 50. The average survival is 6 to 7 years. It results in cell loss in many
areas of the brain, but the cranial nerves and cerebral cortex (minus the frontal lobe) are usually spared.
Symptoms of PSP - correct answer ✔✔paralysis of vertical gaze, signs of parkinsonism, dysarthria and
dysphagia are common, and there are personality and cognitive changes (significant - as the frontal lobe
is damaged). PSP is not responsive to Parkinson's disease medications.
PSP syndromes include - correct answer ✔✔Diffuse Lewy body disease and Pick's disease.
