Podcast
Questions and Answers
What type of exercises are recommended for a patient with severe weakness due to cranial nerve damage?
What type of exercises are recommended for a patient with severe weakness due to cranial nerve damage?
Strengthening exercises are recommended.
How can damage to the Trigeminal Nerve affect speech production?
How can damage to the Trigeminal Nerve affect speech production?
It can lead to jaw weakness, affecting articulation.
What specific exercise can help improve lip strength in patients with Facial Nerve damage?
What specific exercise can help improve lip strength in patients with Facial Nerve damage?
Lip puckering exercises are effective.
What is one surgical treatment for resonance deficits caused by Vagus Nerve damage?
What is one surgical treatment for resonance deficits caused by Vagus Nerve damage?
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What modification can a speaker use to help minimize the effects of hypernasality?
What modification can a speaker use to help minimize the effects of hypernasality?
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Why is it important to reduce the rate of speech in dysarthric patients?
Why is it important to reduce the rate of speech in dysarthric patients?
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What type of procedures are known to improve phonation deficits?
What type of procedures are known to improve phonation deficits?
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What is the impact of using a prosthetic palatal lift for patients with Vagus Nerve damage?
What is the impact of using a prosthetic palatal lift for patients with Vagus Nerve damage?
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What technique is used to relax the head and neck for patients with spastic dysarthria?
What technique is used to relax the head and neck for patients with spastic dysarthria?
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Describe the yawning-sigh exercise and its purpose in treating spastic dysarthria.
Describe the yawning-sigh exercise and its purpose in treating spastic dysarthria.
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What is the primary disorder associated with unilateral upper motor neuron damage?
What is the primary disorder associated with unilateral upper motor neuron damage?
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Identify two common etiologies for unilateral upper motor neuron damage.
Identify two common etiologies for unilateral upper motor neuron damage.
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How does the pacing board aid patients with spastic dysarthria during articulation training?
How does the pacing board aid patients with spastic dysarthria during articulation training?
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What role do intelligibility drills play in the treatment of spastic dysarthria?
What role do intelligibility drills play in the treatment of spastic dysarthria?
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Explain the purpose of using delayed auditory feedback in treating spastic dysarthria.
Explain the purpose of using delayed auditory feedback in treating spastic dysarthria.
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What are some techniques included in the oral motor exercises for patients with spastic dysarthria?
What are some techniques included in the oral motor exercises for patients with spastic dysarthria?
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What role does holding breath play in vocal fold adduction?
What role does holding breath play in vocal fold adduction?
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Describe the hard glottal attack and its components.
Describe the hard glottal attack and its components.
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How can head turning assist individuals with unilateral vocal fold weakness?
How can head turning assist individuals with unilateral vocal fold weakness?
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What are some exercises to improve pitch range variation?
What are some exercises to improve pitch range variation?
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What effect does damage to the hypoglossal nerve have on speech?
What effect does damage to the hypoglossal nerve have on speech?
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What is the purpose of intelligibility drills in articulation treatment?
What is the purpose of intelligibility drills in articulation treatment?
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Explain the use of minimal contrast drills in speech therapy.
Explain the use of minimal contrast drills in speech therapy.
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What techniques can be used to treat resonance issues related to velar hypertonicity?
What techniques can be used to treat resonance issues related to velar hypertonicity?
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Study Notes
Assessment and Treatment of Dysarthria
- Dysarthria treatment varies between clinicians
- A combination of treatments is recommended
- Treatments can focus on the damaged cranial nerve
- Strengthening exercises are suitable for patients with severe weakness
Damage to the Trigeminal Nerve
- Jaw muscle strengthening exercises are recommended
- Three sets of opening and closing the mouth are performed
- Increasing mouth strength by biting down
- Resistance exercises for jaw opening and closing
Damage to the Facial Nerve
- Lip strengthening exercises are crucial
- Lip puckering: fully pucker lips and hold for 10 seconds
- Determining if puckering can move from side to side
- Repeat 10 consecutive lip puckering trials
- Holding a wide smile for 5-10 seconds improves lip strength
Damage to the Vagus Nerve
- Resonance deficits require surgical and prosthetic treatment
- Pharyngeal flap tissue attachment to the velum ensures VP closure
- Teflon injection into the pharynx where soft palate contacts when elevated
- Prosthetic palatal lift pushes the velum upward (effective treatment)
Modification of Speech
- Increasing loudness masks hypernasality
- Reduced speech rate improves intelligibility and reduces perception of hypernasality
Phonation Deficit
- Pushing and pulling procedures:
- Sit and push up on chair while phonating an open vowel
- Pull up on a table edge while prolonging a vowel
- Vocal folds adduction through overall muscle contraction
- Hard glottal attack: complete and rapid adduction, subsequent air pressure explosion initiates phonation
- Head turning and sideways pressure on larynx treats unilateral weakness/paralysis for a breathy voice and increased adduction
Prosodic Deficit - Treatment
- Pitch range exercise
- Prolonged "a" sound at low and high pitches
- Reading sentences with arrows to indicate pitch variation
Damage to the Hypoglossal Nerve
- Tongue weakness and reduced motion causes imprecise consonant production
- Tongue strengthening exercises:
- Resistance
- Lateralization resistance (clinician pushes the tongue to the middle)
- Elevation of the back of the tongue against the tongue depressor
- Exercises performed while looking in a mirror to enhance awareness.
Traditional Articulation Treatment
- Focuses on improving phoneme articulation
- Intelligibility drills: patient reads words/sentences without clinician looking. If the clinician doesn't understand, the patient tries again. If it fails, feedback is provided.
- Phonetic Placement: instructions on the correct position of articulators before trying the sound.
- Minimal contrast drills: use pairs of words/phrases that vary by only one sound to practice voicing, manner, place, or vowel sounds. These drills can be used alone or in phrases/sentences
Resonance Treatment
- Surgical and prosthetic treatments
- Decreasing velar hypertonicity by stimulating the tongue and velum with objects in the mouth
- Massaging the velum with a tongue depressor to reduce hypertonicity
- Using a tongue depressor to press the velum upwards
- Increased volume masks hypernasality, potentially improving intelligibility.
Treatment of Spastic Dysarthria
- Phonation: Head and neck relaxation; gentle massage. The clinician gently tilts the patient's head back and forth, then right and left. Hold at extreme positions for 10 seconds. Gentle massage to reduce muscle tone. Yawn exercises improve relaxation and reduce muscle tension
- Articulation: Tongue stretching, lip stretching (smiling, pursing, puffing cheeks) exercises to improve flexibility and movement.
Unilateral Upper Motor Neuron
- Unilateral damage to upper motor neurons affects cranial nerves
- Impulses to speech muscles are affected, showing weakness on the opposite side of the face, lips, and tongue.
- Most apparent damage is to muscles on the opposite side.
- Common causes include stroke, tumors, and TBI
Treatment Plan
- Comprehensive treatment plan developed before treatment begins
- Plan can be modified during treatment
- Including background information from diagnostic reports.
- Example: An 18-year-old female with articulation errors of /s/, /z/, /ʃ/, and /ʒ/.
Treatment for Dysarthria (Additional details across various sections)
- Respiration: Slow and controlled exhalation; inhale, exhale using a stopwatch.
- Pacing Board: Patient says one word with each finger movement to the next slot.
- Hand/finger taping: Delayed auditory feedback (50-100ms) using an electronic device for feedback.
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Description
Explore the various assessment methods and treatments available for dysarthria, focusing on different cranial nerve damages. This quiz covers recommended exercises for jaw and lip strength, as well as surgical options for resonance deficits related to the vagus nerve.
