Category: Uncategorized

What role does emotion and belief play in our thinking? How can it be used for good or ill?

Select which 3 of the following broad categories of etiologies overlap in flaccid and spastic dysarthria.

Listen to the voice sample. What is the motor speech disorder? *Watch from approximately 0:50-2:00

Ms. Lassiter, a 35-year-old woman presented with a 2-year history of gradual mental deterioration, reduced ability to concentrate, and hand-writing difficulty. She complained of speech difficulty. Neurologic evaluation identified involuntary movements and balance difficulty, generalized motor impersistence, and mild cogwheel rigidity. Neuropsychological assessment confirmed the presence of significant cognitive limitations. MRI showed an abnormality in the right putamen that could represent iron deposition and mild generalized atrophy. During the speech examination rapid, unsustained, choreiform movements of the lower face, jaw, and tongue were present at rest. Involuntary tongue clicking was noted. She had difficulty maintaining a protruded tongue, open mouth, and lip retraction due to both motor impersistence and involuntary movements. Speech was characterized by an accelerated rate, imprecise articulation with irregular articulatory breakdowns, dysprosody, and variable rate. Vowel prolongation was characterized by low-amplitude tremor. Speech AMRs were irregular. Pitch and loudness variability was reduced, but pitch and loudness occasionally varied inappropriately. What type of dysarthria do you suspect?

Mr. Gaines, a 41-year-old male, was hospitalized for management of hypertension and speech and swallowing difficulties. Eleven months ago, in the course of an evening, he developed left hemiplegia. Neurologic examination revealed left hemiparesis. Upper limb reflexes were hyperactive bilaterally, left greater than right. The speech examination noted the patient was nearly anarthric. He produced only a nasally emitted and resonated, quiet but strained-strangled undifferentiated vowel with great effort. With his lips closed he could produce a prolonged, strained /m/.  Voluntary lip and jaw movements were slow and limited in range but were more extensive during reflexive swallowing; the jaw opened widely during a reflexive yawn. Suck, snout, and jaw reflexes were present. Tongue movement was minimal and slow; he was unable to extend it beyond the edge of the lower teeth, elevate, or move it laterally. The palate hung so low in the pharynx the that the uvula could not been seen. The patient produced a sharp cough. Would you recommend treatment? If so, what type of treatment would you recommend?

A nurse wants to enhance their professional identity and decides to:

The movement disorders underlying hyperkinetic dysarthrias are categorized by: (Select all that apply)

Hypokinetic-hyperkinetic mixed dysarthria is commonly associated with ______________________________________.

Speaker strategies could include (Select all that apply)

Ms. Monroe, a 27-year-old woman, presented with a progressive history of gait imbalance, hand incoordination, and “slurred speech.” Her symptoms worsened around her menstrual periods and when she was nervous or fatigued; they had worsened slightly during a pregnancy. During the speech examination, she admitted to an approximately 10-year history of “slurred speech” that did not seem to be worsening. Conversational speech was characterized by occasional irregular articulatory breakdowns. Infrequently, rate was mildly slowed and multisyllabic words were produced with excess and equal stress. Prolonged “ah” was unsteady. Speech AMRs were slow but not noticeably irregular. What do you suspect the prognosis is for her condition?