Deck 8: Clinical Speech Syndromes of the Motor Systems

Question 1

__ may characterize the speech of patients with dystonia and athetosis.

A)An inability to achieve labial closure for plosive consonants
B)Monopitch and monoloudness
C)Hypernasality and reduced intelligibility
D)Manner and voicing errors of initial consonants

Answer 1

C
Speech characteristics of patients with slow hyperkinesias include vowel distortion,irregular breakdown of articulation,variable rate,reduced precision of fricatives and affricates,place and voiding errors in final consonants,and hypernasality.

Question 2

Flaccid dysarthria may be the result of damage to the:

A)neuromuscular junction
B)muscle itself
C)cell body of the lower motor neuron
D)axon of the lower motor neuron
E)All of the above may cause flaccid dysarthria.

Answer 2

E
Any damage along the entire motor unit may cause flaccid dysarthria.

Question 3

Silent aspiration is a characteristic of patients diagnosed with:

A)amyotrophic lateral sclerosis
B)spastic dysarthria
C)flaccid dysarthria
D)Parkinson's disease
E)Huntington's disease

Answer 3

D
Some patients with Parkinson's disease have been seen to aspirate silently,without cough or external signs of aspiration.

Question 4

Which of these is a speech characteristic associated with Parkinson's disease?

A)hoarseness
B)increased loudness
C)rapid rate of speech
D)articulatory errors in sonorants and vowels
E)both A and C

Question 5

Which of the following is NOT a speech characteristic of amyotrophic lateral sclerosis?

A)rushes of speech
B)distorted vowels
C)distorted consonants
D)hypernasality
E)monotonous pitch

Question 6

The following are all characteristics of spastic dysarthria EXCEPT:

A)limited range of motion of the articulators
B)drooling
C)strained/strangled voice
D)chronically absent gag reflex and difficulty in swallowing
E)hypernasality

Question 7

Symptoms of flaccid dysarthria include:

A)hyperreflexia
B)spastic paralysis
C)muscle atrophy
D)positive Babinski sign
E)both C and D

Question 8

Which of these is not a symptom of Parkinson's disease?

A)hypokinesia
B)festinating gate
C)resting tremor
D)involuntary limb movements
E)dementia

Question 9

___ is a motor neuron disease affecting both upper and lower motor neurons.

A)Myasthenia gravis
B)Möbius syndrome
C)Amyotrophic lateral sclerosis
D)Muscular dystrophy
E)Bulbar palsy

Question 10

A patient with flaccid dysarthria would have the most difficulty producing:

A)vowels
B)nasals
C)liquids
D)fricatives

Question 11

Progressively weakening muscles with improvement in performance after rest is a symptom of:

A)an acute lesion of the brainstem nuclei
B)myasthenia gravis
C)an upper motor neuron lesion
D)muscular dystrophy
E)Möbius syndrome

Question 12

___ is a hyperkinetic dysarthria resulting from long-term use of neuroleptic drugs,such as the phenothiazines.

A)Dystonia
B)Tardive dyskinesia
C)Athetosis
D)Huntington's chorea
E)Spasmodic dysphonia

Question 13

A patient cannot keep her tongue protruded for more than 2 seconds.This is a symptom of:

A)Parkinson's disease
B)Sydenham's chorea
C)Huntington's chorea
D)amyotrophic lateral sclerosis
E)ataxic dysarthria

Question 14

Dysarthria can be defined as:

A)an impairment of motor planning that is of neurologic origin
B)an impaired ability to execute speech movements in the absence of paralysis,weakness,or incoordination of the speech musculature
C)a speech disorder resulting from paralysis,weakness,or incoordination of the speech musculature as a result of neurologic damage
D)any symptom of motor disturbance affecting phonation,articulation,and resonance

Question 15

Stroke is the primary etiology for __ dysarthria.

A)unilateral upper motor neuron
B)spastic
C)flaccid
D)hypokinetic
E)hyperkinetic

Question 16

Pseudobulbar palsy is a type of ___ dysarthria.

A)unilateral upper motor neuron
B)spastic
C)flaccid
D)hypokinetic
E)hyperkinetic

Question 17

The most prominent deviant characteristic of speech in a unilateral upper motor neuron dysarthria is:

A)monoloudness
B)imprecise articulation
C)harsh voice
D)difficulty with the oral stage of deglutition

Question 18

Pain in the laryngeal area is a symptom of:

A)spasmodic dysphonia
B)dystonia
C)Huntington's chorea
D)athetosis

Question 19

A unilateral lower motor neuron lesion could result in which of the following symptoms?

A)monotony of pitch
B)a sagging jaw
C)difficulty in protruding the tongue
D)difficulty in puckering the lips
E)both C and D

Question 20

Forced inspiration and breathiness characterize the phonation of patients diagnosed with:

A)organic voice tremor
B)tardive dyskinesia
C)Huntington's chorea
D)dystonia

Question 21

A patient with parkinsonism does not necessarily have Parkinson's disease.

Question 22

The most common disease associated with hypokinetic dysarthria is amyotrophic lateral sclerosis.

Question 23

Dysphagia is usually not a concern to patients with flaccid dysarthria.

Question 24

The slow hyperkinesias of dystonia and athetosis have several different etiologies.

Question 25

___ tremor is one symptom of ataxic dysarthria.

A)Essential
B)Resting
C)Pill-rolling
D)Intention

Question 26

A patient has a hyperactive gag reflex and palatal and lower facial paresis,and his tongue deviates to the right.Based on these symptoms,he likely has a(n):

A)supranuclear lesion
B)lower motor neuron lesion
C)extrapyramidal lesion
D)oral apraxia

Question 27

This autonomic degenerative disease may involve the cerebellum.

A)Parkinson's disease
B)multiple sclerosis
C)Shy-Drager syndrome
D)myasthenia gravis

Question 28

Oral apraxia:

A)does not co-exist with apraxia of speech
B)is often indistinguishable from a lower motor neuron lesion
C)is often indistinguishable from an upper motor neuron lesion
D)can be verified by asking the patient to make oral-facial movements
E)both A and D

Question 29

Spastic dysarthria results from bilateral upper motor neuron lesions.

Question 30

Apraxia of speech:

A)does not co-occur with oral apraxia
B)is limited to lesions of Broca's area
C)is often accompanied by a language disorder
D)is associated with the left temporal lobe

Question 31

Characterizing the speech and swallowing symptoms of patients with multiple sclerosis is difficult because the:

A)onset of the disease is in adulthood
B)symptoms are usually mild
C)course of the disease is predictable,but the site of damage is not
D)type,severity,and rate of deterioration are variable
E)All of the above are truE.

Question 32

A patient with an upper motor neuron dysarthria will experience an absence of reflexes.

Question 33

Apraxia is not a result of:

A)comprehension deficits
B)sensory loss
C)inattentiveness
D)paralysis
E)all of the above

Question 34

Which of these symptoms would indicate apraxia,rather than dysarthria?

A)invariant deficits of phonation
B)paresis of nonspeech musculature
C)distortion of vowels
D)inconsistent errors in initiating speech

Question 35

The most common type of dysarthria associated with multiple sclerosis is:

A)spastic
B)ataxic
C)hyperkinetic
D)a mix of A and B

Question 36

Which of the following is NOT a typical speech characteristic of ataxic dysarthria?

A)excessive loudness
B)hypernasality
C)imprecise consonants
D)vowel distortion
E)difficulties with prosodic features