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XXX UUMN
| Question | Answer |
|---|---|
| What happens when there is only unilateral damage to upper motor neurons? | UUMN can happen |
| Most cranial nerves serving the speech muscles receive unilateral or bilateral innervation? | Most cranial nerves serving the speech muscles receive BILATERAL innervation from the UMNs. |
| Right UMN damage will result in lower left side of the face weakness and | tongue weakness |
| Damage to right UMN will result in | lower left side of face an tongue weakness |
| Severe damage to UMN can result in hemiplegia but more usually | the result is unilateral weakness |
| Unilateral weakness resulting from damage to the UMN can affect the tongue in what way? | The tongue movement can be slow with a reduced ROM |
| What could cause a hemi-lower facial droop? | Damage to the right UMN. |
| If there is damage to the Right UMN, how might the tongue deviate? | The tongue might deviate due to UMN lesion and would deviate to the affected side when protruded. Therefore a Right UMN damange would result in the tongue deviating to the left. |
| Patient may complain of their tongue feeling slow and clumsy if their tongue is impacted by | an UMN lesion |
| UMNs bilaterally innervate which speech mechanisms? | UMNs bilaterally innervate the velum, pharynx, and larynx and thus these structures should not be affected by UUMN damage... however... |
| Even though UMN's bilaterally innervate speech mechanisms, a UUMN can still impact structures additional to tongue and lower face. We know this due to | mild hypernasality and harsh voice quality can result from UUMN damage even though it shouldn't technically happen... |
| UUMN Dysarthria accounts for only what percentage per Duffy's Data? | 9% of motor speech disorders fall into the UUMN category. |
| Damage to an UMN on ONE SIDE (UUMN) results in what? | Weakness of the lower face, lips, tongue on the opposite side of the lesion. |
| UUMN damage is permanent or temporary? | It could be either. |
| UUMN is often accompanied by weakness in the extremities of the opposite side. | Weakness in the extremities of the opposite side of the UUMN is an accompanying trait. |
| What are some Etiologies of UUMN? | Anything that can cause damage to UMNs on one side of the brain. Usually, this is Stroke. |
| The most frequent cause of UUMN is | Stroke |
| 91% of the UUMN cases according to Duffy and Folger was: | Stroke |
| UUMN lesions can occur in this part of the brain | UUMN lesions can occur in any part of the brain that contains UMNs including cortical and subcortical areas. |
| Internal capsule, pericapsular region, frontal lobe, thalamus, midbrain, pons, cortical and subcortical areas: | areas where a UUMN could occur. |
| How can a tumor cause a UUMN? | Tumors are not a common etiology but if they destroy UMNs, displace UMNs or compress blood flow leading to death of UMN cells they could cause a UUMN. More likely though that they would cause BILATERAL effects which is NOT a UUMN. |
| Brain tumor could be a direct cause of UUMN by destroying nearby UMNs as it grows: | there would be degradation of transmission of the UMN impulses to the LMNs. |
| Brain tumor could be a direct cause of UUMN by displacing UMNs | The direct pressure would compromise the function of the neurons |
| Brain tumor could be a direct cause of UUMN by compressing arteries or veins serving the UMNs which | would interfere with blood flow to and from the UMN cells. |
| Tumors are not a common cause of UUMNs because Tumors more likely cause | tumors more likely cause bilateral damage. |
| UUMN in the right hemisphere could also cause | cognition problems |
| UUMN tends to be mild but can come with | apraxia, aphasia or cognition issues. |
| The focus of UUMN treatment is often focused on | aphasia, language issues, apraxia or cognition issues but not so much as a dysarthria problem. |
| Tongue has only this kind of innervation: | CONTRALATERAL |
| UUMN is MOSTLY a problem of the TONGUE and therefore these speech characteristics often present: | slow AMR and imprecise articulation |
| Why does a person get slow AMR and imprecise articulation with a UUMN? | Because range of motion is decreased and there is also a decrease in fine motor control. |
| Is phonation impacted with a UUMN? | Not usually. The primary symptom of a UUMN is ARTICULATION. Some people get hypernasality but only very mildly and in a small number of patients. |
| Only a small percentage of patients get very mild hypernasality resonance issues and phonation issues with | UUMN |
| Imprecise Articulation is key with | UUMN |
| Can the patient or the clinician PREDICT errors with a UUMN? | Yes! With a UUMN the patient or clinician CAN PREDICT ERRORS! Heavy with articulation errors but PREDICTABLY so. |
| Bilateral damage to Upper Motor Neurons that includes both the Pyramidal and Extrapyramidal Neural Pathways | Spastic Dysarthria |
| If damage is only unilateral, the result is Unilateral Upper Motor Neuron Dysarthria, (UUMN Dysarthria.) | UUMN is unilateral damage to UMNs. |
| Severity of UUMN damage can range from | mild to moderate |
| How can phonation be impacted with a UUMN? | Mild to moderate harsh vocal quality. Duffy and Folger: 39% of UUMN patients. |
| How can resonance be impacted with a UUMN? | Duffy and Folger:11% of UUMN cases had hypernasality. A UUMN lesion alone could only result in a very mild hypernasality. Other causes of hypernasality could be illness or a prior lesion. |
| Summary of UUMN: | key deviant speech characteristic = imprecise articulation. |
| Other features that MAY occur with UUMN | slowed rate of speech, harshness, hypernasality (very mild if present) and irregular articulatory breakdowns (?) |
| How would you conduct Key Evaluative Tasks to detect a UUMN? | Review medical chart for site of lesion. Connected speech sample. AMR Task. Prolonged Vowel. |
| Treatment of UUMN Dysarthria: | use traditional treatments for dysarthria but in general if other disorders are co-occurig then dysarthria is generally the last priority. Use Traditional Articulation Tasks. |
| Traditional Articulation Tasks: | Intelligibility Phonetic Placement Exaggerating Consonants Minimal Contrast Drills |
Created by:
MayaMayaAlejandra
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