Anatomy and Physiology Flashcards
What are the components of the velopharyngeal valve?
The velum (soft palate), lateral pharyngeal wall, posterior pharyngeal wall
What is a velar eminance?
The bending of the velum as it pushes against the posterior pharyngeal wall
How does the velum move during closure?
Posteriorly and superiorly
How do the lateral pharyngeal walls move during closure?
Medially to help close against velum. Asymmetry and variation of extent of movement are typical.
How does the posterior pharyngeal wall move during closure?
Less of a role than the velum or lateral pharyngeal walls. Stays in place or slightly moves anteriorly.
What is a Passavant’s ridge/pad?
A temporary structure in some people. Posterior pharyngeal wall bulges forward during velopharyngeal movement. Usually doesn’t help with closure (below closure sight of contact)
What are the muscles of the velopharynx?
Levator veli palatini, tensor veli palatini, superior constrictor, palatopharyngeus, palatoglossus, salpingopharyngeus, musculus uvulae
What are the three typical patterns of velopharyngeal closure?
Coronal, sagittal, circular
Coronal velopharyngeal closure
Most common pattern of closure. Velum moves against posterior pharyngeal wall. Possible slight anterior movement of the posterior wall, minimal contribution of lateral pharyngeal walls. Estimated 70% of speakers.
Circular pattern of VP closure
2nd most common pattern. . All structures contribute equally to closure (velum, lateral walls, posterior walls). About 25% of people. Often have Passavant’s ridge.
Sagittal pattern of VP closure
Least common (<5% of people). Lateral walls move medially, meet in midline behind velum instead of against, soft palate has minimal posterior displacement.
What happens to VP closure in nonpneumatic vs pneumatic activities?
Can show different closure patterns. Appears there is different neuromuscular mechanisms in speech vs nonspeech activities. Closure can be complete for nonpneumatic activities but insufficient for speech/ pneumatic activities. Closure also varies among different nonpneumatic activities.
What are nonpneumatic activities?
Done without airflow ex: gagging, vomiting, swallowing. Can feel velopharyngeal closure. Velum is raised very high in pharynx, lateral pharyngeal walls close firmly across entire length. Prevents nasal regurgitation.
What are pneumatic activities?
Use airflow and air pressure as a result of VP closure. Positive air pressure: blowing, whistling, singing, speech. Negative: sucking, kissing. Closure occurs lower in the nasopharynx.
VP Timing of closure
VP closure must occur before phonation or there is hypernasality. Timing that occurs varies based on manner of articulation and how near the sound is to a nasal sound.
VP height of closure
Slightly greater height for high pressure consonants (plosives, fricatives, affricates), voiceless consonants, high vowels
Firmness of VP port closure
More firm in same environments as when higher (higher pressure consonants, voiceless consonants, high vowels. Less firm in vowels near nasals .
Effect of rate and fatigue on VP port closure
Faster rates can reduce height and firmness, increasing hypernasality. Muscular fatigue can decrease the height and firmness of closure even in typical people.
What are the bones of the facial skeleton?
Mandible, Maxilla, nasal bones, palatine bones, lacrimal bones, zygomatic bones, inferior nasal concha, vomer
What are the bones of the cranium?
Frontal, parietal, occipital, and temporal bone, sphenoid bone, ethmoid bone
What are the maxilla processes?
zygomatic, frontal, alveolar, palatine/palatal, body
What are the sutures of the hard palate?
transverse suture (fuse maxilla and palatine), median palatine suture
What composes the nasal septum?
Cartilage of septum, perpendicular plate of ethmoid bone, vomer
What is a deviated septum?
Nasal septum deviating to one side. Bone bends at one of the sutures fusing the nasal septum. The bones are thin and fragile.
What composes the bony septum?
Perpendicular plate of ethmoid bone, vomer
What are the elevator muscles of the velum?
Levator Palatine, uvulus
What are the depressor muscles of the velum?
Palatoglossus, palatopharyngeus
What are the other muscles of the velum (not elevators/depressors?)
Auditory tube dilator, tensor palatine
What is typically the prinicpal muscle of velar closure?
Levator
What is unusual about the levator muscles?
They interweave through the midline, gives them extra strength
What is a suture?
Line of fusion between bones
What are the major sutures of the skull?
Sagittal(midline, means arrow), coronal(greek word for crown), lambdoidal (looks like lowercase green lambda), squamosal (attaches temporal bone to rest of skull), metopic
Why do we have sutures in the skull?
Need room for the brain to grow. Are cartilaginous in between when younger, allows expansion of the skull.
Later when older, ossify and turn to bone
What is plagiocephaly?
An asymmetrical or abnormal skull shape. May be due to synostosis or positional pressure.
What is synostosis?
(premature ossificiation of suture). Can harm the nervous system.
What is craniosynostosis?
Abnormal development of skull shape d/t synostosis of one or more cranial sutures resulting in malformation of skull in growth
What is the incidence of craniosynostosis?
1/2000 live births
Is positional pressure harmful to the nervous system?
No. Nervous system is soft, can still grow in other idrection.
Is single suture craniosynostosis concerning?
No medical concern, purely cosmetic concern
What are the statistics for the different sutures involved in craniosynostosis?
55% sagittal, 20% coronal, 5% lamdoidal, 5% metopic
