Chapter 6 Flashcards

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1
Q

cleft lip and palate are the most ?
how many
-can occur on ?
since the lip and the palate develop separately, it is possible for the child to have a ?

A

common birth defects in US

  • 1/600-6800 newborns affected
  • one side (unilateral) / both sides (bilateral)
  • cleft lip, cleft palate, or both
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2
Q

cleft lip:
-often includes

cleft palate:

A

separation of the lip

  • bones of the upper jaw and or upper gum
  • an opening in the roof of the mouth in which 2 sides of palate did not fuse as unborn baby was developing
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3
Q

craniofacial abnormality:

embryology

A

reflects involvement of the bony features of the skull, as well as tissue features of the face
-study of prenatal growth and process of development

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4
Q

face embryology
-development of the face occurs :
in normal development the facial tissues and bones ?

A

during embryonic period of pregnancy

-grow toward the midline and fuse together

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5
Q

the lip and the palate meet at ?
so around week 6 the ? and by week 12
degree of clefting is related to the amount of ?

A

midline and develop from front (lip) to back (uvula)

  • lips fuse/ soft palate fuses
  • embryonic damage to the lip and palate
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6
Q

disorder of the cleft lip and palate
cleft lip and cleft palate can occur on ?
since the lip and the palate develop separately it is possible
the cleft may be further characterized as

A

one side or both
-for child to have a cleft lip, palate, or both

complete cleft lip 
incomplete cleft lip 
complete cleft palate 
incomplete cleft palate 
submucous cleft palate
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7
Q
characteristics of CL/P 
cleft lip and palate =
cleft lip =
cleft palate= 
2:1
2:1
A

50%
25%
25%

males to females have cleft lip with or without cleft of palate
females to males have cleft of palate only

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8
Q

etiology
cleft lip and palate are ? which occur

majority of clefts appear to be due to ? or a combo of ?

a child born with a cleft frequently requires ?

A

congenital defects/very early in pregnancy

multifactorial causation/genetics and environmental factors

several diff. types of services eg surgery , dental/orthodontic care, speech therapy

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9
Q

assessment of CL/P
aside from the obvious physical features which serve to confirm the ?
there are related areas that are assessed in regard to the childs health status

A

assessment of cl/p

feeding
hearing
dentition 
voice 
speech
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10
Q

feeding
feeding difficulties are often experienced by infants with clefts include problem with providing adequate nutritional intake due to

A
nasal regurgitation 
poor suction 
excessive air intake 
frequent burping 
prolonged feeding times
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11
Q

hearing
children born with a cleft palate commonly experience
if left untreated this can cause
many children with a cleft will require ?

A

middle ear prob. and associated hearing loss

  • permanent hearing loss
  • tubes to be inserted into the eardrum to allow drainage of fluid from the middle ear
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12
Q

dentition:
clefts can cause ? such as?

in addition children with cleft often have

children with a cleft may also be at greater risks for ? since they often have ?

A

dental prob: missing, misshaped or irregularly aligned teeth

alveolar ridge defect

cavities/ weak areas in their enamel and thicker less effective saliva (in adults can cause oral cancer)

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13
Q

Communication assessment: Voice

the particular voice problem assoc. with CL/P concerns the ability to regulate ?
3 types

A

air flowing through the nasal cavity during speech production

velopharyngeal closure
velopharyngeal inadequacy or insufficiency (VPI)
hypernasal speech

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14
Q

assessment of VPI

goal

A

to detect nasal airflow

2 devices: seescape and a nasal mirror

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15
Q

Speech Concerns:
cleft lip or palate can make the voice ?
children frequently exhibit articulatory errors because of ?

A

hypernasal and diff. to understand

nature of cleft 
inadequate or too short palate 
misaligned teeth 
hearing loss 
delayed development
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16
Q

common sounds affected

if surgery delayed past age 2 the childs articulation becomes ?

A
phonemes that require build up of intra oral pressure
-glottal stop 
-pharyngeal fricative 
vowels esp. nasal 
disordered and harder to correct
17
Q

Treatment of CL/P
cleft palate team:

the team will evaluate the childs progress regularly examining ?

A
audiologist 
geneticist 
orthodontist 
otolaryngologist (sometimes same as surgeon, anything that is going on with hearing/tubes) 
pediatrician 
psychologist 
SLP 
surgeon 

hearing, speech, nutrition, teeth, emotional state

18
Q

treatment of CL/P
surgery

SLP: fewer than 10% are likely to require ? major focus on

psychology: psychological issues are a critical part of the ? and must be

A

repair of lip and palate
pharyngeal flap
pharyngoplasty

therapy/ reducing hypernasal speech

management of child with CL/P / addressed from onset of care

19
Q

cultural considerations and CL/P
management with CL/P may require ?
including

A

special multicultural considerations

religious and philosophical beliefs