Chapter 7 Flashcards
What is articulation?
The totality of motor processes involved in the planning and execution of sequences of overlapping gestures that results in speech OR the point of union between 2 structures
How do we measure articulation?
Cineradiography, electopalatopgraphy, electromyography
Cinderadiography
A radiology (xray) technique that captures a series of images of moving objects in rapid succession to create a motion picture
Electopalatography
A computer-based technique that monitors the tongue’s contact with the hard palate during speech (measures electrical signals of the palate as it moves)
Electromyography
A medical test that measures the electrical activity of muscles and the nerves that control them (muscle energy in the face)
What creates the labial seal?
Obicularis oris
Labial Seal
The obicularis oris creates a labial seal where other muscles insert here and create pull and force in multiple directions to create lip shapes
Does the upper lip move faster or slower than the lower lip?
The upper lip moves slower than the lower lip
What is the purpose of the lower lip?
It does most of the work in lip closure & it is faster and stronger than the upper lip due to the position of trhe mandible and mentalis (being attached to the jaw makes it able to move)
Are the lips highly adaptable?
The lips are highly adaptable to structural interference; teeth, appliances, holding something in the mouth. It is governed by proprioception
What is propioception?
Awareness of the position and movement of the body
How does propioception work?
Sensory rectoption in our muscles, joints, and tendors, send messages to our brain telling us where our body is
Do stroke patients have good propioception?
No
How many muscles open the mandible?
4
How many muscles close the mandible?
3
What is the purpose of the mandible?
To assist lips & tongue
How does the mandible assist the lips and tongue?
Carries lips and tongue to the target position & brings structures closer to the teeth when needed
Why does the manible change positions?
To support lip movement and tongue movement
What muscles open the mandible?
Digasticus, Mylohoid, Geniohyoid, Lateral Pterygoid
What muscles close the mandible?
Temporalis, Masseter, Medial Pterygoid
What is the purpose of the tongue?
Articulation & swallowing & taste
Is the tongue strong?
Yes, only 20% of the tongues strength is used for articulation
If we lose tongue strength what would we most likely have trouble with?
Swallowing
What is the sensory makeup of the tongue?
Muscle spindles are sensory stretch receptors, golgi tendon organs for proprioception, and tactile sensors
What are some examples of the extreme sensitivity of the tongue?
The tongue can differentiate points of contact only 1.5 mm apart & it aids in proprioception and monitoring of articulation placement
What do the extrinsic muscles of the tongue help with?
Gross motor movements and taking the tongue to the general area it is needed
What do the intrinsic muscles of the tongue help with?
They create fine motor movements for the creation of unique speech sounds
Why is the velum a fast mover?
The velum must open and close at a high rate of speech to accommodate for nasal and non nasal speech sound production
What happens when the velum is closed?
Contraction of the levator veli palatini results in non-nasal speech (creates intraoral pressure for fricative and plosive production)
What happens when the velum is open?
Relaxation of the levator veli palatini allows for the voice to resonate in the nasal cavity (nasal sounds)
What is nasal assimilation?
The resulting sound of nasal resonance when not appropriate (nasal sounds on other phonemes or cleft palate)
What sounds should be developed by the end of age 2?
p,h,n,d,b,w,m
What sounds should be developed by the end of age 3?
t,f,y,ng,k,g
What sounds should be developed by the end of age 4?
ch,l,s,v,z,dz,sh
What sounds should be developed by the end of age 5?
th (voiced), zh, r
What sounds should be developed by the end of age 6?
th (thumb)
What articulation needs to be developed before starting speech?
reflexes, vestibular development, motor development, extension, trunk/neck stability, CV structures
Reflexes
Sucking, step, rooting, grasp
Vestibular development
Balance
Motor development
Head to tail & medial to distal (need head and neck stability before we can sit up and before we can move our hands)
Extension
When you give babies tummy time so they can be in an open position
Trunk/neck stability
Crucial for sitting and walking
CV structures
valving & gross motor —> (before) fine motor (babababa)
How does the oral cavity grow?
It grows so much and changes in many ways!
Does the nasopharynx get bigger or smaller?
Bigger and is more sharply angled relative to the oropharynx (more distance in between)
Does the oral cavity get bigger or smaller?
Grows and gets bigger
Does the tongue ascend or descend?
It descends and lays in the bottom of the mouth
Does the oropharyngeal space increase or decrease?
Increase
What is important to know about the growth of structures?
As the growth of structures changes so does the relationship of the articulators (this will impact our therapy over time)
When is the adult oral cavity size reached?
Between 7 and 18 years of age
Where is the vocal tract?
the VTL is from the lips to the vocal cords
Does the vocal tract expand as you grow?
Yes
What is the VTL at birth?
6-8 cm (2.3-3.15 inch)
What is the VTL in adult?
15-18 cm (6-7 inch) (it doubles in size)
When are the VT rapid changes?
0-1 year and 12 year (puberty)
When does the VT plateu?
4 years
How does the oral cavity grow?
Gradually from 4 years old to adulthood
How does the pharynx grow?
Growth spurt between 8-12
What are some main points from bone, muscle, and laryngeal development?
As things grow it allows for more space within the vocal tract. 24 mo and 7 years are the big milestones (0-2 is fast and gradual growth until year 7). the jaw has to grow before the tongue can grow
Hard palate
Increases by 1 cm in length by 24 mo
Soft palate
Increases by 0.5 cm in length by 24 mo
Mandible
Grows from 2-4 cm by 24 mo and typically is 5 cm by age 7. The depth increases allowing for larger oral cavity and room for the tongue
Tonuge
As mandible grows, allows for more space for the tongue. 75% of adult tongue by 7 years of age
Larynx
3 cm drop of the larynx in the neck by age 7
How doe we get to articulation?
We need emotions, language and cognition, and motor speech
A though to be expressed
emotion
Words chosen
lang and cog
Words put in correct order
lang and cog
Sounds of the words and sequenced
motor speech
Motor plan is mapped
motor speech
Motor sequencing movements are sent to the muscles
motor speech
Associated chain theory
Articulation is a series of motor sequences that are learned
Coarticulation
The overlapping impact of one speech sound on another
Central Control Theory
Master control mechanism dictates the muscle movement based on the linguistic goal
Feedback Theories
Sensory feedback from the articulators influence accurate speech sound production
Dynamic or action theory
The end product of muscle activity is goal driven
DIVA model
A feedback driven model
Why are theories of articulation important?
It impacts how we approach therapy/treatments
Dentition Pathologies
Trama to teeth & cleft lip
Trama to teeth
Motor vehicle accident and sports injuries
Cleft lip
Congenital interruption of lip fusion and may impact the alveolar ridge
How would dentition pathology impact Articulation, Mastication, and Deglutition?
A: dental sounds are distorted
M: can’t do big biting motions
D: if not grinding food down then could choke while swallowing
Lip/Palate Pathologies
Trauma to lips, congenital lip issues, congenital palate issues, velopharyngeal insufficiency
Trauma to lips
Sports injury, physical assault, motor vehicle
Congenital lip issues
cleft lip, interruption of lip fusion
Congenital palate issues
cleft palate, interruption of palate fusion
Velopharyngeal insufficiency
Failure of the soft palate to be able to meet the back wall of pharynx
How would lip and palate pathology impact Articulation, Mastication, and Deglutition?
A: disordered
M: anterior spillage
D: cannot create intraoral pressure to swalloe
Tongue Pathologies
Trauma, oral disease, developmental tongue issues, cancer
Trauma to the tongue
Surgical intervention for disease, motor vehicle accident, sports injury
Oral Disease
Ulcers, burning tongue syndrome
Developmental Issues
Ankyloglossia (tongue tie), macroglossia (large tongue)
Cancer
70% of oral cancer is caused by smoking tobacco
How would tongue pathology impact Articulation, Mastication, and Deglutition?
A: distortion to r sound and l sound (slurred speech)
M: cannot push food back to molars so there is oral residue remaining and it is hard to chew effectivly
D: tongue pushes bolus down so its hard to drive the force of the swallow
Mandible or Maxilla Pathologies
Retrognathia, Prognathic mandible, tauma
Retrognathia
Class 2 malocclusion= Overbite (surgical remedy)
Prognathic mandible, tauma
Class 3 malocclusion = underbite (surgical remedy)
Trauma
Falls, gun shot wounds (surgical remedy/prosthetics)
How would mandible/maxilla pathologies impact Articulation, Mastication, and Deglutition?
A: can’t talk (but usually no issues with articulation w over or underbite bc of adaptation)
M: can’t chew or molars do not like up so it is harder to chew
D: bad intraoral pressure
Neurological Pathologies
CVA, parkinsons, cerebellar damage
Cerebrovascular Accident
Upper and lower motor neuron damage= dysarthria, damage to the motor planning areas of the brain = apraxia
Parkinsons
Hypokinetic dysarthria (issues w motor speech/slurred speech)
Cerebellar Damage
Problems with coordination of muscles of articulation
How would neurogenic pathologies impact Articulation, Mastication, and Deglutition?
A: apraxia and dysarthria are acquired motor speech disorder that will effect articulation
M: muscle weakness and discordination so hard to push food back
D: weakness of throat muscles so hard to swallow and easy to choke
Other pathologies
Toxins, trauma, traumatic brain injury, degenerative diseases
