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Cleft Palate > Chapter One > Flashcards

Chapter One Flashcards

1
Q

Cleft

Cleft Lip (fusion normally@ 6-7 weeks)

Cleft Palate (Fusion at 9-10 weeks and complete by 12 weeks)

A

An abnormal opening or a fissure in an anatomical structure that is normally closed

It is the result of failure of parts of lip to come together early in the life of fetus

It occurs when the parts of the roof of the mouth do not fuse normally during fetal development, leaving a large opening between the oral cavity and the nasal cavity.

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2
Q

External ear
a)
b)

A

a) Pinna (helps funnel sound into canal)

b) External auditory canal (leads to the TM; S shaped structure; lined by cilia; helps keep insects and other junk out)

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3
Q

Middle ear (communicates with the mastoid- important for BC hearing)
a)
b)

A

a) Tympanic membrane- air is converted into acoustic energy

b) Eustachian tube- connects the middle ear to the pharynx; very important for equalizing pressure

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4
Q

Inner ear
a)
b)
c)

A

a) Cochlea- snail shaped organ
b) Organ or Corti- contains outer hair cells which are the functional units of hearing
c) Semicircular canals- balance and equilibrium

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5
Q

Nose and Nasal Cavity (Know the figure on slide 5*****)

Nasal root

Nasal bridge/nasion

Columella

Nasal tip

Ala nasi
Alar rims
Alar base

Nasal sill

Pyriform aperture

A

Nasal root- where the nose begins

Nasal bridge/nasion- bony strucute

Columella- fleshy structure that separates the two nostrils

Nasal tip- protruding pointy structure

Naris (pl. nares) or nostril- open cavities

Ala nasi:
Alar rims- c shaped curved structures
Alar base- where the nose connects with the upper lip

Nasal sill

Pyriform aperture- opening of the nose

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6
Q

Nasal septum (Image*)

A

Quadrangle septal cartilage

Vomer—fits in median palatine suture groove

Perpendicular plate of the ethmoid

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7
Q

Turbinates and meatuses (Image*)

A

Superior, middle, inferior turbinates (choanae) - make sure the air is channeled into the windpipe

Superior, middle, inferior nasal meatuses-

Paranasal sinuses (frontal, maxillary, ethmoid, and sphenoid)- cavities within the bone

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8
Q

Upper Lip (Image*)

Philtrum-
Philtral ridges/columns-
Cupid’s bow-
White roll-
Vermilion-
Tubercle-
A

Philtrum- bridge which connects tip f nose to upper lip

Philtral ridges/columns

Cupid’s bow- not seen in cleft lip

White roll- just below cupisa bow

Vermilion

Tubercle- pointy structure of upper lip

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9
Q

Oral Cavity

Hard palate
Alveolar ridge
Velum (soft palate)
Uvula
Tongue
Dorsal and ventral surface
Faucial pillars
Anterior and posterior
Tonsils (palatine tonsils)
Posterior pharyngeal wall
A

Hard palate- bony structure

Alveolar ridge

Velum (soft palate)- muscular structure

Uvula

Tongue

Dorsal and ventral surface

Faucial pillars

Anterior and posterior

Tonsils (palatine tonsils)

Posterior pharyngeal wall

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10
Q

Palate and Pharynx

A

Hard palate (maxilla)

Velum (soft palate)

Eustachian tube

Tonsils

Adenoid (pharyngeal tonsil)

Tonsils (palatine tonsils)

Lingual tonsil (at base of the tongue)

Epiglottis

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11
Q

Hard Palate

Separates ….

Serves as ____ of mouth and ___of nasal cavity

Palatal vault—

Alveolar ridge (alveolus)—

A

nasal cavity and oral cavity

roof; floor

dome on upper part of oral cavity

provides bony support for teeth

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12
Q

Mucoperiosteum-

Mucous membrane—

Periosteum—

A

tissue that covers the hard palate

lining of stratified squamous epithelium
and lamina propria

thick, fibrous tissue that covers bone

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13
Q

Rugae-

Incisive papilla-

Palatine (median) raphe-

A

ridges that run horizontally

projection of mucosa at area of incisive foramen (just behind central incisors)

line from incisive foramen to uvula

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14
Q

Foramen—

Incisive Foramen-

A

hole or opening in a bony structure to allow blood vessels and nerves to pass through to the mucosa

In the area of alveolar ridge behind the central incisors
Starting point of embryological development

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15
Q

Premaxilla

_______-shaped bone

Bordered by incisive foramen and incisive sutures

Contains ___ maxillary incisors

A

Triangular

4

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16
Q

Palatine processes of maxilla

Forms anterior ___of maxilla

Two plates separated by ________

Nasal aspect of palatine suture forms groove for lower portion of vomer (nasal septum)

A

3/4th

median (intermaxillary) palatine suture

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17
Q

Suture lines

A

Incisive suture lines

Median (intermaxillary) palatine suture

Transverse palatine (palatomaxillary) suture lines

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18
Q

Horizontal plates of the palatine bones

_____ portion of the hard palate

Bordered by the transverse palatine suture lines

Meet in ____ at the median palatine suture

Ends with the _____

A

Posterior

midline

posterior nasal spine

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19
Q

The hard palate is divided into***
1.
2.

A

Palatine processes of maxilla

Horizontal plates of the palatine bones

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20
Q

Torus Palatinus (Palatine Torus)

A

Seen in some Caucasians of Northern European descent

Prominent longitudinal ridge on oral surface along intermaxillary suture line

Normal variation and usually not the cause of a problem

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21
Q

Sphenoid and temporal bones

Medial and lateral pterygoid plates—part of pterygoid process of sphenoid bone

Pterygoid hamulus—inferior end of pterygoid plate
Both provide bony attachment for velopharyngeal musculature

A

….

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22
Q

Velum (Soft Palate)

Consists of ____and _____ (no bone)

Attaches to ______

Median palatine raphe continues to _____

Uvula attaches to the ______

A

muscles; mucosa

hard palate

uvula

posterior border

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23
Q

Palatine (Velar) Aponeurosis*

Consists of _____

Anchoring point for ____***

Provides ______

A

fibrous, connective tissue

velar muscles

stiffness

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24
Q

Uvula

____-shaped pendulum

Consists of ____________ tissue

Very ________

Has no known function

A

Teardrop

mucosa, glandular, and adipose

vascular

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25
Q

Pharynx (Throat)

  1. Nasopharynx—above ____
  2. Oropharynx—_____velum
  3. Hypopharynx-

Posterior pharyngeal wall-

A

velum

below velum

around laryngeal region

Adenoid tissue located just behind the velum

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26
Q

Adenoid Pad

Mass of _________

Located on _________, just behind the velum

More prominent in ________

A

lymphoid tissue

posterior pharyngeal wall

children than in adults

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27
Q

Eustachian Tube

Connects _____with _____

At horizontal angle in children under age ____

At a ___ - angle in adults

A

middle ear; pharynx

6

45º

28
Q

Eustachian Tube

Pharyngeal opening is____and slightly above velum

Torus tubarius-

Salpingopharyngeal folds-

A

lateral

ridge located posterior to Eustachian tube

originate from torus tubarius and course down to the lateral pharyngeal wall

29
Q

Velopharyngeal (VP) Closure

Coordinated _____closure of structures

Closes valve like a _____

Closes off _____from _____

A

three-dimensional

sphincter

nasal cavity; oral cavity

30
Q

Velopharyngeal (VP) Function

Regulates and directs transmission of ______and _____ in the oral and nasal cavities

Important for production of _________consonant sounds and all vowels

A

sound energy and airflow

“pressure-sensitive”

31
Q

VP function requires coordinated movement of the following structures: ***
1.
2.
3.

A
  1. Velum (soft palate)
  2. Lateral pharyngeal walls (LPWs)
  3. Posterior pharyngeal wall (PPW)

Combined effort of these structures

32
Q

VP port is always ____ at rest and always ____ when eating

Open during the production of _____

A

open; closed

nasals

33
Q

Velar Movement

Moves in a ______ and _____ direction

Has a type of ____ action

Moves toward the _____

Velar dimple—

A

superior; posterior

“knee”

posterior pharyngeal wall

point of bend in the velum during contraction

34
Q

Lateral Pharyngeal Wall (LPW) Movement

Moves _____

Usually close against the ____

Sometimes close in ___behind the velum

A

medially

velum

midline

35
Q

Posterior Pharyngeal Wall (PPW) Movement

Moves _____toward the velum

Has very ____role, however

Passavant’s ridge—

A

anteriorly

little

bulge of muscle on the posterior pharyngeal wall during speech; occurs in some normal and abnormal speakers

36
Q

Muscles of VP Closure

1.
2.
3.
4.
5.
6.
A
  1. Levator veli palatini (velar “sling”)
  2. Superior constrictor (pharyngeal ring)
  3. Palatopharyngeus (posterior faucial pillar)
  4. Palatoglossus (anterior faucial pillar)
  5. Musculus uvulae (bulge on nasal surface)
  6. Tensor veli palatini
37
Q

Motor and Sensory Innervation

Pharyngeal plexus—

A

plexus—a network of nerves that lies along the posterior wall of the pharynx and consists of the pharyngeal branches of the glossopharyngeal nerve (CN IX) and the vagus nerve (CN X)

38
Q

Cranial Nerves

Trigeminal (V)

Facial (VII)

Glossopharyngeal (IX)

Vagus (X)

Accessory (XI)

Hypoglossal (XII)

A

…

39
Q

Patterns of VP Closure*** IMAGE

Coronal pattern—

Sagittal pattern—

Circular pattern—

A

Coronal pattern—involvement of velum and PPW
Most common

Sagittal pattern—LPWs
Least common

all structures
Sometimes includes Passavant’s ridge

40
Q

Pneumatic vs. Nonpneumatic Activities

Nonpneumatic:

Pneumatic
Positive pressure—whistling, blowing, speech
Negative pressure—sucking, kissing

A

Swallowing, gagging, vomiting

Positive pressure—whistling, blowing, speech
Negative pressure—sucking, kissing

41
Q

***During nonpneumatic activities:
Entire length of _____move together with exaggerated movement.

Closure is ____than with speech.

During speech:
Greatest movement occurs with ______.

Note: Closure for speech and other positive pressure activities are different. Do not work on blowing/sucking to improve speech!

A

LPWs

higher

high-pressure consonants

42
Q

Timing of Closure

Valve closes before phonation begins or sound will be ______.

Closure is maintained until a _____or the utterance is ended.

A

hypernasal

nasal consonant

43
Q

Height of Closure

Closure contact may vary with different _____.

Closure tends to be higher and tighter with _____and ______, especially voiceless consonants.

Closure can be affected by ___ and ____

A

sounds

high vowels AND high-pressure consonants

rate AND fatigue.

44
Q

Firmness of Closure

Contact firmness varies with ____.

Gap of ______ is the threshold for hypernasality.

Even very small gaps cause _______.

A

consonant

5 mm (20 mm2)

audible nasal air emission

45
Q

Rate and Fatigue

Velar movement and closure can _____ with rapid rate and muscular fatigue.

Rate and fatigue affects the _____ AND ____of closure.

A

decrease

height and firmness

46
Q

Changes with Growth and Age

Velum increases in _____ AND _____—”velar stretch.”

Maturation results in an increase in ________.

A

thickness and length

oral-motor coordination

47
Q

Changes with Growth and Age

Facial skeleton, including hard and soft palate, moves____and ____

_________changes in inclination and bends forward.

Gradual involution of ____tissue occurs, particularly around puberty.

A

down AND down

Posterior pharyngeal wall

adenoid

48
Q

Subsystems for Speech

A

Respiration

Phonation

Prosody (stress, rhythm, and intonation)

Resonance and velopharyngeal function

Articulation

49
Q

Respiration

Air pressure is required to initiate and sustain phonation:

A

Vocal folds close.
Subglottic air pressure builds.
Vocal folds break open and begin to vibrate.
Pressure is released.

50
Q

Respiration

Breathing for vegetative purposes is _____than breathing for speech.

There is a need to control breathing for _____.

Ratio at rest:
Ratio during speech:

A

different

phrasing

50: 50
10: 90

51
Q

Respiration

Provides airflow, which converts to _________ for articulation

Is important for ______ sounds

A

intraoral air pressure

pressure-sensitive

52
Q

High-pressure sounds:

A

Plosives (p, b, t, d, k, g)
Fricatives (f, v, s, z, ʃ, Θ, ð)
Affricates (ʧ, ʤ)

53
Q

Low-pressure sounds

A

Liquids (l, r)

Glides (w, j)

54
Q

No-pressure sounds

A

Nasals (n, m, ŋ)

55
Q

Must be able to _______phonation quickly throughout
an utterance

Example: “a cup” requires start-stop-start-stop of phonation in just two syllables

A

start and stop

56
Q

Prosody

A

Stress and intonation

57
Q

Velopharyngeal Function
For oral sounds:

Velopharyngeal valve is ____

This allows acoustic energy to ______

It is important for the production of most ______sounds (particularly plosives, fricatives, affricates) and all vowels.

A

closed.

enter oral cavity.

consonant

58
Q

Velopharyngeal Function

For nasal sounds:
Velopharyngeal valve is _____.

This allows most of the sound energy to _________

It is important for ____sounds (m, n, ŋ).

A

open

enter the nasal cavity

nasal

59
Q

Velopharyngeal Function

Velopharyngeal valve must open and close quickly and efficiently

Example: “It’s my map.” requires the valve to close-open-close-open-close in just three syllables.

A

….

60
Q

Articulation

Vowels:
Produced by _____oral resonance

Formant frequencies affected by:
1.
2.

Acoustics and vowel perception affected by ________

A

altering

  1. Position of tongue, jaw, and lips
  2. Size and shape of oral cavity

formant frequencies

61
Q

Articulation

Consonants:
Produced with partial or complete _____ of oral cavityand then release

Usually produced with ______

A

obstruction

air pressure

62
Q

Articulation

Manner of Production:
Plosives (p, b, t, d, k, g)

1.
2.
3.

A
  1. Completely close oral cavity.
  2. Build up air pressure.
  3. Release air pressure suddenly.
63
Q

Articulation

Manner of Production:
Fricatives (f, v, s, z, ʃ, Θ, ð)

1.
2.
3.

A
  1. Partially close oral cavity.
  2. Build up air pressure.
  3. Release air pressure gradually.
64
Q

Manner of Production
Manner of Production:
Affricates (ʧ, j)

A

Combine a plosive with a fricative.
ʧ = t + ʃ
ʤ = d + ʒ

65
Q

Subsystems
All subsystems need to be good “team players.”

If one subsystem is not working well, it affects the ___of the other “team players.”

A

work

Cleft Palate (19 decks)

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