Cleft-Leaders Project

Question 1

When does the lip & alveolus begin to develop in utero?

Answer 1

6-7 weeks of gestation

Question 2

Development starts at the _____ ______

Answer 2

incisive foramen

Question 3

When does the hard palate develop?

Answer 3

Begins at 8-9 weeks of gestation

Question 4

When is the velum & uvula formed?

Answer 4

12 weeks gestation

Question 5

Which muscle opens & closes the Eustachian Tube?

Answer 5

Tensor Veli Palatini

Question 6

Why do kids with Cleft Palate often have conductive hearing loss?

Answer 6

Because their Tensor Veli Palatini muscle is displaced.

Question 7

Which is the primary muscle in soft palate closure?

Answer 7

The Levator Veli Palatini lifts up & back in the soft palate to close against the PPW (posterior pharyngeal wall)

Question 8

The point in palate from which lips fuse and from which the palate fuses is called the _______ ________

Answer 8

Incisive Foramen

Question 9

Palate closes from incisive foramen toward the ________

Answer 9

Palate closes from incisive foramen toward the back (toward PPW)

Question 10

Alveolus/ lips close from the incisive foramen toward the _____

Answer 10

Front/ towards the lips

Question 11

How does the velum move?

Answer 11

Up & Back against the PPW for closure.

Question 12

How do the Lateral Pharyngeal walls move? Which muscle?

Answer 12

From the sides, inwards; Superior Pharyngeal Constrictor muscle

Question 13

Which muscle pulls the velum down?

Answer 13

Glossopalatini or palatoglossus

Question 14

Which muscle is important in swallowing and may/ may not have a role in VP closure?

Answer 14

Palatopharyngeus

Question 15

________ is the cartilage between tip of nose and face

Answer 15

Columella

Question 16

_____ is the depression between the 2 seams

Answer 16

Philtrum (“love charm”)

Question 17

3 characteristics of submucous cleft?

Answer 17

1. Bifid Uvula
2. Zona pellucida (bluish area in middle of velum)
3. Notch in posterior border of hard palate

Question 18

Another type of hidden cleft is called…

Answer 18

occult cleft– But, the only way to see that is through a nasoendoscopy exam, where you put the camera on the tube with a light, up through the nose to see if there’s a clefting.
You look above to see if the clefting is in the nasal mucosa, through that way

Question 19

Muscle responsible for the velum to move upward and back, so it moves like a sling: up and back.

Answer 19

Levator veli palatini—- With a child with a cleft palate, the sling didn’t fuse and so it’s open, and so the child’s not going to have that proper movement in order to achieve velopharyngeal closure

Question 20

the muscles that are involved with the LPW- lateral pharyngeal walls, so that they can move inward

Answer 20

Superior pharyngeal constrictors.

Question 21

Muscle which contracts during phonation and creates that bulge in the velum

Answer 21

Musculus uvulae

Question 22

Muscle which depresses the velum.

Answer 22

Palatoglossus muscle

Question 23

muscle is responsible for the opening and closing of the eustachian tubes for middle ear drainage.

Answer 23

Tensor veli palatini

Question 24

Why children with clefts have hearing issues?

Answer 24

So, it’s an important muscle because a lot of children with cleft palate, their hearing may be affected because that muscle is not inserted in the right place.

Question 25

____ closure is when the velum moves towards the PPW to close

Answer 25

Coronal

Question 26

_____ closure, where there is more movement of the lateral pharyngeal walls and little movement of the soft palate, the velum, and the posterior pharyngeal wall.

Answer 26

Sagittal

Question 27

_____ closure is where all the areas are involved in closure

Answer 27

Circular pattern closure

Question 28

_________ ______ is this dynamic structure in the posterior pharyngeal wall PPW- that occurs when you phonate and you swallow, and so with this closure, it goes against the Passavant’s ridge

Answer 28

Passavant’s ridge is this dynamic structure in the posterior pharyngeal wall PPW- that occurs when you phonate and you swallow, and so with this closure, it goes against the Passavant’s ridge

Question 29

______ _______ is when there are structural issues involved

Answer 29

Velopharyngeal Insufficiency (structural, anatomical deficit)

Question 30

_________ ________ is when there is a functional issue

Answer 30

Velopharyngeal incompetency refers to the
Refers to functional part of it - the movement area.
So, there may be a neurological or physiological issue involved that does not allow for velopharyngeal closure, maybe the tissue doesn’t move enough
apraxia, so it does not coordinate at the right times.
It may be related to ALS, dysarthria, brainstem tumor, stroke or TBI.

Question 31

_________ ___________ is when structure and function are normal, but they have errors

Answer 31

Velopharyngeal mislearning
results in an articulation disorder that seems like velopharyngeal dysfunction, but the structure is normal and the function is normal.

Question 32

: “p”, “t”, “k”, “g”, “s”, “ch”, “sh”, “v”, “j”., “s”. are classified as ____ _______ sounds

Answer 32

High Pressure

Question 33

“w”, “l”, “r”, and “y”. are classified as ____ ______ sounds

Answer 33

Low Pressure

Question 34

In ______-nasality. The “m”s and “n”s, which are the nasal sounds, may become oral sounds, such as “by bobby bakes bilk.

Answer 34

Hypo-nasality

Question 35

In _____-nasality, , “b”s become “m”s, “d”s become “n”s, and “g”s, such as “g,” become “ng,

Answer 35

Hyper-nasality

Question 36

Hyponasality characteristics may be present in ____________________________ in that the velum does not lower fast enough for nasal phonemes once it has been raised for the oral sounds

Answer 36

Hyponasality characteristics may be present in apraxia of speech (CAS, AOS), in that the velum does not lower fast enough for nasal phonemes once it has been raised for the oral sounds

Question 37

__________________ occurs when transmission of acoustical energy is trapped in a blind pouch with an entrance, but there’s no outlet

Answer 37

oral cul-de-sac resonance “potato in the mouth”

Question 38

Mixed resonance is when…

Answer 38

Hyper and Hypo Nasality co-occur

Question 39

During oral examination, look for ______

Answer 39

Fistulas, including alveolar fistulas (check under upper lip)

Question 40

Oral Exam– Notice amount of space btwn the ______ and the _________ ____________ ____

Answer 40

Velum & PPW-posterior pharyngeal wall. If a lot of space, hard to achieve velopharyngeal closure

Question 41

Difficulty coordinating movements could be a sign of what

Answer 41

Oral apraxia

Question 42

What sentences are recommended for assessment

Answer 42

Americleft sentences

Question 43

What kind of approach(es) is/are best for good articulation therapy?

Answer 43

Multi-sensory approach (auditory, tactile, & visual cues) traditional Van Riper– isolation, to syllables to words, etc.

Question 44

Should you start with voiced or voiceless sounds?

Answer 44

Start with voiceless

Question 45

_______________ errors/ misarticulations are caused because of structural or physiological reason

Answer 45

Obligatory

Question 46

Obligatory errors ___ (are/are not) corrected through speech therapy

Answer 46

Obligatory errors are not corrected through speech therapy, only surgery

Question 47

Glottal stops, pharyngeal fricatives, pharyngeal stops, mid-dorsum palatal stops, & nasal rustles are possible examples of _______ misarticulations

Answer 47

Compensatory misarticulations, which are learned from having a faulty mechanism & may persist after surgery

Question 48

Nasal emissions are only due to mislearning (T/F)

Answer 48

False. Nasal emissions can be obligatory (due to a structural reason-e.g. fistula leading the air to the nasal cavity)OR due to mislearning

Question 49

speech therapists who do not know about cleft palate speech hear a glottal stop as an _______of a sound.

Answer 49

omission

Question 50

What sound can be used before the target sound to help eliminate glottal stops

Answer 50

/h/ in a continuous prlonged manner hhhhhhp using gentle production of the stop sound /p/

Question 51

Should you plug the nose when trying to eliminate glottal stops?

Answer 51

No, becausee glottal stops are at the level of the glottis, so plugging nose makes no difference

Question 52

__________ _________ are typically mislearning errors used to substitute for fricatives and sometimes affricates

Answer 52

Pharyngeal Fricatives

Question 53

A _____________ _____ is used to substitute for /k, g/

Answer 53

pharyngeal stop

Question 54

Nasal rustle can occur due to ________ ______ or ____________________

Answer 54

structural defect or misarticulation.

Question 55

If due to structural defect, nasal rustle typically occurs ____________ (consistently/ inconsistently) on high pressure sounds (p, t, k) & often increases with utterance length and/or fatigue

Answer 55

Inconsistently

Question 56

Nasal rustle due to misarticulation typically occurs _________ (Consistently/ inconsistently) on certain phonemes

Answer 56

Consistently. Ex: every time produces “s” you may hear it. Most commonly happens on sibilants

Question 57

The first part of the speech hierarchy is _____

Answer 57

Discrimination

Question 58

What method do they use for syllables?

Answer 58

Acevedo Spoke method

Question 59

Why don’t oral motor exercises work?

Answer 59

These non-speech movements will not help with speech, because the parts of the brain that control movements for speech are different from the parts of the brain that control non-speech movements. It’s a brain thing.

Question 60

Why is strengthening not needed for speech therapy?

Answer 60

Very little strength is needed to produce speech. Agility and coordination are needed, but little strength. Also, it is surprisingly difficult to accurately determine strength. Therefore, any statements about weakness are questionable.