cleft palate Flashcards

1
Q

what causes hypo nasality?

A
  • upper airway obstruction due to adenoid hypertrophy or nasal blockage (pg.339)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what causes cul-de sac resonance?

A

caused by enlarged tonsils, which blocks the entrance to the oral cavity causing pharyngeal cul-de-sca- resonance
(pg.339)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinician decides to do nasopharyngoscopy, in which the nasopharyngoscope is passed through the
middle meatus and back to the area of velopharyngeal closure. What will this procedure
enable the clinician to observe?

A

The child’s posterior and lateral pharyngeal walls, as well as the nasal aspect of the velum
and the adenoid pad as the child produces sentences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What speech characteristics could you expect to find with a partial submucous cleft palate accompanied by a bifid uvula.?

A
  • Hypernasality
  • decreased intraoral breath pressure
  • difficulties with fricatives, affricates, and plosives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Eustachian tube dysfunction in children with cleft is most related to lack of contraction of the ________________.

A

tensor veli palatini muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Are cleft lips more often unilateral or bilateral?

A

unilateral on left side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Development of upper lip and primary palate take place between ___ and ___ weeks gestation

A

4-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Soft palate is formed by the _____________ week.

A

12th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hard palate fuses between __ and ____ weeks gestation

A

8-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Etiology of Clefts

A

Genetic abnormalities
Environmental factors
Mechanical factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Congenital Palatopharyngeal Incompetence (CPI) refers to what?

A

velopharyngeal closing-valve function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Laryngeal and phonatory disorders with Cleft

A
  • -Nodules
  • -Hypertrophy and edema of the vocal folds
  • -Hoarseness
  • -Resonance disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Assessment:

What allows examiner to view posterior and lateral pharyngeal walls as well as nasal aspect of velum and adenoid pad as client produces sentences?

A

Nasopharyngoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Assessment:

What can observe movements of soft palate, lateral pharyngeal wall, posterior pharyngeal walls and tongue as client produces CV’s, voiced and voiceless fricatives and selected phrases?

A

Videofluoroscopic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Assessment:

What gives ratios of inhalation and exhalation?

A

Oral manometer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does a ratio of 1.0 on an oral manometer suggest?

A

adequate velopharyngeal closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does a ratio of less than 1.0 on an oral manometer suggest?

A

VPI, reduced intelligibility, hypernasality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does a ratio of less than .89 on an oral manometer indicate?

A

VPI, reduced intelligibility, hypernasality

19
Q

Assessment:

Measures nasalance, gives ratio formed between oral and nasal sound pressures and sssesses VP function

A

Nasometer

20
Q

Surgical Management of Clefts

Initial surgery which closes cleft

A

Primary surgery

21
Q

Surgical Management of Clefts

closes unilateral or bilateral cleft of lip

A

Lip surgery

22
Q

Surgical Management of Clefts

appearance

A

secondary surgery

23
Q

Surgical Management of Clefts

closes cleft or clefts of palate

A

c. Palatal surgery

24
Q

Surgical Management of Clefts

secondary procedure in which flap is cut from posterior pharyngeal wall, raised and reattached to the velum. The openings allow for nasal breathing, drainage and production of nasal sounds.

A

d. Pharyngeal Flap

25
Q

Surgical Management of Clefts

teflon, silicone, or dacron wool is injected into posterior pharyngeal wall to make f bulge and close velopharyngeal port.

A

e. Pharyngoplasty

26
Q

Hyponasality due to velopharyngeal incompetence should not be treated until ___________ and _______________.

A
  • Surgical or prosthetic efficacy to improve functions

- Child is capable of velopharyngeal closure

27
Q

what are the effects of cleft lip and palate on speech?

A
  1. dental and occlusal anomalies, particularly cross bites and class III malocclusions
  2. hearing loss due to eustachian tube malfunction
  3. velopharyngeal insufficiency
28
Q

what are the effects of cleft lip and palate of feeding?

A

cleft lip usually does not affect feeding

29
Q

nasal emissions results in

A
  1. weak or omitted consonants
  2. short utterance length
  3. dysphonia
  4. compensatory articulation productions
  5. obligatory distortions
30
Q

Nasal emission resulting in weak or omitted consonants with cleft palate are due to the lack of ______________________.

A

adequate air pressure

31
Q

Nasal emission resulting in short utterance length with cleft palate are due to need to ______________________________.

A

take frequent breaths to replenish the lost airflow through the nose

32
Q

Nasal emission resulting in dysphonia with cleft palate is due to strain in ______________.

A

the entire vocal tract in efforts to achieve velopharyngeal closure

33
Q

Nasal emission resulting in compensatory articulation productions with cleft palate are due to abnormal articulation placement in an attempt to _________________________________.

A

compensate for the lack of air pressure in the oral cavity; usually produced in the pharynx where there is air pressure

34
Q

Nasal emission resulting in obligatory distortions with cleft palate are due to ________________.

A

abnormal structure, despite normal articulation placement

35
Q

Cephalometric analysis

A

analyzes motion of the soft palate reporting a ratio relationship between depth of the nasopharynx and length of the soft palate.

36
Q

Cephalometric analysis ratio of less than 60 indicates what?

A

nasopharynx is too shallow or soft palate is too long

37
Q

Cephalometric analysis ratio of 60-80 indicates what?

A

velum is too short or nasopharynx is too deep.

38
Q

Cephalometric analysis ratio of 80 indicates what?

A

adequate tissue.

39
Q

velopharyngeal incompetence (VPI):

A

due to abnormal movement

40
Q

velopharyngeal insufficiency (VPI):

A

due to abnormal structure

41
Q

velopharyngeal mislearning:

A

due to abnormal speech sound production.

42
Q

most sensitive to the effects of velopharyngeal dysfunction (VPD),

A

High-pressure consonants due to weak pressure and nasal emission, (both being obligatory features of VPD)

43
Q

treatment to Reduce hypernasality:

A
increased vocal loudness, 
discrimination training to distinguish oral from nasal resonance, 
lowered pitch 
oral opening
and biofeedback.