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SLP A & P Exam 2 > Exam 2 Prep > Flashcards

Exam 2 Prep Flashcards

1
Q

Cricoid cartilage

A

Ring like cartilage resting atop the trachea
Most inferior of the laryngeal cartilage
Higher in posterior than anterior

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2
Q

Thyrohyoid membrane

A

Stretches across the space between the greater Cornu of the hyoid and the lateral thyroid
See page 194 for anatomical location

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3
Q

Cartilages of the larynx

A

3 unpaired cartilages:
Cricoid
Thyroid
Epiglottis
3 paired cartilages:
2 arytenoids
2 corniculates
2 cuneiforms (in aryepiglottic folds)

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4
Q

Thyroid cartilage

A

Largest of the laryngeal cartilages
Articulates with the cricoid cartilage below by means of paired processes that let it rock forward and backward at that joint

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5
Q

Arytenoid cartilage

A

Rides on the high-backed upper surface of the cricoid cartilage
Forms the posterior point of attachment for the vocal folds
Paired

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6
Q

Corniculate cartilage

A

Rides on the superior surface of each Arytenoid
prominent landmarks in the aryepiglottic folds
Articulates with the apex or superior process of the Arytenoid cartilage

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7
Q

Cuneiforms cartilage

A

Resides within the aryepiglottic folds
Provides a degree of rigidity to the folds

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8
Q

Cricothyroid joint

A

Thyroid and cricoid cartilages articulate with this joint
Allows the two cartilages to come closer together

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9
Q

Muscles attach to laryngeal cartilage

A

See photos and pages 214, 216-223

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10
Q

Thyrovocalis

A

Attaches to Arytenoid VOCAL process
Tenses the vocal folds
Responsible for adduction of the membranous portion of the vocal folds
Originates from the inner surface of the thyroid cartilage near the thyroid notch
Contraction draws thyroid and cricoid cartilages further apart in front
Glottal tensor

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11
Q

Infrahyoid muscles

A

Depress the hyoid bone
Consists of sternohyoid and omohyoid muscles

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12
Q

Pressure during the open phase of phonation

A

Subglottal pressure is greater than supraglottal pressure

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13
Q

Cause of vocal folds to return to resting position after being blown apart

A

Negative pressure between the folds
Elasticity of the vocal folds

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14
Q

What happens to airflow when the vocal folds make contact?

A

Air flow is completely halted and the cycle of vibration is complete

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15
Q

Adduction

A

Act of bringing the vocal folds together for phonation

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16
Q

Abduction

A

Process of drawing the vocal folds apart to terminate phonation

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17
Q

Bernoulli principle

A

Given a constant volume flow or air or fluid
At point of constriction there will be a DECREASE in pressure perpendicular to the flow and an INCREASE in velocity of the flow

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18
Q

Bernoulli principle in relation to phonation

A

Low pressure created behind the fast moving air column produces Bernoulli effect which causes the bottom of vocal folds to close followed by the top
Air pressure flowing between the vocal folds is lower than the pressure outside so the vocal folds vibrate together
Systems want to move to a place of lower pressure
Closure of the vocal folds cuts off the air column and releases a pulse of air

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19
Q

Posterior cricoarytenoid

A

SOLE abductors of vocal folds
See pages 216 and 217 for picture
Origin: posterior cricoid lamina
Insertion: posterior aspect of the arytenoids

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20
Q

Myoelastic aerodynamic theory

A

Elasticity refers to elastic recoil
Aerodynamic refers to the Bernoulli priniciple
Vibration of vocal folds depends on the elements embodied in the name of the theory
Myoelastic element i the elastic component of muscle (myo)
Associated soft tissues of the larynx, and the aerodynamic component is that of the airflow and pressure through this constricted tube
Combination of tissue elasticity, which causes the vocal folds to return to their original position after being distended and the Bernoulli effect, which helps promote this return by dropping the pressure at the constriction, accounts for the sustained vibration

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21
Q

Nasoendoscopy

A

Fiber-optic, flexible scope that is inserted transnasally
Through the nose and velopharyngeal port
Fiberoptic bundle provides an image of the vocal folds and laryngeal structure in real time
Excellent tool for swallowing evaluation

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22
Q

Changeable elements of vocal folds, affects pitch

A

Tension - when increased the natural frequency of the vibration will increase
Length - as the vocal folds lengthen it lowers the fundamental frequency
Mass - as mass of the vibrating body decreases, frequency of vibration will increase

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23
Q

Type of pressure brings the vocal folds together

A

Negative pressure

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24
Q

Fundamental frequency

A

The lowest frequency of vibration of the vocal folds or of a harmonic series
Increased fundamental frequency means we are lengthening the vocal folds, decreased means we are shortening.
As frequency increases so does pitch

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25
Q

Intrinsic muscles of larynx

A

Adductors
Abductor
Glottal tensors
Relaxers
Auxiliary musculature

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26
Q

Adductors (Intrinsic Laryngeal)

A

OBLIQUE ARYTENOID MUSCLES
Lateral cricoarytenoid muscles
Transverse Arytenoid muscles
THESE MUSCLES TENSE DURING ADDUCTION..IDENTIFY ON A PHOTO(SEE PHOTO APP)

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27
Q

Abductor (Intrinsic Laryngeal)

A

Posterior cricoarytenoid muscles
THESE MUSCLES ROTATE AND ROCK ARYTENOIDS MEDIALLY (ID ON PHOTO APP)

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28
Q

Glottal tensors (Intrinsic Laryngeal)

A

Circothyroid muscles, pars recta and pars oblique
Thyrovocalis (medial Thyroarytenoid) muscles

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29
Q

Relaxers (intrinsic laryngeal)

A

Thyromuscularis (lateral thyroarytenoid) muscles

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30
Q

Auxiliary musculature (Intrinsic Laryngeal)

A

Thyroarytenoid muscles
Superior thyroarytenoid muscles
Aryepiglotticus muscles
Thryoepiglotticus muscles

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31
Q

Extrinsic muscles of larynx

A

Hyoid and laryngeal elevators (suprahyoid)
Hyoid and laryngeal depressors (infrahyoid)

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32
Q

Hyoid and laryngeal elevators (suprahyoid) - Extrinsic laryngeal

A

1Digastricus anterior and posterior
3StyloHYOID muscles
3MyloHYOID muscles
3GenioHYOID muscles
2HypoGLOSSUS muscles
2GenioGLOSSUS muscles
2ThyroPHARYNGEUS muscles
2Inferior PHARYNGEAL constrictor muscles

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33
Q

Hyoid and laryngeal depressors (infrahyoid) - Extrinsic laryngeal

A

1SternoTHYROID
3OmoHYOID
3SternoHYOID
3ThyroHYOID

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34
Q

Identify epiglottis, true vocal folds, trachea

A

See photos in photo app

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35
Q

Cricotracheal membrane (ligament)

A

The trachea attaches to the larynx bia the cricotracheal ligament (membrane)
Ligament between the cricoid cartilage of the larynx and the tracheal cartilage
ID ON A PHOTO

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36
Q

Cricothyroid ligament (membrane)

A

Membranous lining below the level of the vocal folds, lining the subglottal region, and attaching to the thyroid, cricoid, and Arytenoid cartilages
ID ON A PHOTO

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37
Q

Termination of phonation

A

Completion of the period during which vocal folds are vibrating for a given segment

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38
Q

Abdominal fixation

A

Process of impounding air within the lungs through inhalation and forceful vocal folds adduction that results in increased intra-abdominal pressure

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39
Q

Cough

A

Forceful evacuation through the respiratory passageway, entailing deep inhalation through widely abducted vocal folds, tensing and tight adduction of the vocal folds, and elevation of the larynx, followed by forceful expiration

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40
Q

Pitch

A

The psychological (perceptual) correlate of frequency of vibration

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41
Q

Frequency definition

A

Number of cycles of vibration per second

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42
Q

Breathy vocal attack

A

Vocal attack in which expiration occurs before the onset of vocal folds adduction

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43
Q

shimmer

A

Measures variability in amplitude
Increased shimmer can indicate a breathy or hoarse quality
Looking at loudness
Deals with sustained phonation - high shimmer if cannot sustain phonation

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44
Q

Intensity

A

Magnitude of sound expressed as the relationship between 2 pressures
Loudness, subglottal pressure increases, and medial compression
Vocal folds tighten

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45
Q

What is vocal shimmer

A

Measure of the cycle by cycle variation in intensity

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46
Q

Cricothyroid Innervation

A

X vagus and superior laryngeal nerve

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47
Q

All intrinsic laryngeal muscle Innervation MINUS Circothyroid
(Cricoarytenoid & lateral cricoarytenoid, thyromuscularis)

A

X vagus
Recurrence laryngeal nerve

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48
Q

Digastricus anterior Innervation

A

V Trigemnial nerve, mandibular branch, via the mylohyoid branch of the inferior alveolar nerve

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49
Q

Digastricus posterior Innervation

A

VII facial nerve, Digastric branch

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50
Q

Stylohyoid Innervation

A

Motor branch of the VII facial nerve

51
Q

Geniohyoid Innervation

A

XII hypoglossal nerve and C1 spinal nerve

52
Q

3 muscles that elevate the larynx

A

Thryopharyngeus
Cricopharyngeus
Thyrohyoid
When they elevate the larynx they change the shape of the vocal tract

53
Q

Phonation occurs when the vocal folds do what?

A

Vibrate within the larynx

54
Q

Vocal hygiene

A
  1. Hydration
  2. Avoid: caffeine, smoking, alcohol, throat clearing, habitual coughing
  3. Manage reflux
  4. Get plenty of rest
55
Q

Intrinsic vs extrinsic muscles

A

Intrinsic make fine adjustments on vocal cords, extrinsic change the length of the vocal tract

56
Q

Paired facial bones

A
  1. Maxillae
  2. Palatine
  3. Zygomatic
  4. Nasal
  5. Lacrimal
  6. Inferior nasal conchae bones
57
Q

Immobile articulators

A
  1. Alveolar ridge
  2. Hard palate
  3. Teeth
58
Q

Label facial muscles

A

Temporalis
Masseter
frontalis,
zygomatic minor
zygomatic major
risorious
depressor anguli oris
SEE PHOTO APP

59
Q

Class I Occlusion

A

First molar of the mandibular arch is one-half tooth advanced of the maxillary molar
Normal relationship between the molars of the dental arches

60
Q

Class II malocclusion

A

The first mandibular molars are retracted at least one tooth from the first maxillary molars
Mandible is retracted

61
Q

Class III Malocclusion

A

First mandibular molar is advanced farther than one tooth beyond the first maxillary molar
Mandible is protruded

62
Q

Class I malocclusion

A

Normal orientation of molars, but an abnormal orientation of the incisors

63
Q

Nerve damage to VII facial nerve

A

Make it hard to say ooo
Lip rounding is effected
Innervates the orbicularis oris

64
Q

Lavator veli palatini

A

Muscle of the velum
Elevates and retracts the posterior velum
Essential for swallowing
Makes up the bulk of the soft palate
Primary elevator of the soft palate

65
Q

Function of the transverse muscle of the tongue

A

Provides a mechanism for narrowing the tongue

66
Q

What happens with a nasal sound?

A

Velum lowers to allow air into the nasal cavity
Produces m, n, ŋ

67
Q

How are vowels produced?

A

Without closure or narrowing in the vocal tract

68
Q

Vowel chart

A

SEE PHOTO APP

69
Q

/l/

A

Liquid and lateral b/c it is flat

70
Q

Cognate pairs

A

Have the same place and manner but different voicing

71
Q

Plosive cognate pairs

A

(P, b) (t,d) (k,g)

72
Q

Fricative cognate pairs

A

(F,v) (θ, ð) think, them (s,z) (ʃ, ʒ) ship, beige

73
Q

Affricate cognate pairs

A

tʃ chew, dʒ join

74
Q

Glide cognate pair

A

ʍ,w why way

75
Q

Apraxia

A

Deficit in programming of musculature for voluntary movement that is NOT attributable to muscular weakness or paralysis
Oral apraxia might have difficulty using the facial and lingual muscles of non speech acts
Verbal apraxia - deficit in planning the motor act and programming the articulators for speech sound production. Makes error in correct articulation of the sounds of speech, although the errors vary widely from one attempt to another
Cause: lesions in brain structure, damage to left hemisphere premotor region

76
Q

What is the most important function of the mandible

A

mastication

77
Q

Is the infant or adult larynx more elevated?

A

Infant

78
Q

What reflex allows the infant to gain nutrition?

A

Rooting
Responds to tactile stimulation of lips or cheek
Turns toward stimulus and opens mouth

79
Q

Respiratory center of the brain

A

Medulla oblongata

80
Q

3 main stages of the swallow

A
  1. Oral (prep & transport) - voluntary…transport can be voluntary or involuntary
  2. Pharyngeal - involuntary
  3. Esophageal - involuntary
81
Q

Main function of epiglottis

A

Cover the entrance of the larynx so food and liquid do not enter the windpipe and lungs

82
Q

Oral transport stage

A

When bolus contacts faucies pharyngeal swallow is triggered

83
Q

Glossopharyngeal nerves IX (9)

A

Responsible for taste on the posterior 1/3 of the tongue
Bitter taste

84
Q

Facial nerve VII (7)

A

Taste: sweet, salty, sour
Anterior 2/3 of tongue
Palate

85
Q

Does breathing cease during swallow?

A

Yes

86
Q

General terms

A
  1. Mastication - chewing
  2. Deglutition - swallowing
  3. Dysphagia - difficulty swallowing
  4. Bolus - ball of liquid or food
  5. Gustation - sense of taste
  6. Papillae - taste buds
87
Q

Deficits of oral prep stage

A
  1. Loss of sensation and awareness, coupled with weak baccalaureate musculature, lead to pocketing of food in the lateral or anterior dulcimer
  2. Weak muscles of mastication cause inadequately chewed food
  3. Weak lingual muscles may result in poor mixing of saliva with the food, inadequate bolus production, poor lip seal and posterior tongue elevation to impound the bolus, difficulty compressing the bolus onto the hard palate
  4. Muscles of soft palate are compromised velum may not be fully elevated and tongue may not be elevated back, permitting food to escape into the pharynx before initiation of the pharyngeal reflex (could cause aspiration pneumonia)
88
Q

Deficits of oral transit stage

A

Center around sensory and motor dysfunction
1. Weakened movements cause reduced oral transit time of bolus to pharynx. Food may remain on tongue or hard palate following transit
2. Epiglottis may fail to invert over the laryngeal opening and to have limited elevation of the hyoid. Increased pooling of food or liquid in vallecuale
3. Difficulty initiating a reflexive swallow

89
Q

Deficits of the pharyngeal stage

A

Sensory and motor deficit
1. Slowed velar elevation may result in nasal regurgitation (loss of food or liquid through the nose and loss of pharyngeal pressure
2. Reduced sensation at the faucets, posterior tongue, pharyngeal wall, or soft palate may result in elevated threshold for the trigger of the swallowing reflex
3. Reduced function of the pharyngeal constrictors may result in slowed pharyngeal transit time of the bolus, may prematurely reinitiate respiration
4. Weakened pharyngeal function may result in residue left in the valleculae
5. Failure of the hyoid and thyroid to elevate may result in the loss of airway protection, so that food may fall into the larynx and be aspirated on reinflation of the lungs

90
Q

Deficits of the esophageal stage

A
  1. Gastoesophageal reflux disease (GERD) - acids from stomach refluxed into your esophagus or pharynx
    Lower esophageal sphincter relaxes allowing gastric juices to enter esophagus
    If upper sphincter is weaker acid reflows into pyriform sinus assaulting pharyngeal tissue
    If happens during night when sleeping acid may flow into the airway resulting in aspiration
  2. Hiatal hernia - stomach herniates through the esophageal hiatus
  3. Stenosis - fair congenital malformation of esophagus loss of nutrition for newborn
  4. Rare maldevelopment of the esophagus may even result in the esophageal contents directly entering the trachea
91
Q

Fine and gross motor movements

A

Fine = intrinsic muscles
Gross = extrinsic

92
Q

Tensor veli palantini muscle

A

Dilator of the auditory tube permitting aeration of the middle ear cavity

93
Q

Lingual muscles of the tongue are innervated by what nerve?

A

XII Hypoglossal nerve

94
Q

Masseter (mandibular muscle) Innervation

A

V Trigeminal - anterior trunk of the mandibular nerve arising form the V Trigeminal

95
Q

Temporalis (mandibular muscle) Innervation

A

V Trigeminal - Temporal branches arising from the mandibular nerve of V trigeminal

96
Q

Medial pterygoid (mandibular muscle) Innervation

A

V Trigeminal - mandibular division of the V trigeminal nerve

97
Q

Lateral Pterygoid (mandibular muscle) Innervation

A

Mandibular branch of the V trigeminal nerve

98
Q

Digastricus anterior (mandibular muscle) Innervation

A

Mandibular branch of the V trigeminal nerve
Via the mylohyoid branch of the inferior alveolar nerve

99
Q

Digastricus posterior (mandibular muscle) Innervation

A

Digastricus branch of the VII facial nerve

100
Q

Mylohyoid (mandibular muscle) Innervation

A

Alveolar nerve, arising from the V trigeminal nerve, mandibular branch

101
Q

Geniohyoid (mandibular muscle) Innervation

A

XII hypoglossal nerve and spinal C1 nerve

102
Q

Platysma (mandibular muscle) Innervation

A

Cervical branch of the VII facial nerve

103
Q

Baby teeth (deciduous teeth) erupt

A

6-12 months

104
Q

Superior longitudinal tongue muscle

A

Elevates, assists in retraction of, or deviates tip of tongue
Important in production of /t/, /d/, /s/, /z/, /n/, /l/ - alveolar phonemes

105
Q

Inferior longitudinal tongue muscle

A

Pulls tip of the tongue downward, assists in retraction, deviates tongue

106
Q

Cleft lip definition

A

Occurs along the premaxillary suture
Due to failure of embryonic facial and labial tissue to fuse during 4th and 7th weeks of pregnancy

107
Q

Cleft palate

A

Can involve both hard and soft palates
Between 6th and 9th week
Tongue should drop away from the processes so maxilla can close along the suture line

108
Q

Primary palate

A

Includes alveolar arch

109
Q

Fistula

A

small channel formed from the infected area of the tooth, which usually coincides with the tip of the root, until the external surface area of the gum

110
Q

Movement of mandible is much greater during speech or mastication ?

A

Mastication

111
Q

Alveoli (dental)

A

sockets in the jaws in which the roots of teeth are held in the alveolar process with the periodontal ligament.

112
Q

DIVA model

A

Include some forms of feedback about the accuracy of articulation
Feedback monitors output as well as auditory

113
Q

DIVA model provides explanation for what?

A

Motor equivalence, contextual variability, speech rate effects and coarticulation

114
Q

Feed forward in DIVA model

A

Sending a signal in anticipation of known cues
Feedback is used to create feedback forward
Allows for modifications of speech production

115
Q

Areas of brain involved in feedback and feed forward

A

Pre motor cortex
Cerebellum
Auditory cortex
Somatosensory cortex

116
Q

Condyloid process articulates with

A

Temporal bone in the mandibular fossa forming the TMJ

117
Q

Dynamic/action theory

A

Think domino effect
Functionally defined group of muscles (coordination structures) and associated articulators are assigned a task, many ways to complete task
Explains co articulation b/c there’s overlapping. Perturbation or sudden unexpected force applied to another articulators
The motor act is accurately achieved within the bounds of variability
Motor equivalence states that a goal can be achieved through various means and systems

118
Q

Dynamic/action theory account for

A

Dynamic aspects of the physical system required to achieve a specific target within the environment

119
Q

Do gross motor movements develop before fine motor movements?

A

YES

120
Q

Oral preparatory phase deficits

A
  1. Decreased awareness of food
  2. Difficulty holding food in mouth
  3. Pocketing food in cheeks
  4. Premature spillage of food into airway
    Difficulty chewing and forming a bolus
    May be a problem with dentition
    Don’t have buckle or the orbicularis oris musculature is weak
    Chewing but don’t swallow
121
Q

Oral transport phase deficits

A
  1. Anterior spillage
  2. Premature spillage into airway
  3. Difficulty moving bolus back towards pharynx
    No swallow trigger or delayed swallow response
    Impaired coordination of oral and pharyngeal structures
    Weak elevation of the velum
    Inadequate closure of the vocal folds
    Reduced high, low laryngeal elevation
    Weak elevation of the tongue
122
Q

Pharyngeal phase deficits

A
  1. Delayed swallow response
  2. Impaired coordination of oral and pharyngeal structures
  3. Weak elevation of velum
  4. Inadequate closure of vocal folds
  5. Reduced hyolaryngeal elevation
123
Q

Esophageal phase deficits

A
  1. Upper esophageal sphincter does not open
  2. Slow or absent esophageal peristalsis
    Can fix with proton pump inhibitor

SLP A & P Exam 2 (7 decks)

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