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CD 660 Exam 3 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

single words uses

A

high pressure consonants

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2
Q

What are adaptive misarticulations

A
  • occur in response to oral structural deviations

- are obligatory

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3
Q

Potential Causes of mechanical obstruction

A
  • excessively large palatine TONSILS

- structurally anomalous faucial pillars

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4
Q

NAE primarily affects

A

high pressure/obstruent consonants

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5
Q

compensatory misarticulations (CMAs) are predominantly take place where in the oral cavity?

A
  • errors in place and tend to be backed

- below the defect causing VPI

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6
Q

PSNE is perceptually seen as

A

a nasal fricative

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7
Q

What is in overjet

A
  • protrusive premaxilla with or without Angle Class II malocclusion
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8
Q

What is velopharyngeal insufficiency due to (5)

A
  • unrepaired palatal clefts
  • mechanical interference (tonsils, adenoid, posterior pillar webbing)
  • post-surgical insufficiency
  • palatopharyngeal disproportion
  • ablative palatal lesions (cancer, TBI)
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9
Q

Given diagram be able to identify landmarks associated with hard and soft palate (Module 17, slide 6?)

A
  • rugae
  • palatine tonsils
  • anterior and post faucial pillars
  • uvula
  • median raphe
  • hard palate
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10
Q

What does it mean when errors are obligatory vs optional/learned

A

OBLIGATORY
- due to structural or neurogenic problems
- require physical management
OPTIONAL/LEARNED
- habituated errors that are the result of early mislearning
- exist despite adequate VP closure
- require speech remediation

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11
Q

What are the four types of speech deviations associated with cleft palate speech

A
  • resonance (hypernasality)
  • airflow (nasal air emission)
  • air pressure (weak or absent oral pressures)
  • articulation (maladaptive compensatory misarticulations)
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12
Q

An open bite can be anterior or

A

lateral

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13
Q

The size of the tongue can be assessed by

A
  • its objective size

- in relationship to the size of the mandibular or maxillary arch

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14
Q

How do you know the NAE is caused by phoneme specific nasal emission (PSNE)

A
  • the NAE affects only selected phonemes
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15
Q

Compensatory misarticulations can persist after a cleft is repaired and can be a source of

A

VPI

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16
Q

How do you know NAE is caused by VPI

A

NAE will be constant/pervasive

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17
Q

Function of Palatopharyngeus

A

pulls soft palate back and down

  • narrowing of VP port
  • medial movements of lateral pharyngeal walls (below level of palatal plane)
  • velar lowering
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18
Q

What is an open bite

A
  • both the upper and lower teeth are forced outwards to an extent that the teeth of the upper and the lower jaw do not touch each other, even when the mouth is closed.
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19
Q

Airflow in cleft palate speech leads to

A

nasal air emission

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20
Q

True or false:
Learned NAE can be realized in different forms:
- as a fricative substitution, with or without turbulence
- as NE that is co-produced with the target, with or without turbulence

A
  • No - as a nasal fricative substitution, with or without turbulence
  • True
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21
Q

PSNE occurs in what population

A

non-cleft

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22
Q

What is velopharyngeal incompetency (internet definition)

A
  • when there is a problem in how the soft palate moves to make speech sounds
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23
Q

How are obligatory errors better treated

A

surgically or prosthetically

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24
Q

What is the function of the uvulus?

A
  • gives bulk to soft palate, and helps move uvula forward

- bulges the middle third of the dorsal surface of the velum making a major contribution to levator (velar) eminence

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25
Q

Where do missing teeth tend to be

A

where the cleft is or was

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26
Q

Can adequate movement to achieve velopharyngeal closure be detected intra-orally

A

no but we can describe whether or not any movement was observed and whether or not movement was symmetrical

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27
Q

What is VP mislearning (internet)

A

the person has not learned how to use the VP mechanism properly

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28
Q

Microglossia/underdeveloped tongue can cause

A

bilateral collapse in mandibular arch

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29
Q

How can adequate movement to achieve VP closure be detected

A

an instrumental evaluation (nasendoscopy or videofloroscopy)

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30
Q

Persisting post-op NE is perceptually sees as

A
  • co-produced NE

- a nasal fricative

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31
Q

Is the cause of VP incompetence structural, neurogenic or mislearning

A

neurogenic

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32
Q

Causes of ankyloglossia: frenum is

A
  • too short
  • attached too far anteriorly
  • attached too broadly on inferior surface
  • combinations of above
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33
Q

VP incompetence is seen in patients with?

A

dysarthria

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34
Q

What is hyponasality, and which sounds does it affect?

A
  • too little nasal resonance
  • cold-in-the-head sound
  • affects vowels, sonorants and nasal consonants
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35
Q

What is the function of the levator veli palatini?

A
  • Levator veli palatini elevates and retracts the velum
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36
Q

Therapy for kids after 3 years old involves traditional articulation techniques with an emphasis on

A
  • teaching the identity, location, and actions of oral structures (mirror, pictures)
  • teaching how sounds are made (using multiple modalities of learning or the difference between oral and nasal airflow)
  • phonemic placement techniques
  • sound contrasts
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37
Q

Ectopic teeth are the consequence of

A

an underdeveloped, crowded maxillary/mandibular arch

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38
Q

What are the sampling contexts for assessing cleft palate speech

A
  • single words
  • sentences
  • zoo passage
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39
Q

What are the different forms of VP closure?

A
  • coronal (velum with lateral pharyngeal walls)
  • sagittal (lateral pharyngeal walls with some velum)
  • Circular (lateral pharyngeal walls and velum are equal)
  • circular with passavant’s ridge (lateral pharyngeal walls, velum and passavant’s ridge are equal)
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40
Q

Function of superior pharyngeal constrictor?

A
  • medial movements of the lateral pharyngeal walls
  • forward movement of the posterior pharyngeal wall
  • at the level of the palatal plane (or below for swallowing)
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41
Q

What causes of VP incompetency

A
  • Dysarthria (primary motor/neuromotor control)
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42
Q

What is velopharyngeal inadequacy

A
  • umbrella term for different types of velopharyngeal dysfunction
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43
Q

What are the non-cleft causes of VPI (velopharyngeal inadequacy)

A

palatopharyngeal disproportion

  • mechanical obstruction
  • VP incompetency
  • VP mislearning
44
Q

Adaptive oral misarticulations include speech sound errors because of

A
  • dental deviations
  • occlusal deviations
  • lip incompetence 2 malocclusion (surgery or both)
45
Q

What is macroglossia

A

unusually large tongue

46
Q

An early focus of intervention for prelinguistic kids is on

A

achieving any sounds that have airflow

47
Q

You must distinguish between what potential sources of NAE

A
  • VPI
  • fistula
  • phoneme specific nasal air emission (PSNE)
48
Q

What is diastema

A
  • space between teeth not due to missing dentition

- common in transitional dentition

49
Q

Is the cause of VP insufficiency structural, neurogenic or mislearning

A

structural

50
Q

Do enlarged palatine tonsils usually interfere with velopharyngeal closure

A

no, unless they expand superiorly into the VP port

51
Q

Analysis of a speech sample involves making the following analyses:

A
  • rate overall intelligibility
  • document phonetic inventory (inventory size, comparison to developmental norms, and presence of compensatory maladaptive articulations)
  • document resonance
  • document nasal air emission
52
Q

Is the adenoid pad visible intra-orally

A

no

53
Q

NAE can be _ or _

A
  • audible or inaudible

- obligatory or learned

54
Q

What are the structural causes of early VP mislearning

A
  • deficient velopharyngeal valve
  • absent or structurally aberrant bony partition
  • hearing loss 2o MEE (2nd to middle ear infection)
55
Q

What is nasal air emission

A
  • airflow deviation characterized by speech airflow and emission through the nose
  • inappropriate/abnormal coupling or oral and nasal cavities
56
Q

Are obligatory errors expected to respond to behavioral treatments

A

no, unless the problem is subtle/mild

57
Q

What is velopharyngeal insufficiency (internet definition)

A

when there is not enough tissue in the palate or throat to let the palate contact the back of the throat during speech.
(structural/anatomic/mechanical)
- due to anatomic dysfunction

58
Q

what is phoneme-specific nasal emission (PSNE)

A
  • nasal emission that is selective (affects only certain pressure consonants)
59
Q

What is an underbite

A

the projection of the lower teeth beyond the upper

60
Q

What are the potential causes of hypernasality

A
  • cleft palate: (either persisting VP insufficiency or oronasal fistula)
61
Q

What are some causes of VP mislearning (4)

A
  • phoneme-specific nasal emission
  • persisting post-op nasal emission (with adequate closure ability)
  • compensatory misarticulations
  • deafness/hearing impairment
62
Q

What are treatable errors

A

those that are learned and no longer obligatory (because the cleft is now repaired)

63
Q

What are the main muscles of velopharyngeal closure?

A
  • levator veli palatini
  • unulus
  • palatopharyngeous
  • superior pharyngeal constrictor
64
Q

Audible NAE can be

A

turbulent or non-turbulent

65
Q

Adaptive oral misarticulations are observed more often in

A

CL +- CP

66
Q

What is the impact of VPI on phonation

A
  • voice problems in cleft palate
  • hoarseness 2nd to vocal nodules
  • soft voice syndrome
67
Q

Hyponasality can perceptually mask

A

a VPI

68
Q

Cleft palate speech includes deviations in the following areas:

A
  • resonance
  • airflow
  • air pressure
  • articulation
69
Q

What are compensatory misarticulations (CMAs)

A
  • learned articulatory deviations

- substitution errors in place of articulation

70
Q

What is mixed nasality

A
  • elements of both hypernasality and hyponasality

- there is increased nasal cavity resistance

71
Q

What is a submucous cleft

A

Mucosal covering is intact, but there is some clefting in hard or soft palate

72
Q

When should SLPs meet with the parents in order to educate

A

before the child is 3 months old

73
Q

What is nasal turbulence

A
  • more of a snorting sound

- has been referred to as: posterior nasal friction, nasal snort, nasal rustle

74
Q

intervention for prelinguistic kids focuses on

A

training parents so they can encourage/reinforce correct behaviors

75
Q

Inaudible NAE is not

A

perceptually disruptive to speech but can be a sign of VPI

76
Q

Potential causes of NAE

A
  • VPI (there will be coupling at VP port)

- fistula (there will be coupling via the oral cavity)

77
Q

The function of levator veli palatini?

A
  • elevates and retracts the velum
  • may contribute to medial movements of lateral pharyngeal walls occurring above the level of the palatal plane
  • contributes to the levator eminence
78
Q

What is VP closure?

A

A sphincteric activity that takes place in the nasopharynx and involves movements of soft palate and pharyngeal walls

79
Q

What are the causes of weak pressure consonants

A
  • due to abnormal coupling of oral and nasal cavities

- usually organically based

80
Q

What are the two error patterns of learned NE

A
  • phoneme-specific nasal emission (PSNE)

- persisting post-op nasal emission

81
Q

What are ectopic teeth

A
  • when the tooth does not follow its usual course
82
Q

What are the main muscles of velopharyngeal closure?

A

1) Levator veli palatini
2) Uvulus
3) Palatopharyngeous
4) Superior pharyngeal constrictor

83
Q

Resonance in cleft palate speech leads to

A

hypernasality

84
Q

Audible NAE tends to co-occur with

A

high pressure consonants

85
Q

What is Cul-de-sac resonance

A
  • sound is trapped by anterior nasal cavity constriction

- i.e. deviated septum

86
Q

Pressure in cleft palate affects speech in what way?

A
  • weak oral pressures/weak pressure consonants
87
Q

How do you know the NAE is caused by a fistula

A
  • depending on the place of production

- the place of production will be at or anterior to the fistula

88
Q

What is ankyloglossia “tongue tie” (online definition)

A

a congenital oral anomaly that may decrease mobility of the tongue tip

89
Q

Hypernasality: changes in resonance primarily affects which sound categories?

A
  • vowels

- vocalic consonants (glides/liquids)

90
Q

Sentences uses

A
  • high pressure consonants (1 target/sentence)
  • nasal consonants (loaded)
  • low pressure consonants /r, l, j, w/
91
Q

What are the potential causes of palatopharyngeal disproportion

A

Short hard palate [brings soft palate forward]

  • Short soft palate
  • Excessive pharyngeal depth [20 anomalies of cervical spine/vertebrae, flattened cranial base]
92
Q

Name some maladaptive compensatory misatriculations

A
  • glottal stop
  • pharyngeal stop
  • mid dorsum palatal stop
  • pharyngeal fricative
  • pharyngeal affricate
  • posterior nasal fricative (turbulence)
  • nasal fricative (no turbulence)
93
Q

What innervates the soft palate

A

the pharyngeal branch of CN X

94
Q

Is the cause of VP mislearning structural, neurogenic or mislearning

A

mislearning

95
Q

What is hypernasality

A

resonance distortion that results from abnormal coupling of oral and nasal cavities

96
Q

What is the function of the uvulus?

A

Uvulus bulges the middle third of the dorsal surface of the velum making a major contribution to “elevator”

97
Q

Articulation in cleft palate speech leads to

A

maladaptive compensatory misarticulations

98
Q

Where is the adenoid pad

A
  • posterior to the nasal cavity
  • in the roof of the nasopharynx
  • where the nose blends into the throat
99
Q

Stigmata for submucous cleft

A
  • notch in the bony palate
  • zona pellucida (midline lucency)
  • bifid uvula
100
Q

When examining the hard palate, were looking for

A
  • abnormal height (high or low)
  • submucous cleft palate
  • fistulas
101
Q

Fistulas can occur in the

A

hard and soft palate

102
Q

Role of the adenoid pad in VP closure in adults vs children

A
  • minimal adenoid in adult (velopharyngeal closure in adult)
  • adenoid present in child (veloadenoidal closure in child)
  • gives bulk to pharyngeal wall in children
103
Q

The “zoo passage” uses

A
  • no pressure consonants

- assesses for hypernasality

104
Q 
Velopharyngeal muscles:
What is the function for each?
-Levator veli palatini
-Uvulus
-Palatopharyngeal constrictor
-Superior pharyngeal constrictor
A
  • Levator veli palatini elevates and retracts the velum
  • Uvulus bulges the middle third of the dorsal surface of the velum making a major contribution to “elevator”
  • Palatopharyngeal constrictor may contribute to narrowing of the velopharyngeal port; probably responsible for medial movements of lateral pharyngeal walls which occur below level of the palatal plane
  • Superior pharyngeal constrictor is responsible for medial movements of the lateral pharyngeal wall and forward movement of the posterior pharyngeal wall at or below palatal plane for swallowing
105
Q

What is persisting post-op NE

A
  • NE that persists in repaired CP speakers who have the physiologic ability to attain closure
  • Speaker continues the old pattern of directing air into the nasal cavity
  • Not restricted to any certain sounds, sound group

CD 660 Exam 3 (1 decks)

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