Introduction

Question 1

What are the types of velopharyngeal closure?

Answer 1

Coronal - soft palate does most of the work
Sagittal - lateral pharyngeal walls move in
Circular - all structures draw in equally

Question 2

What is a passavant’s ridge?

Answer 2

A ring of muscle around the velopharyngeal port that pops out to meet the soft palate. Can be seen in normal or pathological cases.

Question 3

What are the factors that influence velopharyngeal closure?

Answer 3

Sex (negligible)
Age (growth of skull, pharynx, and velum, adenoid pad changes)
Phonemes (obstruents and high vowels require more firm closure)
Timing (closure must occur in time with other artic gestures)

Question 4

What is the difference between velopharyngeal dysfunction, insufficiency, and incompetence?

Answer 4

Dysfunction = non-specific
Insufficiency = structural 
Incompetence = functional

Question 5

How does VPD impact vegetative behaviours?

Answer 5

Nasal regurgitation during vomiting or swallowing
Impaired pressurized oral tasks (e.g. blowing)
Impaired sucking (through nipple or straw)

Question 6

How does VPD impact speech?

Answer 6

Hypernasal resonance on voiced continuants
Nasal air emission on obstruents
Reduced intelligibility
Reduced loudness
Maladaptive compensatory behaviours (artic or phonatory)

Question 7

What is hypernasality and why does it occur?

Answer 7

Perception of too much nasal resonance for listener expectations. This is caused by too much air going up through the nasal cavity during speech due to VPD.

Question 8

What type of sounds is most affected by hypernasality?

Answer 8

High vowels are most affected because they require the most oral resonance of the voiced continuants.

Question 9

What are the differences between hypernasality and nasal air emission?

Answer 9

Hypernasality occurs on voiced continuants, nasal air emisson occurs on obstruents (pressure consonants).
Hypernasality is audible, nasal air emission itself may or may not be audible but will co-occur with audible distortion of the sound.

Question 10

What is nasal turbulence/rustle?

Answer 10

Air being forced through a partially open VPP, or through a congested or obstructed nasal cavity. Can be heard as a bubbly sound in the nose and often occurs with voiceless fricatives.

Question 11

What is cul-de-sac resonance?

Answer 11

The result of sound energy being trapped in a part of the vocal tract where it is absorbed, i.e. the tongue is held in a strange position, causing resonance in the back of the throat rather than the oral cavity.
Cul-de-sac speech sounds similar to Kermit the Frog, Mr. Bean, or Jennifer Coolidge.

Question 12

List possible congenital causes of resonance disorders.

Answer 12

Cleft lip and palate
Dwarfism / size discrepancies
Tongue too small or too large

Question 13

List possible medical causes of resonance disorders.

Answer 13

Radiation therapy (fibrosis)
Tonsil or adenoid removal
Head and neck cancer surgeries
Treatment of palatopharyngeal myoclonus (Botox)

Question 14

List possible behavioural (functional) causes of resonance disorders.

Answer 14

Abnormal tongue carriage

Learned substitution of nasal sounds for other sounds (usually sibilants and affricates)

Question 15

List possible neurological cause(s) of resonance disorders.

Answer 15

Stroke (LMN or UMN damage)

Question 16

True or false: Cleft lip is more common in biological males, whereas cleft palate is more common in biological females.

Answer 16

True - this is likely due to differences in timing of development in utero

Question 17

An incomplete cleft of the primary palate/premaxilla is also called a ___.

Answer 17

Cleft lip

Question 18

A cleft of the primary palate is complete if…

Answer 18

It goes all the way through the premaxilla

Question 19

A cleft of the secondary palate is the result of the failure of the ____ to fuse with each other, with the nasal septum, or with the posterior premaxilla.

Answer 19

Palatine processes of the maxillary prominences

Question 20

The ‘secondary palate’ consists of the ____ and the ____.

Answer 20

Hard palate and soft palate

Question 21

When the palate appears to be intact, but has underlying bony or muscular separation, this is called ___.

Answer 21

A submucosal cleft palate

Question 22

List the 3 signs of a submucosal cleft.

Answer 22

Bifid uvula
Blue line or translucent line along the midline of the soft palate
Palpable notch in posterior border of hard palate in midline where bone is absent

Question 23

An occult submucosal cleft palate will result in a midline trough due to the absence of ____ muscles (reduced palatal bulk) and possibly malinsertion of extrinsic ____ muscles.

Answer 23

Uvular

Velar

Question 24

List possible causes of palatal clefts.

Answer 24

Genetic - chromosomal or gene level mutation or heredity (e.g. velocardiofacial syndrome)
Pharmaceuticals during pregnancy
Compression during pregnancy
Multifactorial causes

Question 25

What is Congenital Palatal Insufficiency?

Answer 25

A condition wherein the velum is short from birth. May be associated with velocardiofacial syndrome or Down syndrome.

Question 26

What type of nasal resonance would we likely see in someone with one of the following conditions?
-Nasal obstruction, large pharyngeal flap surgery, enlarged adenoids, chronic nasal inflammation, small nasal airway, nasal polyps, deviated septum, patulous Eustachian tubes

Answer 26

Hyponasal resonance

Question 27

What type of nasal resonance would we see in someone who has a small nasal airway, but also has VP incompetence due to a history of palatal cleft?

Answer 27

Mixed nasal resonance

Question 28

What type of resonance will cause listeners to perceive the speaker as having a cold?

Answer 28

Hyponasal resonance

Question 29

The ridges of the upper lip are called…

Answer 29

the philtral ridges

Question 30

The structure that separates the two nostrils is called…

Answer 30

the columella

Question 31

The ______ suture runs the length of the anterior 3/4 of the palate.

Answer 31

Intermaxillary

Question 32

The hard palate is made up of:

Answer 32

Palatine processes of maxillary bones

Horizontal plate of palatine bone

Question 33

What muscle is responsible for moving the post. pharyngeal wall forward?

Answer 33

Superior pharyngeal constrictor

Question 34

The tensor veli palatini is responsible for the dilation of the ______.

Answer 34

Eustachian tube

Question 35

The palatoglossus ______ the soft palate.

Answer 35

Depresses