Lecture 4: Velopharyngeal Dysfunction (VPD) Flashcards
Types of resonance disorders
Hypernasality
Hyponasality
Cul-de-sac
Mixed
What is Hypernasality?
coupling of oral & nasal cavities during nonnasal (oral) sounds; “muffled” due to damping effect (sound absorption) thru turbinates
What is Hyponasality?
reduced nasal resonance of nasal sounds due to blockage; “stuffed up”
What is cul-de-sac resonance?
structural obstruction; muffled; “potato-in-the-mouth”
What is mixed resonance?
combo on different sounds; common in apraxia
What are other effects of VPD?
Nasal air emission Nasal grimace Weak or omitted consonants Short utterance length Altered rate and duration Compensatory Artic
What is nasal air emission?
“rustle” due to vp leak or fistula on plosives, fricatives, affricates
What is nasal grimace?
m. contraction above nasal bridge in effort to achieve vp closure
Weak or omitted consonants
due to reduced air pressure in oral cavity
Short utterance length
frequent replacing of air pressure
Altered rate and duration
longer time for utterances, longer VOT
How do they compensate articulation?
Middorsum palatal stop a.k.a. palatal-dorsal Backing Velar fricative Oral consonant nasalization Vowel nasalization Nasal snort Nasal sniff Pharyngeal Posterior nasal fricative Glottal stop /h/ for voiceless plosives Breathiness
Describe dysphonia
Breathy Hypernasal Hoarse Low intensity Glottal fry Hyperfunctional Vocal fold nodules
What are some factors that impact VPI and speech?
Size of VP opening
Inconsistency of VP closure
Abnormal artic
Abnormal phonation
What are causes of VPD?
VPInsufficiency (anatomy - structure)
VPIncompetence (physiology - mvmt)
VP mislearning
What causes VPInsufficiency?
Cleft palate
Short velum
Deep pharynx (cranial base anomalies)
Adenoid atrophy or irregularity or adenoidectomy
Hypertrophic tonsils or tonsillectomy (rare)
Teeth malocclusion (Class III) - underbite
Oral cavity tumor
What causes VPIncompetence?
Abnormal m. insertion Hypotonia/poor pharyngeal wall mvmt Dysarthria, apraxia, neurom. disorders CN defects ( Unilateral velar paralysis/paresis) Velar fatigue
What causes VP misleading?
Faulty artic
Bad speech habits
Hearing loss
