modules 3, 8, 13, and 14

Question 1

what is the basic craniofacial dichotomy?

Answer 1

cleft lip with or without cleft palate (CL+/-CP) vs. cleft palate only (CPO)

Question 2

define velopharyngeal closure (VP closure)

Answer 2

a sphincteric activity occurring in the nasopharynx involving movement of the soft palate and pharyngeal walls

Question 3

list the four muscles involved in velopharyngeal closure

Answer 3

levator veli palatini, uvulus, palatopharyngeus, superior pharyngeal constrictor

Question 4

name the muscle with the following function(s): elevates and retracts the velum, contributes to medial movements of the lateral pharyngeal walls, contributes to levator eminence

Answer 4

levator veli palatini

Question 5

name the muscle with the following function(s): bulges the middle third of the velum on the dorsal side, contributes to levator eminence

Answer 5

uvulus

Question 6

name the muscle with the following function(s): responsible for medial movements of the lateral pharyngeal walls, forward movement of the posterior pharyngeal walls

Answer 6

superior pharyngeal constrictor

Question 7

name the muscle with the following function(s): contributes to narrowing of the velopharyngeal port, responsible for medial movements of the lateral pharyngeal walls, participates in velar lowering

Answer 7

palatopharyngeus

Question 8

describe coronal velopharyngeal valving

Answer 8

valving mostly comes from the top with some lateral valving ( - )

*occurs the most in both cleft palates and normals

Question 9

describe sagittal velopharyngeal valving

Answer 9

mostly lateral valving, with some valving from the top ( | )

Question 10

describe circular velopharyngeal valving

Answer 10

equal-moderate valving from the top and laterally ( . )

Question 11

describe circular with passavant’s ridge velopharyngeal valving

Answer 11

equal-moderate valving from all sides, even from below ( . )

Question 12

describe a submucous cleft palate (SMC)

Answer 12

bifid uvula, midline lucency (of soft palate, hard palate, or both), palpable notch in bony palate, levator insertion into cleft margins of the bony palate

Question 13

describe velopharyngeal closure involving the adenoid pad in children

Answer 13

closure takes place in the back of the velum and against the pharyngeal wall (adenoid tissue)

Question 14

describe velopharyngeal closure involving the adenoid pad in adults

Answer 14

involves the top of the velum (which has changed in angle following childhood) and against the velopharyngeal wall above it

Question 15

true or false: the adenoid pad is visible intraorally

Answer 15

false

Question 16

describe the location of the adenoid pad

Answer 16

sits posteriorly to the soft palate (velum) and is superior to the posterior pharyngeal wall

Question 17

what innervates the soft palate?

Answer 17

the pharyngeal branch of the vagus nerve (CN X)

Question 18

list the four non cleft causes of velopharyngeal inadequacy (VPI)

Answer 18

palatopharyngeal disproportion, mechanical obstruction, velopharyngeal incompetency, velopharyngeal mislearning

Question 19

describe palatopharyngeal disproportion

Answer 19

characterized by a length-of-velum depth-of-nasopharynx mismatch, including: short hard palate, short soft palate, and / or excessive pharyngeal depth

Question 20

describe mechanical obstruction-interference

Answer 20

characterized by obstruction due to enlarged tonsils, protrusive adenoid pad, posterior pillar webbing, etc. resulting in VPI

Question 21

describe velopharyngeal incompetency

Answer 21

characterized by absent or inadequate movement of the velum during attempted velopharyngeal closure

Question 22

describe velopharyngeal mislearning

Answer 22

characterized by phoneme specific nasal emissions (PSNE) where there is no physical problem, nasal emissions persisting after surgery, deafness / hearing impairment, and compensatory misarticulations (usually hard glottal attacks) on VP closure

Question 23

velopharyngeal inadequacy (VPI) is categorized between ___ and ___

Answer 23

cleft VPI and non cleft VPI

Question 24

cleft VPI : VP insufficiency :: non cleft VPI : ___, ___, & ___

Answer 24

VP insufficiency, VP incompetency, and VP mislearning

Question 25

list potential causes of cleft VPI, VP insufficiency

Answer 25

unrepaired palatal clefts, post-surgical insufficiency

Question 26

list potential causes of non cleft VPI, VP insufficiency

Answer 26

mechanical interference, palatopharyngeal disproportion, ablative palatal lesions

Question 27

list potential causes of non cleft VPI, VP incompetency

Answer 27

primary motor / neuromotor control (dysarthrias that are congenital or acquired), motor association / motor programming (apraxia of speech or oral non speech apraxia)

Question 28

list potential causes of non cleft VPI, VP mislearning

Answer 28

phoneme-specific nasal emissions, persisting post-op nasal emissions, compensatory misarticulations, deafness / hearing impairment

Question 29

structural deviations : VP ___ :: neurogenic VP dysfunction : VP ___ :: phonologic patterns : VP ___

Answer 29

insufficiencies, incompetencies, mislearning