quiz 9 vp intervention

Question 1

norms for resonance for nasal airflow

Answer 1

• normal is 28% or less - will be perceived as an appropriate oral resonance
• nasalence is a good acoustic perceptive measure

Question 2

VP incompetence

Answer 2

• velum structure is intact, but the problem is lack of innervation
• there is complete tissue, but it is not functioning properly

Question 3

VP insufficiency

Answer 3

• velum is properly innervated, but is an incomplete structure with missing tissue that leads to incomplete closure

Question 4

palatal lift

Answer 4

• props up soft palate to eliminate hypernasality

Question 5

potential problems of palatal lift for client

Answer 5

• generate excess saliva - people with palatal lift also have dysphagia
• not tolerated by everyone
• need cognition/memory or compensatory techniques to remember it

Question 6

patient characteristics appropriate for a palatal lift

Answer 6

• must have a big gap between soft palate and posterior pharyngeal wall that is consistently open
• must have fair to good articulation, as it will not significantly improve articulation
• must be able to generate adequate Psg
• must not have a gag reflex

Question 7

nasal obturator

Answer 7

• occludes nares to eliminate hypernasality
• worth considering for those who cannot tolerate a palatal lift
  may work best with a custom fitting
  may not work - just sounds like hypernasal speech with a plugged nose

Question 8

palatal obturator

Answer 8

• prosthesis that acts to complete missing tissue of velum to achieve full closure

Question 9

function of palatal lift

Answer 9

• hooks on to teeth with prosthesis molded to hard palate, and wired portion extending back to lift up soft palate at all times when being worn
• by lifting soft palate, it assists in velopharyngeal closure for those who have a lack of innervation

Question 10

regular vs. hinged palatal lift

Answer 10

• patient may pop out regular lift if velum kicks down during swallowing
• hinged lift allows for movement if velum kicks down, while still remaining hooked on to teeth
• dont knw impact on speech

Question 11

impact of increased vocal loudness on nasalance in dysarthria

Answer 11

• flaccid: increased loudness reduced hypernasality in most, not all; most likely to benefit from increased loudness
• spastic: decreased loudness reduced hypernasality in most, but not by much; most likely to benefit from decreased loudness
• ataxic: inconsistent effect in loudness impacting nasalence, worth a try
• hyperkinetic: for most, no change either way, for one, nasalence improved
• loudness is worth manipulating to see if it effects nasalence

Question 12

effects of LSVT on hypernasality

Answer 12

• decreased it, although not maintained
• flaccid is most likely to see a difference with LSVT improving hypernasality

Question 13

effects of increased mandibular excursion on hypernasality

Answer 13

• benefit of bigger mouth opening: more acoustic energy through the mouth, changing the proportion of acoustic energy from mouth to nose
• wouldn’t do in isolation, would do while pairing with increased vocal effort
• don’t really have data