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Voice > Resonance-Test 2 > Flashcards

Resonance-Test 2 Flashcards

1
Q

Anatomical/physiological etiologies of nasal resonance disorders

A

Velopharyngeal inadequacy

Velopharyngeal incompetency

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2
Q

What happens during Velopharyngeal Closure

A

Palate elevates to pharyngeal wall, pharyngeal wall moves forward, lateral pharyngeal wall moves medially

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3
Q

Velum elevated except for ____

A

Nasal consonants: m, n, ng

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4
Q

Hypernasality

A

Plosives, fricatives, snorting

Facial grimacing

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5
Q

Hyponasality sounds like _____

A

Sounds like a cold

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6
Q

Cul-De-Sac Resonance

A

Disorder of muscle hyperfunction
Results from an occluded or obstructed nasal airway in conjunction with significant pharyngeal tension
The typical voice of a deaf child
Tongue retracted posteriorly which creates the peculiar resonance heard in deaf speakers

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7
Q

Etiologies of Hypernasality

A 
Clefts of hard or soft palate
Submucous clefts
Inadequate velar length
Paralysis or paresis of velum
Paralysis/paresis of pharyngeal constrictor muscles
Paralysis/paresis of lateral walls
Anterior levator insertion
Large tonsils
Fistula in hard or soft palate
Deep pharynx
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8
Q

Etiologies of Hyponasality (lack of nasal resonance on nasal consonants)

A 
Deviated septum
Nasal polyps
Enlarged adenoids
High arched palate
Too wide pharyngeal flap
Too large obturator bulb
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9
Q

Evaluation of Resonance Disorders

A
  1. Count from 60-100
  2. Mirror under pt’s nose
  3. Sucking through a straw
  4. Cine fluoroscopy/lateral radiography
  5. Nasendoscopy
  6. Oral monometer
  7. See-scape
  8. Sound spectrography
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10
Q

When does hypernasality (excess nasal resonance) occur? (evaluation of quality)

A
  1. During production of vowels

2. High pressure consonants (fricatives, affricates, plosives)

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11
Q

Evaluation of hypernasality

A
  1. Reading of single words vs. connected speech
  2. Note nasal emission
  3. Iowa Pressure Test
  4. Phonation of vowels /i/ & /u/ alternately compress & release nostril: adequate–no difference; incompetence–flutter sound
  5. Fiberoptic nasopharyngoscopy
  6. Videofluroscopy
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12
Q

When hyponasality (lack of nasal resonance) occurs (eval of quality)

A
  1. Vowel sounds are denasalized
  2. Voice is dull & muffled
  3. Most evident with nasal consonants (m, n, ng)
  4. Speech resembles their plosive counterparts: b, d, g
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13
Q

Eval of hyponasality

A
  1. Read from a word list or reading passage loaded with nasals
  2. Common substitutions: b/m, d/n, g/ng
  3. Inability to hum
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14
Q

Eval of cul-de-sac resonance

A
  1. Evaluate tongue position of /a/ prolongation
  2. Look for improvement with:
    - Tongue tip sounds: t, d, s, z
    - Front vowels: i, I, e
    - Front consonants: w, p, b, f, v, th, l
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15
Q

What to do during radiographic studies or speech films

A
  1. quiet breathing
  2. vowel “e” prolongation
  3. connected speech
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16
Q

What to look at on radiographic studies

A
  1. Measure gap between velum & posterior wall of pharynx
  2. Presence & effect of enlarged tonsils
  3. Presence & size of adenoid mass
  4. Configuration of nasopharynx
17
Q

Tx Options for VPI

A
  1. Functional: speech tx prior to surgery
  2. Surgical intervention: flaps, implants
  3. Prosthetics
  4. Speech tx following surgery &/or prosthetics
18
Q

Therapy

A
  1. Blowing, sucking, swallowing, gagging exercises are unsuccessful
  2. Blowing plus speech
  3. Establish oral air flow
  4. Increase oral articulator mobility
19
Q

Prostheses

A
  1. Palatal lift

2. Palatal lift & bulb

20
Q

Speech Bulb

A

Soft palate too short to contact posterior pharyngeal wall (PPW)
Bulb contacts PPW
Maintain some opening on the sides of the bulb for the nasal breathing

21
Q

Palatal Lift

A

Soft palate of sufficient length but lacks sufficient mobility
Soft palate contacts PPW
Maintain some opening on sides of the elevated palate for nasal breathing

22
Q

Considerations for Pharyngeal Flap

A
  1. Preoperative eval of lateral wall motion is vital
  2. 2mm in medial direction
  3. Decreased movement-make flap wider
23
Q

Pharyngeal Flap Procedure

A

For hypernasal speech
A superiorly based flap of tissue is raised from posterior pharynx & sutured to soft palate thereby decreasing amount of air through the nose
Lateral ports or holes are left so that nose won’t be obstructed

Voice (12 decks)

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