Speech Production Basics: from normal to disorders Flashcards
Motor neurons innervating speech are part of the ___ system.
physiology
What is the speech chain?
linguistic level → physiological level → acoustic level → physiological level → linguistic level
T/F. The Lower vocal tract is responsible for resonating and modifying sound.
False, the UPPER vocal tract is responsible for resonating and modifying sound.
Which system is the power source, performs inhalation vs exhalation, speech vs quiet breathing and is egressive?
respiratory system
Vocal folds vibrations are best explained by ___ ___ theory. What does it state?
Myoelastic Aerodynamic theory
the rate of vocal fold vibration (in cps or Hz) is perceived as pitch.
f=ακ / m
males (120Hz), females (200Hz), children (over 300Hz)
T/F. Pitch is controlled by folds stretching.
True.
The ___-___ system is responsible for articulation and resonance consisting of various structures within the nasal oral and pharyngeal cavities, collectively called the ___ ___.
Supra-Laryngeal; vocal tract
How are consonants produced?
manner of articulation “how”
place of articulation “where”
voicing
teeth (need upper incisors)
Define the velopharynx.
soft palate and lateral and posterior pharyngeal walls
The ___ is physiologically responsible for determining coupling/decoupling between oral and nasal cavities and modulating sound and air flow along the upper respiratory tract.
velopharynx
What are cleft palate babies lacking?
no soft palate means that the levator veli palatini muscle sling is missing its attachment on hard palate
How is cleft palate repaired? What type of problems are commonly reported?
levator veli palatini reconstruction and repositioning normally within 6-12 months
residual resonance problems - improperly positioned/structured palatal muscles, insuficient volume, contractile properties, fiber type compositions
The Cleft-Palate-Craniofacial Team must have, as a minimum core, what professional?
- speech-language pathology
- surgery
- orthodontics
T/F. Feeding is an issue with cleft lip.
False, it is not an issue
Which comes first, lip or palate repair, if both are present?
lip repair is followed by palate repair.
The patient needs to be 101lbs and at least 10 wks old
The ___ velopharyngeal closure pattern is the most common pattern mainly achieved by the posterior/superior movement of the ___ (plus anterior movement of the ___ ___ wall).
coronal; velum; posterior palatal wall
With circular velopharyngeal closure pattern, what is involved to make the sphincter?
soft palate, lateral and posterior palatal walls all contribute
Describe the least common pathway for velopharyngeal closure patterns.
sagittal- achieved by the medial movement of the lateral palatal wall
The primary palate includes the ___ and ___ ___. It can be complete or incomplete or unilateral or bilateral.
lip; alveolar process
The secondary palate includes the ___ and ___ ___ (area ___ to incisive foramen). It can be complete or incomplete or unilateral or bilateral.
hard; soft; posterior
What is seen with a submucous cleft?
intact mucous membrane
see: bifid uvula, zona pellucida (bluish tint along palate), furrow along midline, bony notch along the hard palate
T/F. About 7,000 babies are born with cleft lip/palate every year in the US.
True. cleft types: 25% = lip only 25% = palate only 50% = lip and palate
T/F. There is a high incidence in Native Americans and African Americans.
False, Native Americans and Asian Americans
What is the incidence among gender?
males > females with combination clefts
males > females with severe forms
females > males with palatal clefts only
What is the etiology?
multifactorial inheritance: predisposition is exasperated by environmental factors
-genetic and environmental (teratogens, drugs, smoking, insufficient folic acid)
Formation of the structures of the primary and secondary palates occurs from roughly the end of the ___ week to the end of the ___ week.
5th; 12th
week 7 = wk for max / week 9 = palatal growth
When can ultrasonographs detect a cleft?
as early as 13 weeks
T/F. If the cleft is on the primary palate there are more dental issues compared to having a cleft on the secondary palate.
True.
List the different types of velopharyngeal dysfunction.
velopharyngeal insufficiency (anatomical/structural defect) velopharyngeal incompetence (neuromotor/physiological disorder) velopharyngeal mislearning (faulty development of articulation patterns
What is the gold standard for clinical assessment?
listener judgement (perceptual analysis)
What areas are evaluated to assess velopharyngeal dysfunction?
- resonance
- nasal air emission (airflow deviation)
- articulation (compensatory mis-articulation)
- voice
List some resonance disorders.
- hypernasality
- hyponasalitiy (denasality)
- cul de sac (mumbled sound)
- mixed (hyper- and hypo-)
Airflow deviation errors depend on the ___ of the velopharyngeal gap, occurs with high pressure ___ and frequency is accompanied by facial ___.
size; consonants; grimace
List some compensatory misarticulations.
- glottal stops
- pharyngeal stops/fricatives/affricates
- mid-dorsal palatal stops
- posterior nasal fricative
What is overdriven in the absence of velopharyngeal valving?
laryngeal valving
What instruments measure indirectly? Directly?
indirect - nasometer
direct - videofluoroscopy, flexible nasendoscopy (nasopharyngoscopy)
What are VPD treatment options?
- re-do palatoplasty
- pharyngeal wall augmentation
- pharyngoplasty (pharyngeal flap and sphincter pharyngoplasty)
