THAS 102 MIDTERM PREP

Question 1

What are the different types of cleft lips

Answer 1

1) bilateral
2) unilateral
3) complete

Question 2

What are the 4 areas of communication disorders?

Answer 2

1) articulation
2) language
3) fluency
4) voice

Question 3

4 types of voice disorders?

Answer 3

1) pitch (abnormal pitch for gender/age)
2) quality (smokers voice)
3)loudness (appropriate for environment)
4) resonance ( hyper and hypo nasality)

Question 4

What is the difference between hyper and hypo nasality?

Answer 4

Hyponasality: occurs when there is not enough sound resonating in the nasal cavity (nose) during speech
Hypernasality: excessive nasal resonance on vowels and voiced oral consonants

Question 5

Quiet (tidal) breathing vs speech breathing

Answer 5

Tidal: breathing to sustain life, Rate and depth of breaths taken during “QB” determined by bodies O2 needs and amount of CO2 in the blood , ~½ liter of air is inhaled - sitting and breathing quietly

Speech breathing: the kind of breathing you do when you’re speaking aloud, inhalation only occurs at Speech Breathing: the kind of breathing you do when you are speaking aloud, Inhalations only occur at major linguistic boundaries such as end of phrases or sentences ( ex one would never inhale in middle of word or phrase) . Requires active muscle contraction during exhalation and muscles on inhalation

Question 6

Lifespan issues of the respiratory system?

Answer 6

A: Respiration - power supply, involves diaphragm and other muscles
B: Phonation - noise source, vocal folds of larynx
C: Resonation - tone shapers, involved pharynx, mouth and nasal cavities
D: Articulation - producers of speech sounds, involves articulators

Question 7

What is respiration?

Answer 7

Power supply
Involves diaphragm ( most important muscle for this use) and other muscles
Speaker inhales to capture air and then in a controlled manner, exhales to force a colum of air into the larynx

Question 8

What is phonation?

Answer 8

Noise source
Involves vocal folds of the larynx
VF’s drawn together by contraction of specific muscles
Exhaled air ( from respiration) causes VF’s to vibrate which vibrates the air column

Question 9

What is resonation?

Answer 9

Tone shapers
Involves pharynx, mouth and nasal cavities
As vibrating air column passes through the throat, mouth and nasal cavities it is resonated ( tone of VF’s is modified according to size & shape of resonating cavities)

Question 10

What is articulation?

Answer 10

Producers of speech sounds
Involves lips,teeth, tongue, hard & soft palate and mandible
Vibrating and resonated air column passes through the mouth
The tongue, teeth and other structures in mouth break up airstream into the sounds of speech

Question 11

Muscles of inhalation?

Answer 11

Found above the diaphragm, most NB single muscle of respiration
Thin, dome shaped
Composed of muscle fibers & board tendon on superior surfac e
Separates thoracic & abdominal cavities
In addition to the diaphragm, numerous thoracic and neck muscles contribute to the inhalation process

Question 12

Muscles of exhalation?

Answer 12

part of the resp process that allows carbon dioxide to be expelled from the body via the lungs and speech to be produced
primary muscles for exhalation located in anterior & lateral aspects of abdomen
Some muscles in thoracic cavity & some muscles of back can assist in exhalation

Question 13

Different types of speech of speech breathing patterns

Answer 13

1) Clavicular:
Primarily relies on the neck accessory muscles which provides very poor respiratory support for speech
Shoulders elevate during inhalation & breathing may be effortful
Least efficient breathing pattern - particularly for speech
2) Thoracic:
Relies on thoracic muscle which provide adequate respiratory support for speech
Chest usually expands & contracts on inhalation and exhalation
Most common of the three breathing patterns
3) Diaphragmatic-thoracic:
Utilizes lower thoracic & abdominal muscles which provide optimal respiratory support for speech
Very little if any chest movement occurs
Most people do not use this pattern naturally

Question 14

Lifespan issues of the respiratory system?

Answer 14

At birth: newborn tidal breathing at rest of 30-80 breaths per minute
By age 3: decreases to 20-30 breaths per minute
By PS: deeper & more frequent inhalations compared to adults
As child develops, resp system’s structures increase in size & lung capacity increases
Max lung capacity reached in early adulthood & remain fairly constant until middle age

Question 15

Laryngeal system function

Answer 15

Hyoid bone - point of attachment for both the laryngeal & tongue musculature, horseshoe shaped
Larynx - consists of several cartilages connected to one another by ligaments and membranes
Thyroid Cartilage (largest laryngeal cartilage) - forms the front & side lateral walls of the larynx, forms the Adam’s apple
Cricoid cartilage: Sits directly below thyroid cart & immediately above 1st tracheal ring
Arytenoid Cartilages: On back & top border of the cricoid cartilage
Epiglottis: Large leaf shaped cart attached to thyroid cartilage just below laryngeal prominence
Midportion attaches to body of the hyoid bone
Top aspect of the epiglottis is free - extending to the root of the tongue
Function: Assists in preventing food from entering larynx & lower airways during swallowing

Question 16

3 cavities of the articulatory system?

Answer 16

1) pharyngeal cavity
2) oral cavity
3) nasal cavity

Question 17

5 structures involved in swallowing?

Answer 17

1) tongue
2) pharyngeal walls
3)epiglottis
4) larynx
5) esophagus

Question 18

Stages of swallowing

Answer 18

1) anticipatory phase - Occurs before food actually reaches the mouth
Provides sensory information about what is going to be eaten
Helps the person “get ready” for the food

Question 19

Oral phase (oral preparatory )

Answer 19

Drinking: tongue cups; holds liquid bolus against the front portion of the hard palate
Solid foods: tongue and cheek moves the food to the teeth for chewing/mixing with saliva to form a solid bolus

Question 20

Oral phase (oral transport)

Answer 20

Tongue pushes the bolus against the palate, moving it from the front to the back of the mouth
( takes approx 1 second)
Triggers pharyngeal swallow reflex
Oral phases is voluntary

Question 21

Pharyngeal phase

Answer 21

Takes approx 1 second
Begins when triggered following the oral transport phase
This serves 2 purposes, to protect the airway and to direct the bolus towards the stomach
Velopharyngeal port closes
Bolus is squeezed to top of esophagus
Larynx and hyoid bone move up and forward
Larynx closes ( to prevent food from entering airway)
Epiglottis drops the larynx to provide additional protection

Question 22

Esophageal phase

Answer 22

Muscles of the esophagus move the bolus in peristaltic or rhythmic, wavelike contractions from top of esophagus into the stomach
Typical swallow takes approx 8-10 seconds

Question 23

What is dysphasia?

Answer 23

Impairment of swallowing - Most common causes:
Neurological damage due to stroke (most common) brain injury, or disease ( ex parkinson’s, ALS, CP, MS)
Laryngeal damage due to radiation, surgical removal of larynx
50% of stroke survivors develop dysphagia
25-75% of individuals with TBI exhibit dysphagia
Congenital includes: CP, Spina Bifida, Austism, Cleft Lip/Palate
Acquired: stroke, cancer, MS, AIDS, spinal cord injury

Question 24

What is a cleft lip or palate?

Answer 24

Abnormal opening in an anatomical structure representing a failure of structures to fuse early in embryonic development. It is caused by failure of structures in the oral cavity to unite during pregnancy (occurs in week 5-12 of gestation)

Question 25

What is a submucous cleft?

Answer 25

Muscular, (often you don’t even notice it until later in life) occurs in ~1-1200 live births.

Question 26

Cleft of the lip

Answer 26

• may occur unilater or bilateral (most commonly on left side)
• extends from external portion of lip and up to nose
  -if bilateral, generally occurs with cleft palate as well

Question 27

Unilateral cleft of lip/palate

Answer 27

Extends from external portion of upper lip, through alveolus, hard and soft palate
Nasal septum attaches to larger of the two palatal segments

Question 28

Bilateral complete of lip and palate

Answer 28

Most severe due to severe tissue deficiency
Lip and alveolus are cleft under both nostrils
Tip of nose may attach directly to lip
Nasal septum not attached to either of palatal shelves

Question 29

Submucous cleft?

Answer 29

Muscular cleft of soft palate
Cleft covered by thin layer of mucosal tissue making it hard to see lack of muscle fusion
Bifid uvula may indicate a submucous cleft
Presences of blueish color in middle of soft palate
Notch may be felt in posterior border of hard palate

Question 30

What is Pierre Robin Syndrome?

Answer 30

Genetic disorder that presents as mictongnathia aka small chin, congenital heart problems, finger and toe abnormalities, conductive hearing loss, developmental delays including delayed speech.

Question 31

What is Treacher Collin’s syndrome?

Answer 31

A genetic disorder that presents as underdeveloped cheekbones and mandible, misformation of the external ear and ear canal, conductive hearing loss, major communication difficulties resulting from VPI aka velopharyngeal incompetence, conductive hearing loss.

Question 32

What is 22Q11 deletion (velocardiofacial syndrome)?

Answer 32

Tied with language, speech and learning difficulties, range of severity, heart abnormalities, characteristic facial features)

Question 33

What is apert syndrome?

Answer 33

Craniosynostosis aka premature closing of the sutures on the skull, misformation of hands, high and vaulted palate but actual clefts are only present in 30% of cases, CHL, developmental delays including lang.

Question 34

Effects on cleft palates

Answer 34

Feeding - can’t create a seal so very hard to feed
Speech - hypernasal resonance, articulation errors such as glottal stops, mid dorsal palatal stops, pharyngeal stops,pharyngeal fricatives, nasal rustle
Hearing - more prone to ear infections because the muscle that drains the Eustachian tube is not formed
Voice - decreased loudness as a compensation for hypernasality can result in a weak, breathy voice.

Question 35

4 main components of the hearing system

Answer 35

1) outer ear
2) middle ear
3) inner ear
4) central auditory pathways

Question 36

Types of hearing loss

Answer 36

1) conductive
2) sensorineural
3) mixed

Question 37

What is conductive hearing loss?

Answer 37

Issue with outer or middle ear, sound is not being conducted to inner ear (quieter but not distorted) Causes include impacted cerumen, hole/tear in eardrum, infection or poor Eustachian tube function. It may be temp or permanent/unilater/bilateral.

Question 38

What is sensorineural hearing loss?

Answer 38

Occurs when there is damage to the inner ear (cochlea), it is the most common HL and reduces the ability to hear faint sounds. Can be unilateral or bilateral. Varies from mild-profound and can be aided with HA, CI, and FM system. Causes include prenatal infection, HIV/AIDS, premature birth, anoxia,

Question 39

What is mixed hearing loss?

Answer 39

Conductive hearing loss that occurs in combination with SNHL, it is damage to the outer or middle and inner ear(cochlea) or auditory nerve. It can include tinnitus, Ménière’s disease (extreme vertigo). Inappropriate phrasing to distinguish stressed and unstressed syllables. Voice and resonance may be distorted.