THAS 102 MIDTERM PREP Flashcards
What are the different types of cleft lips
1) bilateral
2) unilateral
3) complete
What are the 4 areas of communication disorders?
1) articulation
2) language
3) fluency
4) voice
4 types of voice disorders?
1) pitch (abnormal pitch for gender/age)
2) quality (smokers voice)
3)loudness (appropriate for environment)
4) resonance ( hyper and hypo nasality)
What is the difference between hyper and hypo nasality?
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
Quiet (tidal) breathing vs speech breathing
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
Lifespan issues of the respiratory system?
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
What is respiration?
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
What is phonation?
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
What is resonation?
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)
What is articulation?
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
Muscles of inhalation?
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
Muscles of exhalation?
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
Different types of speech of speech breathing patterns
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
Lifespan issues of the respiratory system?
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
Laryngeal system function
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
3 cavities of the articulatory system?
1) pharyngeal cavity
2) oral cavity
3) nasal cavity
5 structures involved in swallowing?
1) tongue
2) pharyngeal walls
3)epiglottis
4) larynx
5) esophagus
Stages of swallowing
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
Oral phase (oral preparatory )
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
Oral phase (oral transport)
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
Pharyngeal phase
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
Esophageal phase
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
What is dysphasia?
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
What is a cleft lip or palate?
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)
What is a submucous cleft?
Muscular, (often you don’t even notice it until later in life) occurs in ~1-1200 live births.
Cleft of the lip
- 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
Unilateral cleft of lip/palate
Extends from external portion of upper lip, through alveolus, hard and soft palate
Nasal septum attaches to larger of the two palatal segments
Bilateral complete of lip and palate
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
Submucous cleft?
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
What is Pierre Robin Syndrome?
Genetic disorder that presents as mictongnathia aka small chin, congenital heart problems, finger and toe abnormalities, conductive hearing loss, developmental delays including delayed speech.
What is Treacher Collin’s syndrome?
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.
What is 22Q11 deletion (velocardiofacial syndrome)?
Tied with language, speech and learning difficulties, range of severity, heart abnormalities, characteristic facial features)
What is apert syndrome?
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.
Effects on cleft palates
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.
4 main components of the hearing system
1) outer ear
2) middle ear
3) inner ear
4) central auditory pathways
Types of hearing loss
1) conductive
2) sensorineural
3) mixed
What is conductive hearing loss?
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.
What is sensorineural hearing loss?
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,
What is mixed hearing loss?
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.
