VP Subsystem Flashcards
Which cranial nerve innervates the tensor veil palatini
V
Which cranial nerve innervates the levator veil palatini
X
*possibly VII in speech
Which cranial nerve innervates the palatoglossus
X
Which cranial nerve innervates the palatopharyngeus
X
Which cranial nerve innervates the uvular muscle
X
*possibly VII in speech
Which cranial nerve innervates the superior pharyngeal constrictor
X
*possibly VII in speech
T or F: the velum is not affected by the position of oral articulators
False - biomechanics forces of the tongue pulling downward can affect velar elevation and port size
List speech sounds from most to least tolerant of VPI
vowels glides /h/ fricatives affricates plosives (least tolerant because need adequate intraoral pressure)
Movements of the velum may begin around _________ before acoustic event as long as it doesn’t distort previous segment
300ms
Increased nasal airflow and nasalance are found in ________ speaking rates but not in _______ rates
slow
fast
How does decreased speech rate lead to increased nasality?
If you speak slower, VP is open for longer amounts of time and slows the speed of elevation of the velum. And so slower speech is more nasal.
There is _______ lowering of the velum at slow rates
multistage
At fast rates there is _________ in magnitude of velar movements
reduction
What 3 structures work together to achieve VP closure?
velum
lateral pharyngeal walls
posterior pharyngeal wall
What are the 4 types of disordered patterns in VP function
1) consistently inadequate closure (too much/too little opening)
2) inappropriate timing
3) inconsistent closure
4) worsening over time (fatigue, worsening in complex sequences
What is a disorder in which fatigue of the soft palate would be common
myasthenia gravis
During our perpetual assessment, what are we looking for?
- hypernasality
- nasal emissions (pressure consonants)
- imprecise consonants
- hyponasality
One way to quickly determine if someone has hyper nasal speech is what
to test speech with nares occluded
In order to determine both presence and degree of a VP problem, we use _________ assessment
aerodynamic assessment
Normal pressure of oral consonants is what
5-10cm H20
Normal nasal flow in non-nasal sounds is what?
<30 cc/sec
Why would we look at the word ‘hamper’ when looking at temporal measures of VP function?
Hamper involves open VP, for m and then closes really quickly for p and then opens again.
-this is a very fast gesture and if there is any weakening, this is where problems will be visible
In hamper, if the oral pressure peak and nasal flow peak are too far away, what does this indicate?
VP weakening
When assessing hamper. if there is VP weakening, then…
the distance between the peaks will be the same over productions
When assessing hamper, if there is VP incoordination,
then the distance between the peaks will change each production
T or F: in patients with ALS, there is less nasalance in their speech compared to normal speakers
False - there is more nasal
List the 5 behavioural treatments for speakers with mild impairment and intermittent VPI
- articulatory drills
- speaking rate intervention (slower or faster)
- reducing loudness
- clear speech
- strengthening using CPAP
Why is CPAP beneficial for speech if it is a strengthening treatment?
Because they train strength using SPEECH tasks
What are 3 examples of augmented feedback that can aid in the cognitive phase of learning ?
- see scape
- nasometer Kay-Pentax
- endoscopy
For patients with consistently present inadequacy with moderate-severe effect on speech intelligibility, a _____________ is suggested
palatal lift prosthesis
What are the factors needed for palatal lift candidacy?
- Consistent VP insufficiency
- Adequate respiratory support
- Presence of voluntary phonation
- Can tolerate the lift (desensitization may be required)
- Cooperation
- Non-spastic
- No severe swallowing disorder
- Course of the disease (degenerative)
What is the evidence for blowing, sucking, swallowing, gagging, electrical stimulation and tactile simulation on VP function?
Never found to be effective either in producing soft palate elevation or carrying over to speech
