VP Subsystem

Question 1

Which cranial nerve innervates the tensor veil palatini

Answer 1

V

Question 2

Which cranial nerve innervates the levator veil palatini

Answer 2

X

*possibly VII in speech

Question 3

Which cranial nerve innervates the palatoglossus

Answer 3

X

Question 4

Which cranial nerve innervates the palatopharyngeus

Answer 4

X

Question 5

Which cranial nerve innervates the uvular muscle

Answer 5

X

*possibly VII in speech

Question 6

Which cranial nerve innervates the superior pharyngeal constrictor

Answer 6

X

*possibly VII in speech

Question 7

T or F: the velum is not affected by the position of oral articulators

Answer 7

False - biomechanics forces of the tongue pulling downward can affect velar elevation and port size

Question 8

List speech sounds from most to least tolerant of VPI

Answer 8

vowels
glides
/h/
fricatives
affricates
plosives (least tolerant because need adequate intraoral pressure)

Question 9

Movements of the velum may begin around _________ before acoustic event as long as it doesn’t distort previous segment

Answer 9

300ms

Question 10

Increased nasal airflow and nasalance are found in ________ speaking rates but not in _______ rates

Answer 10

slow

fast

Question 11

How does decreased speech rate lead to increased nasality?

Answer 11

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.

Question 12

There is _______ lowering of the velum at slow rates

Answer 12

multistage

Question 13

At fast rates there is _________ in magnitude of velar movements

Answer 13

reduction

Question 14

What 3 structures work together to achieve VP closure?

Answer 14

velum
lateral pharyngeal walls
posterior pharyngeal wall

Question 15

What are the 4 types of disordered patterns in VP function

Answer 15

1) consistently inadequate closure (too much/too little opening)
2) inappropriate timing
3) inconsistent closure
4) worsening over time (fatigue, worsening in complex sequences

Question 16

What is a disorder in which fatigue of the soft palate would be common

Answer 16

myasthenia gravis

Question 17

During our perpetual assessment, what are we looking for?

Answer 17

• hypernasality
• nasal emissions (pressure consonants)
• imprecise consonants
• hyponasality

Question 18

One way to quickly determine if someone has hyper nasal speech is what

Answer 18

to test speech with nares occluded

Question 19

In order to determine both presence and degree of a VP problem, we use _________ assessment

Answer 19

aerodynamic assessment

Question 20

Normal pressure of oral consonants is what

Answer 20

5-10cm H20

Question 21

Normal nasal flow in non-nasal sounds is what?

Answer 21

<30 cc/sec

Question 22

Why would we look at the word ‘hamper’ when looking at temporal measures of VP function?

Answer 22

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

Question 23

In hamper, if the oral pressure peak and nasal flow peak are too far away, what does this indicate?

Answer 23

VP weakening

Question 24

When assessing hamper. if there is VP weakening, then…

Answer 24

the distance between the peaks will be the same over productions

Question 25

When assessing hamper, if there is VP incoordination,

Answer 25

then the distance between the peaks will change each production

Question 26

T or F: in patients with ALS, there is less nasalance in their speech compared to normal speakers

Answer 26

False - there is more nasal

Question 27

List the 5 behavioural treatments for speakers with mild impairment and intermittent VPI

Answer 27

• articulatory drills
• speaking rate intervention (slower or faster)
• reducing loudness
• clear speech
• strengthening using CPAP

Question 28

Why is CPAP beneficial for speech if it is a strengthening treatment?

Answer 28

Because they train strength using SPEECH tasks

Question 29

What are 3 examples of augmented feedback that can aid in the cognitive phase of learning ?

Answer 29

• see scape
• nasometer Kay-Pentax
• endoscopy

Question 30

For patients with consistently present inadequacy with moderate-severe effect on speech intelligibility, a _____________ is suggested

Answer 30

palatal lift prosthesis

Question 31

What are the factors needed for palatal lift candidacy?

Answer 31

• 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)

Question 32

What is the evidence for blowing, sucking, swallowing, gagging, electrical stimulation and tactile simulation on VP function?

Answer 32

Never found to be effective either in producing soft palate elevation or carrying over to speech