Week 2a

Question 1

Orofacial examination purpose?

Answer 1

The purpose is to identify or rule out structural or
functional factors that relate to a communicative disorder or dysphagia.

Question 2

Must-have tools of the OME?

Answer 2

Gloves
Tongue depressor
Small flashlight

Question 3

OME components to look out for?

Answer 3

STRUCTURES: Symmetrical, breathing, teeth, occlusion, lips, tongue, palate, size

MOVEMENT: Jaw, smooth, fluidity, sounds, tongue, lips, rapid/slow

STRENGTH: Jaw, tongue, lips, breath support for speech

OROPHARYNX: Color, tonsils, uvula, palate, rugae, alveolar ridge, gag reflex, movement of palate.

Question 4

Structures to examine?

Answer 4

Face
• Eyes
• Jaw
• Nose
• Neck
• Cheeks
• Other

Oral Cavity
-Lips
• Tongue
• Hard Palate
• Soft Palate
• Teeth
• Inner cheeks (buccae)
• Tonsils
• Uvula
• Frenulum

Question 5

Structural disorders

Answer 5

Changes in physiological structures
e.g., cleft palate, tumors, surgeries, etc.

Question 6

Functional disorders

Answer 6

Reduced ROM, strength, or sensation.
Usually due to motor neuron deficits
Look at cranial nerves

Question 7

Crowding/overcrowding

Answer 7

Due to a lack of space in the mouth

Teeth are crooked and overlap

Question 8

Overjet (not an overbite)

Answer 8

Top teeth extend past the bottom teeth horizontally

Protruding teeth are susceptible to damage

May cause problems with speech and eating

Question 9

Overbite

Answer 9

Top teeth extend past bottom teeth

Can cause speech problems (e.g., lisp) depending on
how the teeth and tongue are affected

Question 10

Open bite

Answer 10

Top teeth don’t overlap with lower teeth

Question 11

Crossbite

Answer 11

Top teeth bite inside lower teeth (On one side)

Question 12

Underbite

Answer 12

Bottom teeth protrude further than top teeth

Question 13

Spacing

Answer 13

Too much space between each tooth

Missing teeth, small teeth, tongue thrust, thumb
sucking

Question 14

Movement

Answer 14

1. Range of motion (ROM)
   a. Is movement reduced or absent?
   b. Is movement symmetrical?
   c. Is it replicated? (*did they do what you did?)
2. Strength (*less significant with peds)
   a. Symmetry in strength
   b. Check using resistance
   c. May need to coach client to use maximal strength
3. Look for dyskinesias (involuntary repetitive movements of the mouth/face)

Question 15

Coordination/Tone

Answer 15

1. Coordination
   a. Examine rate, coordination, and accuracy of movement
   b. Speech and non-speech AMRs/SMRs
   i. Peds: Pattycake/buttercup/tacobell
   c. Make sure to tell client to do tasks QUICKLY and
   ACCURATELY
2. Muscle tone and tension
   a. Assess tone at rest and with movement
   b. Assess for primitive reflexes (like bite reflex)

Question 16

Control/Sensation

Answer 16

1. Modulation of movement
   a. How well does the patient respond to your
   instructions?
   b. Can they modify their movement?
   c. Better movement modulation = better therapy
   prognosis
2. Sensation
   a. Touch, taste, proprioception

Question 17

Oral agility: Diadochokinetic rates (DDK)

Answer 17

Ability to make rapid alternating speech movements
• Movement, rhythm, coordination are indicators of
neuromuscular integrity
• /p^/, /t^/, /k^/
• Separately = Alternating motor/motion rates
• Together = Sequential motor/motion rates
• Count syllables in # of seconds
• Time needed to do # of repetitions
For kids: buttercup, pattycake, taco bell