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SPSC 367 - Voice Disorders > Week Thirteen > Flashcards

Week Thirteen Flashcards

1
Q

What are the three stages of antenatal development?

A

Conception - 2 weeks = zygote
2 - 8 weeks = embryonic period
9 - 38 weeks = foetal period

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2
Q

What is a teratogen?

A

Something that causes atypically development

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3
Q

What is a known teratogen that can cause cleft palate?

A

alcohol

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4
Q

True or false: teratogens do not cause any damage in the first 2 weeks of development

A

True, because the zygote is not attached to the uterine wall.

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5
Q

How does typical development of facial structure occur?

A
  • Structures move toward the midline and fuse together starting at the lip.
  • Starts at around 6 weeks and progresses to the soft palate
  • Soft palate will be sealed around 16 weeks
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6
Q

What are the different types of clefts?

A

Cleft Lip
- range from notch to complete separation in one (unilateral) or both (biliateral) sides of the lip

Cleft palate
- roof of the mouth not joined completely

Submucous Cleft
- Cleft of the soft palate that is covered by a layer of skin

Bifid Uvula
- Cleft of the uvula only

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7
Q

Can clefts be identified before birth?

A

Generally, a cleft lip can be detected.

Cleft palate and submucous clefts are more difficult to identify before birth.

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8
Q

How common are clefts?

A
  • Third most common congenital birth defect in NZ
  • 1/550 live births in NZ
  • Māori population have the highest incidence of cleft palate in the world 1/500
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9
Q

What is the cause of cleft?

A

In most cases, it is a combination of genes and environment (multifactorial)

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10
Q

Why might a psychologist need to be involved in the cleft process?

A
  • Decisions about surgery
  • Worries
  • Mood
  • Self esteem
  • Appearance related concerns
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11
Q

Around what age might surgery be preformed?

A

Cleft lip: 3 - 6 months

Cleft Palate: 9 - 13 months

Alveolar Bonegraft: 9 - 10 years old

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12
Q

What are some secondary surgeries that may be preformed?

A
  • Pharyngeal flap
  • Pharyngoplasty
  • Grommets
  • Orthognathic surgery
  • Rhinoplasty
  • Lip revisions
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13
Q

What type of malocclusions are there?

A

Type II: upper teeth too far in front of lower teeth

Type III: Upper teeth behind lower teeth

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14
Q

What is a position that may help to breast feed?

A

The football hold

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15
Q

True or False: There are special bottle teets for children with cleft

A

True

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16
Q

How is hearing impacted with individuals with cleft palate?

A
  • Otitis media is more common in children with cleft palate due to more exposure of the eustachian tube
  • Often grommets are used
  • Hearing issues may persist into adulthood
17
Q

What are the speech implications for those with cleft?

A

Cleft Lip
- Normal articulation

Cleft Palate
- Cleft palate speech
- the “cleft accent”

18
Q

What are some syndromes associated with cleft?

A
  • Stickler syndrome
  • 22q11 deletion
19
Q

What is velopharyngeal insufficiency?

A

Incomplete velopharyngeal closure as a result of anatomical defects

  • short velum
  • cleft palate
  • enlarged tonsils
20
Q

What is velopharyngeal incompetence?

A

Incomplete veloharyngeal closure as a result of physiological defects

  • poor muscle function
  • neuromuscular disorders
21
Q

What is cul de sac/potato in the mouth resonance?

A

Occurs when the sound resonated in the pharynx or nasal cavity, but is not released due to an obstruction

22
Q

What can occur with abnormal nasal airflow?

A
  • nasal grimace
23
Q

What are some passive speech errors?

A

Weak or ommited consonants
- Nasal air emission reduces oral pressure which means pressure consonants become weak or left out

Short utterance length
- Losing air through the nose means ore respiratory effort

24
Q

Why might someone with cleft have a voice disorder?

A

Use of glottal stops as a compensatory articulation production or the development of nodules as a result of strain in the vocal tract to achieve closure

Breathiness may be a compensatory strategy to reduce nasal air emission

25
Q

What speech compensatory strategies are made?

A
  • manner of articulation is preserved, but the place of articulation moves back
  • glottal stop replaces plosives
  • pharyngeal plosives replaces velar sounds
  • pharyngeal fricatives
  • pharyngeal affricate
  • nasal sniff
26
Q

How to assess cleft?

A
  • Visual inspection
  • nasal mirror test
  • hyponasality: 90-99
27
Q

How to treat hypernasality

A
  • bending straw from nose to ear
  • biofeedback e.g., nasal mirror
  • exaggerated articulation
  • ## decreasing speaking rate
28
Q

Treatment of compensatory articulation

A

basic articulation therapy

train front sounds prior to back sounds

train voiceless before voiced

SPSC 367 - Voice Disorders (13 decks)

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