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PRAXIS SLP > cleft palate > Flashcards

cleft palate Flashcards

1
Q

True/false: during nasal breathing, the velum rests against the base of the tongue creating a patent airway

A

true (pg.333)

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2
Q

True/false: during speech the velum raises in a superior and posterior direction to contact the posterior pharyngeal wall

A

true (pg.333)

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3
Q

a shelf-like projection from the posterior pharyngeal wall that occurs inconsistently in some normal and abnormal individuals during velopharyngeal activities, such as speech, whistling, and blowing

A

passavant’s ridge (pg.334)

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4
Q

true/false: passavant’s ridge indicates an abnormality

A

false (pg.334)

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5
Q

a. levator veli palatini
b. superior constrictors
c. palatopharyngeus
d. tensor veli palatini

-provide the man muscle mass of the velum

A

a. levator veli palatini (pg.334)

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6
Q

a. levator veli palatini
b. superior constrictors
c. palatopharyngeus
d. tensor veli palatini

-responsible for the medial displacement of the lateral pharyngeal walls to narrow the velophraryngeal port to close around the velum

A

b. superior constrictors (pg.334)

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7
Q

a. levator veli palatini
b. superior constrictors
c. palatopharyngeus
d. tensor veli palatini

-assocaited with the medial movement of the lateral pharyngeal walls

A

c. palatopharyngeus (pg.334)

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8
Q

a. levator veli palatini
b. superior constrictors
c. palatopharyngeus
d. tensor veli palatini

  • open the eustachian tubes when the velum moves during swallowing or yawning:
  • enhances middle ear aeration and draining
A

d. tensor veli palatini (pg.334)

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9
Q

a. palatoglossus
b. salpingopharyngeus
c. musculus uvulae

-depresses the velum for production of nasal consonants in connected speech

A

a. palatoglossus (pg.334)

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10
Q

a. palatoglossus
b. salpingopharyngeus
c. musculus uvulae

-have no significant role in achieving velopharyngeal closure

A

b. salpingopharyngeus (pg.334)

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11
Q

a. palatoglossus
b. salpingopharyngeus
c. musculus uvulae

  • only intrinsic muscles of the velum
  • contracts during phonation to create a bulge on the superior and posterior part of the nasal surface of the velum
  • provides additional stiffness to the nasal side of the velum during velopharyngeal closure
A

c. musculus uvulae (pg.334)

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12
Q

variations in velopharygeal closure among speakers

a. coronal
b. circular
c. sagital

  • most common closure pattern
  • posterior movement of the soft palate closes against a broad area of the posterior pharyngeal wall
  • little contribution from lateral pharyngeal wall
  • when closure is complete, there is a coronal slit
A

a. coronal (pg.334)

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13
Q

variations in velopharygeal closure among speakers

a. coronal
b. circular
c. sagital

  • second-most common pattern
  • soft palate moves posteriorly, the posterior pharyngeal wall moves anteriorly and the lateral pharyngal wall moves medially
  • closes like a true sphincter
  • when closure is complete there is a circular slit
  • passavan’ts ride is commonly seen with this type of closure
A

b. circular (pg.334)

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14
Q

variations in velopharygeal closure among speakers

a. coronal
b. circular
c. sagital

  • least common pattern
  • lateral pharyngeal walls move medially to meet in milling behind the velum
  • there is minimal posterior displacement of the soft palate for closure
  • when closure is complete, there is a sagittal slit
A

c. sagital (pg.334)

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15
Q

______ activities do not involve air pressure

nonpneumatic or pneumatic activities

A

non pneumatic (pg.335) including

-swallwong, gagging and vomiting

pneumatic activities= blowing, whistling, singing, and speech

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16
Q

true/false: blowing and sucking exercises do not improve velopharyngeal function for speech

A

true (pg.335)

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17
Q

a. primary cleft palate
b. secondary cleft palate

  • complete cleft of the primary palate extended through the lip and alveolus to incisive foramen
  • incomplete cleft do not extend all the way to the incisive formen and include
    • a slight notch of the lip
    • a cleft of the lip only
    • a cleft of the lip and just part of the alveolus
  • can be unilateral or bilateral
A

a. primary cleft palate (pg.335)

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18
Q

a. primary cleft palate
b. secondary cleft palate

  • complete clefts of the secondary palate extend from the uvula to incisive foramen
  • incomplete clefts do not extend all the way to the incisive foramen and can include
    • a bifid uvula
    • a cleft of velum only
    • a cleft of the velum and just part of the hard palate
  • cleft location midline only
A

b. secondary cleft palate (pg.335)

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19
Q

what are the effects of cleft lip and palate on speech?

A
  1. dental and occlusal anomalies, particularly corssbites and class III malocclusions
  2. hearing loss due to eustachian tube malfunction
  3. velopharyngeal insufficiency
    (pg. 335)
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20
Q

what are the effects of cleft lip and palate of feeding?

A
  1. cleft lip usually does not affect feeding
  2. cleft palate causes the inability to build up suction due to the open cleft and can cause initial difficulty with compression of the nipple
  3. breastfeeding is usually not possible with a cleft palate
  4. with use of special nipples and bottles until the palate is repaired, most babies with clefts are able to feed well (pg.335)
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21
Q
  • a wide, bell-sharped cleft palate
  • seen with micrognathia (small mandible), glossoptosis (posterior tongue position)
  • airway and feeding problems
  • speech issues secondary to velopharyngeal insufficiency
A

pierre robins sequence (pg.335)

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22
Q

a. velocardiofacial syndrome
b. stickler syndrome
c. fetal alcohol syndrome
d. trisomy 13

  • usually occult submucosus cleft or velopharyngeal hypotonia
  • hypernasality
  • minor cardiac and vascular abnormalities
  • microcephaly
  • micorgnathia
  • nasal anomalies
  • narrow palpebral fissures
  • thin upper lip
  • minor auricular anomalies
  • abundant scalp hair
  • long slender features
  • hyperansality and speech sound errors, language delay and learning problems and risk psychiatric problems in adolescence
A

a. velocardiofacial syndrome (pg.336)

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23
Q

a. velocardiofacial syndrome
b. stickler syndrome
c. fetal alcohol syndrome
d. trisomy 13

  • cleft palate only
  • pierre robin sequence
  • wide flat face with mid face hypoplasia
  • epicnathal folds
  • sensorineural hearing loss
  • high myopia and risk for retinal detachments
  • risk for velopharyngeal insufficiency
A

b. stickler syndrome (pg.336)

24
Q

a. velocardiofacial syndrome
b. stickler syndrome
c. fetal alcohol syndrome
d. trisomy 13

  • pierre robin sequence, cleft palate and cleft lip
  • short palpebral fissures
  • short nose, flat philtrum and thin upper lip
  • microcephaly
  • developmental disabilities, behavior problems and speech and language disorders
A

c. fetal alcohol syndrome (pg.336)

25
Q

a. velocardiofacial syndrome
b. stickler syndrome
c. fetal alcohol syndrome
d. trisomy 13

  • cleft lip and palate, may have a midline cleft
  • holoprosencephaly, severe eye deficits, midline facial deformities
  • usually fatal before the first birthday
A

d. trisomy 13 (pg.336)

26
Q

a. optiz G
b. van der woude
c. orofacialdigital syndrome
d. wolf-hichhorn

  • cleft palate
  • distinctive facial appearance likened to a Greek helmet
  • hypertelorism
  • coloboma of the iris
  • prominent nasal bridge
  • microcephaly
  • microagnathia
  • short philtrum
  • dysplastic ears
  • pre-auricle tags
  • developmental disabilities, speech and language disorders, occasional hearing loss
A

d.wolf-hichhorn (pg.336)

27
Q

a. optiz G
b. van der woude
c. orofacialdigital syndrome
d. wolf-hichhorn

  • laryngeal cleft, cleft lip, cleft palate,
  • hypertelorism, flat nasal bridge, thin upper lip and low-set ears
  • voice and swallowing problems if there is a laryngeal cleft
A

a. optiz G (pg.336)

28
Q

a. optiz G
b. van der woude
c. orofacialdigital syndrome
d. wolf-hichhorn

  • cleft lip and palate
  • bilateral lip pits on the lower lip, missing teeth
  • speech disorders related to cleft lip and palate
A

b. van der woude (pg.336)

29
Q

a. optiz G
b. van der woude
c. orofacialdigital syndrome
d. wolf-hichhorn

  • cleft lip, cleft palate, midline cleft lip
  • hyperterlorism
  • lobulated tongue
  • multiple hyperplastic oral frenula
  • notching in alveolar ridge
  • broad nose
  • hydrocephalus
  • absence of corpus callosum
  • developmental disabilities and speech and language disorders
A

c. orofacialdigital syndrome (pg. 336)

30
Q

a. saethre-chotzen
b. crouzon
c. apert
d. pfeiffer

  • cleft palate or submoucous cleft palate
  • oronasal synostosis, ptosis of the eyelids, mid face hypoplasia, external ear anomalies
  • risk for developmental disabilities
A

a. Saethre-chotzen (pg.337)

31
Q

a. saethre-chotzen
b. crouzon
c. apert
d. pfeiffer

  • cleft palate, sub mucous cleft palate is occasionally seen
  • similar to apert syndrome including a broad forehead
  • flat occiput, exposthalmos, hypertelorism, antimongoloid slant, strabismus and mid face hypoplasia/retrusion, class III malocclusion, low-set ears
  • risk of developmental disabilities and upper airway obstruction
A

b crouzon (pg.337)

32
Q

a. saethre-chotzen
b. crouzon
c. apert
d. pfeiffer

  • cleft palate occurs infrequently
  • similar to crouzon, including prominent forehead with a flat occiput, exophthalmos, hyperterlorism, antimongoloid slant, strabismus and mid face hypoplasia retrusion, class III malocclusion, low-set ears,
  • developmental disabilities, speech and language disorders, upper airway obstruction
A

c. apert (pg.337)

33
Q

a. saethre-chotzen
b. crouzon
c. apert
d. pfeiffer

  • cleft palate is rare
  • coronal craniosynostosis
  • midface hypoplasia
  • shallow orbits with exophthalmos
  • hyperterolrism
  • tracheal anomalies
  • upper airway stenosis
  • hearing loss, developmental disabilities in type 1 and type 2 and upper airway obstruction
A

d. pfeiffer (pg.337)

34
Q

a. hemifacial microsomia
b. CHARGE
C. teacher collins
d. beckwith- wiedemann

  • cleft lip and palate in about 15% of the cases
  • facial asymmetry due to unilateral hypoplasia of the face, malar, maxillary, and or mandibular processes
  • cleft-like extension of corner of mouth
  • ear anomalies including microtia or anotia and pre auricular tags or pits
  • eye anomalies including colobomas of upper eyelid, epibulbar lipodermoids, microphthalmia
  • dysplasia or aplasia of temporomandibular joint, affecting the opening of the mouth and excursion of mandible
  • hearing loss, occasional velopharyngeal insufficiency or incompetence due to unilateral velar paralysis or paresis
A

a. hemifacial microsomia (pg.337)

35
Q

a. hemifacial microsomia
b. CHARGE
C. teacher collins
d. beckwith- wiedemann

  • pierre robin sequence, cleft lip and palate
  • Coloboma
  • Heart disease
  • Atresia of the choanae
  • Retarded growth and development
  • Genital anomalies
  • Ear anomalies
A

b. CHARGE (pg.337)

36
Q

a. hemifacial microsomia
b. CHARGE
C. teacher collins
d. beckwith- wiedemann

  • cleft occur infrequently, despite pierre robin sequence
  • downward slanting of the palpebral fissures
  • colobomas of the lower eyelids
  • microtia or middle ear anomalies
  • hypoplastic zygomatic arches
  • macrostomia or microstomia
  • micorgnathia
  • glossoptosis
  • hearing loss
A

c. teacher collins (pg. 337)

37
Q

a. hemifacial microsomia
b. CHARGE
C. teacher collins
d. beckwith- wiedemann

  • no cleft
  • hypertrophic facial features
  • macroglossia
  • airway, feeding and speech disorders
A

d. beckwith-wiedemann (pg. 337)

38
Q

true/false: treatment for velopharyngeal insufficiency always requires physical management

A

true (pg.338)

39
Q

true/false: speech therapy is often required to change compensatory productions that developed as a result of the VPI

A

true (pg.338)

40
Q

true/false: treatment for velopharyngeal incompetence usually requires physical management (palatal lift, or even surgery)

A

True (pg.339)

41
Q

true/false: treatment for velopharyngeal mislearning always requires speech therapy and never requires surgery

A

true (pg.339)

42
Q

nasal emissions results in…. (5 things)

A
  1. weak or omitted consonants due to the lack of adequate air pressure
  2. short utterance length due to need to take frequent breaths to replenish the lost airflow through the nose
  3. dysphonia due to strain in the entire vocal tract in efforts to achieve velopharyngeal closure
  4. compensatory articulation productions: abnormal articulation placement in an attempt to compensate for the lack of air pressure in the oral cavity; usually produced in the pharynx where there is air pressure
  5. obligatory distortions: distortions due to abnormal structure, despite normal articulation placement
    (pg. 339)
43
Q

a. hyper nasality
b. hyponasality
c. cul-de sac resonance

  • too much sound resonating in the nasal cavity during speech
  • most perceptible on vowels
  • voiced consonants maybe nasalized
A

a. hyper nasality (pg. 339)

44
Q

a. hyper nasality
b. hyponasality
c. cul-de sac resonance

  • not enough sound resonating in the nasal cavity during speech
  • most perceptible on nasal consonants
  • can also be noted on vowel sounds
A

b. hypo nasality (pg. 339)

45
Q

true/false: hypernasality does not affect voiceless consonants because resonance is the result of sound vibration

A

true (pg.339)

46
Q

what causes hyper nasality?

A
  • VPI or a fistula, can even be caused by keeping the back of the tongue too high when articulating vowels
    (pg. 339)
47
Q

what causes hypo nasality?

A
  • upper airway obstruction due to adenoid hypertrophy or nasal blockage (pg.339)
48
Q

a. hyper nasality
b. hyponasality
c. cul-de sac resonance

-occurs when the sound resonates in the pharynx or nasal cavity but is not released due to obstruction

A

c. cul-de sac resonance (pg.339)

49
Q

what causes cul-de sac resonance?

A

caused by enlarged tonsils, which blocks the entrance to the oral cavity causing pharyngeal cul-de-sca- resonance
(pg.339)

50
Q

what causes mixed nasality?

A
  • occurs when there is hyper nasality and/or nasal air emission on oral consonants and hypo nasality on nasal consonants
  • caused by apraxia or a combination of velopharyngeal dysfunction and upper airway obstruction
    (pg. 339)
51
Q

true/false: speech therapy can correct hyper nasality or nasal emissions due to VPI

A

False: speech therapy cannot correct hyper nasality

52
Q

speech therapy is appropriate after repair of the structure to address:

A
  1. compensatory articulation errors due to VPI
  2. compensatory productions due to a fistula
  3. phoneme-specific nasal air emission
  4. variable resonance due to apraxia
  5. hyper nasality or nasal emission following surgical correction (patient needs to learn to use the corrected value through auditory feedback
  6. compensatory productions due to abnormal dental occlusion
    (pg. 340)
53
Q

true/false: patient needs to learn to use the corrected valve through auditory feedback

A

true (pg.340)

54
Q

what are techniques used during treatment of resonance and velopharynegal dysfunction?

A
  1. auditory awareness and auditory feedback
  2. articulation techniques to correct placement
  3. drills and frequent practice
    (pg. 340)
55
Q

true/false: blowing exercises, sucking exercises, velar exercises or oral-motor exercise are effective and are totally appropriate

A

False: they are NOT effective and are totally inappropriate

pg.340

56
Q

timeline for intervention and assessment for children with history of cleft lip and palate:

  • ___________: should monitor language development and start language therapy, if needed
  • ___________: should evaluate velopharyngeal function and start speech therapy, if needed
A
  • birth to three
  • three years
    (pg. 341)

PRAXIS SLP (18 decks)

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