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  1. how long does it take the face and mouth to develop
    develops over the course of 20 years
  2. when does development begin
    in the first month of intrauterine life and ends some time between the 18th and 25th year
  3. what happens at the 12th week of gestation
    • intrauterine face has recognizable features:
    •   1. maxillary shelves have closed
    •   2. the soft palate has developed
    •   3. the tongue has emerged and occasionally makes swallowing movement
    •   4. deciduous teeth (milk teeth/baby teeth) have begun to calcify
    •   5. the mandible has basic structure which is cartilage

    this all occurs in critical first trimester when all of the above are forming and could be affected by disease, drugs, nutrition etc
  4. what are the scales of baby head to adult head (sizes)
    • the face is 1/8 the size of the cranium while in the adult it is 1/3-1/2
    • the cranium reaches max growth at the age of 12
    • the nasomaxillary complex completes growth around age 18
    • the mandible may continue to grow up to the age of 25
  5. facial growth does not show uniform increases in size but...
    • growth spurts
    • face is responsive to tissue changes throughout life
  6. what may initiate facial changes
    • disease
    • tensions and pressure of muscle functioning
    • malnutrition
    • trauma
    • changes from formation, eruption, and loss of teeth
  7. facial changes
    tension and pressure of muscle functioning
    • muscle dysfunctions which persist through critical periods of orofacial growth can distort the direction of facial development to cause permanent deformities of the dental arch
    • growing muscles exert a molding influence on bones
    • ex: mouth breathing leads to a high, narrow palatal arch secondary to a lowered tongue posture
    •    this interferes with the lateral widening of the maxillary arch because the molding action of the tongue is lost and the cheek muscles exert an inward force
    •      these children may have:
    •           a. slack upper lip
    •           b. shortened upper lip
    •           c. lower lip positioned beneath and behind the upper incisors
    •           d. an overbite
    •           e. chapped lower lip and or large lower lip
    •           f. allergic signs
    •                -raccoon eyes
    •                -allergic crease
    •                -allergic salute
    •                -mouth breathing
    •                -pharyngeal "scratch"
  8. facial changes
    may lead to bone deformities and may affect speech through damage to the neuromuscular system which regulates the speed and accuracy of muscle movements
  9. facial changes
    changes from formation, eruption, and loss of teeth
    the response of facial tissue to the design of false teeth
  10. the human face is not  _____________ and nothing is stable or unalterable about the ________ it modulates.
    static, speech
  11. what is the purpose of the oral peripheral exam 
    to determine the functional adequacy of the oral structure
  12. what happens in an oral peripheral exam
    • slp assesses whether or not the structures are adequate for speech
    • if deemed not adequate for speech, slp must decide whether the indiv can be helped to obtain more effective functioning from the deviant structures or whether physical changes must be made before attempting to change the function
  13. what must be considered when doing an oral peripheral exam
    • 1. not just the effect of orofacial structures on speech, but also the possible influences of speech on the formation of the dental arches and dental occlusion
    • 2. the influence which the malfunction or orofacial structures and speech have on the personality and the life outlook of the indiv
    • 3. the level of intelligence, motivation, emotional stability, auditory acuity, stimulability and auditory discrimination

    • case history must be carefully reviewed looking evidence of the following:
    •     1. disease
    •     2. malnutrition
    •     3. trauma
    •     4. growth/hereditary factors
    •     5. medical/dental care
  14. why is the evaluation of speech structures difficult
    • it involves estimates or judgments rather than direct measurements
    • the range in mobility, shape and size of the structures is great. RELY ON EXPERIENCE
    • evaluation are made of the structures and spaces on the basis of the relationship between them
    • if there are several deviations of the speech mechanism, their affect tends to be cumulative, even though the indiv deviations may appear to be insignificant
    • as a rule, we do not find dramatice deviations of the oral structure which can be conclusively related to the specific speech deviation
    • people show great ability in compensating for structural irregularities
  15. in terms of sound production, why might defective sounds occur
    if the essential valves are not properly created due to abnormal oral structures or maladaptive patterns of articulation movements
  16. 8 valves or structures involved in speech
    • glottis
    • soft palate and nasopharyngeal tissue
    • tongue and soft palate
    • tongue and hard palate
    • tongue and alveolar ridge
    • tongue and anterior teeth
    • lower lip and upper teeth
    • lips
  17. what can happen if orofacial paralysis occurs early in the development of the face
    may cause orofacial deformities and contribute to defective speech
  18. how do we test for orofacial paralysis
    • comparing the action of the two halves during the oral peripheral exam
    • 1. normal wrinkles tend to be smoothed around the mouth and eye
    • 2. sagging of the skin and underlying muscles on one or both sides of the face
    • 3. inability to raise eyebrows or close eyes tightly
    • 4. inability to press lips tightly together on one or both sides
    • 5. inability to smile, retract, elevate angles of the mouth
    • 6. drooling from one corner
    • 7. inability to protude the tongue or protrude in the midline
    • 8. " to raise/lower the tongue tip inside or outside the mouth
    • 9. " to touch the corners of the mouth w/ the tongue tip
    • 10. " to protrude and retract the jaw at midline
    • 11. "to open and close bite with equal strength on each side
    • 12. " to prevent air from moving through the nasopharyngeal valve and nasal passages during blowing or speaking
    • 13. " to retract and elevate the palate and associated palatopharyngeal tissue during phonation
    • 14. " to maintain elevated position of the palate during sustained phonation
    • 15. " to impound air in cheeks or keep cheek from puffing during the production of plosives
  19. what characteristics of a human's face can affect speech sounds
    • orbicularis oris has a prominence not present in other primates
    • the complexity, size and number of the muscles originating particulary at the corner of the mouth greatly facilitate oral mobility in man
    • anatomy of lips and the shape of the mouth make rapid and airtight closure and sudden explosive opening possible-both necessary for articualtion
    • our cheeks cover most of our molars and we can never bare all of our teeth
    • due to great evenness in height and width of all teeth in man, the denture forms an unbroken palisade around the oral cavith which is a prerequisite for the production of /f,v,s,z/
    • the ratio of height, length and wider of the oral cavity is different in man due to a shift in the position, suspension, and attachment of the tongue
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2013-02-10 20:36:39

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