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Levator Veli Palatini
major muscle for velum elevation
closes off part of the oral cavity and pull velum down
2 layers of tissue, how the embryo begins
what happens when the facial parts do not meet correctly.
creates cranial fissures, clefts, immorality
what week does face formation take place?
within 4 weeks
what weeks does that palate form?
direction of face formation
all comes down from midbrain or together from sides
mechanically induced malformation
factors that directly influence the development of the embryo
malformation of the cranium and face that effects or has the potential to effect communication
elongated opening, resulting from failure of parts to fuse. Includes: lip, hard palate, and soft palate
minimal changes is oralfacial structures
examples of microforms
cleft uvula, submucous cleft, hairline indention of the lip, minimal palatal defects
a patient with a cleft uvula is life to have
submucous cleft (palatal cleft hiding)
some tissue is covering the hard palate so looks normal, but the bone and muscles have not fused
indications of submucous cleft
cleft/bifid uvula and/or high palatal vault
cleft palate is related to what factor
sex: more frequent in males
cleft palate is linked to ages in males or females (dads or moms)
males younger than 20 and older than 40
international classification of clefts is based on:
where the lack of fusion took place
muscles that make up the soft palate
levator and tensor palatine
language disorder related to cleft palate and cleft lip and palate
mild language disorder
language disorder related to cleft lip
no language disorder
when to children with clefts begin to babble and speak?
later age than non-clefted children
what speech sounds are the most frequent in error?
ones the require build up of oral pressure--intra-oral pressure
what speech sounds of least affected with cleft palate?
nasal consonants and semi-vowels
what common substitution patterns (2) for cleft palate?
- glottal stops for oral stops
- nasal fricatives for oral fricatives
percent of cleft population that has phonatory problems
vocal problems are related to what happening with the vocal folds?
- hyperfunction of vocal folds overdrivien to compensate for inadequate velopharyngeal function
- push from the throat instead of the diaphragm to get louder voice
soft voice syndrome
loss of air pressure through the nasal cavity
quality of sound damped/enhanced by the cavities above the vocal folds
resonance deal with...
nasal emission deals with...
how does articulation affect resonance?
- the position of the tongue in the oral cavity
- the tongue is held high or retracted--air gets sent through the nose and not mouth.
how does the position of the mouth/lips influence resonance?
- limited opening of the mouth/lips results in limited jaw movement
- air mostly moves through the nasal cavity
- nasal cavity is open
- occurs with abnormal coupling of the oral and nasal cavities
- sound: "too nasal"
- can be heard well on vowels
- nasal cavity is closed
- occurs when VP port or nasal airway is partially or totally closed.
- noticeable on consonants
hypernasality occurs with what factors:
- high vowels
- oral opening is small
- when valving closes too late or too early
- high tension in head and neck
nasal air emission
- inappropriate release of air though the nasal cavity during speech
- only occurs on consonants
- most observable on high pressure consonants
hypernasality is as ____disorder
nasal air emission is a ____ disorder
the greater the nasal air emission, the greater the likelihood of weak or omitted consonants
closing the cleft
refining anatomic structures for speech normalcy and cosmetic concerns
after prepalatal surgery what is used to keep lines from tearing
bilateral clefts needs pre-surgical management of what
the maxillary, to keep from collapsing by use of an arch expander
what is also done prior to bilateral ceft surgery
premaxilla taping so tissues get used to being in place and wont tear after surgery
issue with early secondary cleft repair
potentially interfere with mid facial growth
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