Anatomy and Physiology

Question 1

What are the components of the velopharyngeal valve?

Answer 1

The velum (soft palate), lateral pharyngeal wall, posterior pharyngeal wall

Question 2

What is a velar eminance?

Answer 2

The bending of the velum as it pushes against the posterior pharyngeal wall

Question 3

How does the velum move during closure?

Answer 3

Posteriorly and superiorly

Question 4

How do the lateral pharyngeal walls move during closure?

Answer 4

Medially to help close against velum. Asymmetry and variation of extent of movement are typical.

Question 5

How does the posterior pharyngeal wall move during closure?

Answer 5

Less of a role than the velum or lateral pharyngeal walls. Stays in place or slightly moves anteriorly.

Question 6

What is a Passavant’s ridge/pad?

Answer 6

A temporary structure in some people. Posterior pharyngeal wall bulges forward during velopharyngeal movement. Usually doesn’t help with closure (below closure sight of contact)

Question 7

What are the muscles of the velopharynx?

Answer 7

Levator veli palatini, tensor veli palatini, superior constrictor, palatopharyngeus, palatoglossus, salpingopharyngeus, musculus uvulae

Question 8

What are the three typical patterns of velopharyngeal closure?

Answer 8

Coronal, sagittal, circular

Question 9

Coronal velopharyngeal closure

Answer 9

Most common pattern of closure. Velum moves against posterior pharyngeal wall. Possible slight anterior movement of the posterior wall, minimal contribution of lateral pharyngeal walls. Estimated 70% of speakers.

Question 10

Circular pattern of VP closure

Answer 10

2nd most common pattern. . All structures contribute equally to closure (velum, lateral walls, posterior walls). About 25% of people. Often have Passavant’s ridge.

Question 11

Sagittal pattern of VP closure

Answer 11

Least common (<5% of people). Lateral walls move medially, meet in midline behind velum instead of against, soft palate has minimal posterior displacement.

Question 12

What happens to VP closure in nonpneumatic vs pneumatic activities?

Answer 12

Can show different closure patterns. Appears there is different neuromuscular mechanisms in speech vs nonspeech activities. Closure can be complete for nonpneumatic activities but insufficient for speech/ pneumatic activities. Closure also varies among different nonpneumatic activities.

Question 13

What are nonpneumatic activities?

Answer 13

Done without airflow ex: gagging, vomiting, swallowing. Can feel velopharyngeal closure. Velum is raised very high in pharynx, lateral pharyngeal walls close firmly across entire length. Prevents nasal regurgitation.

Question 14

What are pneumatic activities?

Answer 14

Use airflow and air pressure as a result of VP closure. Positive air pressure: blowing, whistling, singing, speech. Negative: sucking, kissing. Closure occurs lower in the nasopharynx.

Question 15

VP Timing of closure

Answer 15

VP closure must occur before phonation or there is hypernasality. Timing that occurs varies based on manner of articulation and how near the sound is to a nasal sound.

Question 16

VP height of closure

Answer 16

Slightly greater height for high pressure consonants (plosives, fricatives, affricates), voiceless consonants, high vowels

Question 17

Firmness of VP port closure

Answer 17

More firm in same environments as when higher (higher pressure consonants, voiceless consonants, high vowels. Less firm in vowels near nasals .

Question 18

Effect of rate and fatigue on VP port closure

Answer 18

Faster rates can reduce height and firmness, increasing hypernasality. Muscular fatigue can decrease the height and firmness of closure even in typical people.

Question 19

What are the bones of the facial skeleton?

Answer 19

Mandible, Maxilla, nasal bones, palatine bones, lacrimal bones, zygomatic bones, inferior nasal concha, vomer

Question 20

What are the bones of the cranium?

Answer 20

Frontal, parietal, occipital, and temporal bone, sphenoid bone, ethmoid bone

Question 21

What are the maxilla processes?

Answer 21

zygomatic, frontal, alveolar, palatine/palatal, body

Question 22

What are the sutures of the hard palate?

Answer 22

transverse suture (fuse maxilla and palatine), median palatine suture

Question 23

What composes the nasal septum?

Answer 23

Cartilage of septum, perpendicular plate of ethmoid bone, vomer

Question 24

What is a deviated septum?

Answer 24

Nasal septum deviating to one side. Bone bends at one of the sutures fusing the nasal septum. The bones are thin and fragile.

Question 25

What composes the bony septum?

Answer 25

Perpendicular plate of ethmoid bone, vomer

Question 26

What are the elevator muscles of the velum?

Answer 26

Levator Palatine, uvulus

Question 27

What are the depressor muscles of the velum?

Answer 27

Palatoglossus, palatopharyngeus

Question 28

What are the other muscles of the velum (not elevators/depressors?)

Answer 28

Auditory tube dilator, tensor palatine

Question 29

What is typically the prinicpal muscle of velar closure?

Answer 29

Levator

Question 30

What is unusual about the levator muscles?

Answer 30

They interweave through the midline, gives them extra strength

Question 31

What is a suture?

Answer 31

Line of fusion between bones

Question 32

What are the major sutures of the skull?

Answer 32

Sagittal(midline, means arrow), coronal(greek word for crown), lambdoidal (looks like lowercase green lambda), squamosal (attaches temporal bone to rest of skull), metopic

Question 33

Why do we have sutures in the skull?

Answer 33

Need room for the brain to grow. Are cartilaginous in between when younger, allows expansion of the skull.

Later when older, ossify and turn to bone

Question 34

What is plagiocephaly?

Answer 34

An asymmetrical or abnormal skull shape. May be due to synostosis or positional pressure.

Question 35

What is synostosis?

Answer 35

(premature ossificiation of suture). Can harm the nervous system.

Question 36

What is craniosynostosis?

Answer 36

Abnormal development of skull shape d/t synostosis of one or more cranial sutures resulting in malformation of skull in growth

Question 37

What is the incidence of craniosynostosis?

Answer 37

1/2000 live births

Question 38

Is positional pressure harmful to the nervous system?

Answer 38

No. Nervous system is soft, can still grow in other idrection.

Question 39

Is single suture craniosynostosis concerning?

Answer 39

No medical concern, purely cosmetic concern

Question 40

What are the statistics for the different sutures involved in craniosynostosis?

Answer 40

55% sagittal, 20% coronal, 5% lamdoidal, 5% metopic