Chapter One Flashcards by Becky Chesney

Cleft

Cleft Lip (fusion normally@ 6-7 weeks)

Cleft Palate (Fusion at 9-10 weeks and complete by 12 weeks)

An abnormal opening or a fissure in an anatomical structure that is normally closed

It is the result of failure of parts of lip to come together early in the life of fetus

It occurs when the parts of the roof of the mouth do not fuse normally during fetal development, leaving a large opening between the oral cavity and the nasal cavity.

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External ear
a)
b)

a) Pinna (helps funnel sound into canal)

b) External auditory canal (leads to the TM; S shaped structure; lined by cilia; helps keep insects and other junk out)

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Middle ear (communicates with the mastoid- important for BC hearing)
a)
b)

a) Tympanic membrane- air is converted into acoustic energy

b) Eustachian tube- connects the middle ear to the pharynx; very important for equalizing pressure

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Inner ear
a)
b)
c)

a) Cochlea- snail shaped organ
b) Organ or Corti- contains outer hair cells which are the functional units of hearing
c) Semicircular canals- balance and equilibrium

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Nose and Nasal Cavity (Know the figure on slide 5*****)

Nasal root

Nasal bridge/nasion

Columella

Nasal tip

Ala nasi
Alar rims
Alar base

Nasal sill

Pyriform aperture

Nasal root- where the nose begins

Nasal bridge/nasion- bony strucute

Columella- fleshy structure that separates the two nostrils

Nasal tip- protruding pointy structure

Naris (pl. nares) or nostril- open cavities

Ala nasi:
Alar rims- c shaped curved structures
Alar base- where the nose connects with the upper lip

Nasal sill

Pyriform aperture- opening of the nose

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Nasal septum (Image*)

Quadrangle septal cartilage

Vomer—fits in median palatine suture groove

Perpendicular plate of the ethmoid

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Turbinates and meatuses (Image*)

Superior, middle, inferior turbinates (choanae) - make sure the air is channeled into the windpipe

Superior, middle, inferior nasal meatuses-

Paranasal sinuses (frontal, maxillary, ethmoid, and sphenoid)- cavities within the bone

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Upper Lip (Image*)

Philtrum-
Philtral ridges/columns-
Cupid’s bow-
White roll-
Vermilion-
Tubercle-

Philtrum- bridge which connects tip f nose to upper lip

Philtral ridges/columns

Cupid’s bow- not seen in cleft lip

White roll- just below cupisa bow

Vermilion

Tubercle- pointy structure of upper lip

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Oral Cavity

Hard palate
Alveolar ridge
Velum (soft palate)
Uvula
Tongue
Dorsal and ventral surface
Faucial pillars
Anterior and posterior
Tonsils (palatine tonsils)
Posterior pharyngeal wall

Hard palate- bony structure

Alveolar ridge

Velum (soft palate)- muscular structure

Uvula

Tongue

Dorsal and ventral surface

Faucial pillars

Anterior and posterior

Tonsils (palatine tonsils)

Posterior pharyngeal wall

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Palate and Pharynx

Hard palate (maxilla)

Velum (soft palate)

Eustachian tube

Tonsils

Adenoid (pharyngeal tonsil)

Tonsils (palatine tonsils)

Lingual tonsil (at base of the tongue)

Epiglottis

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Hard Palate

Separates ….

Serves as ____ of mouth and ___of nasal cavity

Palatal vault—

Alveolar ridge (alveolus)—

nasal cavity and oral cavity

roof; floor

dome on upper part of oral cavity

provides bony support for teeth

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Mucoperiosteum-

Mucous membrane—

Periosteum—

tissue that covers the hard palate

lining of stratified squamous epithelium
and lamina propria

thick, fibrous tissue that covers bone

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Rugae-

Incisive papilla-

Palatine (median) raphe-

ridges that run horizontally

projection of mucosa at area of incisive foramen (just behind central incisors)

line from incisive foramen to uvula

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Foramen—

Incisive Foramen-

hole or opening in a bony structure to allow blood vessels and nerves to pass through to the mucosa

In the area of alveolar ridge behind the central incisors
Starting point of embryological development

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Premaxilla

_______-shaped bone

Bordered by incisive foramen and incisive sutures

Contains ___ maxillary incisors

Triangular

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Palatine processes of maxilla

Forms anterior ___of maxilla

Two plates separated by ________

Nasal aspect of palatine suture forms groove for lower portion of vomer (nasal septum)

3/4th

median (intermaxillary) palatine suture

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Suture lines

Incisive suture lines

Median (intermaxillary) palatine suture

Transverse palatine (palatomaxillary) suture lines

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Horizontal plates of the palatine bones

_____ portion of the hard palate

Bordered by the transverse palatine suture lines

Meet in ____ at the median palatine suture

Ends with the _____

Posterior

midline

posterior nasal spine

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The hard palate is divided into***
1.
2.

Palatine processes of maxilla

Horizontal plates of the palatine bones

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Torus Palatinus (Palatine Torus)

Seen in some Caucasians of Northern European descent

Prominent longitudinal ridge on oral surface along intermaxillary suture line

Normal variation and usually not the cause of a problem

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Sphenoid and temporal bones

Medial and lateral pterygoid plates—part of pterygoid process of sphenoid bone

Pterygoid hamulus—inferior end of pterygoid plate
Both provide bony attachment for velopharyngeal musculature

….

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Velum (Soft Palate)

Consists of ____and _____ (no bone)

Attaches to ______

Median palatine raphe continues to _____

Uvula attaches to the ______

muscles; mucosa

hard palate

uvula

posterior border

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Palatine (Velar) Aponeurosis*

Consists of _____

Anchoring point for ____***

Provides ______

fibrous, connective tissue

velar muscles

stiffness

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Uvula

____-shaped pendulum

Consists of ____________ tissue

Very ________

Has no known function

Teardrop

mucosa, glandular, and adipose

vascular

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Pharynx (Throat) 1. Nasopharynx—above ____ 2. Oropharynx—_____velum 3. Hypopharynx- Posterior pharyngeal wall-

velum below velum around laryngeal region Adenoid tissue located just behind the velum

Adenoid Pad Mass of _________ Located on _________, just behind the velum More prominent in ________

lymphoid tissue posterior pharyngeal wall children than in adults

Eustachian Tube Connects _____with _____ At horizontal angle in children under age ____ At a ___ - angle in adults

middle ear; pharynx 6 45º

Eustachian Tube Pharyngeal opening is____and slightly above velum Torus tubarius- Salpingopharyngeal folds-

lateral ridge located posterior to Eustachian tube originate from torus tubarius and course down to the lateral pharyngeal wall

Velopharyngeal (VP) Closure Coordinated _____closure of structures Closes valve like a _____ Closes off _____from _____

three-dimensional sphincter nasal cavity; oral cavity

Velopharyngeal (VP) Function Regulates and directs transmission of ______and _____ in the oral and nasal cavities Important for production of _________consonant sounds and all vowels

sound energy and airflow “pressure-sensitive”

VP function requires coordinated movement of the following structures: *** 1. 2. 3.

1. Velum (soft palate) 2. Lateral pharyngeal walls (LPWs) 3. Posterior pharyngeal wall (PPW) Combined effort of these structures

VP port is always ____ at rest and always ____ when eating Open during the production of _____

open; closed nasals

Velar Movement Moves in a ______ and _____ direction Has a type of ____ action Moves toward the _____ Velar dimple—

superior; posterior “knee” posterior pharyngeal wall point of bend in the velum during contraction

Lateral Pharyngeal Wall (LPW) Movement Moves _____ Usually close against the ____ Sometimes close in ___behind the velum

medially velum midline

Posterior Pharyngeal Wall (PPW) Movement Moves _____toward the velum Has very ____role, however Passavant’s ridge—

anteriorly little bulge of muscle on the posterior pharyngeal wall during speech; occurs in some normal and abnormal speakers

Muscles of VP Closure ``` 1. 2. 3. 4. 5. 6. ```

1. Levator veli palatini (velar “sling”) 2. Superior constrictor (pharyngeal ring) 3. Palatopharyngeus (posterior faucial pillar) 4. Palatoglossus (anterior faucial pillar) 5. Musculus uvulae (bulge on nasal surface) 6. Tensor veli palatini

Motor and Sensory Innervation Pharyngeal plexus—

plexus—a network of nerves that lies along the posterior wall of the pharynx and consists of the pharyngeal branches of the glossopharyngeal nerve (CN IX) and the vagus nerve (CN X)

Cranial Nerves Trigeminal (V) Facial (VII) Glossopharyngeal (IX) Vagus (X) Accessory (XI) Hypoglossal (XII)

...

Patterns of VP Closure*** IMAGE Coronal pattern— Sagittal pattern— Circular pattern—

Coronal pattern—involvement of velum and PPW Most common Sagittal pattern—LPWs Least common all structures Sometimes includes Passavant’s ridge

Pneumatic vs. Nonpneumatic Activities Nonpneumatic: Pneumatic Positive pressure—whistling, blowing, speech Negative pressure—sucking, kissing

Swallowing, gagging, vomiting Positive pressure—whistling, blowing, speech Negative pressure—sucking, kissing

***During nonpneumatic activities: Entire length of _____move together with exaggerated movement. Closure is ____than with speech. During speech: Greatest movement occurs with ______. Note: Closure for speech and other positive pressure activities are different. Do not work on blowing/sucking to improve speech!

LPWs higher high-pressure consonants

Timing of Closure Valve closes before phonation begins or sound will be ______. Closure is maintained until a _____or the utterance is ended.

hypernasal nasal consonant

Height of Closure Closure contact may vary with different _____. Closure tends to be higher and tighter with _____and ______, especially voiceless consonants. Closure can be affected by ___ and ____

sounds high vowels AND high-pressure consonants rate AND fatigue.

Firmness of Closure Contact firmness varies with ____. Gap of ______ is the threshold for hypernasality. Even very small gaps cause _______.

consonant 5 mm (20 mm2) audible nasal air emission

Rate and Fatigue Velar movement and closure can _____ with rapid rate and muscular fatigue. Rate and fatigue affects the _____ AND ____of closure.

decrease height and firmness

Changes with Growth and Age Velum increases in _____ AND _____—”velar stretch.” Maturation results in an increase in ________.

thickness and length oral-motor coordination

Changes with Growth and Age Facial skeleton, including hard and soft palate, moves____and ____ _________changes in inclination and bends forward. Gradual involution of ____tissue occurs, particularly around puberty.

down AND down Posterior pharyngeal wall adenoid

Subsystems for Speech

Respiration Phonation Prosody (stress, rhythm, and intonation) Resonance and velopharyngeal function Articulation

Respiration Air pressure is required to initiate and sustain phonation:

Vocal folds close. Subglottic air pressure builds. Vocal folds break open and begin to vibrate. Pressure is released.

Respiration Breathing for vegetative purposes is _____than breathing for speech. There is a need to control breathing for _____. Ratio at rest: Ratio during speech:

different phrasing 50: 50 10: 90

Respiration Provides airflow, which converts to _________ for articulation Is important for ______ sounds

intraoral air pressure pressure-sensitive

High-pressure sounds:

Plosives (p, b, t, d, k, g) Fricatives (f, v, s, z, ʃ, Θ, ð) Affricates (ʧ, ʤ)

Low-pressure sounds

Liquids (l, r) | Glides (w, j)

No-pressure sounds

Nasals (n, m, ŋ)

Must be able to _______phonation quickly throughout an utterance Example: “a cup” requires start-stop-start-stop of phonation in just two syllables

start and stop

Prosody

Stress and intonation

Velopharyngeal Function For oral sounds: Velopharyngeal valve is ____ This allows acoustic energy to ______ It is important for the production of most ______sounds (particularly plosives, fricatives, affricates) and all vowels.

closed. enter oral cavity. consonant

Velopharyngeal Function For nasal sounds: Velopharyngeal valve is _____. This allows most of the sound energy to _________ It is important for ____sounds (m, n, ŋ).

open enter the nasal cavity nasal

Velopharyngeal Function Velopharyngeal valve must open and close quickly and efficiently Example: “It’s my map.” requires the valve to close-open-close-open-close in just three syllables.

....

Articulation Vowels: Produced by _____oral resonance Formant frequencies affected by: 1. 2. Acoustics and vowel perception affected by ________

altering 1. Position of tongue, jaw, and lips 2. Size and shape of oral cavity formant frequencies

Articulation Consonants: Produced with partial or complete _____ of oral cavityand then release Usually produced with ______

obstruction air pressure

Articulation Manner of Production: Plosives (p, b, t, d, k, g) 1. 2. 3.

1. Completely close oral cavity. 2. Build up air pressure. 3. Release air pressure suddenly.

Articulation Manner of Production: Fricatives (f, v, s, z, ʃ, Θ, ð) 1. 2. 3.

1. Partially close oral cavity. 2. Build up air pressure. 3. Release air pressure gradually.

Manner of Production Manner of Production: Affricates (ʧ, j)

Combine a plosive with a fricative. ʧ = t + ʃ ʤ = d + ʒ

Subsystems All subsystems need to be good “team players.” If one subsystem is not working well, it affects the ___of the other “team players.”

work