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Flashcards in Cleft Palate Deck (33)
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1
Q

What 5 specific structures are involved in cleft palate?

A

Nose, upper lip, hard palate, soft palate, and pharynx

2
Q

What is the most important structure for closing off the airway so speech comes out the mouth instead of the nose?

A

Soft palate/velum

3
Q

What is the #1 muscle responsible for raising the velum?

A

Levator veli palatini

4
Q

What muscle opens and closes the eustachian tube?

A

Tensor veli palatini

5
Q

In cleft palate surgery, what differentiates a good surgery that makes a difference in the velum raising and lowering vs. just a cosmetic surgery?

A

If they reconnected muscles or not (better to do a z-plasty suture instead of just a midline suture)

6
Q

Cleft palates are the ___ most common birth defect and the ___ common congenital defect of the face.

A

4th most common

most common defect of face

7
Q

When do cleft palates occur?

A

During the first trimester

8
Q

What are the 4 basic causes of cleft palate?

A

1 - chromosomal disorders
2 - genetic disorders
3 - environmental teratogens
4 - mechanical factors in utero

9
Q

What are the 2 categories of classification of cleft palate?

A

Cleft of the primary palate and cleft of the secondary palate

10
Q

What is the primary palate?

A

Anterior to incisive foramen, includes the lips!

11
Q

What is the secondary palate?

A

Posterior to the incisive foramen

12
Q

What is the incisive foramen?

A

Where everything starts fusing together

13
Q

What does it mean if a cleft LIP is incomplete?

A

Can be just a notch in the lip with alveolar ridge intact (can go into nasal sill)

14
Q

What is a complete cleft lip?

A

Cleft of primary palatea ll the way to incisive foramen through entire lip and alveolus

15
Q

What is an incomplete cleft palate?

A

Can be bifid uvula only or farther into the velum

16
Q

What is a complete cleft palate?

A

Extends through uvula and velum and through hard palate (usually associated with some type of syndrome)

17
Q

What is a submucous cleft?

A

Congenital defect that is in the underlying structures of the palate, not on the oral surface; can involve muscles of the soft palate and or boney structures of the hard palate

18
Q

What are some classic characteristics of a submucous cleft?

A

Bifid uvula, bluish line, or a notable inverted V

19
Q

What are the three primary effects of cleft palate?

A

1 - nasalized speech
2 - articulation errors
3 - increased risk of otitis media, possible hearing loss

20
Q

What are the 2 different ways to classify cleft palate speech errors?

A

Obligatory and compensatory

21
Q

What are obligatory errors a consequence of?

A

Direct consequence of anatomic or physiological defects

22
Q

When will obligatory errors be corrected?

A

They will spontaneously correct when the cause of the error is corrected (surgery!!)

23
Q

What are some examples of obligatory errors?

A

Nasal emission (during consonants), hypernasality (during vowels), weak consonants, nasal turbulence, etc.

24
Q

What are compensatory errors?

A

Things that a speaker does to replace sounds when they are unable to physically produce an actual sound

25
Q

Examples of compensatory errors?

A

Glottal stops, pharyngeal fricatives, pharyngeal stops, etc.

26
Q

What are 3 different ways to assess CP speech?

A

1 - perceptual assessment
2 - intra-oral assessment (oral periph)
3 - instrumental assessment

27
Q

What is the protocol for a perceptual assessment?

A

1 - obtain an adequate speech sample
2 - analyze speech sample
3 - correlate perceptual data with orofacial exam findings
4 - interpret the clinical data

28
Q

Connected speech samples are the best representations to do what 3 things?

A

1 - judge speech intelligibility
2 - check for consistency of errors
3 - judge voice quality and resonance

29
Q

What are some ways to test for hypernasality?

A

Sample should contained voiced, oral sounds (vowels)

  • prolong “ah”
  • repeating oral syllables “papapapa, titititi, kakakaka,” etc.
  • See Scape, fogging on mirror, etc.
30
Q

What are some ways to test for nasal emission?

A

Voiceless, pressure sensitive consonants (lots of “s”s)
Look for facial grimacing
Counting 60-70

31
Q

Say “no” to speech intervention ONLY if..

A

If the cause of the speech disorder is abnormal structure only; if nasality is consistent across all phonemes; if there is a consistent velopharyngeal opening due to insufficiency

32
Q

What speech therapy options are there for an abnormal structure?

A

ONLY surgical correction!

33
Q

What is our goal of therapy prior to surgery?

A

Early intervention - goal is to minimize those compensatory errors! Seriously educate the parents.