Examination 2

Question 1

describe prenatal facial development for cleft

Answer 1

primarily during the embryonic period which ends around 8 weeks of gestation and the early fetal period follows immediately

Question 2

3-4 weeks

Answer 2

structures undifferentiated- not an identifiable face

Question 3

5-6 weeks

Answer 3

face is apparent

Question 4

7-8 weeks

Answer 4

nose, eyes, mouth fully recognizable

Question 5

3-4 mo

Answer 5

point out rapid growth

Question 6

where could a cleft occur

Answer 6

see handout/drawing; any of the junctures- cleft of the lip,palate, etc

Question 7

Lip cleft

Answer 7

unilateral or bilateral, off to side, true hare lip at midline is rare

Question 8

palate- complete

Answer 8

2 palatal shelves totally separated

Question 9

palate-incomplete

Answer 9

2 palatal shelves partially fused

Question 10

sub mucous cleft

Answer 10

tissue covers cleft, bifid uvula may suggest same with bluish line and body notch; speech may be hyper nasal if soft palate doesn’t have enough tissue mass so the velopharyngeal port may not be adequately closed= air escapes up

Question 11

what are the best ways to test for a sub mucous cleft

Answer 11

to feel around, take pen light into nasal cavity into mouth and see movement

Question 12

describe the eval procedure for cleft, specifically the oral cavity exam

Answer 12

note where is/was cleft, note complete or partial/unilateral or bilateral, note/eval repair and function of the lips, dental ridge, hard palate and palatal closure

Question 13

which speech sounds are a problem

Answer 13

bilabial, labiodental, alveolar, interdental

Question 14

how many teeth do adults have

Answer 14

32 (8 incisors (4central and 4 lateral), 4 cuspids, 8 bicuspids and 12 molars)

Question 15

how many teeth do children have

Answer 15

20 (8 incisors, 4 cuspids, and 8 deciduous molars)

Question 16

where does cleft always occur? between which teeth

Answer 16

between lateral incisors and cuspids

Question 17

why do we need to note the condition of the teeth

Answer 17

we need good, healthy teeth to attach prosthetics to

Question 18

what is a normal bite

Answer 18

normal occlusion-alignment of teeth, buccal cuspids of upper teeth fit outside lower teeth

Question 19

what is a cross bite

Answer 19

anything different from normal- one arch may be larger than other arch; the upper arch may be small enough to fit inside the largest lower arch

Question 20

what bite would you expect in cleft

Answer 20

2nd pic

Question 21

what do we mean by an open bite

Answer 21

top teeth do not touch lower teeth- problems with s, alveolar sounds-t

Question 22

define a closed bite

Answer 22

top teeth completely cover lower

Question 23

mesial

Answer 23

to the midline

Question 24

distal

Answer 24

away from midline

Question 25

buccal

Answer 25

cheek-outside of tooth that touches cheek

Question 26

lingual

Answer 26

side of tooth that touches tongue

Question 27

occlusal

Answer 27

the top of the teeth

Question 28

how do you know if a patient is getting vp closure

Answer 28

movement, testing of eee and ooo when nose is plugged to see if air is escaping

Question 29

normal occlusion

Answer 29

if individual teeth in the 2 arches are properly aligned and the upper and lower dental arches meet in a fairly symmetrical manner

Question 30

neutrocclusion

Answer 30

class 1 malocclusion- when dental arches are properly aligned at molars but individual teeth are misaligned

Question 31

distocclusion

Answer 31

class 2- the mandible is set back, the first mandibular molars are retracted by at least one tooth from first maxillary molars

Question 32

mesiocclusion

Answer 32

class 3- the mandible is jutting forward, the first mandibular molar is advanced at least one tooth beyond the first maxillary molar

Question 33

what is meant by VP insufficiency

Answer 33

not enough tissue to create a palate that will close

Question 34

VP incompetence

Answer 34

enough tissue, but not enough competence in using tissue

Question 35

What is the Iowa Pressure Teset designed to test?

Answer 35

articulation test designed to assess speech of people with clefts - subtest of temple barley test of articulation

Question 36

nasal emission

Answer 36

discharge of air through nose during production of non nasal speech sounds -silent or audible

Question 37

nasal resonance

Answer 37

resonance (modification of sound by other structures through which it passes) influenced heavily by the nose

Question 38

how do you test for nasal emission

Answer 38

by holding a mirror under nostrils and seeing if mirror is fogged by warm air escaping through the nose

Question 39

would we expect language issues with cleft

Answer 39

not all children with cp need formal and intensive intervention for language problems, so not necessarily. slight lang delays might be corrected by home programs designed to stimulate language

Question 40

would we expect hearing issues with cp

Answer 40

yes bc of high frequency of hearing loss in kids with cp, problems with otitis media (middle ear) conductive hearing loss

Question 41

surgery schedule?

Answer 41

10 pounds/10 weeks- traditional ; 10 months, traditional by 6 months=lip; 1 year=soft palate; 3-5 year=hard palate; some do everything by 6 months