VIVA (Week 1-6)

Question 1

What are the five subdivisions of anatomy, and how can you remember them? Memory Aid: “My Microscopic Duck Cooks Curry”

Answer 1

Macroscopic, Microscopic, Developmental, Comparative, Clinical).

Macroscopic (Gross) Anatomy: Visible structures (organs, systems).
Microscopic Anatomy: Cells (cytology) & tissues (histology).
Developmental Anatomy: Changes during growth (e.g., embryology).
Comparative Anatomy: Compares humans to other species.
Clinical Anatomy: Applies to diagnosing/treating diseases.

Question 2

Methods of Studying Anatomy? Memory Aid: “Doctors Make Skeletons 3D Texts”

Answer 2

Dissection: Hands-on with cadavers.
Medical Imaging: X-rays, MRIs, etc.
Surface Anatomy: External observation.
3D Models & Digital Tools: Interactive visualizations.
Textbooks/Atlases: Detailed explanations.

Question 3

What is the anatomical position, and why is it important? Memory Aid: “Super Ants Meditate Properly”

Answer 3

Superior/Inferior: Above/below.
Anterior (Ventral)/Posterior (Dorsal): Front/back.
Medial/Lateral: Toward/away from the midline.
Proximal/Distal: Closer to/farther from the trunk or attachment.

Question 4

What are the body divisions? Memory Aid: Two A’s

Answer 4

Axial: Head, neck, trunk.
Appendicular: Limbs.

Question 5

Name three planes of the body and their sections. Memory Aid: SomeTigersCry

Answer 5

Sagittal Plane: Left/right.
Transverse Plane: Top/bottom.
Coronal (Frontal) Plane: Front/back.

Question 6

List common body movements. Memory Aid: Flamingos Act Ridiculous

Answer 6

Flexion/Extension: Bending/straightening.
Abduction/Adduction: Away from/toward midline.
Rotation: Turning around an axis.

Question 7

What is the structure and function of the thoracic walls?
Memory Aid: “Bones, muscles, and tissues protect and support.

Answer 7

Bones: Ribs, sternum, thoracic vertebrae.
Muscles: Intercostals, diaphragm.
Function: Protects organs, supports respiration, muscle attachment.

Question 8

Distinguish true, false, and floating ribs?
Memory Aid: “7-10-12 Rule”: 7 True, 8-10 False, 11-12 Floating.

Answer 8

True (1-7): Attach directly to sternum.
False (8-10): Attach indirectly via cartilage.
Floating (11-12): No anterior attachment.

Question 9

Parts of the sternum? Memory Aid: MBX (Manubrium, Body, Xiphoid) – like MBX = Mailbox

Answer 9

Manubrium: Top, attaches to clavicle/ribs 1-2.
Body: Long middle section.
Xiphoid process: Cartilage at bottom.
Sternal angle: Joint between manubrium and body.

Question 10

Joints between sternum, ribs, and cartilage? Memory Aid: “SCI Joints” – Sternocostal, Costochondral, Interchondral.

Answer 10

Sternocostal: Ribs to sternum.
Costochondral: Ribs to cartilage.
Interchondral: Between cartilages of ribs 6-9.

Question 11

Skeletal components of thoracic inlet and outlet? Memory Aid: “1 Man Top, 12 X Marks Bottom” (T1 & Manubrium at the top, T12 & Xiphisternum at the bottom).

Answer 11

Inlet: T1 vertebra, first ribs, manubrium.
Outlet: T12 vertebra, costal margin, xiphisternal joint.

Question 12

Function of external and internal intercostal muscles? Memory Aid: “Ex = Expand (inhale), In = In (compress/force out).

Answer 12

External: Elevate ribs (inspiration).
Internal: Depress ribs (forced expiration).

Question 13

Attachments and structure of the diaphragm? Memory Aid: “Diaphragm DOME = ‘Double-Dome, Central Tendon.’”

Answer 13

Attachments: Ribs, sternum, lumbar vertebrae.
Structure: Two domes with a central tendon.

Question 14

Structures passing through the diaphragm? Memory Aid: “EAT (Esophagus, Aorta, IVC Through Diaphragm).”

Answer 14

Esophagus.
Aorta.
Inferior vena cava (IVC).

Question 15

Pump handle vs. bucket handle movements? Memory Aid: “Pump = Push Forward (A-P); Bucket = Open Wide (Sideways).”

Answer 15

Pump handle: Upper ribs move anteriorly (increase A-P diameter).
Bucket handle: Lower ribs move laterally (increase transverse diameter).

Question 16

Muscles’ role in respiration? Memory Aid: “DIE Ab” (Diaphragm, Intercostals External = Inhale; Abdominals = Expire).

Answer 16

Quiet inspiration: Diaphragm, external intercostals.
Forced expiration: Internal intercostals, abdominal muscles.
Accessory muscles: Used in deep/labored breathing.

Question 17

Phases of breathing? Memory Aid: “QUIET = Passive, FORCED = Power.

Answer 17

Quiet inspiration: Diaphragm contracts, thoracic volume increases.
Quiet expiration: Passive; diaphragm relaxes.
Forced inspiration: Accessory muscles expand thorax.
Forced expiration: Abdominal/internal intercostals compress thorax.

Question 18

Conducting vs. respiratory portions of the respiratory system? Memory Aid: “Conduct = Carry, Respiratory = Release O2/CO2.”

Answer 18

Conducting: Nasal cavity → terminal bronchioles (air transport).
Respiratory: Respiratory bronchioles, alveoli (gas exchange).

Question 19

Pleurae and their function? Memory Aid: “V and P: Viscera = Very Close to lungs, Parietal = Peripheral.

Answer 19

Visceral pleura: Covers lung surface.
Parietal pleura: Lines thoracic walls.
Pleural cavity: Fluid reduces friction.

Question 20

Components of the respiratory tract? Memory Aid: “Tubes Become Tiny (Trachea → Bronchi → Tiny Airways)

Answer 20

Trachea: Flexible tube → primary bronchi.
Bronchi: Split into secondary and tertiary bronchi → smaller airways.

Question 21

Structure of the lungs? Memory Aid: “Right = 3 Rooms; Left = 2 Levels (with a Heart Cutout).”

Answer 21

Right lung: 3 lobes (superior, middle, inferior).
Left lung: 2 lobes (superior, inferior), cardiac notch, lingula.
Hilum: Entry for bronchi, vessels, lymphatics, nerves.
Apex: Extends behind the clavicle.

Question 22

Where is the larynx located, and what are its main functions?
Memory Aid: “Larynx is like a traffic controller at C3–C6: directs air, sounds alarms (voice), and stops intruders (food).”

Answer 22

Location: Anterior neck, level of C3–C6 vertebrae.
Functions:
Respiration: Pathway for air between pharynx and trachea.
Phonation: Produces sound by vibrating the vocal folds.
Protection: Prevents foreign objects from entering the trachea during swallowing.

Question 23

What are the three divisions of the larynx, and what structures do they include?
Memory Aid: “Think of a 3-level building: Supraglottis (roof), Glottis (middle floor), Subglottis (basement leading to the airway).”

Question 24

Describe the anatomy and function of the thyroid cartilage.
Memory Aid: “Thyroid cartilage is the front gate—big, protective, and anchors vocal cords like a fence.”

Answer 24

Structure: Largest cartilage; forms the Adam’s apple.
Two laminae fused anteriorly with superior and inferior horns for attachment.
Function: Anchors vocal folds and laryngeal muscles.

Question 25

Describe the anatomy and function of the cricoid cartilage. Memory Aid: "Cricoid = circular ring that keeps the airway open and stable."

Answer 25

Structure: Ring-shaped cartilage, located below the thyroid cartilage. Function: Only complete ring in the airway; attachment for ligaments and intrinsic muscles.

Question 26

What is the function of the epiglottis, and where is it located? Memory Aid: "Epiglottis is the trapdoor—closes to keep food out of the airway."

Answer 26

Structure: Leaf-shaped cartilage attached to the thyroid cartilage. Function: Covers the glottis during swallowing to prevent food from entering the airway.

Question 27

What are the three paired cartilages of the larynx and their functions? Memory Aid: "Paired cartilages: Arytenoid (Anchor), Corniculate (Caps), Cuneiform (Cushions)."

Answer 27

Arytenoid: Anchor vocal folds; allow movement for phonation. Corniculate: Horn-shaped; provide structural support. Cuneiform: Rod-shaped; support soft tissues in aryepiglottic folds.

Question 28

What are the five major ligaments of the larynx? Memory Aid: "TCCVQ = Tough Connections Create Vocal Quality."

Answer 28

Thyrohyoid Ligament: Connects thyroid cartilage to hyoid bone. Cricothyroid Ligament: Links cricoid and thyroid cartilages; site for emergency airway access. Cricotracheal Ligament: Joins cricoid cartilage to the first tracheal ring. Vocal Ligaments: Elastic fibers forming the vocal folds' core. Quadrangular Membrane: Forms aryepiglottic folds and false vocal cords.

Question 29

What is the difference between vocal folds and vestibular folds? Memory Aid: "Vocal folds = voice makers, vestibular folds = voice protectors.

Answer 29

Vocal Folds (True Vocal Cords): Vibrate to produce sound; composed of vocal ligament, vocalis muscle, and mucosa. Vestibular Folds (False Vocal Cords): Protect the vocal cords; do not produce sound.

Question 30

What are the extrinsic laryngeal muscles, and what are their functions? Memory Aid: "Elevators rise to swallow, Depressors drop after swallowing.

Answer 30

Function: Move and stabilize the larynx as a whole. Elevators (Raise larynx): Stylohyoid, digastric, mylohyoid, geniohyoid. Depressors (Lower larynx): Sternohyoid, sternothyroid, omohyoid.

Question 31

Which muscles are involved in abduction and adduction of the vocal folds? Memory Aid: "Posterior cricoarytenoid = open door; Lateral/interarytenoid = close door.

Answer 31

Abduction (Opens vocal folds): Posterior cricoarytenoid. Adduction (Closes vocal folds): Lateral cricoarytenoid, interarytenoid.

Question 32

What are the functions of the intrinsic laryngeal muscles? Memory Aid: "PLITC: Posterior (Pull apart), Lateral (Lock together), Interarytenoid (Seal back), Thyroarytenoid (Loosen), Cricothyroid (Tighten for high notes)."

Answer 32

Posterior Cricoarytenoid: Abducts (opens) vocal folds. Lateral Cricoarytenoid: Adducts (closes) vocal folds. Interarytenoid: Closes the posterior glottis. Thyroarytenoid: Relaxes vocal folds. Cricothyroid: Tenses and elongates vocal folds for higher pitch.

Question 33

What is the function of the occipito-frontalis muscle, and where is it located? Memory Aid: "Occipito-frontalis lifts eyebrows, moves scalp!

Answer 33

Structure: Composed of two parts: Occipital belly: Located at the back of the scalp, attached to the occipital bone. Frontal belly: Located at the forehead, attached to the skin above the eyebrows. Function: Moves the scalp backward and forward, raises the eyebrows, and wrinkles the forehead. Important for non-verbal communication, such as expressing surprise or curiosity.

Question 34

What are the muscles of facial expression responsible for? Memory Aid: "Facial muscles move skin, not bones!"

Answer 34

Structure: These muscles move the skin and soft tissues, inserting into the dermis or connective tissue, unlike typical skeletal muscles.

Question 35

What causes wrinkles on the face? Memory Aid: "Repeated frowning or smiling causes wrinkles!"

Answer 35

Repeated contraction of facial muscles, such as frowning or smiling. Loss of skin elasticity with age. Wrinkles correspond to the orientation of underlying muscle fibers.

Question 36

What is the function of the orbicularis oculi muscle, and where is it located? Memory Aid: "Like binoculars around your eyes, closes them tight!"

Answer 36

Structure: Encircles the eye. Function: Closes the eyelid during blinking or squinting.

Question 37

How does the platysma muscle affect the body? Memory Aid: "Platysma tenses neck and expresses tension!"

Answer 37

Structure: Located in the neck. Function: Depresses the mandible, tenses the neck, and expresses horror or tension.

Question 38

What are the main muscles involved in chewing? Memory Aid: "More Tea, Less Milk!"

Answer 38

Masseter: Elevates the mandible, closing the mouth. Temporalis: Elevates and retracts the mandible, closing the mouth. Lateral pterygoid: Protracts the mandible and enables side-to-side movements. Medial pterygoid: Elevates the mandible and assists in side-to-side movements

Question 39

What are the main components of the oral cavity? Memory Aid: "Cheeks, teeth, and tongue fill the oral cavity!

Answer 39

Vestibule: Space between the cheeks/lips and the teeth. Oral cavity proper: Main space enclosed by the teeth and gums. Limits: Roof: Formed by the hard and soft palates. Arches: Palatoglossal and palatopharyngeal arches form boundaries. Contents: Includes palatine tonsils, teeth, and tongue.

Question 40

What are the major salivary glands, and what do they secrete? Memory Aid: "Small, medium, large glands—mucous, mixed, and serous saliva!

Answer 40

Sublingual: Smallest, located under the tongue, secretes mucous saliva. Submandibular: Located beneath the mandible, secretes mixed (serous and mucous) saliva. Parotid: Largest, located in front of the ear, secretes serous saliva.

Question 41

What are the features of the mandible? Memory Aid: "Mandible has body, ramus, condyle, and foramen!"

Answer 41

Features: Body: Horizontal part housing the lower teeth. Ramus: Vertical part extending upwards. Processes: Condyle: Articulates with the temporal bone to form the TMJ. Coronoid process: Attachment site for the temporalis muscle. Foramina: Mental foramen: Passage for nerves and vessels. Mandibular notch: Separates the condyle and coronoid process.

Question 42

How does the temporomandibular joint (TMJ) function? Memory Aid: "TMJ moves jaw—open, close, protract, retract!"

Answer 42

Structure: Synovial modified hinge joint with an articular disc for smooth movement. Movements: Elevation: Closing the mouth (masseter, temporalis, medial pterygoid). Depression: Opening the mouth (lateral pterygoid, suprahyoid muscles). Protraction: Moving the jaw forward (lateral pterygoid). Retraction: Pulling the jaw backward (temporalis). Lateral movements: Grinding actions (pterygoids).

Question 43

What nerves are involved in the sensory and motor innervation of the face? Memory Aid: "Trigeminal for sensation, Facial for movement!"

Answer 43

Sensory: Trigeminal nerve (CN V), branches: Ophthalmic (V1), Maxillary (V2), Mandibular (V3). Motor: Facial nerve (CN VII): Controls muscles of facial expression. Mandibular nerve (V3): Controls muscles of mastication.

Question 44

How is the blood supply to the face and scalp organized? Memory Aid: "Carotid artery feeds face and scalp; veins drain into jugular!"

Answer 44

Arteries: Common carotid artery → External carotid artery supplies the face and scalp. Internal carotid artery supplies deeper structures. Veins: Internal Jugular drains facial artery and all sinuses. External Jugular drains maxillary artery. Both drain into the brachiocephalic vein, then the superior vena cava.

Question 45

What are the three sections of the pharynx, and what do they do? Memory Aid: "Nose, Mouth, Larynx" (Naso, Oro & Lary)

Answer 45

Nasopharynx – Located behind the nasal cavity, only air passes through. Oropharynx – Located behind the oral cavity, both food and air pass through. Laryngopharynx – Near the larynx, directs air into the larynx and food into the esophagus during swallowing.

Question 46

What is the function of the auditory (Eustachian) tube? Memory Aid: "Yawning and Swallowing for Equal Ears" – When you yawn or swallow, the auditory tube opens to balance ear pressure.

Answer 46

The auditory tube connects the middle ear to the nasopharynx and helps equalize air pressure in the middle ear, which is important for hearing.

Question 47

Where are the palatine, lingual, and adenoids tonsils located, and what is their function? Memory Aid: "Palate, Lingual, Adenoid" – Tonsils at the back of the mouth, tongue, and nose trap germs like a security team!

Answer 47

Palatine Tonsils: At the back of the mouth on either side. Lingual Tonsils: At the base of the tongue. Adenoids (Pharyngeal Tonsils): At the back of the nose.

Question 48

What are the two muscle layers of the pharynx, and their functions? Memory Aid: "Circular moves food, Longitudinal lifts pharynx" – One moves food down, the other lifts the pharynx up!

Answer 48

Circular Muscles (Constrictors): Propel food down during swallowing (superior, middle, inferior constrictors). Longitudinal Muscles (Levator): Elevate the pharynx for swallowing and speech (Stylopharyngeus, Palatopharyngeus).

Question 49

What nerves control the pharynx muscles, and how is the pharynx supplied with blood? Memory Aid: "Vagus, Accessory, IX - Pharynx’s Nerves!" – Remember the pharynx is “VAXed” with nerves and blood!

Answer 49

Motor Innervation: Pharyngeal plexus (vagus CN X, accessory CN XI), with stylopharyngeus controlled by cranial nerve IX (glossopharyngeal). Sensory Innervation: Cranial nerve IX. Blood Supply: Ascending pharyngeal artery and inferior thyroid artery.

Question 50

What is the difference between the hard and soft palate? Memory Aid: "Hard and Soft – Roof and Flap" – Hard is bony, soft is floppy

Answer 50

Hard Palate: Bony part of the roof of the mouth (palatine process of maxilla and palatine bones). Soft Palate: Muscular flap at the back of the mouth that includes the uvula and helps with swallowing and speech.

Question 51

Name the muscles of the soft palate and their functions. Memory Aid: "Tensile, Lift, Lower, Depress, Uvula" – Palate muscles: tension, lift, lower, and depress with the uvula at the end!

Answer 51

Tensor Veli Palatini: Tenses the soft palate, opens the auditory tube. Levator Veli Palatini: Elevates the soft palate to close off the nasopharynx. Palatoglossus: Lowers the soft palate, elevates the back of the tongue. Palatopharyngeus: Depresses the soft palate and elevates the pharynx. Uvular Muscle: Shortens and raises the uvula.

Question 52

Which nerves control the muscles of the soft palate? Memory Aid: "Vagus, Glossopharyngeal, and V for Tensor" – Vagus and Glossopharyngeal for most, V for tensor!

Answer 52

Most muscles are controlled by the pharyngeal plexus (cranial nerves IX and X), except for tensor veli palatini, which is innervated by the trigeminal nerve (CN V).

Question 53

What are the parts of the tongue and their functions? Memory Aid: "Tip, Body, Root – Move, Speak, Swallow" – The tongue’s three parts help you move, speak, and swallow!

Answer 53

Apex (Tip): Interacts with teeth and roof of mouth, key for speech. Body: Helps in food manipulation and speech shaping. Root: Anchored to the floor of the mouth, assists in swallowing. Lingual Tonsils: Traps pathogens at the back of the tongue.

Question 54

Where on the tongue are the five tastes detected, and what do they signal? Memory Aid: "Sweet Sour Salty Bitter Umami – Tip to Back, What to Track!" – Taste across the tongue, from sweet to savory!

Answer 54

Sweet: Tip of the tongue, signals sugars for energy. Sour: Sides of the tongue, signals acids. Salty: Tip and sides, detects electrolytes. Bitter: Back of the tongue, detects toxins. Umami: Back and middle, detects proteins.

Question 55

What are the extrinsic muscles of the tongue and their functions? Memory Aid: "Geniuses Have Stylish Palates!" – Move your tongue in all directions with these muscle geniuses!

Answer 55

Genioglossus: Pulls the tongue forward. Hyoglossus: Pulls the tongue downward. Styloglossus: Pulls the tongue backward and upward. Palatoglossus: Helps elevate the back of the tongue.

Question 56

What are the intrinsic muscles of the tongue and their functions? Memory Aid: "Superior, Vertical, Transverse, Inferior – Tongue’s Shape-shifting Squad!" – These muscles shape the tongue in every direction!

Answer 56

Superior Longitudinal: Curls the tongue upwards. Vertical: Flattens the tongue. Transverse: Narrows the tongue. Inferior Longitudinal: Curls the tongue downward.

Question 57

What are the motor and sensory innervations of the tongue, and its blood supply? Memory Aid: "Hypo-Glo-Vagus-Tri for Tongue!" – Hypoglossal does motor, Vagus and Trigeminal do sensory!

Answer 57

Motor Innervation: Controlled by the hypoglossal nerve (CN XII), except for the palatoglossus, which is controlled by the vagus nerve (CN X). Sensory Innervation: CN V (Trigeminal): Anterior two-thirds. CN VII (Facial): Taste to the anterior two-thirds. CN IX (Glossopharyngeal): Sensation and taste to the posterior third. Blood Supply: The lingual artery, a branch of the external carotid artery.

Question 58

WeekWhat is the overview of the swallowing (deglutition) process? Memory Aid: Swallowing: like a team sport with 26 players, some on break, some working overtime.

Answer 58

Coordinated Action: Involves oral cavity & pharynx structures (tongue, palate). Control: Both voluntary & involuntary processes. Frequency: Swallowed ~500–700 times/day; once per minute while awake, 3 times per hour while asleep. Muscle Involvement: Uses at least 26 muscles. Disorders: Injury can lead to dysphagia (difficulty swallowing).

Question 59

What happens during the Oral Preparatory Phase of swallowing? Memory Aid: It's like prep work before a big party: chewing, moistening, and getting the food ready!

Answer 59

Voluntary phase where chewing, moistening, and bolus formation occur. Structures involved: Lips, tongue, teeth, salivary glands. Larynx/pharynx remain at rest, and breathing continues.

Question 60

Q: What happens in the Oral Phase of swallowing? Memory Aid: The tongue is the hero, pushing the food back like a conveyor belt at a snack factory.

Answer 60

Voluntary phase: Tongue moves bolus posteriorly. Lips sealed, bolus pushed to oropharynx (~1-1.5 sec).

Question 61

Describe the Pharyngeal Phase of swallowing. Memory Aid: Time for the body to go into protective lockdown mode—airway secured, food on the move!

Answer 61

Automatic phase triggered when bolus passes palatoglossal arches. Soft palate elevates, nasal cavity closes. Hyoid/larynx elevate, breathing stops. Airway protected by epiglottis closure; UES opens.

Question 62

What occurs during the Oesophageal Phase of swallowing? Memory Aid: Food rides the esophagus like a water slide—fast and smooth!

Answer 62

Involuntary phase: Peristaltic waves transport bolus (~8 sec). Breathing resumes once bolus enters the oesophagus.

Question 63

What is the key mechanism of phonation? Memory Aid: Vocal folds closing = air gets trapped and makes sound, like a tiny drum.

Answer 63

Vocal folds adduct for vibration.

Question 64

What is subglottic pressure and its role in phonation? Memory Aid: It's like inflating a balloon—pressure builds, and pop—vibration happens!

Answer 64

Subglottic pressure is air pressure beneath the vocal folds that initiates vibration.

Question 65

hat are the steps in the sequence of phonation? Memory Aid: It's like a quick 5-step dance: breath in, fold up, pressure builds, vibrate, and open!

Answer 65

Inhalation: Quick intake of air. Adduction: Vocal folds close. Subglottic Pressure: Builds until folds blow apart. Vibration: Folds repeatedly blow apart and close (hundreds/sec). Termination: Abduction (folds open) ends phonation

Question 66

What are the three vocal registers? Memory Aid: From low, crackly whispers to high-pitched squeaks, your voice is like a karaoke playlist!

Answer 66

Modal: Everyday speech; strong, low-pitch range. Glottal Fry: Crackly, low-pitch; lax folds. Falsetto: High-pitch, thin, stiff folds

Question 67

How is pitch determined in phonation? Memory Aid: Pitch is like a rubber band—tighten it for high, loosen it for low.

Answer 67

Pitch is determined by vocal fold tension, which affects frequency (measured in Hz).

Question 68

What factors influence loudness in phonation? Memory Aid: Louder = more air pressure, more squeezing, and a bigger echo!

Answer 68

Loudness is influenced by subglottic pressure, medial compression, and resonance.

Question 69

What is articulation in speech production? Memory Aid: It’s like shaping clay—turning the raw sound into clear words!

Answer 69

Articulation is the process of shaping vocal fold sound into speech using structures like the tongue, lips, and soft palate.

Question 70

What is the Source-Filter Theory? Memory Aid: The vocal folds are the sound machine; the mouth is the sound sculptor!

Answer 70

The source is the vocal folds that produce sound, and the filter is the vocal tract that shapes the sound into speech.

Question 70

What are syllables, and how many syllables does an adult typically speak per minute? Memory Aid: Syllables are like Lego blocks—basic speech units!

Answer 70

Syllables are basic speech units (vowel ± consonants). An adult speaks around 240 syllables per minute.

Question 71

What are the implications of impairments to swallowing, phonation, or articulation? Memory Aid: If the nerves or muscles are broken, it's like a broken gear in a well-oiled machine—everything gets jammed!

Answer 71

Damage to nerves or muscles can affect these processes, with specific muscles and nerves playing key roles in each function. Dysfunction can impair swallowing, speech production, and clarity of articulation.