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Cleft Palate Exam Questions
Terms in this set (66)
What is the bony roof of the nasal cavity
Ethmoid Bone (cribriform plate)
What is the upper part of the bony nasal septum?
Perpendicular plate of the ethmoid bone
What is the upper portion of the lateral nasal wall
lateral walls of the ethmoid bone
What is the lower portion of the bony nasal septum?
The palate is composed of the __________ and __________bones
The Palatal process of the maxilla (anterior 2/3rds) and the Palatal process of the Palantine bone
The portion of the hard palate containing the incisor teeth is the ___________
alveolar process (the pre maxilla)
What is the posterior bony projection of the hard palate?
The posterior nasal spine projecting posteriorally from the palatal process of the palatine bone
The inferior turbinate articulates with the Maxilla and the other turbinates articulate with what bone?
The labyrinth of the ethmoid bone
The portion of the temporal bone immediately posterior to the bony external auditory meatus is the what?
The portion of the temporal bone containing the bony external auditory meatus is the ________ ________
The maxilla grows in thickness by means of ___________ growth?
Appositional growth (made by cell division)
Describe the permanent teeth
Two central incisors, two lateral incisors, two cuspeds (k-9s), 4 bicuspids, 6 molars
Describe the Deciduous teeth
Two central incisors, two lateral incisors, two cuspeds, four molars (do not contain premolars)
What is hypertelorism?
This is when the space between the acanthi of the eyes is longer than normal (inter canthal distance)
What is the primary palatal muscle of velopharyngeal closure?
The levator veil palatini
Where does the levator veil palatini originate?
From the inferior portion of the temporal bone near the torus tuberous
What pharyngeal muscle can aid the levator veil palatini in VP closure?
The Superior pharyngeal constrictor
A third muscle that can aid in VP closure along with the levator veil palatini and the superior pharyngeal constrictor is what muscle?
The Musculus uvula. Upon constriction, it bunches the velum aiding in VP closure
Airation of the middle ear cavity is accomplished by what muscle?
Tensor veli palatini muscle
If the middle ear does not get aerated with fresh air via the eustachian tube due to a cleft palate, then what can happen?
The air can be absorbed by the surrounding middle ear tissue. This absorption of air causes a negative pressure within the middle ear.
If there is a negative pressure in the middle ear, what type of tympanogram will result?
A type c tympanogram because the TM is concave.
if the middle ear has negative pressure, what can happen?
The negative pressure can form a type of vacuum and suck liquid from the moist mucosal middle ear lining.
If the middle ear has been filled with liquid what type of tympanogram can result?
The TM will be convex toward the outer ear and result in a Type B tympanogram (flat) because the tympanic membrane is unable to reflect the wave. The ear canal volume will be normal.
If a child has tubes in their ears, what type of tympanogram will result?
A type B tympanogram BUT with LARGE ear canal (indicating a perforation in the TM)
When is surgical closure of a cleft lip usually accomplished?
Before 3 months
When is surgical closure of a cleft PALATE usually accomplished
The surgical goal of cleft lip repair is ________
-a good looking, functional cupid's bow
-restoring alar cartilage symmetry
Surgical repair of the palate is accomplished by ______
Most surgical techniques utilized today for the repair of the palate were derived from a procedure invented in 1860 by?
Palatal closure using the Furlow technique is most effective to provide
Palatal lengthening and reorienting the legator muscle
With cleft lip and palate, the primary treatment problem facing the orthodontist is _____
maxillary arch collapse
What are two types of maxillary expansion devices and what age are they employed?
-Split Lingual Expansion Arch (8 yrs) uses a spring mechanism to exert lateral force to prevent maxillary arch collapse
-Split Palatal Expansion Arch (8 years) employs the use of a split retainer (split down the middle) and in the split area is a jackscrew that can be turned with a key to exert lateral force on the arch
At what age does the alveolar bone graft take place?
What is the primary deciding factor that determines this timing of the alveolar bone graft?
The primary deciding factor is the maxillary permanent k-9 growth. Typically there should be 1/4 to 1/2 root growth as seen through x-rays
What is Velo-cardio-facial syndrome?
A syndrome often involving a Submucal Cleft Palate. Sometimes involve hurt problems, hypo-tonia of the face often the corners of the mouth, and infra orbital hypoplesia. AKA: DeGeorge Syndrome 22Q deletion and Shprintzen syndrome
What is the Rule of 10 when it comes to cleft lip repair?
-must be at least 10lbs
-must be at least 10 weeks of age
-must have 10g of hemoglobin
-have less than 10,000 WBC so no infections
What is the frequency of overall clefting?
1:750 live births in the US
What type of cleft is most common?
Cleft lip and palate (left side is also most common)
What is the prevalence of cleft with respect to race?
1:500 asians and native americans
1:750 Overall US
1:2,000: African Americans
What is the prevalence of cleft with respect to gender?
2:1 males to females
For isolated cleft palate, what is the prevalence with respect to gender?
2:1 females to males
What are the features associated with Submucous cleft palate?
-Zona Pelucida: the mesoderm is not intact so shows a blue tint when shining a light onto the soft and hard palate
-A shaped levator
-Absent Posterior Nasal Spine
What are four of the most prevalent causes of cleft lip/palate?
4) Environmental (teratogenic such as maternal rubella)
What are the four major types of orofacial clefting?
-Celft lip and palate
-Isolated cleft palate
-Submucal cleft palate
Why would a surgeon perform pharyngeal flap surgery? What is the ideal age?
The surgery is known as a Speech Surgery to aid in speech. It is done for people with good side wall closure but a large gap between the velum and posterior pharyngeal wall. The ideal age is 3.5-4 years allowing for sufficient A-P palatal growth and so that children do not have ingrained compensatory articulations
What can be done if a person has a small velopharyngeal gap?
Can do injection of hydroxi-appetite on the posterior pharyngeal wall to "plump" it out so the velum can make contact
What can be done if a person has a medium sized velopharyngeal gap?
Can do the Furlow surgery which takes triangular flaps and attaches them on the opposite side and has the effect of lengthing the palate.
What can be done if the person has a large VP gap?
Can be fixed using posterior pharyngeal flaps. These flaps can have 4 different positions
-High place high base
-High place low base
-Low place high base
-low place low base
With resistance held constant, as pressure increases, flow:
With pressure held constant, as resistance decreases, Flow:
With flow held constant, as resistance increases, pressure:
T or F: Hypernasality for vowels can be defined as the amount of excessive nasal resonance present as measured by nasal sound pressure level and nasal air flow?
Coupling the nasal chamber to the oral chamber does what to the amount of sound pressure level measured at the mouth?
Reduces the amount of sound pressure level measured at the mouth
The incidence of vocal nodules is greater or less in cleft populations?
a source function and a filter function
T or F: Nasometry can distinguish oral-nasal resonance imbalance from audible nasal emission?
False...one of the shortcomings thus it should be second to the clinician's ear which is the gold standard
Greater oral air flow is associated with what type of vowels?
Low vowels (I'm assuming this is because the tongue is lower in the oral cavity and thus allows the air less resistance when exiting?)
What type of speech productions produce the greatest VP closure?
Plosives, Fricatives, High Vowels
The greatest intramural pressure is associated with what type of speech production?
What is Nasality?
The listener's perspective of the acoustic and aerodynamic events following a lowered velum. This definition takes into account dialectical nasality due to the lowered velum and also nasality as a result of VPI.
What is hyper nasality?
The affect of oral nasal resonance imbalance as a result of a lowered velum. With hyper nasality, there is a perceived excessive resonance in the nasal chamber. H
Why is Hypernasality only a voiced phenomenon?
Because of the resonance component and it can be perceived by the listener in voiced consonants and vowels
How do you test for oral-nasal resonance imbalance?
Have the person produce a high vowel such as /i/ and sustain it while the clinician pinches their nose. This is because if there is good VP closure, the production will stay the same. If it does not stay consistent, this could mean possible VPI and sound is coming through the nose. The anterior nose pinch is creating cup-de-sac resonance and the sound is resonating int he nasal chamber then coming back thru the oral chamber.
How do you test for Auditory nasal emission of air?
Have the person produce voiceless high pressure consonants so as to hear nasal emission if it is there. High pressure voiceless consonants require complete VP closure for the flow to travel thru the oral cavity. If there is VPI, due to ohms law, flow will follow the path of least resistance and travel thru the nasal chamber. This will be audible. Can use words such as Puppy or a sentence like Jerry's fuzzy slippers
What are several mis articulations due to VPI?
Glottal stops for stops, pharyngeal fricatives for fricatives, and backing in general.
Dialectical Nasality vs Nasality Due to VPI
-Oral nasal resonance imbalance
-No audible nasal emission
-No misarticulations (related to VPI)
Nasality due to VPI
-Oral nasal resonance imbalance
-Probable audible nasal emission
-Probable compensatory misarticulations
THIS SET IS OFTEN IN FOLDERS WITH...
Cranio Chapter 1
Craniofacial study guide
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