Untitled Quiz

Voice and Resonance

• Voice quality is produced by sound vibrations in the pharyngeal, oral, and nasal cavities
• Velopharyngeal Insufficiency (VPI) is the failure of the velopharyngeal mechanism to separate the oral and nasal cavities during speech and swallowing
• The velum, when activated, separates the oral and nasal cavities
• Vocal pitch is perceived as the rate of vocal fold vibrations (frequency, measured in Hertz). Vocal loudness is perceived as intensity (measured in decibels), determined by the pressure of air from the lungs on vocal folds.
• Normal conversational speech averages around 60dB
• Vocal Nodules: Localized growths from frequent, hard vocal collisions. Usually bilateral, occurring in the juncture of the anterior and posterior two-thirds of the vocal folds. Soft and pliable. Most common in adult women (20-50 years old), and in children prone to excessive talking or screaming. Characterized by hoarseness and breathiness. Treatment involves vocal rest and plenty of water.
• Vocal Polyps: Fluid-filled lesions caused by ruptured blood vessels. Usually unilateral. Larger than nodules. Vascular, prone to hemorrhage. Commonly caused by a single traumatic event. Characterized by hoarseness and breathiness.
• Contact Ulcers: Small, reddened ulcerations on the posterior surface of the vocal folds (arytenoids region). Usually bilateral and painful. Replaced by granulated tissue. Result from trauma (like intubation). Characterized by hoarseness, breathiness, and throat clearing. Treatment efficiency is questionable, some reappear after removal.
• Vocal Fold Paralysis: Bilateral or unilateral paralysis is dangerous due to increased risk of aspiration if vocal folds are abducted. Cause damage to CN X (vagus nerve).
• Cleft: Abnormal opening in an anatomical structure due to failure of structures to fuse during development
• Hyponasality: Blockage in the nasopharynx preventing sounds from traveling through the nose, resulting in a nasal sound defect.
• Hypernasality: When the velopharyngeal mechanism fails to separate oral and nasal cavities adequately, causing nasal sounds to be overly prominent.

Motor Speech Disorders

• Pyramidal tracts (direct activation pathway) connect the cortex to the neurons
• Extrapyramidal tracts (indirect activation pathway) regulate reflexes and maintain posture/muscle tone
• Peripheral nervous system provides framework for movement

Dysphagia/ Disorders of Swallowing

• Aspiration: Silent aspiration is not further described
• Oral Preparation Phase: The tongue cups fluid to form a bolus, cheeks/teeth move bolus towards the back of the mouth
• Oral Phase: Bolus is formed and moved from the front to the back of the mouth, triggering the swallow reflex.
• Pharyngeal Phase: Velum contacts the rear wall of the throat, muscles squeeze the bolus down, vocal cords close, and the epiglottis lowers.
• Disorder Characteristics: Lips may not seal, impaired chewing, insufficient saliva, food may pocket, muscles may not function properly

Audiology and Hearing Loss

• Hearing loss prevalence: 20% of Americans report some degree. 3-1,000 births result in hearing loss.
• Deaf definition: Hearing loss of 90dB or more
• Outer ear components: Pinna and external auditory meatus
• Middle ear space: An air-filled space lined with mucous membranes, containing the Eustachian tube opening.
• Cochlea function: Processes auditory input for the central auditory system
• Otitis media: Middle ear infection that requires ventilation for resolution.
• Conductive hearing loss: Defects in outer or middle ear
• Sensorineural hearing loss: Inner ear damage (permanent)
• Mixed hearing loss: Combined conductive and sensorineural hearing loss
• Hearing loss causes in adults: Injury or other problems.
• Newborn hearing screenings: Important to detect and identify. occur in hospitals before release
• Hearing assessment tools: Pure-tone audiometry, tympanometry, behavioral observation, visual reinforcement audiometry.

Augmentive and Alternative Communication

• Unaided vs. aided AAC: Unaided uses body to communicate, Aided utilizes equipment.
• AAC system types: No tech, low tech, mid tech, and high tech
• Selection types: Direct (touch) vs indirect (scanning).
• AAC sample devices: Icons, PECS, Big Mack buttons, speech generating devices, iPads

Screening and Evaluation

• Screening: Determines if a problem exists.
• Evaluation: Provides diagnosis.
• Referrals: Can happen at any age by a variety of individuals (parent, oneself, pediatrician)