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____ assessment (_____) should always precede instrumental assessment?
Clinical (orofacial and speech)
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The outcome of the clinical assessment determines? (3)
The need for an instrumental assessment
The type of instrumental study
Questions to be answered by the study
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Direct observatoin instrumental assessment is the most clinically useful approach and includes? (2)
Videonasendoscopy [sphincteric/superior view]
Videofluoroscopy [multiple views]
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Direct observation assessment should always preced _____ surgical management when possible?
secondary
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The goal of any orofacial exam in speech pathology is to identify _____, _____, and ____ or problems that may explain _____?
structural, oral motor and oral sensory deviations
the presenting speech disorder or complaint.
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Scarring on lips can have an effect on?
mobility for rounding, spreading, compressing and everting the lips.
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______:This refers to how the lips meet one another?
Anterior-posterior relationship of lips
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_____: Is there a collapsed naris/nostril, a depressed nasal tip, or other structural difference that is constricting the opening?
Anterior patency/openness
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_____:This is evaluated by the ENT/otolaryngologist, but findings can have significance for speech?
Interior patency
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Interior patency:
Blocked nasal passages can ? by blocking? and can change?
mask cleft palate speech problems.
nasal air emission that would otherwise escape
resonance quality of speech, which would otherwise be hypernasal
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So blocked passage (s) can mask?
CP closure problem and/or contribute to "mixed" resonance
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Often children with cleft palate, especially ini, will have a deviated or bowed septum because of the asymmetric attachment of ?
vomer (one of two bones that make up the bony nasal septum)
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Intraoral structures are:? (5)
- Dentition
- Occlusion
- Tongue
- Hard Palate and alveolus
- Velum and uvula
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Dental deviations refer to deviations in ?
specific teeth
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Dental deviations include the following:?
- Missing teeth
- ectopic teeth
- supernumerary teeth
- rotated teeth
- diastemas
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Missing teeth:
The _____ of missing teeth is important in considering the impact on speech articulation?
location
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These are teeth in the wrong place
ectopic teeth
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Supernumerary teeth are often _____ because there is not enough room for them in the dental arch?
ectopic
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____ are common on the transitional dentition?
Diastemas
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___: protrusive premaxilla (with or without an Angle Class II malocclusion)
Overjet
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____: (with or without an Angle Class III malocclusion) this can be due to maxillary deficiency
also call a pseudo CL III malocclusion
Underjet/underbite
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____ are a hazard for speech and can occur anteriorly and laterally in the dental arch?
Open bites
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If the tongue does not fit an adequate introral space we tend to diagnose ____?
macroglossia
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___: is the term for tongue-tie.
The ____ can be too short, attached too far anteriorly, attached with too broad an attachment to the inferior lingual surface, and combinations of these?
Ankyloglossia
Frenum (frenulum)
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It is important to consider the impact of anyloglossia on both ?
range of movements and precision of the tongue (tip)
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___: this is a condition where the tongue falls back into the airway?
Glossoptosis
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Glossoptosis should be looked for in all babies who present with?
Also children who present with ? and presents with?
respiratory (upper airway) problems.
Robin sequence and articulatory backing pattern
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