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VPI/A starts with ____ process then ____ follows, and then _____ is done to confirm and explain the perceptual findings?
- diagnostic
- clinical assessment
- instrumental assessment
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Instrumental approaches?
- Cephalometric radiography
- videofluroscopy
- videonasendoscopy
- aerodynamic/pressure flow studies
- nasometry
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Direct assessment includes?
- Visual imaging
- qualitative data
- still radio graphs
- videofloroscopy
- videoendoscopy
- tomorraphy (CT scans, ultasound, MRI)
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Indirect assessment includes?
- Aerodynamic and acoustic outputs
- Objective data
- No direct visual imaging
- Includes:
- Pressure flow studies
- Acoustic:
- Nasometry
- Spectrography
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Most commonly used approaches at CF Centers?
- Videonasendoscopy
- Videofluoroscopy
- Pressure-flow studies
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Cephalometric x-ray:
____ views?
___ images are obtained: (3)?
Gives good information on?
low ___?
- lateral and frontal
- still:
- during rest
- during sustained phonation of /u,i/
- during sustained production of /s/ or other oral fricative
- Good info
- tonsils, adenoid and T-A velum interaction
- cervical spine anomalies
- occlusion
low radiation
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Videofluoroscopy:
joint participation of?
____ can be used to outline soft tissue structures
Views?
- SLP and radiologist
- liquid barium
- sagittal, frontal, base or superior)
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Videofluoscopy sagittal (___)view:
Provides info on ____:
Shows:
Size and extent of ?
(lateral)
velar movement, adenoid and tonsils
- velar contact with PPW
- velum-to adenoid contact
- height (level) of VP closure/velar eminence
- Passavant's ridge/activity in VP closure
- palatine tonsils-
- extension up and behind velum into nasopharynx
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Videofl: frontal (___) view:
Provides info on ?
shows?
- (A-P)
- medial movement of LPWs
- shows:
- level of match between velum and LPWs
- any asymmetry of LPWs
- asymmetry of velar elevation
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in sagittal and frontal views patient is ?
seated in the upright position
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Base or superior view:
Only view that can show ____ and the ?
shows:
but misses?
- sphincteric closure
- the interactive movements between tonsils, adenoid and velum
- shows:
- asymmetry of LPWs
- asymmetry of velar movement
- tonsillar poles that project up into the nasopharynx
- Misses:
- vertical data superior to inferior extent of adenoid, height of VP closure
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base view: taken from?
below with patient in sphinx position
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VNE provides ___ view only?
data on the following?
superior view
- sphincteric pattern of closure
- velar and LPW symmetry in closure
- occult SMCP (on dorsal surface of velum)
- velum to adenoid contact
- palatine tonsils
- passavants ridge activity durign closure
- presence of tortuous arteries (pose risk factor for surgery)
- allows us to visualize anatomy better than VFL
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Mc Williams & Bradley
Rates ___ reltaionship?
developed when ?
Not widely used today
- velum to PPW
- relied on lateral stills and lateral cines
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Skolnick & colleagues
Describe?
Used?
- the valving patterns (coronal, sagittal, circular, circular with passavants ridge)
- by most centers and SLPs
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International Working Group-SLPs
Rating system based on ___ and ____?
Has ?
extent of movement of velum and PWs relative to their rest postitions
utility for both clinical and research applications
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Aerodynamic Studies Pressure flow technique
based on a theory that states that the area of ______ can be determined by _____ and _____?
an opening
measuring the sirflow through and pressure drop across that opening
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Aerodynamic Studies Pressure flow technique
As applied to VP function for speech: the mm extent of opening in the VP can be determined by measuring__?
nasal airflow (thru a nostril) and the difference in air pressure between the mouth (oral pressure) and the other nostril (nasal pressure) as measured by a pressure-sensing tube.
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Pressure-flow-technique does not?
- visulaize or describe VP movements
- locate opening continuous speech
- sample continuous speech
- account for coproduced compensatory misarticulations which can affect oral and nasal pressures and flows
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