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CDIS 123 FINAL 2

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What is a cleft?
an opening of structres normally closed.
Where can a celft occur on the face?
There are Clefts of the Lip, and Palate
When are the critical times of the face in order of normal development?
weeks 4-12 for the face, and 8-12 weeks for palate
What is the Maxillae?
A Pair of large facial bones that form the hard palate and upper jaw.
What is the Alveolar process?
This is the outer edge of the mazillary bones.
What is the function of the hard palate?
To seperate the oral and nasal cavatives
What is the function of the soft palate?
to open and close a port between the nose and the mouth.
What is the average incidence for a cleft to occur?
1 in 750 births
*25% have cleft lip only
*25% have cleft palate only
*50% have clefts of both.
What are the 3 main causes of a cleft?
1) Genetic
2) Chromosomal
3) Teratogenic
What is ment by Teratogenic causes?
*drugs
*substance abuse
*Radiation
*maternal infections or diseases
What are the three clinical classifications of clefts?
Laterality: Unilateral(one side) Bilateral(both sides)

Severity: Complete or Incomplete

Structre(s):Lip and/or Palate
Who are the important people in making a diagnosis for Clefts?
*Parents
*The Surgeon
*SLP
*Orthodontist
*Dentist
*Social Workers
What does the cleft lip do to effect your speech?
It actually isn't to much trouble
What is the effect of a cleft palate on speech?
*resonance changes
*articulatory changes
~weak consonants
~nasal emission
~articulators need to compensate
*Voice can sound horse
How doe s a cleft effect Language?
Generally there is a expressive language delay, but also they are susceptable to receptive delays.
Why can language be effected due to a cleft?
*hearing problems
*less language stimulation at an early age
*direct relationships to the medical condition
Other issues that effect cleft patients?
*Psycho-social issues
~scarring
~different face apperence
*Higher incidence of LD/BD
*Missed school days
*May have feeding issues
What is the treatment for a cleft?
*Surgery
~Lip surgery at 3-4 months of age
~Palate Surgery:
*usually at 12 months, if speech problems persist a second one is done a 5-6 years of age.
*SLP Therapy
*Prosthetics
What is the prevelence of Aphasia in America?
1 million people have it. Most common and prevelant adult language disorder.
What is the most frequent casue of Aphasia?
Strokes
Name the three types of strokes associated with Aphasia.
1) Thrombotic
2) Embolic
3) Hemorrhagic
What is a Thrombotic Stroke?
A build up of plaque that blocks an artery
What is an Embolic Stroke?
A blood clot forms somewhere in the body, breaks off, and is carried to an artery in the brain. It then lodges and blocks the blood supply.
What is a Hemorrhagic Stroke?
A weakended arterial wall bursts and flood flows freely into the brain tissue causeing increased sweeling and pressure in the brian.
Besides strokes what are other causes of Aphasia?
Head Injury
Tumor
What is Wernicke's Aphasia?
*Speech is well articulated, but it lacks content.
*Poor auditory comprehension
*the Lesion is in the posterioe cortex.
What is Broca's Aphasia?
*Speech is slow and labored=poor verbal expression.
*Good comprehension
*Omiision of grammatical forms
*Wriiting is impaired
*Lesion is in the anterior cortex.
How does one evaluate Aphasia?
*Auditory Comprehension
*Reading Comprehension
*Conversation fluency
*Naming Ability
*Repition
*Written Expression
What is dysarthria?
A group of speech disorders caused by paralysis, weakness, or incoordination of the speech muscles.
What is the main focus of Aphasia Therapy?
the main thing of the therapy is to build bridges from the thigns a pateint can do to those that he or she cnanot do
What are causes of Dysarthria?
*Strokes (same three as aphasia)
*Head Injury
~Closed Head (no skull)
~Piercing (goes through the skull)
*Dieases
~Parkinsons, MS, ALS
*Toxic/Metabolic
~Heavy Metals
~Drugs
What is the Evaluation of Dysarthria include?
*Medical chart/history review
*Interview with patient and/or family
*Oral motor examination
*Production of word lists
*Intelligibility evaluation
~Speech, Readin, and Conversation
*Naturalness of Speech
THE HAPPENS OVER SEVERAL DAYS!!!!
What are some treatments of Dysarthria?
*Sugical Intervention
~Brain Stimulator, minimalize seizure activity.
*Medical/Pharmacetical
What is the reasons behind Speech Therapy in Dysarthria?
*Drecreasing speech rate
*Relaxation Exercises
*Over-articulating speech sounds
*Increase respiratory support by improving posture and muscle strength
*Augmentative and alternatice communication
What is Apraxia?
Impairment in planning, coordination, and timed execution of movement patterns for speech.
What is the primary cause of Apraxia?
Strokes
What is wrong with Speech in Apraxia?
They tend to make error of articulation, recognize the errors, and make repeated attemts to correct the error; but each attemt may result in a different type of error.
What is treatment for Apraxia like?
*Sequenced production of speech sounds
*Oral Motor exercises: non-speech movements of the tounge and lips
*Alternative and Augmentative Communication
What is a Laryngectomy?
*Surgical Removal of the larynx-all the muscle, cartilage, and tissue.
~Included the Vocal Folds
~The person has NO voice left
*Turn the trachea out to the front of the neck
*Reconstruct the inside of throat for swallowing
What is the Incidence, and Prevelence of Laryngeal Cancer?
3-5% of human cancer
About 13,000 Cases known
What are the common etiologies of people with laryngeal cancer?
*smoking
*alcohol consumption
*chemical exposure
*Diet
*Genetics
What are signs and syptoms of Laryngeal Cancer?
*Persistent Hoarseness
*Trouble Breathing (Dyspnea)
*Stridor (Trouble when you breath)
*Pain
*Persistent coughing
*Hemoptysis (coughing up blood)
*Swelling and/or tenderness in the neck
What are the three types of communication options after a laryngectomy?
1) Artifical Larynx
2) Esophageal Speech
3) Tracheoesophageal Speech
What is an Artifical Larynx?
*Medical Device
*Hold it to the neck or cheek
What is Esophageal Speech?
*Take air into esophagus
*return it up
*this vibrates the top of the esophagus

(Like burping on conmand)
What is Tracheoesophageal Speech?
*Small prosthesis alloes air from trachea to esophagus
*Vibrates the esophagus
What is Dysphagia?
a swallowing disorder characterized by difficulty in oral preparation for the swalloe or the movement of material from the mouth to the stomach
What can cause dysphagia?
*Central neurological problems
*Peripheral Neurological problems
*anatomical/structural problems
*behavioral problems (RARE)
*pysochological problems (rare)
What can go wrong during a swallow?
*Can have problems in any stage
*Examples:
~Drooling
~Food pocketing in cheek
~Food/liquid spilling to throat to early.
~Food/Liquid sticking tothe throat
~Choke/cough
Name Stage One of the Swallowing process and explain it.
ORAL PREPARTORY PHASE
*Lip closure
*Facial tone
*chewing ability
~rotary jaw motion
~rotary, lateral tounge motion
*Soft Palate down, resting on back of tounge
*Tounge gathers food and liquid when ready to swallow and holds in in the front of the mouth
Name Stage 2 of the swallowing process and explain it.
ORAL TRANSIT
*1 sec or less to move material from front of mouth to the throat
*should leave the mouth and tounge with no residue
*ends the oral phase
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