SPAUD 524 MIDTERM EXAM 2024/2025 /COMPLETE ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS )
ALREADY GRADED A+.
What is a cleft? - ANSWER-An opening in the lip, alveolar ridge, hard
palate, and/or soft palate
Forms when there's failure of the tissues to fuse during early fetal
development
Describe the process and direction of embryological development of
the lip and palate - ANSWER-~6-7 weeks gestation= incisive foramen -
-> alveolus --> base of nose --> upper lip
- 7-8 weeks= tongue begins to drop gradually
~8-9 weeks gestation= hard palate --> velum (soft palate) --> uvula
Incisive foramen - ANSWER-Opening in the midline bone of the oral
hard palate where blood vessels and nerves may pass.
Starting point of embryological development of lip and palate
Causes of a cleft - ANSWER-1. Genetic factors contribute to 20-50% of
clefts
- American Indians at highest risk
Classifications of clefts:
unilateral bilateral complete incomplete submucous -
ANSWER-Unilateral: cleft only on one side
Bilateral: cleft on both sides
Complete: cleft that extends into the nose
Incomplete: cleft that does not extend into the nose
Submucous: congenital defect that affects underlying structures of
the palate while the structures on the oral surface are intact; can
involve muscles of the velum and bony structure of the hard palate
Characteristics of submucous cleft: - ANSWER-Bifid uvula: split in the
uvula which can sometimes be difficult to visualize unless it is an
overt defect
,Zona Pellucida: translucent area in the middle of the velum; result of
thin mucosa and lack of musculature underneath; use of a flashlight
during an OME will help reveal this
Notch: in the posterior portion of the hard palate (due to muscle
formation)
Describe the movement of the velopharyngeal structures and role of
the velopharyngeal muscles in closing and opening of the
velopharyngeal valve - ANSWER-
velopharyngeal insufficiency (VPI) - ANSWER-Caused by abnormal
structure
Velum moves normally but is too short for closure due to abnormal
structure
Can occur as a result of a palatal repair in which a straight-line
closure technique is utilized and can contribute to a shortened palate
OR can occur as a result of an adenoidectomy where the adenoid pad
was the previous source of closure and now the body cannot
compensate for the lack of strucutre resulting in a velopharyngeal
gap leading to nasal air escape
velopharyngeal incompetence - ANSWER-Structure is fine, but
function/movement is inadequate
, Velum is normal length, but does not move normally
Can occur as a result of scarring from a palatal repair, negatively
impacting velar mobility OR as a result of low tone or weakness such
as paresis from a CVA or TBI or low tone from Cerebral Palsy
velopharyngeal mislearning - ANSWER-VP dysfunction exists despite
sufficient structure and capable function
Patient develops a compensatory articulation such as a fricative
produced in the pharynx which results in decreased VP closure
contributing to nasal air emission (phoneme specific nasal emission)
where the child can acheive VP closure on some phonemes but not all
Most typically impactedE= /s z sh ch j/ treated through speech therapy
Describe the importance of team care and team composition -
ANSWER-- The greater number of patients seen by a team, the better
the chance that the care provided will be optimum
- More economical for both the family and for third-party payer as they
often only have one co-pay on team days rather than paying
separate co-pays when seeing professionals separately on different
days
- Patients will receive better care with coordination of treatment
through a team
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