Ultimate Praxis 5331 SPEECH PATHOLOGY

vocal fold nodules

Typically bilateral and sit opposite of each other, typically appear at the junction of the anterior and middle third portion of the folds

cluttering

Highly dysfluent, rapid, unclear and disorganized speech. Lack of personal concern or reduced awareness about problem

gestural AAC

No instruments or external aids are used; pantomime, eyeblink encoding, American Indian hand talk, ASL

Hemorrhagic stroke

Caused by bleeding in the brain due to ruptured blood vessels. Intracerebral (within brain) or extracerebral (within the meninges, resulting in subarachnoid, subdural and epidural varieties)

Diaphragm

Respiration relies on the muscles of inspiration and expiration. The thick dome shaped muscle that separates the abdomen from the thorax is called the

Diaphragm

Respiration relies on the muscles of inspiration and expiration. The thick dome shaped muscle that separates the abdomen from the thorax is called the

orbicularis oris

The primary muscle of the lips is the

efferent nerves

Also called motor nerves; nerves that carry information out of the brain and spinal cord to other areas of the body.

globus, pallidus, caudate, and putamen

The corpus striatum is composed of three nuclear masses, which are the

corpus callosum and basal ganglia

The anterior cerebral artery supplies blood to the

Aryepiglottic folds

These are composed of a ring of connective tissue and muscle extending from the tips of the arytenoid cartilages to the larynx. They separate the laryngeal vestibule from the pharynx and help preserve the airway

palatoglossus, tensor veli palatini, and levator veli palatini

Muscles that contribute to the velopharyngeal closure through tensing to elevating the velum are the

lingual frenulum

The structure at the inferior portion of the tongue that connects the tongue with the mandible is the

genioglossus

When a person is producing voiced and voiceless /th/, the muscle most involved is the

X

The cranial nerve that innervates the larynx and inneravates the levator veli palatini, palatoglossus, and palatopharyngeus muscles is

Lateral cricoarytenoids and transverse arytenoids

Which muscles from the list are most involved in adducting the vocal folds?

commissural fibers

cerebral hemispheres are connected by

reticular activating system

The central nervous systems primary mechanism of attention, alertness, and consciousness, which is also related to sleep wake cycles is the

percentral gyrus

The primary motor cortex in the frontal lobe is located on the

Coarticulation

the influence of one phoneme upon another in production and perception wherein two different articulators move simultaneously to produce two different speech sounds.

mass and elasticity

Two properties of a medium that affect sound transmission are

sinusoidal wave

a sound wave that has horizontal/vertical symmetry, one peak and one valley, single frequency and results of simple harmonic motion.

octave

an indication of the interval between two frequencies

natural frequency

a frequency with which a source of sound vibrates naturally

oscillation

Back and forth movement of air molecules because of vibrating object is known as

fundamental frequency

The lowest frequency of a periodic wave is also known as the

complex tone

When two or more sounds of differing frequencies are added the result is a

harmonics

In a periodically complex sound, tones occur over the fundamental frequency and can be characterized as a whole number multiples of the fundamental frequency are called

Bloodstein

advocated that stuttering may be caused by any belief that speech is a difficult task, resulting in tension and speech fragmentation.

Brutten and Shoemaker

proposed that stuttering is limited to part word repetitions and sound prolongations, stuttering is due to classically conditioned negative emotion, some dysfluencies are operantly conditioned

stuttering modification approach

Cancellations, pull outs, and preparatory sets are taught in:

fluency shaping techniques

Skills like managing airflow management, gentle phonatory onset, and reduced rate of speech are targets in:

Vocal adductors

posterior cricoarytenoid (PCA

Inhalation

expand the lungs pressure within compared to outside the lungs. Air moves through the open laryngeal valve and equalizes pressure inside and outside the lungs.

Myoelastic Aerodynamic Theory

Vocal folds vibrate because of the forces of pressure of air and elasticity of vocal folds: Myoelastic aerodynamic theory

Bernoulli Effect

Increased speed of air passing between vocal folds, sucking motion of the folds towards each other

Mucosal wave action

The cover and transition of the vocalis muscle slide to produce a wave, critical to phonation

Energy in vibration is modified by resonance characteristics of vocal tract

Genioglossus

Forms the bulk of the tongue and allows it move freely

peripheral nervous system

Controls cranial nerves, spinal nerves, autonomic nervous system

central nervous system

consists of the brain and spinal cord

Thalamus

Regulates sensory information and relay sensory impulses to portions of cerebral cortex

hypothalamus

Controls emotions, helps integrate actions of the ANS

basal ganglia

Recieves input from frontal lobe and relays back to higher centers of brain, part of extrapyramidal system, leiosns result in unsual body postures, dysarthria

extrapyramidal system

Transmits impulses, controls postural support for fine motor movement, indirect activation and interacts with motor system, maintains posture, regulate movement:

pyramidal system

Controls voluntary movement of speech muscles, corticobulbar, corticospinal, desscuates medullary level from right side of body that originates in left cerebral cortex:

sound waves

Made up on movements of particles, expansions/contractions:

rarefaction

Thinning of molecules when vibration returns to equilibrium:

compression

Vibratory movement of objects, increase density of air molecules:

amplitude

Magnitude or strength of a sound signal:

incidental learning

A child's ability to learn based on a few exposures:

birth to 3 months

Startle response, moves head towards voice, cries for assistance, produces vowels:

7 to 9 months

Comprehends "no", looks at common objects when named, sound combinations, general language patty cake, variegated babbling, object permanence:

4 to 6 months

Raises arms to mother, moves towards family members when named, raspberries, varies pitch vocalizations, vocalizes displeasure/pleasure, marginal babbling, varies volume:

10 to 12 months

Understands 10 words, simple 1 step directions, object permanence established, obey commands, turns head to name, consonant vowel sounds in vocal play:

Behavioral Theory

Theory that learning plays a major role in acquisition of verbal behaviors, they only learn the language they are exposed to severe social deprivation results in language deprivation; functional units of language include mands, tacts, echoics, autoclitics, intraverbals:

nativist theory

Noam Chomsky, universal rules of grammar apply to all languages, the language acquisition device (LAD) specialized language processor that is a physiological part of brain. Competence, the knowledge of rules of universal grammar is innate; performance, the actual production of language is imperfect because of fatigue and distraction:

Cognitive theory

Theory that language is only one expression of a more general set of cognitive activities and proper development of cognitive system is a necessary precursor of linguistic expression, child must acquire concepts before words; piaget proposed four stages of cognitive development:

information processing theory

Theory that language learning relies on information processing mechanisms; this view has also been called cognitive connectionism. auditory processing deals with the ability to perceive the brief acoustic events that comprise speech sounds and track changes in these events. Deals with auditory discrimination, auditory attention, auditory memory, auditory rate, auditory sequencing:

social interactionism theory

Theory that language develops because people are motivated to interact socially with others around them. Lev Vygotsky, language knowledge is acquired through social interaction with more competent and experienced members of the child's culture. Thought that children first learned language in interpersonal interactions and then used that language to structure thought:

Expansion

Clinician expands a child's telegraphic or incomplete utterance to a more grammatically complete sentence:

extension

Clinician comments on child's utterance and adds new information:

leukoplakia

Benign growths of thick, whitish patches on the surface membrane of the mucosa. Considered precancerous and must be monitored

laryngomalacia

Epiglottis soft and pliable due to abnormal development:

velopharyngeal insufficiency

Velopharyngeal mechanism is inadequate to achieve closure as a result the nasal cavities are not sealed off appropriately from oral cavity:

Granuloma

Localized inflammatory vascular lesion that is composed of granular tissue in a firm, rounded sac. Frequently develop on the vocal processes of the arytenoid cartilages in posterior laryngeal area:

subglottal stenosis

Narrowing of subglottic space, can be acquired or congenital. Occur from endotracheal intubation, the result of arrested development of the conus elasticus or interruption of the cricoid cartilage during embryological development:

Papilloma

Wart like growths caused by human papilloma virus. Pink, white or both and can be found anywhere in the airway. Voice therapy can be helpful after surgical treatment including relaxation exercises, teaching the patient to use amplification devices or help decrease subglottic hyperfunction:

laryngeal web

Membrane that grows across the anterior portion of the glottis. Can be congenital and acquired due to trauma to the inner edges of the vocal folds. Immediate surgery required, places a laryngeal keel between vocal folds to prevent them from growing back together:

Paradoxical vocal fold motion (PVFM)

Laryngeal dyskinesia, there is an inappropriate closure or adduction of the true vocal folds during inhalation, exhalation or both. Upper airway sensitivity to laryngeal irritants. Appear asthmatic; attributed to psychological and physiological causes:

GERD

gastric contents spontaneously empty into the esophagus when the person has not vomited or belched. May experience heartburn, acid indigestion, sore throat or hoarseness:

Ankylosis

Stiffening of the joints the movement of the arytenoids is restricted because of a bone joint disease such as arthritis:

Spasmodic dysphonia

Vocal laryngeal dystonia. Has neurogenic causes with possible emotional side effects. created by intermittent, involuntary, fleeting vocal fold abduction when patient tries to phonate. Loudness is reduced

Vocal fold polyps

Softer than nodules and may be filled with fluid or have vascular tissue; tend to be unilateral

Ischemic stroke

Caused by a blocked or interrupted blood flow supply to the brain; caused by either a thrombus (collection of blood material that blocks the flow of blood), or an embolus (traveling mass of arterial debris or a clump of tissue from a tumor that gets lodged in a smaller artery and thus blocks the flow of blood

gestural assisted AAC

Gestures or movements combined with instrument or display device, run by software, picsyms (graphic symbols to represent nouns, verbs), pic symbols (drawings on a black background), blissymbols (semi iconic symbols taught to speakers of linguistic and cultural background),, sig symbols (ideographic or pictographic symbols based on ASL, rebuses (pictures represent events), PECS

Neuro assisted AAC

biofeedback, use muscle action potentials for activating messages

behavioral theory

Theory that sound acquisition is based on conditioning and learning; child develops adult like speech through interactions of caregiver

Structural theory

Theory that phonological development follows innate, universal and hierarchal order of acquisition of distinctive features

Natural phonology theory

Natural phonological processes are innate processes that simplify an adult like word

class II malocclusion

Maxilla protruding, and lower jaw receded; overbite

class III malocclusion

Maxilla receded mandible is protruding

class I malocclusion

Arches are aligned, but some teeth misaligned

dysarthria

Motor speech disorder caused by CNS damage, slurred speech, can be caused by degenerative diseases, neurological diseases or strokes

dysarthria treatment

Treatment includes repetitive and structured drill, increasing muscle tone and strength while treating other factors that affect intelligibility

apraxia

Caused by CNS damage, difficulty programming and sequencing articulated speech inconsistent articulation and multiple errors, poor intelligibility

cluttering treatment

Treatment includes increasing awareness of speech problems, maintenance of fluent and articulated speech, reduced rate of speech to improve clarity and fluency

neurogenic stuttering

Fluency disorder caused by neuropathology, caused by strokes, trauma, tumors, brain surgery, dementia, drug toxicity.. etc.

thyroid cartilage

Largest laryngeal cartilage, called the Adam's apple. Prominent in men, shields laryngeal structures

arytenoid cartilage

Shaped like pyramids, most anterior angle of base of arytenoids the true vocal folds attach at vocal process

corniculate cartilage

Sit on the apex of arteynoids and are small and cone shaped

cuneiform cartailges

Tiny cone shaped cartilage pieces under mucous membrane that cover aryepiglottic folds

infrahyoid laryngeal muscles (depressors)

strong impact on pitch. Thyrohyoid, omohyoid, sternohyoid, sternothyroid

suprahyoid laryngeal muscles (elevators)

lie above hyoid bone, include digastric, geniohyoid, mylohyoids, stylohyoid, genioglossus and hyoglossus

maximum phonation time

Client's ability to hold out vowel /a/ as long as possible

mean fundamental frequencies

Pitch of voice averages

MFF men

100 to 150 Hz

MFF women

180 to 250 Hz

Presbyphonia

Age related voice disorder characterized by perceptual changes in quality, range, loudness and itch in an older speaker's voice

Jitter

Frequency perturbation, to variations in vocal frequency that are often heard in dysphonic patients; people with no laryngeal pathology are able to sustain a vowel with less than 1% jitter