Anatomy and Physiology of Speech
Midterm Exam
Course Introduction
This course offers an in-depth exploration of the anatomical structures and physiological processes underlying human speech production. Students will examine the respiratory, phonatory, articulatory, and resonatory subsystems, gaining a comprehensive understanding of how each contributes to voice and speech. Emphasis is placed on the functional integration of these systems, the neural mechanisms controlling speech, and the clinical relevance of normal and disordered speech anatomy and physiology. Through lectures, laboratory experiences, and practical demonstrations, students will develop the foundational knowledge necessary for advanced studies in speech-language pathology, audiology, and related fields.
Recommended Textbook
Cleft Palate and Craniofacial Anomalies Effects on Speech and Resonance 3rd Edition by Ann
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372 Verified Questions
372 Flashcards
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W.
Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) At what vertical level is the greatest medial displacement of the lateral pharyngeal walls during oral speech production?
A)Vocal folds
B)Epiglottis
C)Base of tongue
D)Hard palate
E)Upper esophageal sphincter
Answer: D
Q2) The lateral pharyngeal walls move in which direction to contribute to velopharyngeal closure?
A)Medially
B)Laterally
C)Posteriorly
D)Anteriorly
E)Superiorly
Answer: A
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3
Chapter 2: Clefts of the Lip and Palate
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Q1) Which is never associated with a cleft of the primary palate?
A)Wide and flattened nose
B)Altered orientation of orbicularis muscle
C)Nasal cavity deformities
D)Reduced size of nasal airway
E)Velopharyngeal insufficiency
Answer: E
Q2) Which of the following is associated with clefts?
A)Chromosomal disorders
B)Genetic disorders
C)Environmental teratogens
D)Prenatal exposure to certain medications
E)All of the above
Answer: E
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4
Chapter 3: The Genetics Evaluation and Common
Craniofacial
Syndromes
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Sample Questions
Q1) What is failure of the brain to divide into two separate hemispheres called?
A)Hydrocephaly
B)Macrocephaly
C)Holoprosencephaly
D)Microcephaly
E)Unicephaly
Answer: C
Q2) Cleft palate rather than cleft lip) is more likely to be associated with which of the following?
A)Deformations
B)Malformations
C)Disruptions
D)Associations
E)Other congenital anomalies
Answer: B
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Chapter 4: Genetics and Patterns of Inheritance
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Sample Questions
Q1) In a case in which two individuals who are heterozygous carriers of an autosomal recessive condition have a child, what is the probability that the child is a carrier of a single copy of the mutation?
A)50%
B)25%
C)100%
D)0%
E)75%
Q2) What term is used to describe having two different alleles of a gene for a particular trait?
A)Homozygous
B)Phenotypic
C)Autosomal dominant
D)Heterozygous
E)Multifactorial
Q3) Which of the following is not a rule of inheritance that Mendel described?
A)All alleles are dominant
B)Variations of genes are referred to as alleles
C)We get one gene from each parent
D)Alleles segregate from each other at meiosis
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Chapter 5: Feeding Problems of Infantswith Clefts or
Craniofacial Anomalies
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Q1) Which of the following is true about a child with Pierre Robin sequence?
A)There are fewer feeding difficulties in comparison to infants with other types of clefts.
B)Breastfeeding is easier due to the micrognathia.
C)A shorter wider nipple is best for bottle-feeding.
D)There are often respiratory difficulties associated with feeding attempts.
E)The glossoptosis affects the infant's ability to latch on to the nipple.
Q2) What is the main reason that infants with cleft palate have difficulty with breastfeeding?
A)Abnormal swallowing
B)Inability to generate adequate suction
C)Abnormal compressions
D)Abnormal breathing
E)Poor coordination of suck-swallow-breathe
Q3) Which of the following are essential for normal feeding?
A)Nipple compression
B)Generation of positive pressure suction
C)Generation of negative pressure suction
D)a and b
E)a and c
Page 7
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Chapter 6: Developmental Aspects:speech, Language, and Cognition
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Sample Questions
Q1) Which of the following statements is true?
A)There is an undeniable connection between facial development and the brain based on a wide set of evidence.
B)There is no connection between the facial development and the brain based on a wide set of evidence.
C)The research shows a connection between the brain and facial development, but only when there is both a cleft lip and a cleft palate.
D)Some studies have suggested that there may be a connection between the facial development and the brain.
E)The research shows a connection between the brain and facial development, but only when there is cleft palate.
Q2) Which of the following will increase the child's motivation to learn and use verbal language?
A)Gestures, which are effective in communicating
B)The family responding to gestures and grunts
C)An older sibling speaking for the child
D)The family not responding to gestures and grunts
E)Intelligibility of speech being poor
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Chapter 7: Resonance Disorders Andvelopharyngeal
Dysfunction Vpd
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Sample Questions
Q1) What class of sounds is more often distorted by nasal emission?
A)Voiced fricatives
B)Voiceless fricatives
C)Voiced plosives
D)Voiceless plosives
E)Vowels
Q2) Which compensatory production for velopharyngeal insufficiency is often co-articulated with /b/?
A)Pharyngeal fricative
B)Pharyngeal plosive
C)Palatal dorsal production
D)Nasal fricative
E)Glottal stop
Q3) Very large tonsils are most likely to cause which of the following?
A)Cul-de-sac resonance
B)Hypernasality
C)Hyponasality
D)Mixed resonance
E)Nasal emission
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Chapter 8: Facial, Oral and Pharyngeal Anomalies
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Sample Questions
Q1) Which of the following is not a typical feature that accompanies maxillary retrusion?
A)Tongue tip being anterior to alveolar ridge and maxillary teeth
B)Difficulty producing labiodental sounds
C)Base of tongue retruding into oropharynx
D)Possible difficulty producing bilabial sounds
E)Anterior crossbite
Q2) What muscle is responsible for middle ear function?
A)Levator veli palatini
B)Musculus uvulae
C)Palatopharyngeous
D)Tensor veli palatini
E)Palatatoglossus
F)Superior constrictor
Q3) What is a common cause of acute otitis media?
A)Eustachian tube malfunction
B)Enlarged tonsils
C)Cleft palate
D)Cleft lip
E)Tympanic membrane malfunction
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Chapter 9: Dental Anomalies
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Sample Questions
Q1) Which of the following is true about the effect of missing teeth on speech?
A)There is never an effect on speech.
B)There is always an effect on speech.
C)The effect on speech depends on the size of the oral cavity.
D)Missing incisors will always cause a frontal lisp.
E)Missing teeth only cause problems with sibilant sounds.
Q2) Which of the following is not a dental anomaly associated with clefts?
A)Diastema
B)Rotated teeth
C)Missing teeth
D)Protruding premaxilla
E)Crossbite
Q3) Which sounds are most likely to be affected by an anterior crossbite?
A)Labiodentals
B)Interdental sounds
C)Velars
D)Bilabials
E)Sibilants
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11
Chapter 10: Psychosocial Aspects Ofcleft Lippalate and
Craniofacial Anomalies
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Sample Questions
Q1) Which of the following is true about children and teens with cleft lip and palate, compared to their unaffected peers?
A)They have a characteristic personality type.
B)They are at greater risk of developing psychopathology.
C)They are more aggressive with peers.
D)They have more difficulty with peer relationships.
E)All of the above
Q2) Which of the following is true about teasing of children who have craniofacial anomalies?
A)It is correlated with the degree of difference in their facial appearance.
B)It appears to be an inevitable part of growing up with facial differences.
C)It can be altered by the child's personality style.
D)It persists well into adulthood for most affected individuals.
E)All of the above
Q3) Which is not true about adults with clefts, compared to their unaffected peers?
A)They tend to marry later.
B)They have higher levels of depression.
C)They tend to end their education earlier.
D)They make less money in their jobs.
E)All of the above
Page 12
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Chapter 11: Speech and Resonance Assessment
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Sample Questions
Q1) Which series of numbers is best to use when testing for nasal emission?
A)50s
B)60s
C)70s
D)80s
E)90s
Q2) What phoneme is best to use when testing for hypernasality?
A)/m/
B)/p/
C)/b/
D)/n/
E)/ /
Q3) Which of the following is not an effective way for assessing hypernasality, nasal emission, and velopharyngeal function?
A)A straw
B)Listening tube
C)Manometer
D)Stethoscope
E)All of the above
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Page 13
Chapter 12: Orofacial Examination
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Sample Questions
Q1) To determine whether ankyloglossia is affecting the speech of an English speaker, the examiner should test which of the following phonemes?
A)/l/ and sibilants
B)/l/ and lingual-alveolars
C)/r/ and / /
D)/r/ and /l/
E)/l/ and / /
Q2) If you see evidence of food e.g., chocolate milk or red sauce) around the nostril area, this is an indication of which of the following?
A)Nasolabial fistula
B)Bilateral lip pit
C)Palpebral fissure
D)Oropharyngeal fistula
E)Hypertelorism
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14
Chapter 14: Nasometry
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Sample Questions
Q1) What would you expect from a dialect, accent, or language that contains more high vowels or a higher tongue position in vowel production?
A)Later voice onset time for vowels
B)No effect on the nasalance score
C)A slightly higher average nasalance score
D)A slightly lower average nasalance score
E)Nasalance scores higher than 20%
Q2) What does a low nasalance score typically indicate?
A)Nasal emission
B)Nasal rustle
C)Hypernasality
D)Hyponasality
E)Cul-de-sac resonance
Q3) What does a high nasalance score indicate?
A)Nasal emission
B)Nasal rustle
C)Hypernasality
D)Hyponasality
E)Cul-de-sac resonance
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Page 15
Chapter 15: Speech Aerodynamics
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Sample Questions
Q1) To estimate velopharyngeal orifice size, which of the following aerodynamic measures are needed?
A)Oral air pressure, nasal air pressure, oral airflow
B)Oral air pressure, nasal air pressure, nasal airflow
C)Oral airflow, nasal airflow, oral air pressure
D)Oral airflow, nasal airflow, nasal air pressure
E)Oral air pressure, nasal air pressure, differential pressure
Q2) Aerodynamic techniques do not provide information about which of the following?
A)Intraoral air pressure level
B)Rates of nasal air emission
C)Estimates of VP orifice size during consonant production
D)Estimates of VP orifice size during vowel production
E)Measurements of nasal airway resistance
Q3) Which of the following causes the rapid displacement of the vocal folds during speech?
A)Hypopharyngeal airflow
B)Subglottic air pressure
C)Vocal fold vibration
D)Decrease in air pressure
E)Phonation
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Chapter 16: Videofluoroscopy
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Sample Questions
Q1) Which view shows most of the port?
A)Lateral view
B)Frontal view
C)Base view
D)Oblique view
E)Towne's view
Q2) When there is greater attenuation during radiography, which of the following is true?
A)The image is near the black end of the spectrum
B)More radiation particles will reach the film
C)Fewer radiation particles will reach the image
D)There is more exposure
E)b and d
Q3) Which view used for videofluoroscopy is most similar to the orientation of nasopharyngoscopy?
A)Towne's view
B)Oblique view
C)AP view
D)Base view
E)Lateral view
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Chapter 17: Nasopharyngoscopy
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Sample Questions
Q1) A disadvantage of nasopharyngoscopy is that it does not allow the examiner to see which of the following?
A)Adenoid tissue
B)Nasal surface of velum
C)Length of the posterior pharyngeal wall
D)Oronasal fistula
E)Vocal cords
Q2) Where should you insert the scope when evaluating velopharyngeal function?
A)Inferior meatus because it will come out on top of the velum
B)Inferior meatus because it is the largest and therefore causes the least discomfort
C)Superior meatus because it will allow visualization from the highest point of the nasopharynx
D)Middle meatus because it allows a view from above
E)Superior meatus because its smaller size will keep the scope from "wiggling" around too much
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Chapter 18: Surgical Management of Clefts and
Velopharyngeal Insufficiencyincompetence VPI
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Sample Questions
Q1) What procedure is used for aligning the maxillary segments prior to formal surgery for unilateral and bilateral clefts?
A)Taping the lip
B)Dental elastics
C)Latham appliance
D)Lip adhesion
E)All of the above
Q2) What is the location of an "intentional" fistula?
A)Alveolar ridge
B)Junction of the hard and soft palate
C)Area of the incisive foramen
D)Alveolus under the lip
E)Upper lip
Q3) Why is the alveolar arch cleft left unrepaired until the age of 6 or 7?
A)It is technically difficult to close at an earlier age.
B)It allows anterior facial growth without restriction.
C)It does not affect speech or feeding.
D)Early closure can cause a risk of dental abnormalities.
E)The alveolar cleft will eventually close on its own.
Page 19
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Chapter 19: Orthognathic Surgery for Craniofacial
Conditions
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Sample Questions
Q1) Which of the following is not a common problem as a result of a small maxilla?
A)Articulation errors
B)Sleep apnea
C)Hypernasality
D)Hyponasality
E)Cul-de-sac resonance
Q2) Orthognathic surgery of the maxilla cannot be performed until which of the following is well developed?
A)Maxilla
B)Maxillary sinus
C)Dentition
D)Mandible
E)Palatal arch
Q3) What is the procedure to correct an alveolar cleft?
A)Distraction
B)Corticotomy
C)Taping
D)Bone graft
E)Le Fort I
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Chapter 20: Prosthetic Management
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Sample Questions
Q1) When is it not appropriate to use prosthetic management?
A)For patients with a history of cleft who have a delay for surgery due to medical issues
B)For patients who have undergone a successful cleft repair without complications or residual effects
C)For patients with persistent velopharyngeal insufficiency or incompetence after unsuccessful surgeries
D)For patients with other structural disorders not related to cleft palate
E)For patients who have cancer affecting the maxilla or velum
Q2) Which of the following is not true of reduction therapy?
A)It aims to improve velopharyngeal function.
B)The length of the lift is gradually increased.
C)It aims to stimulate movement of the velopharyngeal structures.
D)It aims to avoid surgery, or reduce the severity of the surgery.
E)The length of time wearing it is gradually decreased.
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Chapter 21: Speech Therapy
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Sample Questions
Q1) In which of the following conditions is speech therapy not appropriate?
A)Compensatory articulation
B)Hypernasality and nasal emission due to apraxia
C)Obligatory errors
D)Post-operative nasal emission
E)Articulation errors due to mislearning
Q2) Which of the following is not a therapy technique used to treat hypernasality, nasal emission, or compensatory productions?
A)Auditory feedback
B)Tactile feedback
C)Oral-motor exercises
D)Visual feedback
E)Nose pinch
Q3) Which of the following can be corrected by starting with the yawn technique?
A)Pharyngeal fricative
B)Pharyngeal plosive
C)Glottal stop
D) /l
E)Velar plosive
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Page 22
Chapter 22: The Team Approach
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Sample Questions
Q1) Based on ACPA recommendations, which professionals must be on a Cleft Palate Team as a very minimum?
A)Plastic surgeon, ENT, pedodontist
B)Surgeon, dental professional, speech-language pathologist
C)Plastic surgeon, ENT, speech-language pathologist
D)Plastic surgeon, oral surgeon, speech-language pathologist
E)Dental professional, orthodontist, plastic surgeon
Q2) Most of the managed care organizations exist as which of the following?
A)For-profit corporations
B)Not-for-profit organizations
C)Third-party administrators
D)Preferred providers PPOs.
E)Government-run providers
Q3) One standard requirement for meeting the ACPA standards is that each Cleft Palate Team must have which of the following:
A)Coordinator
B)Geneticist
C)Psychologist
D)Pulmonologist
E)Medical records specialist
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Chapter 23: Cleft Care in Developing Countries
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Sample Questions
Q1) What is the primary role of the speech-language pathologist on a cleft palate surgical mission?
A)To evaluate patients for VPI
B)To determine which patients are appropriate for palate repair
C)To work with the dental professional to develop speech appliances
D)To provide speech therapy
E)To counsel the family and teach others
Q2) In 1997, the International Task Force on Volunteer Cleft Missions outlined recommendations for volunteer cleft missions based on which of the following?
A)Mission objectives
B)Organization
C)Personal health and liability
D)Funding
E)All of the above
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Chapter 24: Velopharyngeal Dysfunction and Speech Disorders
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Sample Questions
Q1) A patient evaluation finds that she has a combination of hyponasality and inconsistent nasal emission.Irregular adenoids are suspected as a cause.What is the best way to evaluate that?
A)Nasometry
B)Nasopharyngoscopy
C)Videofluoroscopy
D)Aerodynamic measures
E)An Intraoral examination
Q2) What procedure is best for identifying an occult submucous cleft?
A)A visual inspection of the velum
B)Palpation of the velum
C)Videofluoroscopy
D)Nasopharyngoscopy
E)Nasometry
Q3) Nasal emission is most audible on which of the following sounds?
A)Nasal sounds
B)Voiceless consonants
C)Vowels
D)Voiced continuents
E)Voiced plosives
25
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