Clinical Management of Voice and Resonance Disorders
Exam Materials
Course Introduction
This course offers an in-depth exploration of the assessment and treatment of voice and resonance disorders across the lifespan. Students will learn about the anatomy and physiology of the vocal mechanism, etiologies of voice and resonance disorders, and evidence-based clinical management strategies. Emphasis is placed on differential diagnosis, instrumental and perceptual evaluation techniques, and the development of individualized intervention plans. The course also covers interdisciplinary collaboration, cultural considerations, and the psychosocial aspects of voice and resonance disorders, preparing students for clinical practice in a variety of healthcare and educational settings.
Recommended Textbook
Cleft Palate and Craniofacial Anomalies Effects on Speech and Resonance 3rd Edition by Ann
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24 Chapters
372 Verified Questions
372 Flashcards
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2
W.
Chapter 1: Anatomy and Physiology
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) What separates the two plates of the palatine process of the maxilla?
A)Incisive suture lines
B)Median palatine suture
C)Transverse palatomaxillary suture lines
D)Nasal aspect of palatine suture
E)Incisive foramen
Answer: B
Q2) Which structure is a ridge that is caused by a projection of the cartilaginous portion of the Eustachian tube?
A)Torus tubarius
B)Alveolar ridge
C)Median palatine raphe
D)Torus palatinus
E)Passavant's ridge
Answer: A
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Chapter 2: Clefts of the Lip and Palate
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) Which of the following is not characteristic of an overt submucous cleft palate?
A)A bifid uvula
B)Zona pellucid
C)A hypoplastic uvula
D)A protrusive premaxilla
E)A notch in the posterior border of the hard palate
Answer: D
Q2) A bifid uvula, zona pellucida and a notch in the posterior border of the hard palate indicate which of the following?
A)Overt submucous cleft
B)Occult submucous cleft
C)Cleft of the secondary palate
D)Bilateral cleft palate
E)Overt cleft of the secondary palate
Answer: A
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4
Chapter 3: The Genetics Evaluation and Common
Craniofacial
Syndromes
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2 Flashcards
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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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12 Flashcards
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Sample Questions
Q1) Which of the following would be considered a threshold trait associated with multifactorial inheritance?
A)Height
B)Intelligence
C)Blood pressure
D)Cleft palate
E)Weight
Q2) What is the recurrence risk for parents of a child with nonsyndromic cleft lip and/or palate with their next pregnancy?
A)3% to 5%
B)25% to 50%
C)30% to 45%
D)10% to 15%
E)5% to 10%
Q3) Which of the following is not characteristic of 'X-linked inheritance'?
A)It is caused by genes on chromosome 23
B)Females are more severely affected
C)Affected males pass the gene to 100% of their daughters
D)There is no father-to-son transmission
E)Affected females can transmit the disorder to their sons
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Chapter 5: Feeding Problems of Infantswith Clefts or
Craniofacial Anomalies
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) What two items must work synchronously to be effective for normal feeding?
A)Nipple compression and rooting reflex
B)Tongue elevation and cupping of the tongue
C)Nipple compression and generation of negative pressure suction
D)A and B
E)All of the above
Q2) The size of a newborn's larynx is approximately what proportion to that of an adult's larynx?
A)1/2
B)1/3
C)1/4
D)1/5
E)1/8
Q3) Which of the following is described as "assisted fluid delivery"?
A)Use of nasogastric feeding to supplement volume of intake
B)Use of gastrostomy tube feedings following oral intake
C)Use of gentle squeezing of a nipple or flexible bottle during feeding to deliver fluid
D)Use of a crosscut nipple to increase flow of fluid during sucking
E)Use of a tube in addition to breast feeding
Page 7
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Chapter 6: Developmental Aspects:speech, Language, and Cognition
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Which of the following is not true about children with palate only?
A)They are more likely to have deficits in prelanguage skills than their peers.
B)They tend to have the same scores in verbal performance as in nonverbal performance on standardized tests.
C)They may receive more early stimulation than their unaffected peers.
D)They are at increased risk for syndromes.
E)They often have language and learning problems.
Q2) Infants with an unrepaired cleft palate demonstrate an alteration in the manner of production, with a predominant use of which types of consonants?
A)Stops
B)Fricatives
C)Liquids
D)Nasals
E)Glides
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8
Chapter 7: Resonance Disorders Andvelopharyngeal
Dysfunction Vpd
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) 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
Q2) Hyponasality is most noticeable on which of the following:
A)Affricates
B)Vowels
C)Fricatives
D)Plosives
E)Nasals
Q3) Cul-de-sac resonance can be due to which of the following?
A)Adenoidectomy
B)Tonsillectomy
C)Enlarged tonsils
D)Enlarged adenoids
E)A fistula
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Chapter 8: Facial, Oral and Pharyngeal Anomalies
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) What syndrome causes facial nerve paralysis?
A)Crouzon syndrome
B)Down syndrome
C)Moebius syndrome
D)Treacher Collins syndrome
E)Orofaciodigital syndrome
Q2) Which of the following is not used as a treatment for upper airway obstruction in children?
A)Tonsillectomy
B)Adenoidectomy
C)Tracheostomy
D)Uvulopalatopharyngoplasty
E)CPAP
Q3) Which is the condition where the lingual frenulum is congenitally short and attaches to the anterior tongue tip?
A)Microfrenum
B)Microglossia
C)Ankyloglossia
D)Lobulated tongue
E)Microsomia
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Chapter 9: Dental Anomalies
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23 Flashcards
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Sample Questions
Q1) What is the term that describes the part of the dental arch that is posterior to the canine teeth?
A)Labial
B)Buccal
C)Mesial
D)Distal
E)Lingual
Q2) What is the term for teeth that erupt in an abnormal position?
A)Supernumerary
B)Ectopic
C)Diastema
D)Crossbite
E)Malocclusion
Q3) What is the term for the horizontal relationship of the upper to the lower incisors?
A)Labioversion
B)UnderJet
C)OverJet
D)Overbite
E)Diastema
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Chapter 10: Psychosocial Aspects Ofcleft Lippalate and
Craniofacial Anomalies
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11 Verified Questions
11 Flashcards
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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 syndrome includes a risk of psychosis as the child becomes a teenager?
A)Moebius syndrome
B)Velocardiofacial syndrome
C)CHARGE syndrome
D)Apert syndrome
E)Treacher Collins syndrome
Q3) 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
Page 12
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Chapter 11: Speech and Resonance Assessment
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) To an inexperienced listener, a pharyngeal fricative can sound similar to which of the following?
A)Lateral lisp
B)Frontal lisp
C)Palatal-dorsal production
D)Bilabial fricative
E)Labiodental fricative
Q2) What is the appropriate recommendation for treatment of compensatory productions?
A)Surgery and then speech therapy
B)Surgery only
C)Speech therapy for obligatory distortions first
D)Speech therapy and then surgery
E)Speech therapy only
Q3) If the child demonstrates nasal emission on /p/ and /t/, but not on /k/, what is the probable cause?
A)VPI only
B)The fistula only
C)VPI and the fistula
D)Misarticulation causing nasal emission
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Chapter 12: Orofacial Examination
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) An intraoral evaluation reveals a bifid uvula.Which of the following statements is true?
A)Resonance will be hypernasal
B)A tonsillectomy is contraindicated
C)The child will have nasal emission
D)The child may have normal velopharyngeal function
E)The child will have velopharyngeal incompetence
Q2) Long-term upper airway obstruction can cause which of the following?
A)Anterior open bite
B)Anterior tongue position
C)Mandible that grows downward
D)b and c
E)All of the above
Q3) Which of the following is not an indication of an upper airway obstruction?
A)Hypernasality
B)Chronic open-mouth posture
C)Suborbital coloring
D)Strident breathing
E)Snoring
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Page 14
Chapter 14: Nasometry
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) What is the advantage of using a standardized passage to gather nasometric data?
A)The passage can be read by the individual rather than repeated.
B)It is easier to administer because it is well-known by the examiner.
C)The patient's score can be compared to normative data.
D)The passage is designed to contain only certain sounds to make it easier to produce.
E)The passage can be designed to contain only oral sounds.
Q2) What cannot be assessed through nasometry?
A)Resonance
B)Upper airway obstruction during speech
C)Changes in resonance following surgery
D)Phoneme-specific nasal emission
E)Intraoral air pressure
Q3) In normal speech, what is the primary determinant of the nasalance score?
A)Type of the vowels in the passage
B)Type of oral consonants in the passage
C)Percentage of high- versus low-pressure sounds in the passage
D)Person's dialect
E)Person's volume
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15
Chapter 15: Speech Aerodynamics
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15 Flashcards
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Sample Questions
Q1) Why do pressure-flow estimates of orifice size decrease in accuracy when the orifice area exceeds 80 mm<sup>2</sup>?
A)Limitations of the pneumotachograph to record high rates of airflow
B)Limitations of the transducers to detect small pressure changes
C)Limitations of the pneumotachograph to record an increase in nasal airflow
D)Limitations of the transducers to measure an increase in nasal resonance
E)Limitations of the transducers to detect a decrease in oral airflow
Q2) 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
Q3) 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
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Chapter 16: Videofluoroscopy
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14 Flashcards
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Sample Questions
Q1) Which view shows the velum and posterior pharyngeal wall?
A)Lateral view
B)Frontal view
C)Base view
D)Oblique view
E)Towne's view
Q2) On the base view, a black horizontal line during closure indicates which of the following?
A)Passavant's ridge
B)Adenoid pad
C)Coronal pattern
D)Sagittal pattern
E)Circular pattern
Q3) Which view is done to view the lateral pharyngeal walls?
A)Lateral view
B)Frontal view
C)Base view
D)Oblique view
E)Towne's view
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Page 17
Chapter 17: Nasopharyngoscopy
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Sample Questions
Q1) Which of the following suggests the presence of a small velopharyngeal opening?
A)Bubbling of secretions
B)Irregularity of the posterior part of the velum
C)Irregular adenoid tissue
D)A small black circle
E)Visible airflow through the valve
Q2) Which of the following should not be done prior to inserting the scope?
A)Have the child blow his nose
B)Check the image on the camera
C)Put lidocaine gel on the scope
D)Put the child in a supine position
E)Spray the nose with a decongestant
Q3) For surgical planning, what is the most important finding through nasopharyngoscopy?
A)Size of the opening
B)Shape of the opening
C)Location of the opening
D)Timing of closure
E)Pattern of closure
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Page 18
Chapter 18: Surgical Management of Clefts and Velopharyngeal
Insufficiencyincompetence VPI
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Sample Questions
Q1) What is a common surgical procedure for correction of velopharyngeal insufficiency?
A)Palatoplasty
B)Pharyngeal flap
C)Abbe flap
D)Palatal lift
E)Intravelar veloplasty
Q2) Which of the following is true about VPI?
A)It is a surgical disorder.
B)It can be corrected with speech therapy.
C)It requires both speech therapy and surgery.
D)It can be corrected with speech therapy if it is mild.
E)It sometimes gets better without treatment.
Q3) When is a cheiloplasty usually performed?
A)Right after birth
B)3 to 4 weeks
C)5 to 6 weeks
D)10 to 12 weeks
E)16 to 18 weeks
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Chapter 19: Orthognathic Surgery for Craniofacial
Conditions
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Sample Questions
Q1) Which is not a method of mandibular reconstruction?
A)Distraction osteogenesis
B)Le Fort I
C)Rib graft reconstruction
D)Free tissue microsurgical reconstruction
E)Mandibular osteotomies
Q2) Which of the following is a common problem associated with a retrodisplaced or a small maxilla?
A)Hypernasality
B)Sleep apnea and hyponasality
C)Class II malocclusion
D)Occlusal cant
E)Oronasal fistula
Q3) If an alveolar cleft is left untreated, what can be the result?
A)Loss of the permanent lateral incisor
B)Loss of the central incisor
C)Loss of the canine cuspid) tooth
D)a and b
E)a and c
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Chapter 20: Prosthetic Management
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Sample Questions
Q1) In which situations is it most appropriate to consider the use a speech appliance?
A)When there is severe velopharyngeal insufficiency
B)When the patient has primarily obligatory speech distortions
C)When the child is not stimulable for a reduction in nasality with a change in placement
D)When surgical correction is not an option
E)When the cleft of the palate is very wide
Q2) A feeding obturator is not capable of which of the following?
A)Helping an infant to achieve suction
B)Keeping the tongue from resting inside of the cleft
C)Covering an infant's unrepaired cleft during feeding
D)Separating the oral cavity from the nasal cavity
E)Reducing regurgitation into the nasal cavity
Q3) With a palatal lift, which part of the appliance holds the velum in place?
A)Body
B)Tail
C)Mid-piece
D)Prongs
E)Bar
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Page 21
Chapter 21: Speech Therapy
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21 Flashcards
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Sample Questions
Q1) Pushing under the child's chin may help the child to achieve appropriate placement for which group of sounds?
A)Sibilants
B)Lingual-alveolars and /l/
C)Velars and /r/
D)Plosives
E)Fricatives
Q2) Which of the following can be treated by starting with a /t/ sound?
A)Pharyngeal fricatives for /s/ and /z/
B)Pharyngeal plosive for velars
C)Glottal stop for plosives
D)Nasal snort for /s/ blends
E)Stopping of sibilants
Q3) 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
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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) The team's primary contact person for the family is usually which of the following?
A)Primary care physician
B)Pediatrician
C)Family doctor
D)Managing surgeon
E)Team coordinator
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Page 23
Chapter 23: Cleft Care in Developing Countries
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Sample Questions
Q1) 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
Q2) Which of the following statements is true?
A)The prevalence of clefts varies with ethnic background.
B)The prevalence of clefts varies with socioeconomic status.
C)The prevalence of clefts is not affected by malnutrition.
D)a and b
E)b and c
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24
Chapter 24: Velopharyngeal Dysfunction and Speech Disorders
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Sample Questions
Q1) A child presents for an evaluation with a complaint of "nasality." An evaluation reveals abnormal resonance on vowels and the following consonants: m, n, ng.Which condition is present?
A)Hypernasality
B)Hyponasality
C)Oral cul-de-sac resonance
D)Nasal cul-de-sac resonance
E)Assimilated resonance
Q2) Which syndrome is most likely to include hearing loss?
A)Apert syndrome
B)Treacher Collins syndrome
C)Velocardiofacial syndrome
D)Down syndrome
E)Beckwidth-Weidemann syndrome
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
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