Term
| Craniofacial Abnormalities |
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Definition
| Congenitive malformations involving the head or face |
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Term
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Definition
| Abnormal openings in anatomical features, interferes with basic biological functioning (eating) and communication |
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Term
| Velopharyngeal Inadequacies (VPI) |
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Definition
| Velopharyngeal mechanism (velum) does not close adequately |
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Term
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Definition
Alar base and rim - where nose connects to face
Columella - column between nostrils, gives the nose its tip
Philtral ridges - ridges near the upper lip
Philtrum - groove between philtral ridges
Cupid's brow |
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Term
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Definition
| Opening behind the velum, where velum goes when elevated |
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Term
| Complete vs. Incomplete Cleft |
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Definition
Complete Cleft - goes into the nasal cavity
Incomplete Cleft - doesn't reach the nasal cavity entirely |
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Term
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Definition
Bilateral - two, along both sides
Unilateral - one, usually centered |
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Term
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Definition
1. Primary Palate - lip and alveolar process (bilateral/unilateral, complete/incomplete)
2. Secondary Palate - hard and soft palate/velum; area posterior to incisive foramen (complete/incomplete) |
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Term
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Definition
| Funnel-shaped opening in hard palate, located directly behind incisors where blood vessels and nerves pass |
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Term
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Definition
Mucus membrane is intact, cleft is beneath the skin, usually diagnosed by hypernasality in speech
May exhibit: bifid uvula, furrow along midline, zona pellucida (blueish tint to pallate), bony notch where posterior nasal spine should be, anterior insertion of levator muscles |
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Term
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Definition
#1 birth defect in the US
1 in 595 |
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Term
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Definition
25% lip only
25% pallate only
50% lip and pallate
Most common in Native Americans, then Asians, then Caucasians, then African Americans |
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Term
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Definition
males>females with combination clefts
males>females with severe forms
females>males with pallatal clefts only and often associated with syndromes |
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Term
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Definition
Multifactoral Inheritance: predisposition is added onto by environmental factors (terratogens; valium, dilantin, smoking, insufficient folic acid)
20% inherited
3-5% chromosomal
65% environmental/unknown
No specific gene found/specified that causes cleft |
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Term
| Dental Issues in Cleft Lip and Pallate Cases (III Classes) |
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Definition
Class I - occlusion or malocclusion (normal)
Class II - mandibular retrusion and/or maxillary protrusion
Class III - mandibular protrusion and/or maxillary retrusion |
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Term
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Definition
| Arrangement of molars, to fix irregular occlusion must realign jaw |
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Term
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Definition
[image]
Jaws are correctly aligned |
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Term
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Definition
[image]
Cusp of the mandibular 1st molar sits between the 1st and 2nd cusps of the maxillary molars
Mandible is too far back |
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Term
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Definition
[image]
Opposite problem of Class II
Maxilla is too far back |
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Term
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Definition
Overbite - upper teeth cover bottom
Overjet - front teeth too forward
Crossbite - upper teeth inside lower jaw
Missing or Rotated teeth
Supernumerary - extra teeth |
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Term
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Definition
Ossicular Abnormalities
Eustachian tube malformation
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Term
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Definition
Multiple surgeries necessary
Lip can be done at 10 weeks
Palate can be done at 9 to 12 months |
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Term
| Secondary Repair is necessary to: |
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Definition
1. Close palatal fistula (hole in palate)
2. Correct maxillary or mandibular problems
3. Correct Velopharyngeal dysfunction (10-35%)
30% of patients need some type of secondary repair, technically the 3rd surgery but is the 2nd done to the palate |
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Term
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Definition
Cleft Lip - problems with bottle/breast feeding, may see difficulty latching on
Cleft Palate - mostly due to nasal reflux (SLP tries to get rid of/get around reflux), selection of most appropriate bottle/nipple, positioning of infant and nipple, follow feeding schedule, and frequent burping |
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Term
| Psychosocial Issues with Cleft |
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Definition
Perception of Intelligence - existence of cleft does not cause difference in IQ and academic success
Teachers report knowing little about cleft, misconceptions about IQ may shape teachers expectations for students and therefore the student's performance |
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Term
| Speech/Language and Cleft |
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Definition
Babbling - fewer consonants, less frequent, slower, articulatory problems (compensatory articulatory errors)
Development of language is delayed but catches up with age, impairment varies but is associated with receptive, expressive, reading, or learning disorders
Patients with cleft DO catch up! |
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Term
| Velopharyngeal Dysfunction (VP Dys) |
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Definition
| Velum does not close off pharyngeal cavity completely, results in hypernasality |
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Term
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Definition
Excessive nasal resonance caused by structural differences
Hear: "m" and "n" |
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Term
| Hyponasality (denasality) |
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Definition
Lack of normal nasal resonance caused by structural differences
Particularly affects m, n, ng sounds
Hear: "b," "d," and "g" |
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Term
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Definition
More air release through nasal cavity than normal; results in hypernasality, especially on consonants
May exhibit nasal grimace |
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Term
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Definition
Produce posterior nasal fricative in substitution for "s" or "z"
Faulty articulation, not anatomical or physiological problems and therefore only require therapy |
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Term
| Clinical Evaluation Steps |
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Definition
1. Listener judgement/perceptual analysis of problem
2. Assumptions of physiology and anatomy
3. Instrumental analysis should confirm perceptual judgement, NEVER USED TO MAKE DECISIONS |
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Term
| Orofacial Exams, what to look for (oro) |
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Definition
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Term
| Orofacial Evaluations, what to look for (facial) |
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Definition
Lips - is there sufficient movement for speech sounds?
Eyes
Ears
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microtia - deformed ear
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anotia - no outer ear
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atresia - no ear canal
Nose/airway - patency of each nostril
Maxilla - micro/macronathia, micro/macrostoma
Dentition
Tongue
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Term
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Definition
CAN'T change abnormal structure-> must have surgery to correct these problems
CAN change behavior and techniques and correct mislearning, sometimes used for velopharyngeal incompetence |
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