Deck 3: Articulatory Foundations of Speech

Question 1

List the structures of the oral cavity.

Answer 1

The oral cavity, also known as the mouth, is the first part of the digestive system and plays a crucial role in speech, taste, and the initial digestion of food. It is composed of several structures, including:

1. **Lips (Labia)**: The fleshy structures surrounding the opening of the mouth. They help in articulating sounds and are important for facial expressions.

2. **Cheeks**: The sides of the mouth that form the walls of the oral cavity. They contain muscles that assist in the chewing process and help keep food between the teeth.

3. **Hard Palate**: The bony anterior part of the roof of the mouth, which separates the oral cavity from the nasal passages above.

4. **Soft Palate**: The muscular posterior part of the roof of the mouth, which can rise to close off the nasal passages during swallowing to prevent food from entering the nasal cavity.

5. **Uvula**: A small, fleshy projection hanging from the soft palate, which plays a role in speech and in keeping the mouth and throat moist.

6. **Tongue**: A muscular organ on the floor of the mouth that is involved in taste, chewing, swallowing, and speech. It is also a primary organ for sensing taste.

7. **Teeth**: Hard structures embedded in the gums that are used for cutting, tearing, and grinding food into smaller pieces to facilitate swallowing and digestion.

8. **Gingiva (Gums)**: The soft tissue that covers the bones of the jaw and surrounds the base of the teeth, providing them with support and protection.

9. **Floor of the Mouth**: The area under the tongue, which includes various muscles, glands, and the lingual frenulum, a fold of mucous membrane that anchors the tongue to the floor of the mouth.

10. **Salivary Glands**: There are three pairs of major salivary glands (parotid, submandibular, and sublingual) and numerous minor glands that secrete saliva into the oral cavity. Saliva contains enzymes that begin the digestion of carbohydrates and also helps to lubricate food for easier swallowing.

11. **Tonsils**: Lymphatic tissue located at the back of the oral cavity that plays a role in the immune system by trapping pathogens that enter through the mouth or nose.

12. **Oropharynx**: The part of the throat at the back of the mouth that serves as a pathway for both air and food. It is not strictly part of the oral cavity but is closely associated with it.

These structures work together to perform the complex functions of the oral cavity, which include the intake and initial processing of food, the perception of taste, and the production of speech.

Question 2

What are the main biological functions of the tongue?

Answer 2

The tongue is a muscular organ in the mouth that has several important biological functions, including:

1. **Taste**: The tongue is covered with taste buds that allow us to perceive different flavors such as sweet, sour, salty, bitter, and umami. These taste sensations are created when chemicals from food interact with the sensory cells in the taste buds.

2. **Speech**: The tongue plays a crucial role in phonation, the process of producing vocal sounds. It helps in the articulation of speech by shaping the sounds that are produced by the larynx. Different positions and movements of the tongue are essential for the pronunciation of various consonants and vowels.

3. **Mastication and Swallowing**: The tongue aids in the mechanical breakdown of food by manipulating it in the mouth during chewing (mastication). It also helps in forming the food into a bolus (a small rounded mass) and pushing it to the back of the mouth for swallowing (deglutition).

4. **Oral Hygiene**: The tongue helps in cleaning the mouth and teeth. It moves saliva around the mouth, which helps to wash away food particles and bacteria, thus contributing to oral hygiene.

5. **Sensory Perception**: The tongue has nerve endings that provide sensory information about the texture and temperature of food, which is important for the overall experience of eating.

6. **Immune Defense**: The tongue can also play a role in the immune system. Some parts of the tongue have lymphatic tissue (such as the lingual tonsils) that can help in identifying and fighting off pathogens that enter the mouth.

Overall, the tongue is a versatile organ that is essential for various functions related to eating, speaking, and maintaining oral health.

Question 3

Draw and label a schematic sagittal section of the head, identifying lips, teeth, the four sections of the tongue, hard and soft palate, uvula, alveolar ridge, pharynx, epiglottis and larynx, then, identify where the following consonants are articulated [p, t, k].

Answer 3

To draw and label a schematic sagittal section of the head, start by drawing the outline of the head from the side. Label the lips at the front of the mouth, and the teeth just behind them. The tongue can be divided into four sections: the tip, blade, front, and back. Label each section accordingly. The hard palate is the bony part of the roof of the mouth, while the soft palate is the fleshy part behind it, leading to the uvula at the back of the throat. The alveolar ridge is the bony ridge just behind the upper front teeth. The pharynx, epiglottis, and larynx are located further back in the throat.

To identify where the consonants [p, t, k] are articulated, we can look at the specific places of articulation for each sound. The sound [p] is a bilabial sound, meaning it is articulated using both lips. The sound [t] is an alveolar sound, meaning it is articulated by the tongue against the alveolar ridge. The sound [k] is a velar sound, meaning it is articulated by the back of the tongue against the soft palate or velum.

So, on the schematic sagittal section of the head, you would label the articulation points for [p] at the lips, for [t] at the alveolar ridge, and for [k] at the soft palate or velum.

Question 4

What is ankyloglossia, and how prevalent is it in newborns in the United States?

Question 5

List six biological functions of the lips.

Question 6

Describe how the lips are involved in the production of speech.

Question 7

Explain why the hard and soft palates are important for speech production.

Question 8

When do children begin to lose their deciduous teeth and what is a possible consequence of losing the central upper incisors?

Question 9

Describe class I, II and III occlusions, and the possible impact of a class III occlusion on speech production.

Question 10

List the twelve cranial nerves and their functions.

Question 11

Discuss the impact of a complete cleft of the lip, soft palate and hard palate on speech, feeding and dentition.

Question 12

What is the benefit of a newborn hearing screening program and describe the impact of early identification, amplification and intervention on children's speech outcomes?

Question 13

Select one of the following syndromes (Pierre Robin syndrome, Treacher Collins syndrome, Beckwith-Wiedemann syndrome, Down syndrome, oro-facial-digital syndrome, Mohr's syndrome, Klippel-Feil syndrome). Describe (a) the syndrome, (b) the possible structural impairments associated with the syndrome, and (c) how those structural impairments might impact speech acquisition.

Question 14

Discuss the impact of a congenital or acquire neurological condition (e.g., cerebral palsy, muscular dystrophy, Moebius syndrome, cerebellar tumor) on children's speech acquisition.

Question 15

To snip or not to snip? Write a critical appraisal of the literature on ankyloglossia (tongue-tie) and when a frenulectomy may be appropriate.

Question 16

Does an adenoidectomy lead to hypernasal speech? Answer this question based on a review of recent research evidence.

Question 17

Do recurrent episodes of otitis media with effusion (OME) in early childhood lead to speech problems in children? Answer this question based on a review of recent research evidence.

Question 18

Compare and contrast the impact of an injury to the facial nerve (VII) versus the trigeminal nerve (V) on speech production.

Question 19

Discuss what it means to suggest that childhood apraxia of speech (CAS) can be a secondary disorder to complex neurobehavioral disorders such as Joubert syndrome, galactosemia, Rett syndrome, and Rolandic epilepsy.

Question 20

Discuss why it would be important to complete an oral structure and function assessment with a child referred because of concerns about his or her speech intelligibility.

Question 21

The tongue is classified as a muscular hydrostat, which means:

A) the volume of the tongue changes when it is elongated, shortened, bent, or twisted.
B) elongation of the tongue changes the tongue volume but twisting does not.
C) the tongue needs to remain hydrated and moist.
D) the volume of the tongue remains the same regardless of whether it is elongated, shortened, bent, or twisted.

Question 22

The four regions of the tongue body include:

A) tip, alveolar ridge, velum, and root.
B) tip, blade, front, and back.
C) front, back, root, and dorsum.
D) tip, blade, back, and root.

Question 23

Isabella (1;2 years) was diagnosed with ankyloglossia. This means she has:

A) tongue-tie.
B) tongue fasciculations.
C) an unusually large tongue.
D) deviation of the tongue to the left or right side when she pokes it out.

Question 24

Jacob (4;4 years) cannot elevate his the tongue towards his nose. He has no other difficulties with tongue movement. This means that he:

A) has tongue-tie and needs to have it surgically released.
B) would be unable to articulate alveolar consonants /t, d, n/.
C) does not necessarily have tongue-tie and should still be able to articulate alveolar consonants /t, d, n/.
D) has childhood dysarthria.

Question 25

Omar (3;7 years) is multilingual-he speaks English and Arabic. He has tongue-tie. Therefore, during an initial assessment, the SLP should consider:

A) Omar's ability to articulate the alveolar consonants, lick his lips, and clear food from his gums.
B) Omar's ability to articulate the bilabial consonants, blow bubbles, and chew.
C) referring Omar to an oral surgeon before conducting the assessment.
D) Omar's ability to pucker his lips and click his tongue.

Question 26

A bifid tongue can occur in children with:

A) Beckwith-Wiedemann syndrome.
B) Mohr's syndrome.
C) acromegaly.
D) Down syndrome.

Question 27

The philtrum is:

A) the space between the pharyngeal tonsils in the pharynx.
B) the thin fold of connective tissue joining the upper lip and the space between the upper central incisors.
C) the vertical groove in the middle of the upper lip that extends from the upper lip to the nasal septum.
D) the thin fold of connective tissue joining the lower lip and lower central incisors.

Question 28

The type of teeth useful for crushing and grinding are:

A) incisors.
B) canines.
C) premolars.
D) molars.

Question 29

Tiffany is typically developing. She has lost three primary teeth, so is most likely:

A) 3 to 4 years old.
B) 5 to 7 years old.
C) 8 to 10 years old.
D) 10 to 12 years old.

Question 30

A bifid uvula can be a sign of a:

A) submucous cleft.
B) ankyloglossia.
C) enlarged adenoids.
D) enlarged palatal tonsils.

Question 31

Wendy (3;2 years) was born with a cleft of the soft palate. The cleft was surgically repaired, however, her speech is hypernasal. It is possible that Wendy has:

A) velopharyngeal insufficiency.
B) strained and strangled phontation.
C) difficulty raising and lowering the jaw.
D) increasing or decreasing the volume of air passing through glottis.

Question 32

The glottis refers to the:

A) space between the oral and nasal cavities.
B) space between the nasopharynx and oropharynx.
C) space between the vocal folds.
D) the size of the opening of the Eustachian tube.

Question 33

Egressive consonants are produced:

A) during inhalation.
B) during exhalation.
C) with the tongue dorsum.
D) only when a speaker articulates a click.

Question 34

Muhammad (3;2 years) has acute otitis media (AOM). Larry (3;4 years) has otitis media with effusion (OME). This most likely means that:

A) Mohammad has a painful middle ear infection, whereas Larry has a build-up of fluid in the middle ear cavity.
B) Mohammad has a build-up of fluid in the middle ear cavity whereas Larry has a painful middle ear infection.
C) Mohammad has a conductive hearing loss, whereas Larry has sensorineural hearing loss.
D) Mohammad needs pressure equalizer tubes (PE tubes) whereas Larry needs a course of antibiotics.

Question 35

The cranial nerves particularly important for movement of the tongue include:

A) glossopharyngeal (IX), oculomotor (III), and hypoglossal (XII) nerves.
B) trigeminal (V), vagus (X), and hypoglossal (XII) nerves.
C) facial (VII), glossopharyngeal (IX), and abducent (VI) nerves.
D) facial (VII), vagus (X) and trigeminal (V) nerves.

Question 36

The bones of the middle ear include:

A) malleus, incus, and stapes.
B) cochlea, internal auditory meatus, and the vestibular stapes.
C) malleus, stirrup, and stapes.
D) hammer, incus, and anvil.

Question 37

If a person has retrocochlear pathology it means, the person has a problem with:

A) the structure of the cochlear.
B) the vestibular labyrinth.
C) the oval window that links the middle ear cavity with the inner ear.
D) the structure or function of the auditory nerve.

Question 38

You are conducting a routine oral structure and function examination with Myra (4;5 years). With gloves on your hand, you feel her rugae, that is:

A) the mucous membrane covering the hard palate.
B) the wrinkled membrane covering across the slope of her alveolar arch.
C) the thin member of connective tissue joining her upper lip to her upper teeth.
D) the surfaces of her upper and lower molars.

Question 39

Research examining frequency of clefts of the hard palate found that they were:

A) more common in Asian and American Indian populations than African-derived populations.
B) more common in Caucasian populations than any other racial group.
C) more common in African-derived populations than Asian populations.
D) more common in Caucasian populations than Asian and American Indian populations.

Question 40

An impairment of the facial (VII) nerve would most likely result in difficulty articulating which of the following consonants?

A) /p/
B) /?/
C) /h/
D) /k/