____ assessment (_____) should always precede instrumental assessment?

Clinical (orofacial and speech)

The outcome of the clinical assessment determines? (3)

The need for an instrumental assessmentThe type of instrumental studyQuestions to be answered by the study

Direct observatoin instrumental assessment is the most clinically useful approach and includes? (2)

Videonasendoscopy [sphincteric/superior view]Videofluoroscopy [multiple views]

Direct observation assessment should always preced _____ surgical management when possible?

secondary

The goal of any orofacial exam in speech pathology is to identify _____, _____, and ____ or problems that may explain _____?

structural, oral motor and oral sensory deviationsthe presenting speech disorder or complaint.

Scarring on lips can have an effect on?

mobility for rounding, spreading, compressing and everting the lips.

______:This refers to how the lips meet one another?

Anterior-posterior relationship of lips

_____: Is there a collapsed naris/nostril, a depressed nasal tip, or other structural difference that is constricting the opening?

Anterior patency/openness

_____:This is evaluated by the ENT/otolaryngologist, but findings can have significance for speech?

Interior patency

Interior patency:Blocked nasal passages can ? by blocking? and can change?

mask cleft palate speech problems.nasal air emission that would otherwise escaperesonance quality of speech, which would otherwise be hypernasal

So blocked passage (s) can mask?

CP closure problem and/or contribute to "mixed" resonance

Often children with cleft palate, especially ini, will have a deviated or bowed septum because of the asymmetric attachment of ?

vomer (one of two bones that make up the bony nasal septum)

Intraoral structures are:? (5)

DentitionOcclusionTongueHard Palate and alveolusVelum and uvula

Dental deviations refer to deviations in ?

specific teeth

Dental deviations include the following:?

Missing teethectopic teethsupernumerary teethrotated teethdiastemas

Missing teeth:The _____ of missing teeth is important in considering the impact on speech articulation?

location

These are teeth in the wrong place

ectopic teeth

Supernumerary teeth are often _____ because there is not enough room for them in the dental arch?

ectopic

____ are common on the transitional dentition?

Diastemas

___: protrusive premaxilla (with or without an Angle Class II malocclusion)

Overjet

____: (with or without an Angle Class III malocclusion) this can be due to maxillary deficiencyalso call a pseudo CL III malocclusion

Underjet/underbite

____ are a hazard for speech and can occur anteriorly and laterally in the dental arch?

Open bites

If the tongue does not fit an adequate introral space we tend to diagnose ____?

macroglossia

___: is the term for tongue-tie.The ____ can be too short, attached too far anteriorly, attached with too broad an attachment to the inferior lingual surface, and combinations of these?

AnkyloglossiaFrenum (frenulum)

It is important to consider the impact of anyloglossia on both ?

range of movements and precision of the tongue (tip)

___: this is a condition where the tongue falls back into the airway?

Glossoptosis

Glossoptosis should be looked for in all babies who present with?Also children who present with ? and presents with?

respiratory (upper airway) problems.Robin sequence and articulatory backing pattern