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SPAUD 101 Exam #3
| Question | Answer |
|---|---|
| Dysphagia | Difficulty or an inability to swallow May be unable to consume enough food and liquids safely |
| Aspiration | When food enters the airway |
| 4 Stages of a normal swallow | Anticipatory Oral Pharyngeal Esophageal |
| Anticipatory Stage of Swallowing | Before the food reaches the mouth Sensory information helps prepare for food Allows person to discriminate desirable and undesirable things to eat to avoid potential harm |
| Oral Stage: Part 1 of swallowing | Preparatory - food chewed and mixed with saliva to make bolus Voluntary |
| Oral Stage: Part 2 of swallowing | Transport - Tongue pushes the bolus up against palate and moves it posteriorly toward the pharynx Oral phase is over when the bolus passes anterior faucial pillars |
| Pharyngeal Stage of swallowing | Velum elevates and contracts Larynx closes Larynx moves up and forward Epiglottis covers larynx Involuntary |
| Esophageal Stage of swallowing | Begins when larynx lowers backward and breathing resumes Upper esophageal sphincter contracts Bolus moves through esophagus in peristaltic waves |
| Causes of Dysphagia in Adults 1/3 | Cerebrovascular Accident causes oral stage difficulty when damage is in either hemisphere and also aspiration with right hemisphere damage Stroke - oral stage difficulty and delayed/absent pharyngeal swallow |
| Causes of Dysphagia in Adults 2/3 | Dementia - reduced oral awareness and pharyngeal swallow delay TBI - varies by location and severity Neuromuscular disease - difficulty at all stages of swallowing |
| Causes of Dysphagia in Adults 3/3 | Cancer - radiation irritates tissue of mouth and throat Changed structures from surgery |
| Non Instrumental Clinical Exam for dysphagia | Bedside Clinical Assessment - assesses level of alertness, coughing, oral-mech exam |
| Instrumental Assessment for dysphagia | Modified Barium Swallow - Barium coated food - fluoroscope images taken by radiologist Videoendoscopy - camera up nose and to just above epiglottis |
| Treatment for dysphagia | Changing position when swallowing Special spoons or cups Change consistency New swallowing patterns - like dry swallows |
| Goals of Dysphagia treatment in children | Safely meet nutritional needs Normalizing eating and swallowing skills |
| Causes of Brain Damage | Stroke TBI Growths Progressive Deterioration |
| Effects of stroke | Edema - swelling of brain tissue Infarct - tissue death Spontaneous recovery - neural reorganization |
| Effects of TBI | Contusions - brain bruises Lacerations - tearing of structures and vessels Hematomas - areas of encapsulated blood (intracranial - within the brain, and Meninges - in the tissues surrounding the brain) |
| Aphasia | Acquired language disorder that results from brain damage, usually to the left hemisphere Causes naming problems, fluency problems, auditory comprehension problems, and Agrammatism |
| Broca’s Aphasia | Lesion to Broca’s area Nonfluent, awkward verbal expression Short phrases and sentences Slow rate Agrammatism Auditory comprehension is minimally impaired |
| Wernicke’s Aphasia | Damage to Wernicke’s area Impaired auditory comprehension Fluent speech Verbal paraphasias (fork for spoon) Neologisms - making up new words (jargon) Poor repetition |
| Conduction Aphasia | Arcuate Fasciculus damaged Minimally impaired auditory comprehension Good spontaneous speech Hallmark - poor repetition Literal paraphasias Aim for correction Repeating the same phrase over and over |
| Anomic Aphasia | Damage to inferior parietal/posterior temporal lobe Word-finding problems - can’t even describe it - they know what word they want to say but they can’t say it Fluent speech Good comprehension |
| Transcortical Aphasia | Widespread damage to frontal lobe - good comprehension but difficulty initiating utterances Widespread damage to parietal lobe - poor auditory comprehension but good repetition |
| Global Aphasia | Wide lateral damage to the left hemisphere All parts of language processing severely impaired Nonfluent Poor comprehension Poor repetition |
| Intervention for Aphasia | Empower the patient to communicate successfully Communication taste to activate neural plasticity mechanisms Cues and prompts - pictures, phonemic cues, phonological rhyming, etc Compensatory strategies Family support groups |
| Disorders related to aphasia | Right Hemisphere stroke Brain injury Dementia (especially with Alzheimer’s) |
| Outer Ear | Pinna - visible flap of cartilage attached to the head External auditory meatus - external ear canal → oil gland secrete cerumen (ear wax) to protect middle ear |
| Middle Ear | Contains: Tympanic Membrane, Ossicular chain, and Eustachian Tube |
| Tympanic Membrane | In the Middle Ear Ear drum Elastic membrane that separates the outer ear from the middle ear Converts acoustic wave into a mechanical wave |
| Ossicular chain | In the Middle Ear Malleus Incus Stapes |
| Eustachian Tube | In the Middle Ear Connected to throat, helps equalize pressure in middle ear |
| Inner Ear | Hollowed out portion of temporal bone Contains three sensory organs Cochlea - hearing Vestibule - balance Semicircular canals - balance |
| Cochlea | Hollow tube with 2 ½ turns Starts at oval window and ends at round window Has 3 sections: Scala Vestibuli, Scala Media, Scala tympani |
| Basilar Membrane | Separates the Scala Tympani from Scala Media Moves in a wavelike manner Loud sounds create large waves Soft sounds create small waves Tonotopic - high pitches at beginning and low pitches at end |
| Auditory Nerve | Contains 30,000 neurons that conduct information in one direction Afferent Neurons - cochlea to brain Efferent neurons - brain to cochlea |
| Types of Hearing Loss | Conductive - impairment by air conduction Sensorineural - impairment by bone conduction Mixed - conducive and sensorineural components |
| Conductive Hearing loss possible causes | Outer ear - External auditory meatus occluded Middle Ear - Otitis medea, Otosclerosis |
| Sensorineural Hearing loss possible causes | Cochlear: Prenatal - anoxia, trauma Perinatal - disruption during birth process Postnatal - meningitis, high fevers, noise exposure, aging 8th Nerve (Auditory nerve) lesion: Acoustic neuromas (tumor) Acoustic neuritis (inflammation) |
| Audiologic Rehabilitation | Adults or those who need to modify communications skills as a result of acquired hearing impairments |
| Audiologic Habilitation | Children or those who are listening and learning to use speech and language skills for the first time |
| Hearing aids goal and components | Goal: to increase the intensity of the sound to make people hear better Basic components: microphone, amplifier, receiver, battery |
| Difficult listening environments | Reverberations - sound reflections from hard surfaces Signal-to-noise-ratio - the signal intensity minus the noise intensity |
| Cochlear Implants | Physically place the electrode array into the cochlea Electrode array will electrically stimulate the neurons of the auditory nerve |
| Adult candidacy for cochlear implants | Severe to profound hearing loss bilaterally Limited benefit from hearing aids Strong desire to be a part of hearing world |
| Pediatric candidacy for Cochlear Implants | Profound hearing loss bilaterally Limited benefit from hearing aids Willing to be involved in intensive rehabilitation services Have support from educational program |
| Detection | Document the softest sound that can be heard with and without amplification |
| Discrimination | The ability to determine whether two sounds are the same or different |
| Identification | Occurs after a child has learned the symbolic representation of the sound |
| Oral, manual, and total communication | Oral: Uses only auditory signal for transfer of messages Manual: only using hand shapes and movements (ASL) Total Communication - using both |
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