Question

You should prepare a thorough, concise, clear representation of your understanding of the course material through this examination. You are free to use whatever resources you deem necessary in preparing, however, be sure that your sources are reliable and that your work is independent of other students in the class.

I expect a comprehensive synthesis of your understanding of the material and will therefore grade you very strictly. Points will be deducted for any omissions of pertinent elements, problems in conceptual understanding, ambiguity in responses or incorrect information. Be sure that you address ALL aspects of the question. SPELLING will be graded, so, make sure you check the spelling.

YOU MUST RESTRICT YOUR RESPONSES TO ONE PAGE PER QUESTION. This will require you to organize your thoughts carefully and limit what you say to only that which is relevant.

1) Consider the numerous changes that must be made in the respiratory system’s function in order to achieve fluent, natural sounding speech. I would like for you to explain the changes needed in volumes and pressures of air, flow of air, muscular recruitment and activity, and timing for someone to count from 1-50 on a single breath. (20 points)

2) Now consider a patient with a C-6 spinal cord injury who is confined to a supine position. Please discuss the impact to the respiratory system and the effects on speech and swallowing (swallowing – only as you know it thus far). You should be clear to explain your response so I am sure you know why the patient may present with those symptoms. You should include comment on similar issues as in Q#1 (volumes of air, muscular activity, timing, etc..) to demonstrate your understanding of the consequences to the speech and swallowing functions. (20 points)

Now consider Billy and Betty are arguing. He is very upset about all of the money that she continues to spend on shoes. He asks: “Did you buy another pair of shoes?”, to which she emphatically screams: “No, I did not!!!”

3) Please tell me what Billy needs to do, LARYNGEALLY, when he gets to the word “shoes”. Based on what we discussed in class, you should discuss specifically what he must do to say this word with respect to glottal configuration (i.e. what he is doing with the larynx), vocal fold movement, and any other relevant changes that are required to produce this entire word. Do NOT use the letters of the word but rather the sounds! (20 points)

4) Now consider that Betty has weakness to her intrinsic lingual muscles, her velar elevators and her laryngeal adductors. In addition, she has a large polyp on her right vocal fold. Tell me precisely what, why and how she may have difficulty with when it comes to
her production of this statement. Again, you should consider each sound and the overall sentence. (20 points)

Solution Preview

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1) For an individual to be able to count from 1-50 in a single breath, there needs to be a mass utilization of the larynx as well as the bronchi and lungs for an individual to count in one breath. For sound to be produced in the larynx, arytenoid cartilages form synovial joins with cricoid cartilages to create mobility at this junction. There are a few series of small skeletal muscles that attach to the arytenoid cartilages that allow for voluntary movement. Arytenoid cartilages are also attached to the vocal folds and ligament; when the skeletal muscles contract, the arytenoids cartiliages move, adjusting the tension and mass of the vocal folds. Expiration of air from the lungs pass around the vocal folds, creating pressure or sound waves in the air column of the larynx. Pressure waves, originating from the...

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