EVERYTHING YOU ALWAYS WANTED TO KNOW ABOUT VOICE AND RESONANCE DISORDERS BUT WERE AFRAID TO ASK… (I.E. THE MARY AND MARC VELUM AND LARYNX SHOW) Marc Haxer M.A.CCC and Mary K Berger M.S.CCC University of Michigan Health Systems Ann Arbor, MI So where do we start? Anatomy Structures  Hard palate  Palatine raphe/posterior  nasal spine Soft palate/velum  Uvula/musculus uvulae  Anterior faucial arches  (palatoglossus) Posterior faucial arches  (palatopharyngeus) Palatine tonsils  TYPES OF CLEFTING Anatomy Anatomy/physiology Muscles  Palatine aponeurosis  Tensor veli palatini  Levator veli palatini-  muscle repaired at the time of surgery Palatoglossus  Palatopharyngeus  (palatothyroideus) Musculus uvulae  Superior constrictor-  lateral wall movement Perceptual exam Performed by a Speech Pathologist  The Gold Standard for the diagnosis of  velopharyngeal dysfunction Need imaging to determine intervention.  Oral motor exam Head/neck: ears, torticollis, cranial vault  Face: structures, symmetry, sensation  Mandible: structure, ROM, strength testing  Dentition: occlusion, missing teeth, dentures  Tongue: structure, strength, ROM, RAM  Palate: uvula, fistula, length, distance to posterior  pharyngeal wall, Passavant’s ridge, mesial movement of lateral pharyngeal walls, gag response.