Speech
Velar eminence : it is a ridge occupying central portion of nasal surface of
soft palate which is an essential component of velo-pharyngeal closure .
Muscles of soft palate :
Table Palatoglossus Palate-pharyngeus Levator veli Tensor veli Musclus
palatini palatine uvulae
Origin Side and base of Pharynx Petrous part of Sphenoid Apenoursis
tongue temporal bone , bone . of velum
thyroid cartilage anteriorly
Insertion Undersurface of Velum Velum Velum Uvula
soft palate
Action -depress palate - depress soft Its contraction Depress soft Pull it
against levator palate. elevate soft palate palate and toward
palatini -contraction of upward and make it tense apenouresis
- raise back of posterior fibers backward causes during and above
tongue . share in velo- free margins of soft swallowing
-help to seal oral pharyngeal palate touch thus assists its
cavity from oro- sphincter . posterior wall as in contact with
pharynx - with levator veli swallowing and tongue
palatine they oral breathing
retract soft palate
make it more
dome-shaped .
Pharynx have two muscles ( constrictors muscles and salping-pharyngeus
muscle ) .
Constrictors muscles are so arranged by interlocking fibers to constricting
impulses help food to pass towards stomach .
Superior constrictors muscles formed upper part of pharynx which
responsible for speech and swallowing .
While lower part of pharynx concerned of swallowing .
Speech mechanism :
a- During oral breathing or swallowing , levator veli palatine muscle make
soft palate move upward and backward to contact with posterior
pharyngeal wall .
b- During speech , the posterior wall and lateral walls move inward to
form velo-pharyngeal sphincter .
c- During rest , soft palate move downward and back of tongue raise to
allow for oral and nasal breathing .
Velo-pharygneal closure :
- Anterior tubercle of atalas bone which varies in humans.
- Passavant ridge which is horizontal ride around lateral and posterior
walls of pharynx at horizontal level of hard palate . but it present in 33 %
of individuals .
- Recently , studies showed that velo-pharyngeal closure take place at or
above level of palatal bone .
Tongue :
- Attach directly to mandible by geniglosuss muscle or indirectly by
mylohyoid muscle .
- It is major articulator for speech .
- Tongue is principel articulator for vowels and consonants .
- There are many valve , tongue the main participant :
a- Linguo-velar
b- Linguo-palatal
c- Linguo-alveolar
d- Linguo-dental .
e- Labio-dental
f- Labial valve .
g- Glottal valve
h- Palate-pharyngeal valve .
Closure of nasal cavity from oral cavity and pharynx : this occur during
oral breathing or swallowing and some speech sounds as plosives . which
soft palate move upward and backward and posterior and lateral walls of
pharynx move anteriorly and medially . which make airflow direct toward
oral cavity .
Closure of oral cavity from pharynx and nasal cavity :
a- During suckling : which lips anteriorly and soft palate and tongue
posteriorly close to allow negative pressure for flow of milks .
b- Speech : ing or M , N .
Speech mechanism :
a- Learned process .
b- No organ for speech .
c- Take 2 years to learn while 1 year to walk .
d- 7.5 y in boy .
e- 6.5y in girl .
Components of speech :
a- Respiration : which exhalation become more than inhalation during
speech and increase intra-pulmonary pressure to provide a coloum of
air .
b- Phonation : which air expelled form lung pass through vocal cords to
produce complex tone . some times vocal cord are partially or
completely closed as in (O-A-E) or opened in other ways .
c- Neurologic integration .
d- Articulation : Impedence of air to produce sounds by articulators within
oral cavity (tongue , palate , lips ) .
e- Resonation : amplification of voice tone , as sound produced from vocal
cords pass through oral , nasal or pharynx which may amplify some and
mute some .
f- Audition : important in reception of aucostic signal and allow speaker to
monitor and control speech output .
Speech sounds are 44 .
Vowels : voiced sounds (laryngeal phonation) which mean the air stream
pass freely without impedence . tongue play a important articulators for
vowels sounds .
Tongue position and height , lip protrusion , degree of mouth opening
affect pronunciation of vowels sounds .
In all vowels sounds , tip of tongue touch lingual surface of mandibular
anterior teeth .
In vowels sounds , as (A) which tip of tongue touch lingual surfaces of
mandibular anterior teeth , and blade of tongue is arched .
(E) sounds , tongue assume highly position .
In (I) sounds , tongue assume back position then flattened at beginning of
sound then assume (E) position .
(O) sounds , the tongue assume no palatal contact , flatting position .
(I) sound , tongue assume (E) position then flattened .
Sound Type
A Vowels
(b) Plosives
C (soft) Linguo-palatal consanants ( tongue
and posterior portion of hard palate
)
D Plosives , linguopalatal
E Vowels
F Fricative , labial consonants
G Linguo-palatal
S Fricative , linguo-palatal
J Glides , affractive
N Nasal consnants
M Nasal consonants , labial
consonants
Ing Nasal consonants
B Plosives , labial consonants
CH Affractive
E Glides
Th Fricative
Y Uvular consonants
Q Uvular
H Pharyngeal
C (hard ) Tongue with soft palate
CSS (closed speaking space ) : 1mm space present between upper and
lower anterior teeth , help in try in if anterior teeth position .
Fricative sounds used to evaluate VDO : which premature contact between
posterior and anterior teeth assume high VDO while excessive spacing
between teeth indicate Low VDO .
Patient with maxillary defect (maxillary resection ) will suffer from
hypernasality , nasal omission , reduced vocal loudness .
Palatal defects , plosives sounds are most affected due to inaccurate
articulation and seals are broken
So patient with palatal defect will suffer from :
a- Resonance disturbance :
Hypernasality .
Hyponasality : ENT problems , over sized obturator .
b- Articulation disturbance :
Distoration .
Subistuitution .
Omission .
Soft palate defect : velo-pharyngeal closure is controlled by several
muscles which closure is required in oral speech and oral breathing and
degulition while in nasal consonants and vowels the palate-pharyngeal part
will varies in opening .
Velo-pharyngeal deficits :
Velo-pharyngeal insufficiency Velo-pharyngeal incompetence
- Insufficient soft tissue to - Normal velo-pharyngeal
perform velo-pharyngeal structure but patient
closure cannot perform
velopharyngeal closure
- Which result from - Neuro-muscular disorders
congential defects or which soft palate is
acquired defects . normal but muscles don’t
function.
- Movement of remaining - No movment
tissues are within normal
limits
- Result in insufficient - Result in deficient
palatopharyngeal closure palatopharyngeal closure
- Speech aid prosthesis , - Palatal lift prosthesis
pharyngeal obturator
Palatal lift prosthesis :
Used to displace soft palate in patient with velo-pharyngeal
incompetence due to neuro-muscular disorders as
1- Myasthenia gravis .
2- Cebero-vascular accident .
3- Traumatic brain injuries .
4- After adenoidectomy , tonsillectomy , maxillary resection .
Advantages of palatal prosthesis :
1- No gagging sensation due to superior position of prosthesis .
2- Physiology of tongue is not compromised .
3- Lift principles applied to patient who cannot be treated with
palatal surgery .
Dis-advantages :
1- Retention is not available .
2- Palate is not displaceable .
3- Patient is uncooperative .
Palatal lift prosthesis with speech bulb in order to obtain an effect velo-
pharyngeal closure as in case of patients with maxillectomy defect . if
speech remain hyper-nasal after obturation of speech bulb due to lack of
innervation of soft palate so palatal lift prosthesis with speech bulb are
constructed .