Week 1-3 Notes CDS 212
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This 19 page Bundle was uploaded by casscouwenberg on Thursday February 4, 2016. The Bundle belongs to CDS 212 at Syracuse University taught by J. Pellegrino in Summer 2015. Since its upload, it has received 36 views.
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Date Created: 02/04/16
Lecture 1 Unit 1 • CSD 212Introduction to the Professions • The Professions ◦ Topics to cover today ▪ CSD ▪ Speech Language Pathology ▪ Audiology ▪ Related professions ▪ Educational preparation ▪ Professional affiliations • • Communication Sciences and Disorders ◦ Study of human communication processes and the breakdowns in those processes • Communication Sciences and Disorders ◦ Involves the efficacy of practices involved in assessing and assisting individuals with communication differences and disorders ◦ Discipline includes the following areas: speech, language and hearing sciences; audiology; speech language pathology • History ◦ CS&D relatively new field of study; however, the terms speech pathology and audiology have longer histories ◦ The term speech pathology originated in the 1920s and used by Lee Edward Travis (1931) ◦ The term Audiology originated after WWII by Ray Carhart and Norton Canfield to describe noise induced hearing loss and the need for rehabilitation • Professional Organization ◦ American SpeechLanguageHearing Association (ASHA) ◦ Defines CS&D as a single discipline with three separate professions ◦ Developed certification standards for both professions, accredits academic programs and maintains a code of ethics • Speech Language Pathology (SLP) ◦ 1920’s universities offered courses in “speech correction;” however, rehabilitation was limited ◦ SLPs assess, diagnose, treat and help prevent speech, language, cognitive, communication, voice, swallowing, fluency and other related disorders (www.bls.gov) ◦ Terminology used – speech therapists, speech teachers, speech correctionists ◦ ASHA adopted the title speechlanguage pathologist in 1976 • SLP work environments ◦ Elementary and secondary schools ◦ Infant and early childhood programs ◦ Medical settings ◦ Nursing homes ◦ Private practice • Academic requirements ◦ ASHA – master’s degree is the minimum educational requirement ◦ State licensure is required ◦ 9 month clinical fellowship and national examination is required before Certificate of Clinical Competence is obtained • Audiology ◦ The protection, prevention, preservation, evaluation and treatment of the human auditory and vestibular systems ◦ Services may be provided individually or as part of a health care team to improve the patient’s quality of lifE • Specialties within Audiology ◦ Medical Audiologist ◦ Hospital settings ▪ Works with all ages ◦ Member of a communication disorders team ◦ Dispenses hearing aids ◦ Electrophysiologic / intraoperative monitoring • Specialties within Audiology ◦ Pediatric Audiologist ◦ Children’s hospitals ◦ Specializes in causes of childhood deafness ◦ Requires excellent counseling skills ◦ Aural re/habilitation • Specialties within Audiology ◦ Industrial Audiologist ◦ Large corporation or private practitioner contract ◦ Conduct sound surveys in the field ◦ Develop / implement hearing conservation programs ◦ Expert knowledge on OSHA regulations ◦ May be called as expert witness • Specialties within Audiology ◦ Rehab / Dispensing Audiologist ◦ Typically private practice ◦ Extensive hearing aid work • Specialties within Audiology • Educational Audiologist ◦ Responsible for screenings ◦ Amplification and FM systems ◦ Educational issues ◦ CSE meetings, student placement, student services, serve as advocate for the child • Specialties within Audiology ◦ University Audiologist ◦ University clinics ◦ Training of graduate students ◦ Wide knowledge base • Related Professions ◦ Speech Pathology ◦ Otology ◦ Education ◦ Biomedical engineering ◦ Acoustics ◦ Physics and math ◦ Counseling • Educational Preparation ◦ Traditional model ◦ Undergraduate degree in CSD, education, psychology, math, biology ◦ Can have unrelated bachelor’s but will have to take extra courses ◦ Master’s Degree in Audiology ◦ 9 month clinical fellowship (CFY) under guidance of ASHA certified audiologist ◦ Can practice at this level or go on for a Ph.D. • Educational Preparation ◦ Au.D. model ◦ Clinical doctorate now required as entry level degree ◦ Same undergrad ◦ 3 or 4 year post bachelors degree ◦ Required as of Jan 01, 2012 • Educational Preparation ◦ Arguments for AuD ◦ Breadth of information too great to cover in 2 years ◦ Will yield greater autonomy (billing 3 parties) ◦ Successful transitions in other fields (Optometry) • • Educational Preparation ◦ Arguments against the AuD ▪ Unnecessary ▪ What about current practitioners with Master’s ▪ Cost ▪ Will put a strain on research in the field ▪ May shrink the field • Professional Affiliations ◦ ASHA ▪ American Speech Language and Hearing Association ▪ Provides for certification of audiologists ▪ Accredits university programs ▪ Code of ethics ▪ Journals ▪ Conferences • Professional Affiliations ◦ AAA ▪ American Academy of Audiology ▪ Tremendous increase in enrollment in recent years ◦ Association just for audiologists ◦ Trying to establish their own credentialing process ◦ Journals ◦ Conferences • Professional Affiliations ◦ ADA ◦ Academy of Dispensing Audiologists ◦ Fewer members ◦ Not as much influence ◦ Strong advocate for AuD ◦ Annual convention where latest hearing aid technology is unveiled Lecture 2 Unit 1 Anatomy and physiology of the speech and hearing mechanism • Speech structures ◦ All have a primary biological function and a secondary speech function ◦ Patients with physically based speech difficulties often have difficulty with more basic functions such as breathing, chewing, swallowing, feeding • 4 portions of the speech production mechanism ◦ Respiratory: power source ◦ Phonatory: sound source ◦ Articulatory: modifies airway for meaningful speech ◦ Resonance: vibrations of airstream • Respiratory System/mechanism ◦ Lungs, ribcage, abdomen ◦ Biological function: oxygen exchange • Phase 1 of vegetative breathing ◦ Inhale ◦ Muscles contract, chest wall expands ◦ Lungs expand ◦ Negative pressure in lungs ◦ Air rushes in ◦ Muscles stop contracting • Phase 2 of vegetative breathing ◦ Exhale – 3 natural forces ◦ Elastic recoil of the rib cage ◦ Torque ◦ gravity • How chest wall expands: ◦ Vegetative and speech purposes ▪ Major muscles ▪ Diaphragm ▪ External intercostals ▪ Others in back, neck, chest • The Rib Cage (picture) • The Diaphragm (picture) • Breathing for speech ◦ In English, all speech is produced during the exhalation phase • Biological/speech breathing differences ◦ Length of phases ▪ Biological: 50/50 ▪ Speech: 85/15 ◦ Muscle activity ▪ Speech: muscles are active in expiration phase ◦ Restriction of air ▪ Air meets restriction in speech ▪ Open airway for quiet breathing • Exhalation during speech ◦ Muscles are active to keep air from exhaling all at once ▪ Abdominal muscles ▪ Internal intercostals ▪ Others in back, neck, chest • External Intercostals (picture) Lecture 3 Unit 1 • Phonatory Mechanism: sound source ◦ Larynx ◦ Biological function: prevents food, water, dust from entering lungs; expels foreign substances which enter the respiratory tract • Larynx anatomy/physiology ◦ Vocal folds: sound source ◦ Larynx is made up of 4 cartilages ▪ Thyroid like 2 shields that move in and out ▪ Cricoid ring that sits on the top of the Trachea Thyroid Notch: where they meet thyroid, in like a little triangular point ▪ 2 arytenoids on top of cricoid and behind thyroid • Glotis the space/openning between the vocal folds • Vocal folds ◦ 2 meet At the thyroid notch ◦ set the air into motion • Open (abducted) during quiet breathing • Close and vibrate during speech breathing when we exhale • Phonation happens thousand a times a second while speaking ◦ Inhale ◦ Vocal folds close ◦ Forces of exhalation produce pressure beneath the folds ▪ subglottal pressure pressure under the glottis ◦ Pressure builds until the folds are blown apart ◦ A little puff of air is released in the vocal tract ◦ Air pressure below the folds decreases ◦ Vocal folds close • Forces allow the folds to close ◦ Air pressure below folds decreases ◦ Elasticity of the folds allows them to snap back into their adducted position • One vocal fold vibration ◦ These tiny puffs of air are emitted through the quick opening between the folds, creating a vibration in the column of air ◦ Females: 225 times per second (225 Hz.) ◦ Males: 125 cycles per second ◦ Frequency measured in Hz • Can change pitch and loudness ◦ Pitch ▪ Length (change the length of the vocal folds) Increase length = increase in pitch ▪ Mass (thickness) increase mass = decrease pitch ▪ tension: Increase tension = increase in pitch ◦ Loudness ▪ Increase subglottal pressure ▪ Keep vocal folds adducted longer • Resonance • The quality of voice ◦ What makes one voice distinct from another, what makes you sound like you • Cavities ◦ Pharyngeal (back of your throat) ◦ Oral ▪ Mandible (jaw & roof of mouth) ◦ Buccal (space between teeth and cheeks) ◦ Nasal ▪ Velum (soft pallet) separates oral and nasal cavity, soft part in the back of the roof of your mouth ▪ Most sounds in english do not have nasal resonance only ones that do (velum opens so air can go out the nose) “m”, “n”, “ing" • Articulatory portion ◦ Shapes sounds into meaningful speech ◦ From the larynx to the top of the mouth and nose ◦ We change this area in various ways to produce different speech sounds ◦ Ah vs. u vs. ee • Articulators ◦ Structures we manipulate to make different speech sounds ◦ 2 types ▪ Mobile tongue, lips, jaw, velum ▪ Static teeth, hard pallet (roof of mouth), alveolar ridge (behind teeth) • SourceFilter Theory ◦ Sound energy is produced by the ▪ Vocal folds (source) ▪ And modified (filtered) by the ◦ Pharynx ▪ Soft palate Nasal cavity ▪ Tongue ▪ Lips ▪ Jaw, etc. • Two types of speech sounds ◦ Vowels greatest acoustic energy, easier to hear they are powerful ▪ Produced with open airway ◦ Consonants ▪ Articulators/resonators constrict/restrict airway Lecture 4 Unit 1 SEE PDF DIAGRAMS Questions for today: How do we overcome the impedance mismatch? impedance mismatch airborn acoustic signal working its way through the auditory system through a fluid filled area, causes it to lose energy Short Answer: We make it louder What are the transformations of energy acoustic • Topics for today ◦ A & P of the outer ear ◦ A & P of the middle ear ◦ A & P of the inner ear ◦ Transformations of energy Picture: EAR 1 JPEG Outer Ear (ACOUSTIC ENERGY) • Pinna 1 Composed of skin over cartilage 2 Consists of several parts 1 Helix, Antihelix, Concha, Tragus • External Auditory Meatus (ear canal) 1 Long (2.5 cm) and narrow (5–7 mm) canal leading up to the ear drum 2 Houses the ceruminous glands 1 Produces cerumen (ear wax) • Outer Ear 1 Tympanic Membrane (ear drum) 1 Laterally, continuous with skin of canal 2 Medially, continuous with mucosal lining of middle ear 3 Two layers are joined by connective tissue 4 Cone of light • Functions of the outer ear 1 Protects delicate deeper structures of the ear 1 Cerumen (ear wax) has a foul odor which repels insects 2 Cerumen is sticky preventing foreign bodies 3 Canal is bent not allowing straight access in 4 Hair follicles trap dust and dirt 2 Amplifies high frequency sounds (makes stuff louder) 1 Concha resonant frequency around 5000 Hz 2 Canal resonant frequency around 2500 Hz 3 Amplifies sounds around these frequencies by roughly 17 dB SPL 4 STEP 1 IN OVERCOMING THE IMPADANCE MISMATCH 3 Aides in localization of sound (know where sound is coming from) 1 Pinna attenuates sounds from behind • Middle Ear (deeper then the eardrum) ◦ Three tiny bones bridging outer and inner ears (Ossicles) ◦ In order of where they are form inside to out 1 Malleus 1 Comes in contact with TM (Eardrum) 2 Point of attachment is the Umbo (spot where the malleus joins together with the Eardrum (TM) 2 Incus 1 Middle ossicle 3 Stapes 1 Base of Stapes (footplate) sits in the oval window and sends energy into inner ear • Middle ear muscles ◦ Stapedius and Tensor Tympani ◦ Responsible for protecting the hearing nerve by contracting and thus stiffening the middle ear ◦ Known as the acoustic reflex 1 Occurs at about 85 dB SPL (really fucking loud) 2 protection device they contract and make the ossicles not be able to move, don’t allow as much sound to pass through 3 can’t do it for very long • Middle ear dark, moist, air filled cavity • Eustachian Tube ◦ Mucosal lined tube running from the nasopharynx (back of the throat) to the base of the middle ear ▪ TRANSFORMATION OF ENERGY NUMBER 2: acoustic energy > mechanical energy ▪ mechanical energy = physical movement of the ossicles ◦ Opens by yawning, coughing, valsalva (When you hold ur nose and blow) ▪ (only way to get fresh air into the ear) ◦ Purpose of Eustachian Tube ▪ Allows air to enter the ME (regulate pressure) ▪ Allows fluid to drain from the ME (should it develop) ◦ Tube is more horizontal and less mature in children ▪ Children are more prone to ear infections ▪ because the tube is more horizontal and gravity isn’t on your side EAR 2 JPEG Ear Infections • Otitis (“sickness of the ear) Media Sickness of the middle ear ◦ classic ear infections • Otitis Externa Sickness of the outer ear ◦ Swimmers ear Steps of Forming Otitis Media • 1. Swelling in the back of the throat (nasopharynx) ◦ from a cold, allergies, URI • 2. Eustachian tube gets pinched closed • 3. Negative pressure starts to form • 4. Negative pressure draws fluid out of the mucosal lining of the middle ear ◦ Air filled cavity now filled with liquid • 5. Fluid becomes infected • 6. Ear drum ruptures because fluid and pressure builds up • 7. The ear drum will heal itself Treatment • antibiotics for the infection • decongestants (reduces swelling) • PE tubes (pressure equalization) placed in the ear drum ** Side Note ** During this process the swelling in the throat can stop swelling and the tube will open and it will be drained Middle Ear • Function of the Middle Ear ◦ Amplifies incoming signal ▪ Size ratio of TM to footplate (last part of the Stapes) 17 : 1 (Increases dB SPL by 25) size of TM : footplate Impedance mismatch ▪ Lever action of Incus Increases signal by 2 dB SPL ◦ Protection of inner ear ▪ Acoustic reflex Inner Ear • Cochlea responsible for hearing ◦ 2 ¾ turn snail shaped cut out in the temporal bone ◦ “Tube” within the cochlea progresses from basal to apical end ▪ Tube is divided into three sections Scala Vestibuli Scala Media Houses the Basilar Membrane Scala tympani • TRANSFORMATION OF ENERGY NUMBER 3: Fluid movement in the inner ear = hydraulic energy • TRANSFORMATION OF ENERGY NUMBER 4: Auditory nerve is a electrical energy • Also in inner ear is the vestibular system used for balance • Organ of Corti ◦ Sits on the Basilar Membrane (In Scala Media) ◦ Houses the hcells (no follicles) ▪ Outer hair cells Rows of three responsible for perception of volume ▪ Inner hair cells Single row of receptors responsible for clarity of speech ▪ Hair cells provide synaptic junction to 8 cranial nerve (auditory nerve) HOW WE HEAR Eardrum moves > Ossicles move (mechanical energy) Staple footplate connects to cochlea and vibrates liquid within. Hair cells bend and a chemical reaction occurs at the base of the hair cell and a signal (spark) is sent on the auditory nerve. Function of Inner Ear • Round window receives footplate of stapes • As Stapes rocks, fluids in inner ear are set forth • “traveling wave” progresses through cochlea and is relieved at the round window. • Traveling wave will fall on the basilar membrane at a place consistent with the frequency of the signal • Transformations of Energy ◦ Acoustic – mechanical – hydraulic – electrical ◦ Acoustic (outer ear) ▪ Sound energy in canal ◦ Mechanical ( Middle Ear) ▪ Physical movement of ossicles ◦ Hydraulic (Cochlea inner ear) ▪ Traveling wave within cochlea ◦ Electrical (8th cranial nerve: Auditory Nerve) ▪ Firing of hair cells at 8 nerve Lecture 5 Unit 1 Peripheral Nervouse system (Everything that isn’t the CNS) • Sensory neurons (input) • Motor Neurons (output) Central Nervous System (Just the brain and spinal chord) Structure of the Brain • Cortex (grey matter) outside of brain • Cerebrum ◦ Cell Bodies – gray matter (cortex) ◦ Axons – white matter (bring info around the brain_ ◦ Contralateral control (right part controls left half of body) • Cerebellum (bottom under brain kinda, see picture) ◦ Coordination, precision, timing of movements Hemispheres (See picture) -language and hearing are on the left side • Four Lobes of the Brain (Brain Lobes. jpg) • Frontal lobe: front of brain right behind the eyes 1 memory, planning. motivation • Parietal lobe: top most part of the brain 1 integration of sensory information 2 Make sense of all the senses • Occipital lobe: back of the brain 1 vision • Temporal lobe: on the side near ears - 1 language and hearing 2 Sylvian fissure (separates lobes) • Cerebellum: “The little brain” • Sulci - indentation • Gyri – a “bump” • Cerebral Connections Corpus Callosum: major connection between left and right hemispheres • Stroke of Insight • http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight. html • Phrenology ◦ Franz Gall - feelings heads to find bumps ◦ Localist theory - spots for different things • Primary Sensory Regions (pic) • Primary Motor Cortex (JPG) • Sensory Homunculus • Localization of cognitive function ◦ A particular region is solely responsible for complex tasks Over simplified - tasks often require regions to work together in some kind of network ◦ There are specific areas that seem to be largely responsible for processing particular kinds of material • Perisylvian Region (Picture) ◦ Left hemisphere-areas surrounding Sylvian fissure are critical to language. Includes primary auditory cortex, sensory and motor cortices, Broca’s and Wernicke’s areass ◦ ◦ • Broca’s area ◦ area of the brain responsible for speech production • Wernicke’s area ◦ understanding and comprehension of language ◦ if damaged speak gibberish • Arcuate Fasiculus ◦ how Brocca’s area and Wernicke’s area connect ◦ series of axons ◦ • Peripheral Nervous System ◦ sensory neuronsrunning from stimulus receptors that inform the CNS of the stimuli ◦ motor neuronsrunning from the CNS to the muscles and glands - called effectors - that take action. ◦ Includes cranial nerves and spinal nerves PICTURES
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