ASHA Anatomy and Physiology of Communication 2 — Questions and Answers
Question 1: In correct anatomical order from lateral (tympanic membrane) to medial (oval window), the three ossicles are:
- Malleus, incus, stapes (Correct answer)
- Stapes, incus, malleus
- Incus, malleus, stapes
- Malleus, stapes, incus
Correct answer: Malleus, incus, stapes
Vibrations travel from the tympanic membrane to the malleus handle, then via the incudomallear joint to the incus, and finally through the incudostapedial joint to the stapes footplate at the oval window.
Question 2: Glottal fry (pulse register) is characterized by which pattern of vocal fold vibration?
- Rapid, symmetric high-frequency vibration
- Irregular, very low-frequency vibration producing a creaking quality (Correct answer)
- Absence of true mucosal wave
- Symmetric adduction with breathy onset
Correct answer: Irregular, very low-frequency vibration producing a creaking quality
In pulse register (vocal fry), the vocal folds vibrate at irregular, very low rates (20–70 Hz), producing the characteristic popping or creaking sound quality.
Question 3: Broca's area, critical for speech motor programming and expressive language, is located in which brain region?
- Posterior superior temporal gyrus of the left hemisphere
- Inferior frontal gyrus of the left hemisphere (Correct answer)
- Angular gyrus of the left parietal lobe
- Right hemisphere homologue of the temporal lobe
Correct answer: Inferior frontal gyrus of the left hemisphere
Broca's area occupies Brodmann areas 44 and 45 in the left inferior frontal gyrus (pars triangularis and pars opercularis), supporting speech motor planning and syntactic processing.
Question 4: The gag reflex afferent limb is carried by CN IX (Glossopharyngeal), while the efferent (motor) limb is primarily carried by which nerve?
- CN VII (Facial)
- CN X (Vagus) (Correct answer)
- CN XII (Hypoglossal)
- CN V (Trigeminal)
Correct answer: CN X (Vagus)
CN IX provides sensory input from the posterior pharynx triggering the gag, while CN X (vagus) carries motor commands to the pharyngeal constrictors and soft palate to execute the reflex.
Question 5: Wernicke's area, associated with auditory language comprehension, is located in which brain region?
- Left inferior frontal gyrus
- Left posterior superior temporal gyrus (Correct answer)
- Right parietal lobe
- Left angular gyrus
Correct answer: Left posterior superior temporal gyrus
Wernicke's area (Brodmann area 22) in the left posterior superior temporal gyrus is essential for decoding incoming speech and understanding language.
Question 6: Phonation threshold pressure (PTP) is defined as:
- The maximum subglottal pressure achievable during a Valsalva maneuver
- The minimum subglottal air pressure required to initiate and sustain vocal fold vibration (Correct answer)
- The pressure differential across the epiglottis during swallowing
- The intraoral pressure needed to produce plosive consonants
Correct answer: The minimum subglottal air pressure required to initiate and sustain vocal fold vibration
PTP is the minimum subglottal pressure needed to overcome vocal fold tissue stiffness and surface tension to set the folds into self-sustained oscillation.
Question 7: Which resonating cavity is predominantly responsible for adding nasal quality to the voice when the velopharyngeal port is open?
- Oral cavity
- Pharyngeal cavity
- Nasal cavity (Correct answer)
- Laryngeal vestibule
Correct answer: Nasal cavity
When the velum lowers and the velopharyngeal port opens, the nasal cavity couples acoustically with the vocal tract, adding nasal resonance to the voice.
ASHA Anatomy and Physiology of Communication 2
In correct anatomical order from lateral (tympanic membrane) to medial (oval window), the three ossicles are: