Академический Документы
Профессиональный Документы
Культура Документы
ESCUELA DE FONOAUDIOLOGIA
NOMBRE: __________________________________________________________________________________________________
FECHA DE NACIMIENTO:__________________________________ EDAD:_____________________________________________
FECHA DE EVALUACIN: _____________________________________________________________________________________
EVALUADOR: _______________________________________________________________________________________________
Normal Normal
total
Desviacin D-I
Obstruccin I parcial o
Aplanada total
EXAMEN INTRAORAL
Normal
ALVEOLARES superior: inferior: superior:
sublingual:
Normal Normal Normal
Funcion
Macroglosia Descendida Disminuida al
Seccion
ado
Fisurado
PALADAR Anatoma:
SEO
Normal Alto
Ojival Otra alteracin
Plano
PALADAR Anatoma: vula: Funcin en fonacin: Cierre velo-
BLANDO farngeo:
Normal Normal Funcional
Suficien
Corto Corta Insuficiente te
D
Lateralizada
Lateralizada a I
AMGDALAS Anatoma:
Aumentadas
Normales
Asimtricas
Hipertrfica
s Ausentes
al al
Costo-Diafragmtico Costo-
Buca Buc
Diafragmtico
Mixto
l al
Mixto
Mixt Mixt
o o
DEGLUCIN
Normal
Succin de labios
Interposicin lingual
Interposicin labial
OBSERVACIONES:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________