6 - ENT - Upper airway - Voice - Speech production + Assessment

Question 1

how is sound produced? enabled by? frequency adjusted by?

Answer 1

mucosa of membranous part of vocal folds vibrated by air passing over them - enabled by Reinke’s space - potential space beneath epithelium vocal folds

freq adjusted by contraction of vocalis muscle - tension on vocal fold

Question 2

Volume adjusted by? what my weaken speech?

Answer 2

volume influenced by subglottic pressure (by time between opening of vocal folds)
if vocal folds become reduced in contact - (RLN palsy)

Question 3

Vowel and consonants production..

Answer 3

vocal fold vibration allows vowel production - modulated by shaping of vocal tract

consonants prod by air squirting through narrowing in vocal tract - causing turbulence

Question 4

define dysphonia

define dysarthria

Answer 4

dysphonia - any impairment of voice/difficulty speaking

dysarthria - imperfect articulation of speech due to disturbances of motor control or in-coordination

Question 5

define Dysphasia

define hoarseness

Answer 5

dysphasia - impaired speech and verbal comprehension or speech and verbal production
hoarseness - perceived rough, harsh, or breathy quality of voice

Question 6

unexplained hoarseness persisting >3 weeks …..

Answer 6

needs investigation to exclude malignancy

Question 7

Assessment - Hx - 6 signs of possible cancer

Answer 7

pain in throat, odynophagia, dysphagia, referred otalgia, difficulty breathing, lump in neck

Question 8

Assessment - Hx - what points to infective cause?

Answer 8

any other s+s of URTI

Question 9

Assessment - Hx - reflux RF’s

Answer 9

spicy/fatty food
large meals late at night
tea coffee cola
Sx of heartburn, reflux, indigestion, lump in throat

Question 10

Assessment - Hx - other RFs

Answer 10

smoking and alcohol

voice use in occupation

Question 11

How to visualize the laynx

Answer 11

fibreoptic or rigid telescopes

stroboscopy - wave motion of mucosa observation