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Voice Disorders - Assessment of Voice and Resonance > assessment of voice and resonance > Flashcards

assessment of voice and resonance Flashcards

1
Q

What does a voice evaluation include?

A 
Patient History
Voice sample (sustained and connected)
Perceptual analysis
Acoustic Analysis
Stroboscopic Assessment
[Respiratory Assessment]
[Resonance/VP Assessment]
Recommendations/POC
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2
Q

What 2 assessments might we administer when conducting our perceptual analysis?

A

VHI

CAPE - V

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3
Q

Which of the following is an objective measure? Which is subjective?
Perceptual analysis & Acoustic Analysis

A

Perceptual analysis = subjective.

Acoustic Analysis = objective

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4
Q

What does an EMG measure?

A 
muscle activity (volts)
-this is mostly just for research purposes...it measures muscle activity below the placed electrodes
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5
Q

What does an EGG measure?

A

electroglottography: mean rate of airflow at the glottis

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6
Q

Pt Hx: Hx of the problem: what 3 questions are we going to ask about?

A

origin, duration and severity of the problem

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7
Q

Pt Hx: Hx of the problem: what kind of question are we going to ask to assess the duration of the problem?

A

Is there a time of day when the voice is worse/better? ie at morning or at night?

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8
Q

Pt Hx: “Social history” is concerned with…

A

how the pt uses their voice (i.e. socially/professionally as a teacher/singer)

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9
Q

What are some things, relevant to our field, that would be included in a persons medical history?

A

surgeries (that may have damaged nerves), allergies (can cause post nasal drip which can irritate the larynx), URI, psych/depression

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10
Q

Name some (3) factors which can affect vocal hygiene? [relates to diet]

A

caffeine, smoking, hydration, alcohol

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11
Q

How much water should we drink per day?

A

68 oz/day, 8 oz/cup… about 7 cups of water. Hydrate or die.

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12
Q

t/f: a medication list is included in our pt hx

A

True!

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13
Q

Describe the VHI

A

Voice Handicap Index (VHI) - valid and reliable tool, which measures a pt’s perceptual analysis. “30 Q’s rated according to how often it is happening to them: 10 are functional, 10 physical, 10 emotional. Pt answers 0-4 on a Leichart scale (4=always happens). This is a good way to measure the pts perception of the problem)

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14
Q

Describe the CAPEV

A

Consensus Auditory-Perceptual Evaluation of Voice
-reliable and valid tool, used to record the clinician’s perceptual analysis. Clinician rates breathiness, resonance, loudness, raspiness, roughness… on a ranging scale (constant - intermittent)

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15
Q

Is MDVP an objective or subjective measure?

What information does it give us?

A

objective

fundamental frequency and noise:harmonic ratio

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16
Q

Which provides a better view? an oral rigid or flexible scope

A

Oral Rigid

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17
Q

What is a montage?

A

a complete cycle of the vfs… aka 1 Hertz

18
Q

What 10 parameters are rated from a Videostroboscopic Exam?

A
  1. vocal fold edge
  2. Glottal closure
  3. Phase closure
  4. Vertical level of approximation
  5. Amplitude (of vibration), 6: Mucosal Wave 7: Vibratory bx, 8. Phase symetry, 9. Periodocity, 10: Hyperfx
19
Q

During a videostroboscopic exam, Why might you have to look at more than one cycle when assessing phase closure?

A

There may be a pedunculation going b/t under the vfs

20
Q

T/F: most women have a posterior chink

A

True!

21
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the mucosal wave?

A

The assessment of the degree of traveling wave that is present on the superior surface of the vf during phonation

22
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the vocal fold edge?

A

Smoothness/straightness of edges

23
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the glottal closure?

A

The degree to which the vfs close during max adduction during phonation

24
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the Phase closure?

A

The degree to which the vfs move together during vf closure during phonation

25
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the vertical level of approximation?

A

The degree to which the vfs meet on the same vertical plane during phonation

26
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the amplitude?

A

The degree of mvmt from the medial to the lateral aspects of the vf during phonation

27
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the mucosal wave?

A

The assessment of the degree of traveling wave that is present on the superior surface of the vf during phonation

28
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the vibratory bx?

A

identification of portions of the vf that are non-moving during phonation (often we’ll see decreased vibration around lesions)

29
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the phase symmetry?

A

the degree to which the vfs move symmetrically during vf closure during phonation (affected by lesions, paresis, and dyphonia)

30
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the periodicity?

A

regularity of successive cycles of vibration during phonation

31
Q

Re. a Videostroboscopic Exam - what are we assessing when looking at the hyperfx?

A

extraneous activity int eh form of ventricular compression/phonation, &/or A-P press (MTD, laryngitis)

32
Q

What does a spirometer measure?

A

respiratory flow, volumes, and lung capacities (FVC, FEV)

33
Q

What does a manometer measure?

A

air pressure! MIP & MEP

34
Q

What does a pneumotachometer measure?

A

cough strength (peak flow), insp. muscle phase, laryngeal compression of the vf’s phase. . . *most important for pts with swallowing issues, need to have a strong cough to expel food if choking

35
Q

What three instruments can be used when assessing respiration?

A

manometer. spirometer. pneumotachometer

36
Q

What 2 instruments can be used to assess resonance?

A

nasopharyngoscopy (assesses vp closure and larynx), nasometer (measures nasality)

37
Q

What are we concerned with re. recommendations/POC for a client?

A

pt edu., (modified) voice rest, voice exercises for home, reflux management, vocal hygiene, voice therapy/re-eval, referral

38
Q

T/F: the s/z ratio and tongue anchor tests are unreliable and we shouldn’t use them

A

True. She really dislikes both of these.

39
Q

Define Laryngectomee

A

A person who’s had a laryngectomy

40
Q

Describe 3 ways a laryngectomee pt can talk using alaryngeal speech

A
  1. w an electrolarynx
  2. TEP - tracheoesophageal prosthesis… air is channeled through a reed
  3. esophageal (burping) speech
41
Q

Voice assessment for Cleft includes

A

Voice and resonance assessment (flexible nasoendoscopy, nasometry), Lng Assessment, Artic and phono processes assessment

Voice Disorders - Assessment of Voice and Resonance (1 decks)

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