assessment of voice and resonance Flashcards
What does a voice evaluation include?
Patient History Voice sample (sustained and connected) Perceptual analysis Acoustic Analysis Stroboscopic Assessment [Respiratory Assessment] [Resonance/VP Assessment] Recommendations/POC
What 2 assessments might we administer when conducting our perceptual analysis?
VHI
CAPE - V
Which of the following is an objective measure? Which is subjective?
Perceptual analysis & Acoustic Analysis
Perceptual analysis = subjective.
Acoustic Analysis = objective
What does an EMG measure?
muscle activity (volts) -this is mostly just for research purposes...it measures muscle activity below the placed electrodes
What does an EGG measure?
electroglottography: mean rate of airflow at the glottis
Pt Hx: Hx of the problem: what 3 questions are we going to ask about?
origin, duration and severity of the problem
Pt Hx: Hx of the problem: what kind of question are we going to ask to assess the duration of the problem?
Is there a time of day when the voice is worse/better? ie at morning or at night?
Pt Hx: “Social history” is concerned with…
how the pt uses their voice (i.e. socially/professionally as a teacher/singer)
What are some things, relevant to our field, that would be included in a persons medical history?
surgeries (that may have damaged nerves), allergies (can cause post nasal drip which can irritate the larynx), URI, psych/depression
Name some (3) factors which can affect vocal hygiene? [relates to diet]
caffeine, smoking, hydration, alcohol
How much water should we drink per day?
68 oz/day, 8 oz/cup… about 7 cups of water. Hydrate or die.
t/f: a medication list is included in our pt hx
True!
Describe the VHI
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)
Describe the CAPEV
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)
Is MDVP an objective or subjective measure?
What information does it give us?
objective
fundamental frequency and noise:harmonic ratio
Which provides a better view? an oral rigid or flexible scope
Oral Rigid
What is a montage?
a complete cycle of the vfs… aka 1 Hertz
What 10 parameters are rated from a Videostroboscopic Exam?
- vocal fold edge
- Glottal closure
- Phase closure
- Vertical level of approximation
- Amplitude (of vibration), 6: Mucosal Wave 7: Vibratory bx, 8. Phase symetry, 9. Periodocity, 10: Hyperfx
During a videostroboscopic exam, Why might you have to look at more than one cycle when assessing phase closure?
There may be a pedunculation going b/t under the vfs
T/F: most women have a posterior chink
True!
Re. a Videostroboscopic Exam - what are we assessing when looking at the mucosal wave?
The assessment of the degree of traveling wave that is present on the superior surface of the vf during phonation
Re. a Videostroboscopic Exam - what are we assessing when looking at the vocal fold edge?
Smoothness/straightness of edges
Re. a Videostroboscopic Exam - what are we assessing when looking at the glottal closure?
The degree to which the vfs close during max adduction during phonation
Re. a Videostroboscopic Exam - what are we assessing when looking at the Phase closure?
The degree to which the vfs move together during vf closure during phonation
