Ch.8-Voice and Resonance Disorders Flashcards
What is velopharyngeal inadequacy?
when the VP fails to separate the nasal and oral cavities during speech production and swallowing
What causes velopharyngeal inadequacy?
malformations of the hard and soft palate early in embryonic development
What are craniofacial anomalies?
congenital malformations involving the head and face , such as cleft palate
What do the vocal folds do during 1 complete cycle of vocal fold vibration?
vocal folds move from a closed or adducted position to an open or abducted position and back to adduced position
What is the fundamental frequency of an average male’s voice?
about 125 Hz
What is the fundamental frequency of an average female’s voice?
about 250 Hz
What causes someone to have a monotone voice?
they don’t change their usual speaking frequency while they are speaking
What does intensity of a sound equate to?
loudness of a sound
What are features of a voice disorder?
voice production has aberrant voice quality, pitch, loudness, and flexibility.
What percentage of children in the US have a voice disorder?
about 3% to 6%
What percentage of adults in the US have a voice disorder?
about 3% to 9%
What is inappropriate pitch?
a voice that is judged to be outside the normal range of pitch for age and/or sex.
What are pitch breaks?
sudden uncontrolled upward or downward changes in pitch.
What three aspects of pitch may indicate a voice disorder
inappropriate pitch, monotone voice, and pitch breaks
What two aspects of loudness may indicate a voice disorder?
monoloudness and loudness variation
What is monoloudness?
voice lacks normal variations of intensity that happen during speech
What are loudness variations?
extreme variations in vocal intensity: voice is too soft or too loud for a given situation.
What is breathiness?
a voice quality in which air escapes through the glottis during phonation.
What is tremor?
a quality that involves variations in the pitch and loudness of the voice that are not under voluntary control
What does vocal tremor usually indicate?
It usually indicates a loss of central nervous system control over the laryngeal mechanism
What are strain and struggle behaviors related to?
they are related to difficulties in beginning and maintaining voice
What are the nonphonatory disorders?
stridor, consistent aphonia, episodic aphonia
What is stridor?
a nonphonatory disorder, noisy breathing or involuntary sound that occurrs during inhalation or exhalation
What does stridor indicate?
it indicates a blockage of the airway or a narrowing somewhere in the airway
What does excessive throat clearing indicate?
It indicates the attempt to clear mucus from the vocal folds
What is consistent aphonia?
persistent absence of voice; perceived as whispering
What may aphonia be related to?
vocal fold paralysis, disorders of the central nervous system, or psychological problems
What is episodic aphonia?
uncontrolled, unpredictable aphonic breaks in voice that can last for a fraction of a second or longer.
What may cause episodic aphonia?
central nervous system disorders and psychological problems
What vocal disorders are associated with vocal misuse and abuse?
vocal nodules, contact ulcers, vocal polyps, sessile polyps, pedunculated polyps, laryngitis (acute and chronic),
What are vocal nodules?
localized bilateral growths on the vocal folds caused by frequent, hard vocal fold collisions from yelling or shouting; they are 2/2 to vocal misuse or abuse
What are the primary perceptual voice symptoms of vocal nodules?
hoarseness and breathiness; people may complain of soreness in the throat or they can’t use the upper third of their pitch range.
How does one treat vocal nodules?
through vocal rest A.K.A no talking
What are contact ulcers?
bilateral, painful, and reddened ulcerations that develop around the arytenoid cartilages and are on the posterior surface of the vocal folds.
What are the primary voice symptoms of contact ulcers?
vocal hoarseness and breathiness, throat clearing and vocal fatigue
What are vocal polyps?
similar to vocal nodules, are caused by blood vessels in the vocal folds rupturing and swelling. This can cause fluid filled lesions.
What can cause vocal polyps?
one traumatic event, such as yelling at a sports event
What are characteristics of vocal polyps?
unilateral, larger than nodules, vascular, and prone to hemorrhage
What is a sessile polyp?
a polyp that is attached to the vocal fold tissue; it can cover up to 2/3 of the vocal folds
What is a pedunculated polyp?
a polyp that seems to be attached to the free margins or upper and lower surfaces of the vocal folds
What is laryngitis?
inflammation of the vocal folds
What causes laryngitis?
exposure to noxious agents (tobacco smoke, alcohol), allergies, or vocal abuse
What is acute laryngitis?
a temporary swelling of the vocal folds that can lead to vocal hoarseness
What is chronic laryngitis?
vocal abuse that results during periods of acute laryngitis. It can lead to the breakdown of vocal fold tissue
What are symptoms of chronic laryngitis?
persistent cough, frequent throat aches, mild hoarseness to near aphonia
What is the difference between hypoadduction and hyperadduction?
hypoadduction is reduced vocal fold adduction and hyperadduction is increased vocal fold adduction.
What CNS disorder results in hypoadduction?
parkinson’s disease
What is diplophonia?
perception of two frequencies
What can damage to the recurrent branch of the 10th cranial nerve (vagus) result in?
can result in unilateral and bilateral vocal fold paralysis which leads to hypoadduction
What does the 10th cranial nerve do?
It is nerve supply for most of the laryngeal muscles associated with voice production
What neurological disorders are associated with hyperadduction?
spastic dysarthria and spasmodic dysphonia
What is spasmodic dysphonia?
muscles that generate a person’s voice spasms for periods, this leads to a person’s voice breaking up
What are laryngeal papillomas?
tiny wart-like growths that cover the vocal folds and the interior aspects of the larynx.
What causes laryngeal papillomas and which population often suffers from it ?
caused by a papovirus; children younger than 6.
What do children with laryngeal papillomas show?
may show stridor during inhalation and may be aphonic
What are congenital laryngeal webs?
laryngeal webs that typically form on the from parts of the vocal folds
What is laryngeal cancer?
cancer to the larynx that is linked to cigarette smoking and excessive use of alcohol.
What are alternative methods of producing voice when the larynx is removed due to laryngeal cancer?
esophageal speech, electrolarynx, tracheoesophageal shunt
What is esophageal speech?
a different way of producing voice by using the esophagus as a vibratory source and the speaker uses burps to speak.
What is an electrolarynx?
a device used to produce voicing by exciting air in the vocal tract through vibrations
What is a tracheoesophageal shunt?
a device that directs air from the trachea into the esophagus. This allows the speaker to use respiratory air and the cricopharyngeous muscle to produce voice
What are granulomas?
ruptured capillaries covered with epithelial tissue; it is surgically removed from the larynx
What are conversion disorders?
psychogenic voice disorders that result from psychological suppression of emotion
What is conversion aphonia?
a type of vocal conversion disorder in which one tends to whisper to use their voice.
What causes hypernasality?
the velopharyngeal port does not separate the oral and nasal cavities; thus the nasal cavities acts as a second filter.
What causes hyponasality?
partial blockage somewhere in the nasopharynx or nasal cavity.
What is an endoscope?
a device used to view laryngeal structures through a lens
What is a nasometer?
a device used to assess resonance disorder; it measures simultaneously the relative amplitude of acoustic energy being released through the nose and mouth during phonation.
What is one treatment for articulation disorders secondary to VPI?
electropalatography
What is electropalatography?
a technique in which one can see articulatory patterns of their speech on a screen via electrodes placed on their tongue and a palatal plate.
What is a hard glottal attack?
an occurrence in which a client begins speaking using hyperadducted vocal folds
