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Foundations Of Speech Pathology > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

Definition of voice

A

the complex, dynamic product of vocal fold vibration that allows us to vocalize and verbalize

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2
Q

Definition of vocalize

A

to make sounds

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3
Q

Definition of verbalization

A

to produce language through speech

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4
Q

Definition of adduction state

A

when the the vocal folds must be closed, or adducted, at midline

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5
Q

Definition of abduction

A

when not producing voice, the vocal folds rest in an open, or abducted, position so that one can breathe

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6
Q

what has to happen for phonation to occur?

A

air is exhaled from the respiratory system upward against the adducted vocal folds, which are then blown apart and vibrate

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7
Q

Definition of resonation

A

actual air vibration within the pharyngeal column, which impacts the quality of the voice

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8
Q

Definition of articulation

A

when the voice is manipulated within the oral cavity

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9
Q

Definition of frequency

A

the rate of vocal fold vibration, expressed in cycles per second, or hertz

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10
Q

Frequency is an _____, _____ measurement of vibratory rate

A

objective, physical

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11
Q

Pitch is the ____ equivalent to frequency

A

perceptual

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12
Q

Definition of Fundamental frequency

A

the arithmetic mean of the rates of vibration for the vocal folds

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13
Q

if an individual’s vocal folds vibrate 250 times in a second, what is the fundamental frequency?

A

FO is 250 Hz

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14
Q

a person’s fundamental frequency relates to what three characteristics of the vocal folds?

A

length
mass
tension

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15
Q

effect of length of vocal folds

A

Longer vocal folds contribute to a lower FO

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16
Q

effect of mass of vocal folds

A

Thicker vocal fold mass contributes to a lower FO

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17
Q

Definition of tension of vocal folds

A

Greater tension contributes to a higher FO

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18
Q

true or false: the greatest amount of change occurs between birth and puberty

A

true

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19
Q

when does fundamental frequency decreases most significantly for males?

A

puberty

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20
Q

when does fundamental frequency decreases most significantly for females?

A

midlife

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21
Q

Definition of Intensity

A

the physical measurement of sound pressure reported in decibels (dB), which corresponds to the perception of loudness

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22
Q

What two features of vocal production does loudness relate to?

A

the amount of airflow from the lungs

the amount of resistance of the airflow by the vocal folds

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23
Q

true or false: an increase in airflow from the lungs is the only way to result in increased loudness

A

false: increased resistance – achieved through compression of the vocal folds at the midline also increases in loudness

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24
Q

Definition of phonatory quality

A

how well the two vocal folds work during the vibratory cycle

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25
Q

When do individuals exhibit a voice disorder?

A

When their pitch, loudness, or phonatory quality differs significantly from that of persons of a similar age, gender, cultural background, and racial and/or ethnic group

must be serious enough to draw attention and to detract in some way from performance in school, home, community, and/or work

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26
Q

Definition of dysphonia

A

the umbrella term used to refer to a voice that is disordered in some way

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27
Q

Definition of aphonia

A

the total loss or lack of voice

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28
Q

Definition of hypofunction

A

vocal folds that are under functioning and have inadequate tension

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29
Q

true or false: with hypofunction the vocal folds do not come together adequately or evenly, allowing air to escape through the vocal folds and resulting in a breathiness or hoarseness.

A

true

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30
Q

is any voice produced with complete hypo function?

A

no

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31
Q

true or false: hypofunction affects both vocal folds

A

false: hypofunction affects only one vocal fold and the other works normally

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32
Q

Definition of hyperfunction

A

vocal folds that are overly tense and compress together too tightly

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33
Q

true or false: hyper functioning voice may sound too loud, too high, and/or too strained

A

true

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34
Q

what may accompany the hyperfunctioning voice?

A

Excessive tension in the neck or jaw

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35
Q

true or false: in some cases, hyperfunctioning vocal cords completely impede the production of voice, resulting in spasticity, in which the voice stops and starts intermittently

A

true

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36
Q

Definition of diplophonia

A

means “double pitch” and describes a vocal quality in which the vocal folds produce two different pitches simultaneously

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37
Q

what are the two primary causes of diplophonia?

A

the two vocal folds have different mass characteristics and therefore vibrate at different rates

it can also occur if one vocal fold is paralyzed or hyperfunctioning

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38
Q

Definition of laryngectomy

A

a procedure in which a person’s larynx is surgically removed

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39
Q

two primary reasons for a laryngectomy

A

laryngeal cancer and laryngeal trauma

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40
Q

Definition of alaryngeal communication

A

speech is produced outside the larynx, an alternative way to produce speech

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41
Q

what is intensity equivalent to?

A

voice quality

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42
Q

Phonatory quality is influenced by how well the two vocal folds work during the vibratory cycle and ____.

A

the resonation of the voice as it travels up from the vocal folds through the pharynx and into the oral and nasal cavities

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43
Q

true or false: prevalence and incidence of voice disorders in both children and adults is relatively low compared to other disorders of communication

A

false: relatively high

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44
Q

true or false: prevalence and incidence of voice disorders in adult women are higher than men

A

true - 7% for females and 5% for males

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45
Q

when do voice disorders peak for adults?

A

between 40-60 years old

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46
Q

what is the prevalence rate of voice disorders for adults?

A

29%

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47
Q

what is the incident rate of voice disorders for adults?

A

6%

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48
Q

five common causes of voice disorders

A

vocal nodules

vocal fold paralysis

edema/swelling

polyps

carcinoma

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49
Q

what percentage of voice disorders have a functional etiology?

A

10%

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50
Q

what combination of two factors pose the greatest risk for a voice disorder?

A

constant voice use (or overuse)

noisy environment

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51
Q

true or false: one-fourth of children exhibit significant vocal problems

A

true

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52
Q

what percent of children who exhibit significant vocal problems reflect ongoing rather than transient problems?

A

40%

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53
Q

true or false: a small number of cases reflects a congenital problem with the vocal apparatus and a larger number of children, the problem is acquired.

A

true

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54
Q

what is the most common cause of voice dysfunction in children?

A

vocal nodules

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55
Q

what three reasons do voice disorder cases go undiagnosed and untreated?

A

treatment access

knowledge

social perceptions

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56
Q

true or false: ASHA requires that patients receive a medical evaluation from a physician prior to beginning voice therapy with a SLP

A

TRUE

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57
Q

Definition of vocal abuse

A

chronic or intermittent overuse or misuse of the vocal apparatus

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58
Q

what is the most common cause of voice disorders in both children and adults?

A

vocal abuse

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59
Q

Definition of vocal nodules

A

small, bilateral protuberances or calloused growths on the inner edges of the vocal folds

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60
Q

what is the most common symptom of vocal nodules?

A

hoarseness

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61
Q

Definition of Acute nodules

A

bruising on the vocal folds, which over time will thicken and harden as they become a chronic condition and advance to becoming fibrous protuberances

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62
Q

Definition of Contact ulcers

A

inflamed lesions that develop on the arytenoid’s cartilages in the posterior region of the larynx

63
Q

how do contact ulcers develop?

A

repeated forceful contact of the vocal folds and progress from tissue irritation to necrosis, or death of the tissue

64
Q

Definition of granuloma

A

a generated mass of healing tissue at the site of the ulcer

65
Q

contact users and granulomas affect both men and women in what ratio?

A

roughly 4:1

66
Q

Definition of neurogenic Disorders

A

a result from illness, damage, or disease to the neurological system associated with voice production

67
Q

true or false: damage to either the CNS or the PNS can cause dysfunction of the vocal mechanism

A

true

68
Q

where do neurogenic disorders get their name?

A

etiology stems from neurological malfunctioning

69
Q

three causes of vagus Nerve Lesions

A

surgical damage (particularly thyroid surgery)

trauma

viral infections

70
Q

what is the most serious outcome of vagus nerve damage?

A

unilateral vocal fold paralysis

71
Q

Definition of abduction paralysis

A

when the vocal fold is paralyzed in an adducted position (cannot open)

72
Q

true or false: with adduction paralysis, the voice usually is not affected because the other fold can press against it to phonate

A

false: ABduction paralysis

73
Q

true or false: with adduction paralysis, breathing is affected

A

true

74
Q

Definition of adduction paralysis

A

when the vocal fold is paralyzed in an abducted position (cannot close)

75
Q

true or false: with abduction paralysis, vocal production is compromised because the two folds do not meet at the midline

A

false: ADDuction paralysis

76
Q

true or false: with adduction paralysis, voice quality is affected

A

true

77
Q

Definition of tracheostomy

A

an artificial airway is placed below the larynx so the individual can breathe

78
Q

when is a tracheostomy needed?

A

when complete paralysis of the vocal folds occurs, leaving them completely opened or completely blocking the airway

79
Q

Definition of spasmodic dysphonia

A

a disorder affecting motor control of the larynx

80
Q

what is the hallmark of spasmodic dysphonia?

A

vocal spasms that result in intermittent voice

81
Q

six characteristics of spasmodic dysphonia

A

An occasionally normal voice

Intermittent breaks in voicing

normal-sounding whisper

Improved voice at high pitches

Worsening voice with stress

Periods of significant dysphonia

82
Q

Definition of adductor spasmodic dysphonia

A

a hyperfunctioning voice that seems strangled, strained, and squeezing

83
Q

Definition of abductor spasmodic dysphonia

A

hypo functioning voice that is breathy and open

84
Q

what percentage of spasmodic dysphonia are adductor?

A

50%

85
Q

Definition of Amyotrophic Lateral Sclerosis

A

a progressive, degenerative, neuromuscular disease resulting from a muscular weakness, fatigue, and atrophy

86
Q

true or false: the cause of ALS is unknown

A

true

87
Q

what does a vocal disorder with ALS show?

A

soft, breathy

low in pitch and loudness with limited variability

hyper nasal

88
Q

true or false: cognitive abilities of people with ALS remain intact

A

true

89
Q

true or false: ALS patients are unable to produce voice or speech early on in the disease progression

A

false: later on in the disease progression

90
Q

what can provide a person with ALS an alternative way to communicate with others?

A

augmentative communication

91
Q

Definition of Parkinson’s disease

A

a progressive, degenerative neurological disease, one that is caused by dopamine depletion

92
Q

what three voice disorder symptoms does Parkinson’s disease exhibit?

A

weak voice because of a weakened respiratory system

reduced loudness and a breathy

hoarseness and monotonic

93
Q

what two characteristics result from or are linked to psychogenic disorders of voice?

A

emotional and psychological characteristics

94
Q

true or false: a voice disorder can be a result of stress, anxiety or depression

A

true

95
Q

Definition of conversion disorder

A

a psychological disturbance in which an individual exhibits symptom of a physical disease or disorder

96
Q

what is a possible symptom of conversion disorder?

A

dysphonia or aphonia

97
Q

Definition of vocal tic disorder

A

sudden, rapid, recurrent vocalizations

98
Q

Definition of Tourette’s disorder

A

when vocal tics occur simultaneously with other motor tics affecting the head, torso, and extremities

99
Q

true or false: the vocal tics seen in both vocal tic disorder and Tourette’s syndrome are not linked to any known physical cause

A

true

100
Q

what is mutational falsetto (pubertonia)?

A

a male child or adolescent who exhibits an inappropriately high-pitched voice

101
Q

what is Juvenile voice disorder?

A

when women maintain a juvenile voice into adulthood

102
Q

what three characteristics accompany the childlike pitch?

A

low intensity

nasally

breathiness

103
Q

Definition of Alaryngeal Communication

A

voice production without a larynx; most often results from a tracheostomy or a laryngectomy

104
Q

Definition of tracheostomy

A

a surgical procedure in which a trach tube, is inserted through the neck below the vocal folds to direct air into the lungs

105
Q

true or false: for children being on a trach for an extended period of time won’t undermine their ability to develop speech, language, and communication abilities

A

false - it will undermine them

106
Q

Definition of Passy-Muir tracheostomy speaking valve

A

a valving system that sends air downward into the pulmonary system during inhalation but directs exhaled air over the vocal folds to produce speech

107
Q

what is the most common reason for alaryngeal communication in adults?

A

the removal of the larynx due to trauma or cancer

108
Q

what do you call a person whose larynx has been removed?

A

laryngectomee

109
Q

four risk factors of laryngeal cancer

A

male

african american

tobacco use

alcohol use

110
Q

what is the most consistent early symptom of laryngeal cancer?

A

hoarseness

111
Q

As a general rule, what is the longest anyone should ever allow hoarseness to continue without medical evaluation?

A

two weeks, max

112
Q

what are the first two goals in cancer treatment?

A
  1. rid body of malignancy

2. maintain the body’s functions and structures

113
Q

conservation approach to laryngeal cancer

A

the larynx remains, with portions of it removed.

114
Q

cordectomy approach to laryngeal cancer

A

one of the vocal folds is surgically removed and laryngectomy portions of the laryngeal cartilages are removed

115
Q

what three perceptual characteristics can voice disorder impacts?

A

resonance

loudness and pitch

phonatory quality

116
Q

Definition of disorders of resonance

A

problems with control of the velopharyngeal port due to velopharyngeal inadequacy that occurs when there is imperfect closure of the port because of structural or muscular problems

117
Q

Four common causes of velopharyngeal inadequacy

A

Cleft palate and cranio-facial anomalies

iatrogenic problems

Allergies

Neuromuscular impairment

118
Q

four conditions that cause hyponasality

A

Acute rhinitis

Allergic rhinitis

Papilloma

tonsiuitis

119
Q

Definition of Glottal fry

A

a pitch disturbance in which the pitch is low, produced on tight vocal folds

120
Q

Definition of habitual pitch

A

the pitch used in normal speaking situations without applying any extra physiological effort

121
Q

Definition of optimal pitch

A

the pitch at which one’s voice is the least abusive, least effortful, and most efficient

122
Q

Definition of basal pitch

A

the lowest steady pitch a person can produce without pitch breaks or glottal fry

123
Q

Definition of ceiling pitch

A

the highest pitch at which a voice can be sustained without pitch breaks

124
Q

Definition of vocal range

A

the difference between a basal and a ceiling pitch, normally covering two to three octaves

125
Q

Definition of Underloudness

A

a lack of respiratory force due to neurological injury or disease

126
Q

true or false: both overloudness and underloudness are considered vocal abuse

A

true

127
Q

five common disturbances of phonatory quality

A

Glottal fry

Hard glottal attack

Hoarseness

Breathy phonation

Spasticity

128
Q

warning Signs of a Voice Disorder

A

change in the resonance, pitch, loudness, or phonatory quality of an individual’s voice lasts longer than two weeks

129
Q

four roles for SLP’s in assessment

A

characterize the general features of the voice

establish whether any of these features differ significantly from normal

identify the cause of any disorder

identify the most beneficial approach to improving the client’s voice

130
Q

four different tools clinicians use to identify the most successful approach for a voice disorder

A

Case History and Interview

Oral-Motor Examination

Clinical Observation

Instrumental Observation

131
Q

true or false: velopharyngeal inadequacy causes either hypernasality or hyponasality

A

true

132
Q

with hypernasality, the velopharyngeal port remains ____, allowing _____ resonance in the nasal cavity

A

open; too much

133
Q

what does it mean when nasal emissions are present?

A

air emits from the nose during speech

134
Q

with hypernasality, _____ pressure in the oral cavity also degrades the production of some oral speech sounds

A

lowered

135
Q

With hyponasality, there is ____ nasal resonance

A

too little

136
Q

what happens when the nasal cavity is blocked in some way and thus not available to serve as a resonating chamber?

A

sounds that require nasal resonation become denasalized

137
Q

three characteristics of sound that is hyponasality

A

denasalized, stuffy, and congested

138
Q

true or false: voice disorders can also affect loudness

A

true

139
Q

two characteristics of sound affected by loudness

A

insufficiently or overly loud

one in which loudness does not vary - monotonic

140
Q

what occurs to produce an overly loud voice?

A

the air pressure under the vocal folds must build up

141
Q

why is excessive loudness is sometimes seen in persons who are deaf or hard of hearing?

A

because they are unable to monitor the loudness of their own voices

142
Q

why does persistent underloudness can cause vocal strain and fatigue

A

because the vocal muscles must work harder, given the inadequate force of the air stream

143
Q

how can symptoms of vocal abuse be treated?

A

surgery on the vocal folds

144
Q

is voice therapy that focuses on changing vocal behaviors as successful as surgery?

A

typically at least as successful as surgical intervention for vocal nodules and contact ulcers

145
Q

true or false: surgery on vocal folds is enough to keep those symptoms from reappearing

A

false - treatment focused on better use of voice is essential to keep those symptoms from reappearing, even with surgery

146
Q

what does treatment for Neurogenic Disorders look like?

A

combination of medical interventions and voice therapy

147
Q

what does treatment for Psychogenic Disorders look like?

A

multidisciplinary treatment program that focuses on primarily on counseling, reducing tension, and eliminating any voice abuses or misuses

148
Q

true or false: individuals whose larynx has been removed must develop alternative ways to produce voice

A

true

149
Q

when the larynx is removed, the airway between the lungs and the mouth is _____.

A

closed

150
Q

what happens to the airflow when the larynx is removed?

A

the airflow is shunted out the front of the neck via a stoma

151
Q

what used to be the most commonly used alternative for alaryngeal communication?

A

esophageal speech – which the individual traps air in the esophagus and then uses that air to produce voice

152
Q

three alternatives for laryngeal communication

A

an artificial larynx

esophageal speech

tracheoesophageal puncture (TE)

153
Q

Definition of tracheoesophageal puncture (TE)

A

a surgical procedure used to create a channel between the trachea and the esophagus, into which a prosthetic device is inserted

154
Q

how does an individual after a tracheoesophageal puncture speak?

A

takes a deep breath, covers the stoma, and forces the air into the esophagus, providing an air source for speaking

Foundations Of Speech Pathology (13 decks)

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