Chapter 6 Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

3 categories of measuring FF and intensity

A
  1. Levels of habitual use: typical production
  2. Levels of maximum performance - under mechanical stress, what are the physiologic limits
  3. Degree of regularity - how stable is the system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Influence on mean speaking FF and range

A

Linguistic factors such as speech content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is mean speaking FF and range assessed

A

During sustained vowel phonation, reading, or spontaneous speaking task

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the expected Variability in mean speaking FF

A

Approximately 3 semitones across multiple readings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is maximum frequency range of phonation

A

Span from lowest to highest frequency of which the individual is physiologically capable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Regularity of frequency and intensity

A

VF vibration is a quasi periodic function
there is a small amount of cycle to cycle variability
Too much variability and the sound produced is abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is perturbation?

A

The variability or irregularity in a system
Short term FF perturbation is jitter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is jitter

A

The nonvolitional variability in FF - not intentional
Cycle to cycle variability of the duration of the period
Exists at a low level in VF vibration
Measured during sustained vowel phonation, not over the duration of a word or phrase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is jitter ratio?

A

The average difference in period in
Adjacent pairs of cycles
Divided by the average period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why divide the average difference in periods from average periods?

A

Removes the effect of FF from the calculation
The magnitude of jitter is dependent on frequency of phonation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Jitter percent

A

Same as jitter ration just turned into a percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Jitter factor

A

Uses jitter ratio method but replaces period with frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Jitter fun facts

A

Not appropriate as a screening measure to distinguish normal from abnormal voices
Normal vibration will have low level of jitter
Pathological voices have a high level of jitter
Not always sensitive to therapy or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is shimmer

A

The short0term variability (perturbation) in the amplitude of the acoustic waveform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Shimmer in dB

A

Common measure
Ratio of the amplitudes of 2 adjacent cycles averaged over the length of the sample
If expressed as percent then Shimmer Percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amplitude perturbation quotient

A

Measures shimmer
Averages the amplitude over a longer number of cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Shimmer in diagnostics

A

Often used as a diagnostic criterion for abnormal voices Normal vibration
Then as a measure of treatment outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cautions in measurement of shimmer

A

We are unable to perceptually distinguish jitter from shimmer
No direct correlation b/w jitter of shimmer and degree of voice impairment
Should not be used as a screening tool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is mean speaking FF

A

The average FF we use when speaking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is mean speaking FF range

A

Typical range we use when speaking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is voice range profile?

A

Relationship b/w FF and intensity in a graphic display
Horizontal axis = FF
Vertical axis = intensity
Can be done using a sound level meter - at selected pitch as loud and then as soft as possible and then repeated across range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Characteristics of VRP

A

Area of profile
Dynamic range is reduced at extremes
Upper and lower contours tilt upward at high frequencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Area of profile

A

Wider the area, the more flexible the voice
Both dynamic intensity and pith ranges are large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does upper contour of VRP represent

A

Maximum intensity at each frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does the lower contour of VRP represent

A

Minimum intensity at each frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why is it difficult to increase intensity at low frequencies?

A

Requirement of laxness of VF to achieve slow vibration
And requirement of increased resistance to airflow to maintain subglottal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mean airflow measurement

A

Measured as it exits the oral and nasal cavities
Measured as the volume of air that passes a given point in mL per second
Demonstrates control of FF and SPL
Measured USA in g apneumotachograph
Too much variability to be meaningful by itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What other measures can be used with mean airflow

A

Lung pressure - subglottal pressure
Vocal efficiency - glottal resistance, frequency data
Laryngeal airway resistance - intensity data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is pneumotachography

A

Mouthpiece collects airflow
Connected to electronic sensor
Produces a pneumotachograh which is a measure of mean airflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What can alter mean airflow

A

Air pressure
Glottal resistance
Amplitude of vocal fold vibration
Vocal fold tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a key variable in regulation of intensity

A

Subglottal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Direct measurement of lung pressure

A

Needle puncture through the cricothyroid
Must be done by a physician
Very uncomfortable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Estimation of lung pressure

A

Highly common
Clinically friendly
Estimated subglottal pressure from measures of intraoral pressure
Uses a transducer connect to a tube
Intraoral and subglottal pressure are the same in the production of /p/ due to bilabial and velopharyngeal seals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Estimation of lung pressure pros and cons

A

Cons: speech context is artificial, values not reflective of running speech
Pros: Non-invasive and clinically friendly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Airway interruption method

A

Indirect/noninvasive measure of lung pressure
Estimates lung pressure from intraoral pressure
External valve connected to a mouthpiece blocks the airflow during sustained vowel phonation

36
Q

What is vocal efficiency

A

A measure of the relationship of energy input to output
Usually expressed as a percentage
Ratio of radiated acoustic power to aerodynamic power

37
Q

Voice production process

A

Involves converting aerodynamic power to acoustic power

38
Q

Voice production process

A

Involves converting aerodynamic power to acoustic power

39
Q

Vocal efficiency formula Glottal efficiency

A

Aerodynamic power (lung pressure x airflow) divided by radiated acoustic power (intensity)
Acoustic power = amount of energy radiated from a sound source per second measured in watts

40
Q

Why do voice disorders cause poorer vocal efficiency?

A

Lower efficiency values are associated with
Higher airflow rates due to
Incomplete glottal closure

41
Q

Vocal efficiency in treatment

A

Used to document the effect of treatment
Improvements reflect positive changes in phonatory function related to treatment
Over efficiency can result in tissue damage

42
Q

Goal of voice efficiency therapy

A

Decrease efficiency to
Sustain vocal longevity
Temper vocal efficiency with vocal economy - stay within vocal range

43
Q

What is the s/z ratio

A

Maximum performance task that requires no equipment
Assesses the integrity of phonatory glottal closure
Relative duration of the /s/ and /z/

44
Q

Hypothesis of the s/z ratio

A

/s/ and /z/ should be of equal durations, yielding a value of 1
S/z > 1 = lower glottal resistance with incomplete closure allowing air to escape

45
Q

S/z ratio procedure

A

Measure length of time of each
Divide the two figures to obtain a numerical ratio
The higher the ratio the greater the possibility that the person is experiencing difficult with phonation
Must control for intensity

46
Q

S/z ratio results

A

Possible VF pathology if inability to sustain /z/ as long as /s/ bc /z/ is voiced
95% of people who have difficulty with phonation have a ratio of greater than 1.40
Useful in early identification of potential problems
It is useful as a tool to monitor progress

47
Q

Concomitant factors to VF pathology from s/z

A

Low maximum phonation time
Persistent and/or excessive high/low pitch
Hoarseness, harsh voice
Fluctuating loudness

48
Q

Disadvantage of s/z ratio

A

Compensatory behaviors can be used to achieve normal values
Such as
Extra inspiratory checking
Extra VF compression (maladaptive)

49
Q

Maximum Phonation Time (MPT)

A

Measures the duration of a maximally sustained vowel
Elicited by taking a deep breath and sustain a vowel at comfortable pitch and loudness as long as possible

50
Q

Hypothesis of MPT

A

Incomplete glottal closure should abnormally shorten MPT
Men > women due to lung volume capacities

51
Q

Questionable outcomes of MPT

A

Highly sensitive to elicitation methodology
Learning effect - the more a person does they better they do due to practice
Compensatory strategies (same as s/z)
Relationship of MPT to normal speech is unclear

52
Q

Phonation Quotient formula

A

Related to MPT
Vital capacity
Divided by the maximum phonation time
Measured in ML per second

53
Q

What is phonation quotient (PT)

A

A measure of the volume of air consumed during sustained phonation
Used when other aerodynamic measures are not availability

54
Q

Weakness of PT

A

Highly sensitive to elicitation methodology - if instructions are not followed precisely then results are incorrect
Vital capacity is obtained as a non-speech maneuver

55
Q

Key elements of phonation

A

VF vibration
Glottal closure
They are the basis for acoustic vocal characteristics

56
Q

What is glottography?

A

The analysis of vibratory movement of the VF
During phonation using
Any one or a combination of measures
Including:
Photoglottography, electroglottography, ultra-sound glottography and inverse filtering
Waveform studies supplement direct visualization procedures

57
Q

What is stroboscopy?

A

The process of using a pulsing light
to simulate movement
at a slower rate
than the actual rate of movement

58
Q

How does stroboscopy work?

A

Light flashes at a rate synchronized to VF vibration
Still image = same frequency as VF vibration
Walking image = slightly different frequency

59
Q

Talbots law and stroboscopy

A

A series of images appear continuous
When they are projected
Onto the retina
At intervals of
Less than two-tenths of a second

60
Q

How is stroboscopy obtained?

A

By oral or nasal endoscopy
Results in slow motion video of VF

61
Q

Weakness of stroboscopy

A

More irregular the vibration the less accurate
Significant voice disorder can result in blurry or jittery images
The sequential strobe images do not represent true vibratory behavior

62
Q

High speed laryngeal imaging

A

Irregular vibrations can be imaged
Limited accessibility due to high cost
Black and white images
Less sharp than stroboscopy
Vast number of images produced is cumbersome to analyze

63
Q

Videokymography (VKG)

A

Does not image the entire area of the VF
Is a high speed video camera
True cycle-to-cycle imaging
Black and white images - images aren’t intuitive
Less expensive
Must be coupled with other techniques

64
Q

Photoglottopraphy (PGG)

A

Provides information about the size of the glottal opening
Measures the amount of light passing through VF during each vibratory cycle
Provides an approximation of the variable cross-sectional area of the glottis during phonation

65
Q

Limited clinical application of PGG

A

Invasive procedure
Lack of absolute reference
Possibly inaccurate due to vocal tract movement

66
Q

What is electroglottography (EGG)

A

Provides a waveform that
corresponds to
the relative contact
of the VF during vibration

67
Q

How does EGG work?

A

Electrodes placed on neck
Low voltage passes current across neck
Between electrodes
Output device measures change in resistance
Waveform elicited during sustained vowel phonation
Glottis open = resistance to current
Glottis closed = resistance is low
Resistance is a function of the degree of contact of VF

68
Q

Pros/Cons of EGG

A

Easy and non-invasive
Port signal quality is an issue
A voice disorder can alter the waveform making interpretation difficult (mucus strands, hyperfunction)

69
Q

Open quotient (OQ)

A

Ratio of the open phase of VF vibration to
The entire duration of the glottal cycle
In open phase Increases with increasing FF, decreases with greater intensity

70
Q

Speed Quotient (SQ)

A

Ratio of the duration of the closing phase
More independent of FF
Varies directly with intensity

71
Q

Contact quotient (CQ)

A

Ratio of the period during which the VF are in contact to the entire glottal cycle
Increases low/ middle frequency ranges, this increases with increasing intensity
Greater phase lag should result in longer phase

72
Q

Contact quotient (CQ)

A

Ratio of the period during which the VF are in contact to the entire glottal cycle

73
Q

Note of caution on quotients

A

Exact points for closed and open are estimates
Clinical utility of these measures remain relatively unexplored
Contact quotient is not recommended b/c EGG signal does not tell us anything about the glottis

74
Q

What is voice register

A

A series of consecutive FF values
Of approximately equivalent
Voice quality
Refers to particular modes of vibration of VF

75
Q

What are the 3 basic speaking registers?

A
  1. Pulse - glottal fry
  2. Modal - chest voice
  3. Falsetto - loft
76
Q

Four factors of confusion surrounding Vocal Register

A
  1. Registration is a psychoacoustic phenomenon so it is based on perceptual judgment
  2. Physiology and acoustics underlying different registers is not understood
  3. Confused with voice quality changes due to FF alone, not associated with VF
  4. Speaking is different than singing but the terms overlap
77
Q

What is transition

A

The boundary between registers - an abrupt change in voice quality

78
Q

What is a quantal change?

A

The abrupt transition from one state to another
Due to a continuously changing
Variable
Register transitions are quantal

79
Q

what is modal register

A

The usual register for speaking
Singers terminology - head voice, chest voice, low, mid and high voice

80
Q

What is glottal fry (pulse phonation)

A

Minimal tension on the VF
Due to relaxation of the
Cricoidthyroid muscle causing
Short thickened VF
Increased mass per unit length
LAX mucosal covering

81
Q

Four major features of glottal fry

A
  1. FF is quite low
  2. Prolonged duration of the closed phase
  3. Mean airflow and lung pressure is considerably lower than modal voice
  4. Double closure pattern for each cycle
    Dichrotic phonation - creaky sounding
82
Q

Falsetto

A

Produced in frequencies above modal register
Characterized by male voice in a falsely high pitch
Produced by contraction of cricothyroid unopposed by the thyroarytenoid
VF is elongated with a reduced mass per length resulting in tension and stiffness

83
Q

What is whispering

A

It is NOT a mode of phonation
A way to communication WITHOUT VF vibration
Has increased peak flow rates

84
Q

Two laryngeal configurations of whispering

A

Y configuration
Wide straight V

85
Q

Why is whispering not advised as a compensatory behavior for treating voice disorders

A

Increased tensions causes
Drying of the VF
Increased airflow and tension causes
Constriction of the blood vessels in VF
Can contribute to phonotrauma