Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Praxis > Chapter 7: Voice and It's Disorders > Flashcards

Chapter 7: Voice and It's Disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
Praxis (5004) - Elem. Ed: Social Studies flashcards Praxis (5236) - Biology flashcards Praxis (5005) - Elem. Ed: Science flashcards Praxis (5081) - Social Studies (Content Knowledge) flashcards Praxis (5904) - Elem. Ed: Three Subject Bundle - Social Studies flashcards Praxis (7005) - Elem. Ed: Science flashcards Praxis (5905) - Elem. Ed: Three Subject Bundle Science flashcards Praxis (7004) - Elem. Ed: Social Studies flashcards
1
Q

Cover-body theory of phonation

A

The epithelium and the superficial, intermediate, and the deep layers of the lamina propria vibrate as a “cover” on a relatively stationary “body”
The body is composed of the remained of the thyroarytenoid (TA) muscle.

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

Frequency

A

The rate at which the vocal folds vibrate
The number of cycles per second
One closed phase and one open phase of the vocal folds equals one cycle of vibration
Higher frequencies have more cycles per second than lower frequencies

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

Pitch

A

The perceptual correlation of frequency
Typically described as how high or low the voice sounds
It is determined by mass, tension, and elasticity of the vocal folds
Higher pitch results when the vocal folds are thinner, more tense, or both
Lower pitch results when the vocal folds are thicker, more relaxed, or both

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

Frequency and pitch relationship

A

Frequency can stay constant and pitch can change by changing the size or length of the resonating cavity (the vocal tract)
A smaller resonating tube will perceived as a higher pitch

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

Frequency perturbation

A

Aka jitters
Refers to irregularities or cycle-to-cyle variations in vocal fold vibrations that are often heard in dysphonic patients
Can be measured instrumentally as a patient sustain a vowel

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

Loudness

A

The perceptual correlate of intensity
Determined by the amplitude of the sound signal
The larger the amplitude of the vibration, the more intense the sound signal, the greater its received loudness
The greater the amplitude, the louder the voice

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

Amplitude perturbation

A

Aka Shimmer
Refers to the cycle-to-cycle variations in vocal fold amplitude
Measured instrumentally as the patient sustains a vowel

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

Quality

A

The perception of the sound of an individual’s voice

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

Types of Vocal Quality

A
  1. Hoarseness
  2. Strain-strangled
  3. Breathiness
  4. Glottal Fry
  5. Diplophonia
  6. Stridency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hoarseness

A

The harsh vocal quality described as rough, unpleasant, and gravelly sounds. Assoicated with excessive muscular tension and effor

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

Strain-strangle

A

Phonation is effortful
Patients sound as if they are squeezing the voice
Initiating and sustaining phonation are difficult

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

Breathiness

A

Vocal folds are slightly open and not firmly approximation during phonation
Air escapes through the glottis and adds noise to the sounds produced by the vocal folds
Often quiet voice
Can be organic (physical) or nonorganic (nonphysical or funcitonal)

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

Glottal Fry

A

Aka vocal fry
Voice sounds crackly
Vocal folds vibrate very slowly with no clear, regular pattern of vibration
Resulting sound occurs in slow but discrete bursts and its extremely low pitch
Vocal fry may be the vibratory cycle we use near the bottom of our normal pitch range

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

Diplophonia

A

Means double voice
Occurs when a listen can simultaneously perceive two distinct pitches during phonation
Occurs when the vocal folds vibrate at different frequencies due to differing degrees of mass or tension

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

Stridency

A

Voice sounds shrill, unpleasant, somewhat high pitched, and “tinny”
Often caused by hypertonicity or tension of the pharyngeal constrictors and elevation of the larynx

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

Purpose and goal of Voice case history

A

Obtain information about variables like perceptions of the patient, onset, duration, causes, and variability of the voice disorder
Obtain informatio nabotu any assocaited symptoms or problems like slurred speech, difficulty swallowing, excessive coughing, etc
Gather information about previous therapy
Obtain patient’s medical history
For culturally and linguistically diverse clients we want to obtain their specific perceptions for their particular culture

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

Different types of voice instrumental evaluation

A
  1. indirect laryngoscopy (mirror laryngoscopy)
  2. Direct laryngoscopy
  3. Flexible or Ridge Endoscopy with Videostroboscopy
  4. Acoustic Analysis
  5. Electroglottography
  6. Laryngeal electromyography
  7. Videokymography
  8. Aerodynamic measurements
  9. Acoustic measures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Indirect vs direct laryngoscopy

A

Indirect: Specialists use a bright light and maneuver (life velum and press gently against the posterior pharyngeal wall area) a mirror to view the laryngeal structures during phonations (typically during the production of “eeeee”) and during quiet respiration
Direct: Performed by a surgeon when the patient is under general anesthesia in outpatient surgery. Patient can’t phonate during this so vocal function can’t be determined, but the surgeon can get a microscopic view of the larynx

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

Flexible or Ridgid Endoscopy with Videostrobodcopy

A

Helpful in differentiating between functional and organic voice problem
Detect laryngeal neoplasms (tumors)
Can use flexible and ridig endoscope, or both an there is a light at the end of the scope
Flexible endoscope is introduced orally and Rigid endoscope is introducted nasally

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

What are the acoustic measures of the voice used for?

A

A means of evaluating the effectiveness of voice therapy

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

Speech or Sound Spectrography

A

The graphic representation of a sound wave’s intensity and frequency as a function of time.
Extremely useful for quantitative analysis of speech
Produced waceform displays of amplitude and frequency (spectrograms), and other anaylsis displays in real time

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

Spectrogram

A

A resulting picture
Reflects the resonant characteristics of the vocal tract and the harmonic nature of the glottal sound source
Represented by a wideband or narrowband

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

Wideband spectrogram vs Narrowband Spectrogram

A

Wideband: provides better time resolution
Narrowband: have better frequency resolution
- Can see individual harmonics easily
- Useful for evaluating clients with voice disorders because it creates a graphic representation of stability (or instability) of harmonic structure

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

Electroglottography (EGG)

A

Yields indirect measure of vocal fold closure patterns
Surface electrodes are placed on both sides of the thyroid cartilage, and a high-frequency electric current is passed between the electrodes with the patient phonates
A glottal wave form results and specialists are able to observe vocal fold vibration
Also detects breathy and abrupt glottal onset of phonation
Recommended as a cross-validation tool with other measures

25
Q

Laryngeal Electromyography

A

Invasive procedure that directly measures laryngeal function to study the pattern of electrical activity of the vocal folds and to view muscle activity patterns
A specialist inserts needle electrodes into the patients peripheral laryngeal muscles; the resulting electrical signals are judged
The specialists are looking for
a. reduced or increased speech of muscle activation
b. extraneous bursts of muscle activity
c. onset or termination of muscle activity
LEMG is useful when attempting to determine vocal pathology, especially one that is caused by neurological or neuromuscular diseases

26
Q

Aerodynamic Measurements

A

Refer to the airflow, air volumes, and average air pressure produced as part of the peripheral mechanics of the respiratory, laryngeal, and subpharyngeal airways
Used to evaluate dysphonia, monitor voice changes and treatment progress, and differentiate between laryngeal and respiratory problems
Instruments used to obtain these measurements include wet spirometers, dry spirometers, manometric devices, and plethysmographs

27
Q

Different lung volumes

A
  1. Tidal volume: amount of air inhaled and exhaled during normal breathing cycle
  2. Vital capacity: the volume of air that the patient can exhale after a maximal inhalation
  3. Total lung capacity: total volume of air in the lungs
28
Q

Basic principles of a perceptual evaluation

A

The clinician makes subjective judgements of many vocal parameters, including pitch, volume, vocal quality, resonance, respiration, and ability to sustain phonation

29
Q

What do you look at during a pitch assessment

A

Clinicians make subjective judgments about
- The patient’s habitual pitch, or typical conversational pitch
- Whether the patient is using optimal pitch
- Whether the pitch is appropriate to the patient’s gender and age (not too high or too low)
- Whether the patients are monopitched lacking appropriate inflections, as judged by members of their culture)

30
Q

What do you look at during a loudness assessment?

A

Clinicians make subjective judgments about
- Parameters such as harshness, hoarseness, breathiness, and vocal tension
- Whether the patient’s loudness is appropriate for daily situations
- Whether the patient’s voice is too soft or too loud due to possibly physical factors (asthma, hearing loss, etc)

31
Q

What do you look at during a resonance assessment?

A

Clinicians make subjective judgments about
- Hyponasality: absent of nasal resonance on nasal sounds
- Hypernasality: too much nasal resonance on non-nasal sounds

32
Q

What do you look at during a respiration assessment?

A

The clinician looks for different types of breathing
1. clavicular breathing: when the patient inhales and their shoulder elevates. There is often stain and tension. This type of breathing is inefficient
2. Diaphragmatic-adnominal breathing: Used the abdominal region and the lower thoracic cavity. There is little to no chest or shoulder movement
3. Thoracic breathing: Uses inhalation to expand the thorax by using the intercostal muscles to raise the ribs

33
Q

What do you do during a phonation assessment?

A
  1. Maximum phonation time: the patient’s ability to sustain phonation during one exhalation. The clinician gives the patient three trials and compares them to the norms. MPT allows the clinician to observe respiration, glottal efficiency, and the possible presence of vocal pathology (like nodules)
  2. S/z ratio: Used to help determine whether there is laryngeal pathology present; it indicates the efficiency of glottal closure. The patient is asked to produce 2 long /s/ phonemes and 2 long /z/ phonemes. Then divides the longest /s/ by the longest /z/
34
Q

Quality of Life Evaluation

A

Determines the effect of voice disorders and their impact on overall quality of life. Several scales and questionnaires exist for clients to fill out with their initial case history.
Examples
- the voice handicap index (VHI)
- voice-related quality of life scale (VRQOL)

35
Q

Disorders of resonance

A
  1. hypernasality: excessive nasality
  2. hyponasality: lack of appropriate nasal resonance on nasal sounds
  3. Assimilative nasality: Occurs when the sound from a nasal consonant carries over to adjacent vowels
  4. Cul-de-sac (bottom of the sack): resonance occurs when sound waves enter the vocal tract but are blocked from exiting. The trapped sound is then absorbed by the soft tissues in the vocal tract and makes speech sounds seem muffled or hollow. There are three types: oral, nasal, and pharyngeal
36
Q

Medical intervention for resonance

A

Organically based-resonance problems must be treated medically before therapy can be successful.
Medical treatment can be surgery, prostheses, or both

37
Q

Is speech therapy needed after medical intervention?

A

Yes!!! Speech therapy still may be needed because a patient might have improperly learned articulation placement as a compensatory strategy due to the structural abnormality

38
Q

Treatment for Hypernasality

A

Biofeedback can be effective for treating hypernasality. Electronic instruments provide instantaneous visual feedback of oral and nasal resonance
- Nasometer: allows the patient to receive visual feedback through a computer display. Gives feedback includes the target level of nasalance (oral-nasal ratio) and the amount of nasalance the patient is producing
- Using a visual aids like a mirror or tissue and put it under the nose so they can see appropriate vs inappropriate nasal airflow during phonation
- Ear training (helping the patient monitor their own productions)
- Increasing the patient’s mouth opening so oral resonance is enhance
- Increasing the patient’s loudness
- Improving patient’s articulation
- Changing patient’s speaking rate
- Decreasing pitch (can contribute to greater oral resonance)

39
Q

Treatment of Hyponasality

A

Can be effectively treated through feedback such as that provided by a nasometer and video or audio recordings
- Focsusing or directing of the tone into the facial “mask” which is the area above the maxillary sinuses and around the nasal bridge
- Nasal-glide stimulation
- Visual aids (paper or tissue)

40
Q

Oral Cul-de-sac

A

Occurs when sound is partially blocked from exiting the oral cavity during speech production. Can be cause by backward retraction of the tongue, tongue carried too hard posteriorly in the oral cavity

41
Q

Nasal Cul-de-sac

A

Occurs when sound is partially obstructed from exiting the nasal cavity during the production of speech. Mostly occurs when an individual has VPO combined with a blockage in the anterior nasal cavity

42
Q

Pharyngeal Cul-de-sac

A

Occurs when sound is black from exiting the oropharynx during speech production. Hypertrophied tonsils, adenoids, scarring, and other structural abnormalities of the pharyngeal wall may cause this

43
Q

What are things you need to consider for medical treatment of cancer?

A

Site, type, and extent of cancer
Tumors can be
- Supraglottic: above the vocal folds
- Subglottic: below the vocal folds
- Glottic: at the level of the vocal folds
Metastasis: spreading to other regions
Mode involvement

44
Q

3 categories that doctors classify and treat laryngeal cancer based on?

A

T: Primary site of tumor
N: Involvement of the lymph nodes
M: Metastasis

45
Q

3 basic types of medical treatment for laryngeal cancer

A
  1. Surgery
    - Laryngectomy: removal of the entire larynx
    - Hemilaryngectomy: Only the diseased part of the larynx is removed
  2. Chemotherapy: can used alone or in conjunction with other measures
  3. Radiation: may be used alone or combined with therapy
46
Q

Hyperfunctional vs hypofunctional

A

Hyper: Voice disorders that are caused by excessive muscle action of the vocal mechanism.
- There is not enough airflow, which creates a voice that is tense, strained, rough, and hoarse.
- Most vocal fold lesions (vocal nodules, cysts, and polyps can use hyperfunctional disorders due to the laryngeal muscles and surrounding structures are overactivated to compensate for the lesion that is obstructing the vocal folds from abducting properly
Hypo: Voice disorders that are caused by inefficient muscle action of the vocal mechanism
- Vocal folds don’t come together fully causing excessive airflow and creating breathy, hoarse, reduced in loudness, and possibly aphonic vocal quality
- Vocal fold paresis and paralysis are hypofunctional disorders

47
Q

Physical disorders of phonation

A
  • Vocal nodules
  • Polyps
  • Granuloma
  • Hemangioma
  • Reinke’s Edema
    -Hyperkeratosis
  • Leukoplakia
  • Etc
48
Q

Granuloma

A

Localized, inflammatory, vascular lesion that is usually composed of granular tissue in a firm, rounded sac

49
Q

Hemangioma

A

Similar to granlomas but are soft, pliable, and filled with blood.
Usually caused by intubation or hyperacidity due to gastroesophageal reflux

50
Q

Reinke’s Edema

A

Occurs when fluids builds up in the superficial lamina propria of both vocal folds, causing excessive swelling

51
Q

Hyperkeratosis

A

Rough pinkish lesion that can appear in the oral cavity, larynx, or pharynx. Ma occurs in the epithelial cover of the folds as well as the superficial layer of the lamina propria

52
Q

Leukoplakia

A

Benign growths of thick, whitish patches on the surface membrane of the mucosa
Caused by tissue irrittion, especially that caused by smoking, alcohol, or vocal abuse

53
Q

Subglottal Stenosis

A

Narrowing of the subglttic space
Can be acquired or congential

54
Q

Idiopathic Voice Disorders

A

Paradoxical vocal fold motion disorder (PVFM) aka laryngeal dyskinesia
- Inappropriate closure or adduction of the true vocal folds during inhalation, exhalation, or both

55
Q

Neurologically Based Voice Disorders

A

Paralysis
Spasmodic Dysphonia
Neurological Diseases

56
Q

Spasmodic Dysphonia

A

Focal laryngeal dystonia
Abductor spasomidc dysphonia: Created by intermittent, involuntary, fleeting vocal fold abduction when the patient tries to phonate. Loudness is reduced, patient occasionally sounds aphonic with breathy or whispered speech
Adductor spasmodic dysphonia: Most common type, characterized by overpressure due to prolonged over adduction or tight closure of the vocal folds. May sound choked or strangled

57
Q

Psychogenic Voice Disorders

A

Aka functional voice disorders
Occurs when the voice is abnormal in the presence of normal laryngeal strucutres
Examples
- Hsterical (conversion) aphonia
- Muscle tension dysphonia
Mutational Falsetto (puberphonia)

58
Q

What do you need to consider when choosing voice therapy technique

A

Understanding why the voice isorder is occuring (structural, neurological, etc)
How the vibration of the vocal folds is impaired (too much/ not enough closure, too much/ not enough airflow, partia/ absent mucosal wave, increased mass, etc)

59
Q

Types of Behavioral Voice Therapy

A
  • Lessac-Madsen Resonant Voice Therapy
  • Chest Resonance
  • Yawn-Sign
  • Vocal Function Exercises
  • Stretch and Flow
    -Twang
  • Hard Glottal Attack
  • Lombard Effectre

Praxis (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions