- Caused by muscle tension - production of a voice at two pitches - Using the true folds and the false folds at the same time

Classification of Voice Disorders Flashcards by Danielle Sanders

What are the 3 physical classifications of voice disorders?

Functional, Organic, Neurogenic

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What is a functional voice disorder?

A result of incorrect use of some aspect of the phonatory system

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What are the two types of functional voice disorders?

Muscle tension dysphonia

2. Pyschogenic voice disorder

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What is muscle tension dysphonia?

Voice disorders related to the misuse of the vocal mechanisms, producing a hypertension type of dysphonia

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Muscle tension dysphonia includes what two types?

Primary

Secondary

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What is a primary muscle tension dysphonia?

Incorrectly using the voice (hyperfunction)

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What is a secondary muscle tension dysphonia?

Occurs secondary to hypertension- Can often be classified as vocal nodules or polyps on the VF

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What is a psychogenic voice disorder?

Results from emotional trauma or conflict that manifests itself in voice

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What is a psychogenic voice disorder also known as?

conversion aphonia

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Characteristics of a psychogenic voice disorder

aphonia (lack of voice)
generally normal VF
not faking it
often occurs secondary to an upper respiratory infection or laryngitis and persists past the illness

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What is an organic voice disorder?

Due to a physiological abnormality in structure and/or function at various sites along the vocal tract

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What is a neurogenic voice disorder?

Neurological voice disorders are due to problems with muscle control and innervation of the muscles of respiration, phonation, and resonance which may be impaired from birth or secondary to injury or disease to the PNS or CNS

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What is diplophonia?

Caused by muscle tension
production of a voice at two pitches
Using the true folds and the false folds at the same time

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What is Reinke’s edema?

Caused by muscle tension

- accumulation of fluid under the VF cover in Reinke’s space- VF become rather thick and floppy

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What is Traumatic Laryngitis?

caused by excessive yelling
Trauma to the VF
results in hoarseness but often resolves in a few days

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What is a phonation break?

voice cuts out during phonation

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List at least 5 disorders that have a muscle tension problem as the cause

Ventricular Dysphonia 
Muscle Tension Dsyphonia 
Vocal Fold Thickening 
Diplophonia 
Reinke's edema 
Traumatic Laryngitis 
Vocal polyps 
Pitch and phonation breaks

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3 types of voice problems that have a psychogenic cause?

Functional dysphonia
Conversion aphonia
Mutational falsetto

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What is functional dysphonia?

A voice that sounds abnormal with a completely normal larynx
adopted a dsyphonia
can be remediated in a matter of one or two voice therapy

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What is conversion aphonia?

A type of psychogenic voice disorder

- Complete loss of voice (whisper voice)

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What is mutational falsetto?

A type of psychogenic voice disorder
Normal larynx
Individual holds onto their prepubescent voice
typically occurs in males

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Name 10 voice disorders with an organic cause

sulcus vocalis
cancer
leukoplakia
4, hemangioma
hyperkeratosis
laryngectomy
Granuloma
Webbing
Infectious laryngitis
hypothyroidism

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What is sulcus vocalis?

A congenital or acquired disorder
unknown etiology
Results in a long, oval shaped glottal opening during adduction or by a line running longitudinally parallel to the glottis down one or both vocal cords

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When is a contact ulcer due to an organic cause?

In cases of GERD

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What is leukoplakia?

- white patches - due to some type of environmental irritation - smoking or excessive alcohol use - pre-cancerous

How do endocrine changes affect the voice?

- Endocrine changes can affect the larynx during development - Larynx will not grow and the voice will be abnormally high

What is hypothyroidism?

-Improper secretion of hormones

What is a granuloma?

When there is a lesion of ulcer and the body tries to repair itself by growing granulation tissue over it

What is a hemangioma?

A bleed within the VF

What is hyperkeratosis?

- can be cancerous or non-cancerous - Oral or pharyngeal lesion (malignant or non malignant) - Continued tissue irritation - sometimes associated w/ chewing tobacco

What is a laryngectomy?

Can be a partial or total removal of the larynx- often due to laryngeal cancer

What is a papilloma?

- Wart-like growths that are viral in origin and frequently develop in the larynges of young children - sometimes grow very quickly and obstruct the airway

What is webbing?

- Can occur between the VF - can be congenital or acquired - Can make it difficult to breath and can change the sound of the voice because there is less mass

Name 5 voice disorders that are primarily neurologic in cause

1. paradoxical movement 2. spastic dysphonia 3. dysarthria 4. essential tremor 5. vocal fold paralysis

What is the paradoxical movement?

- etiology not well known - Symptoms: wheezing in breathe sounds, difficulty maintaining a breathing pattern - Breathing problem- NOT a voice problem - The VF are adducting on inspiration instead of abducting - seen in athletes - Often confused with asthma - Asthma test will be negative and asthma medication does not work

What is spastic dsyphonia also known as?

Laryngeal stuttering

What is spastic dsyphonia?

- associated with tremors of the head - The VF spasm closed giving the voice a tight, strangled quality - Person cannot control it

What is the most common type of spastic dsyphonia??

Adductor dysphonia

What 5 diseases can result in dsyarthria?

1. ALS 2. Myasthenia gravis 3. MS 4. Huntington's disease 5. Parkinson's disease

Dsyarthia may affect...

All 4 modalities

What is an essential tremor?

- A benign tremor- not progressive and not associated w/ degenerative diseases - Often seen in older individuals - Tremor occurs in the VF

What is VF paralysis?

One or both of the VF are paralyzed

VF paralysis is usually...

unilateral

What are the two types of VF paralysis?

1. Adductor paralysis | 2. Abductor paralysis

What is adductor paralysis?

VF will not close | Results in voice problems

What is abductor paralysis?

VF will not completely open | Results in: difficulty breathing, breathing is primarily affected but voice is affected secondarily

When may the vocal folds be paralyzed bilaterally?

Strangulation

What are the 3 perceptual categories used to classify voice disorders?

1. Pitch 2. Intensity 3. Quality

What is the primary cause of pitch problems?

Mass changes of the VF

A higher pitch correlates to...

longer, thinner and more tense VF

A lower pitch correlates to...

thicker, shorter and less tense VF

Pitch is a problem if the listener observes what?

One of the following: 1. Modal frequency (too high or too low) 2. Narrow range (lack of inflection) 3. Excessive pitch breaks 4. Pitch inappropriate to the situation

How are intensity adjustments made?

- Tightening the muscles used to hold the VF together | - Results in more pressure on the expired breath stream

When is there an intensity problem identified?

When the voice is too soft or too loud for the demands of the situation

If an intensity problem is present, what should be assessed?

Hearing | -could be indicative of a hearing loss

What dB is a comfortable speaking level?

64dB

What affects quality of the voice?

The condition of the vibratory source

What are quality disorders?

Disturbances in laryngeal tone usually associated with sound generated at the level of the VF

If resonance is a problem, that occurs ______ the VF.

ABOVE

A quality disorder is usually indicative of...?

A VF vibration problem

In order to maintain a normal voice, Wilson indicates four important factors:

1. Normal structure 2. Normal physiology 3. Emotional state does not affect quality 4. good vocal habits

A voice that is rough, unmusical sound due to laryngeal tension is...

HARSH

A voice that is rough, has an unmusical quality with diplophonia or voice or phonation breaks is...

HOARSE

A resonance quality problems that occurs in the pharynx- results in a tight, hard sound

STRIDENT

small, childish voice caused by tension in the oral cavity and foward tongue

THINNESS

Which two problems occur at the level of the VF: 1. hoarseness 2. strident 3. harshness 4. thinness

HOARSE and HARSH

Folds do not have good closure air escapes during phonation- what does this cause?

BREATHINESS

Any alteration in normal phonation

DYSPHONIA

Excessive nasality

HYPERNASALITY

Hypernasality can be _____ or _____ in origin

organic or functional

The nasal cavities are congested and there is a reduction in the nasal resonance

HYPONASALITY

A pharyngeal focus of voice due to posterior tongue carriage- "hollow sounding"

CUL-DE-SAC