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COMDIS415 EXAM 2 > COMDIS415 VOICE DISORDERS PART 2 > Flashcards

COMDIS415 VOICE DISORDERS PART 2 Flashcards

1
Q

DYSPHONIA

A

Definition
Characterized by altered: Vocal quality
 Pitch
 Loudness
Vocal effort
Broad, clinical term used to describe abnormal functioning of voice

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2
Q

Auditory-perceptual symptom: vocal quality

A

voice quality - something is different
with their voice that you are able to
notice right away
- Heard as: roughness, breathiness, strained, strangled, hoarse, weak, wet/gurgly

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3
Q

Auditory-perceptual symptom: pitch

A

Heard as: too high, too low, pitch breaks, decreased pitch range

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4
Q

Decreased pitch range (upper)

A

pitch glides - start with lowest pitch
then have patient go up in pitch
easy with vowel ‘e’ rise

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5
Q

Auditory-perceptual symptom: loudness

A

Heard as: too high, too low, decreased range, unsteady volume

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6
Q

Auditory-perceptual symptom: vocal effort

A

Heard as: running out of breath quickly, frequent coughing/throat clearing
- throat clearing causes vocal folds to slam against each other, causes vocal nodules

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7
Q

CAUSES OF VOICE DISORDERS: ORGANIC (STRUCTURAL)

A

Vocal fold abnormalities (e.g., vocal nodules)
Inflammation of the larynx (e.g., arthritis, reflux)
Trauma to the larynx (e.g., from intubation, chemical exposure, external trauma)

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8
Q

CAUSES OF VOICE DISORDERS: ORGANIC (Neurogenic)

A

Laryngeal nerve paralysis
Parkinson’s Disease
Multiple Sclerosis

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9
Q

VOICE DISORDERS: FUNCTIONAL CAUSES

A

phonotrauma
muscle tension
vocal fatigue

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10
Q

Phonotrauma

A
  • Yelling
  • Screaming
  • Excessive throat-clearing
    work on in therapy: focus on breathing, vocal hygiene,
    relaxing muscles
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11
Q

Muscle Tension

A

Excessive squeezing,
tightness of laryngeal muscles

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12
Q

Vocal Fatigue

A

Due to effort or overuse

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13
Q

The process of inspiration is a passive process.

A

false, it is an active process

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14
Q

During rest breathing, the process of expiration is a passive process.

A

true, it recoils, so the diaphragm goes back into position

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15
Q

During speech breathing, the process of expiration is a passive process.

A

false, you have to control air flow that is coming out, so you talk in short breaths groups

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16
Q

Which statement is true of speech breathing?

A

We inhale more air

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17
Q

During inspiration

A

Thoracic volume increases causing a decrease in thoracic pressure

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18
Q

The inverse (opposite) relationship between thoracic volume and thoracic pressure is known as:

A

Boyle’s Law

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19
Q

What subglottal pressure is required for speech production at a comfortable volume?

A

6-8 cm H20

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20
Q

What subglottal presure is required for yelling/loud speech?

A

10-12 cm H20

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21
Q

What subglottal presure is required for minimum amount pressure needed for vibration?

A

3-4 cm h20

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22
Q
  1. Which statement accurately describes vital capacity:
A

a. It declines with age
b. It differs between males and females
c. It is dependent on level of physical activity and health status (e.g. history of smoking, recent illness)

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23
Q

On average, how many syllables per breath group is considered typical?

A

16.5

24
Q

During rest breathing, we pause to breath at linguistically-appropriate boundaries (e.g. a major syntactic boundary)

A

False, we do not talk during rest breathing, only true at speech breathing

25
Q

During vocal fold vibration, the vocal folds close: (Select all that apply)

A

a. Due to elastic recoil
b. Due to the Bernoulli effect

26
Q

During vocal fold vibration, the vocal folds open:

A

Because the pressure below the vocal folds is greater than the pressure above the vocal folds

27
Q

Jitter

A

how stable frequency/pitch is
Norms: 1.04% or lower

28
Q

Shimmer

A

steady of amplitude (loudness)
lower than 3.8%

29
Q

harmonic to noise ratio

A

above 20

30
Q

VOCAL NODULES CAUSE

A

Repeated phonotrauma to vocal folds
 Folds rub together, get sore, and blister  Voice overuse
 Use voice incorrectly

31
Q

VOCAL NODULES SYMPTOMS

A

 Sound deeper, weaker, more breathy
 Hoarse quality
 Voice cuts out

32
Q

VOCAL FOLD PARALYSIS OR PARESIS CAUSES

A

Nerve impulses to larynx are disrupted, muscle
becomes paralyzed
 Injury to vocal fold during surgery  Neck or chest injury
 Stroke
 Tumors
 Neurological conditions

33
Q

VOCAL FOLD PARALYSIS OR PARESIS SYMPTOMS

A

Usually, one vocal fold is paralyzed
 Breathy, hoarse voice
 Noisy breathing
 Loss of vocal pitch and loudness
 Frequent throat clearing

34
Q

MEDIALIZATION THYROPLASTY | INJECTION OF BIOMATERIALS

A

Injections are done every 3-6 months

35
Q

MUSCLE TENSION DYSPHONIA CAUSE

A

Laryngeal muscles become tense
 Respiratory illness, allergies, reflux
 Increased vocal demand
 Stressful life events

36
Q

MUSCLE TENSION DYSPHONIA SYMPTOMS

A

 Rough, hoarse, or raspy voice
 Weak, breathy, airy or is only a whisper
 Strained, pressed, squeezed, tight or tense
 Voice suddenly cuts out
 Pitch too high or too low
 Pain or tension
 Throat feels tired
PRIMARY AND SECONDARY TYPES

37
Q

WHO ASSESSES VOICE DISORDERS?

A

Primary care provider may send you to see an: Otolaryngologist – Ear, Nose, Throat Doctor
 SLP

38
Q

OTOLARYNGOLOGIST

A

Usually examines your vocal folds and larynx with a videostroboscopy

Why is the videostroboscopy done?
 Identify cause of voice dysfunction (inflammation, infection or injury?)
 Assess the movement and function of vocal folds

39
Q

SLP

A

 Assess the vocal characteristics related to respiration, phonation, and resonance:
 Pitch
 Loudness
 Pitch range
 Vocal endurance

Uses:
 Standardized measures
 Nonstandardized measures

40
Q

SLP: ASSESSING FOR VOICE DISORDERS

A

Case History
 Self-Assessment
Oral-Peripheral Exam
Auditory-Perceptual Assessment
Acoustic Assessment

41
Q

CASE HISTORY & SELF-ASSESSMENT

A

We want to know:
Individual’s description of voice problem, including onset and Variability of symptoms
Individual’s assessment of how their voice problem affects them
 Voice Handicap Index (VHI)
 Voice-Related Quality of Life (V-RQOL)

42
Q

ORAL-PERIPHERAL EXAM STRUCTURES

A

 Lips
 Tongue
 Jaw
 Teeth
 Hard & Soft Palates
 Pharynx

43
Q

ORAL-PERIPHERAL EXAM FUNCTION

A

Respiratory Breathing Patterns (single breath
count)
 Coordination of Respiration with Phonation
 Maximum Phonation Time
 Diadochokinetic Rates

44
Q

maximum phonation time

A

ask patient
to take breath and then hold “ah” for as long
as you can at a comfortable loudness
NORM: 20-25 SECS

45
Q

AUDITORY-PERCEPTUAL ASSESSMENT SUBJECTIVE MEASURES

A

Assessing voice quality during the production of sustained vowels,
sentences, and running speech
 Roughness/Hoarseness
 Breathiness – audible air escape in voice
 Strain – perception of excessive vocal effort  Pitch – highness or lowness of tone in voice  Loudness – what’s the sound intensity?

46
Q

ACOUSTIC ASSESSMENT

A

Vocal Amplitude
 Measuring loudness and strength of the voice in decibels Fundamental Frequency
 Measuring the vibration rate of the vocal folds in hertz
COMPARE CLIENTS VOCAL AMPLITUDE + FUNDAMENTAL FREQS TO NORMS

47
Q

SLP: ASSESSING FOR VOICE DISORDERS

A

Case History
Self-Assessment
Oral-Peripheral Exam
Auditory-Perceptual Assessment
Acoustic Assessment

After thoroughly obtaining outcomes for these measures, and the physical findings from the ENT, you can make a diagnosis and recommend treatment

48
Q

DIRECT APPROACH INTERVENTION

A

focus on manipulating the voice-producing mechanisms

49
Q

Physiologic Voice Therapy

A

strive to balance the three subsystems of voice production (respiration, phonation, and resonance).

50
Q

Accent Method

A

Facilitate abdominal breathing, reduce excessive muscular tension, normalize phonation patterns

51
Q

Lee Silverman Voice Treatment (LSVT)

A

Initially developed for patients with Parkinson’s Disease, but used with other populations
 Maximize phonatory and respiratory function

52
Q

Resonant Voice Therapy

A

Increasing vibratory sensations on the lips, teeth or in the nose for easy phonation or easy voicing.

53
Q

Indirect approaches

A

client education and counseling

54
Q

Client education

A

Discussing normal physiology of voice production and the
impact of voice disorders on function.
 Providing information about the impact of vocal misuse and strategies for maintaining vocal health/vocal hygiene.

55
Q

Counseling

A

Identifying and implementing strategies such as stress management to modify psychosocial factors that negatively affect vocal health.

COMDIS415 EXAM 2 (7 decks)

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