Dysphonia

Question 1

Sound in our voices is created by energy from our lungs. This in-turn causes vibration of the vocal cords at what level?

1 - epiglottis
2 - glottis
3 - sub-glottis
4 - throughout all layers

Answer 1

2 - glottis

• Soft tissue above the vocal cords acts as a resonant chamber
• Articulators: Movement of tongue and lips

Question 2

Dysphonia is the term used to describe a disorder of the voice. Which of the following is an infective cause of dysphonia?

1 - Laryngitis
2 - Nodules, polyps, cysts, papillomas
3 - Small cell carcinoma
4 - Vocal cord palsy

Answer 2

1 - Laryngitis

Question 3

Dysphonia is the term used to describe a disorder of the voice. Which nerve can be damaged and cause a dysphonia?

1 - vagus nerve (CN 10)
2 - glossopharyngeal (CN 9)
3 - accessory (CV 11)
4 - oculomotor (CN III)

Answer 3

1 - vagus nerve (CN 10)

Recurrent laryngeal nerve innervates vocal cords and can be damaged in thyroid surgery

Question 4

Wch 2 of the following examinations are typically performed to asses the cause of dysphonia?

1 - throat CT
2 - nasolaryngoscopy
3 - examination of voice quality (subjective and objective)
4 - barium swallow tests

Answer 4

2 - nasolaryngoscopy
3 - examination of voice quality (subjective and objective)

Question 5

Which of the following can be affected in patients who have some form of vocal cord paralysis?

1 - breathing
2 - swallowing
3 - voice quality
4 - all of the above

Answer 5

4 - all of the above

Breathing = vocal cord abduction
Phonation = vocal cord adduction

Question 6

In paralysis does the risk of aspiration increase or decrease?

Answer 6

• increase

Paralysis can be unilateral or bilateral

Question 7

In complete vocal cord paralysis, how can this present?

1 - inability to speak
2 - airway emergency with stridor
3 - chest pain
4 - all of the above

Answer 7

4 - all of the above

Airway emergency with stridor is more likely in

Question 8

Is the left of right recurrent laryngeal nerve more likely to be affected by a lung metastasis?

Answer 8

• left

Question 9

A stridor is high pitched noise caused by restriction of airflow. At what level would a inspiratory wheeze be heard?

1 - Glottis/supraglottis
2 - Subglottic
3 - Tracheal

Answer 9

1 - Glottis/supraglottis

Anything above the glottis would cause an inspiratory wheeze.

Glottis is the level of the vocal cords

Question 10

A stridor is high pitched noise caused by restriction of airflow. At what level would a biphasic wheeze be heard?

1 - Glottis/supraglottis
2 - Subglottic
3 - Tracheal

Answer 10

2 - Subglottic

Question 11

A stridor is high pitched noise caused by restriction of airflow. At what level would an expiratory wheeze be heard?

1 - Glottis/supraglottis
2 - Subglottic
3 - Tracheal

Answer 11

3 - Tracheal

Question 12

A stridor is high pitched noise caused by restriction of airflow. At what level would an expiratory wheeze be heard?

1 - Glottis/supraglottis
2 - Subglottic
3 - Tracheal

Question 13

Although stridor will need to be treated based on the cause, which of the following are treatment options?

1 - High flow oxygen
2 - adrenaline nebuliser
3 - dexamethasone
4 - heliox
5 - IV Antibiotics (if infective)
6 - all of the above

Answer 13

6 - all of the above

Question 14

If a patient has a stridor, which of the following should an throat examination NOT be performed unless by an ENT doctor or specialist?

1 - tonsillitis
2 - croup
3 - epiglottitis
4 - laryngeal nerve palsy

Answer 14

3 - epiglottitis

Can obstruct the airway more and be a medical emergency