Evaluation of Voice Flashcards
The diagnostic evaluation is a ? therapy tool
the effectiveness of the evaluation will dictate the ?
primary therapy
success or failure of therapy
Primary objectives of the voice evaluation:
identify
describe the ?
develop the ?
causes
present vocal components
management plan
Secondary objectives:
patient
patient
establish
education
motivation
credibility of voice pathologist
ICF- what does it ean
-
-
international classification of functioning disability and health
body functions and structures
activities and participation
influence of environmental and personal factors of impairment
Environmental factors are made up of ?
personal factors can be many and as described are not ?
physical
social
attitudinal
acknowledged as co-occuring with voice disorder
Diagnosis - the 5 D’s
determine determine determine determine determine
etiologic factors related to disorder
disorder severity
clinical course
likely response to treatment
actual response to treatment
Specialty of otolaryngology:
the otolaryngologist, or ENT determines the ? which includes ?
structural condition of the vocal folds/ visualizing the vocal folds
Case history is the clinician’s time in which to explore ?
nature and timeline of patient’s presenting symptoms
Data collection phase: collect information about the history of - - - -
obtain a list of the ?
surgeries requiring intubation trauma hospitalizations medical problems being treated by another physician types of medicines
physicians currently treating patient or previous consultations the patient has experiences
The physical exam:
-
-
palpates the ?
palpates the ? under the inner surface of the ? and the ? in front of the ?
head and scalp
nose and sinuses
neck region
cervical lymph nodes near carotid arteries
submaxillary and submental nodes under the inner surface of mandible and preauricular nodes in front of the ear and suboccipital nodes behind the ear
An oral peripheral and cranial nerve exam checks the structures and function of the ? with specific attention to the ?
head and neck
articulators including those of face within mouth and larynx
Visual Examination:
otolaryngologist ?
vocal fold movement CANNOT
the vocal folds move faster than
completed this exam
be assessed with a mirror examination
human eye can resolve
Oral rigid laryngoscopy:
endoscope: instrument
oral endsoscope: placed into ?
advantage of?
if patient cannot tolerate because of gagging?
passed into the body
back of mouth
increased maginifcation
topical anasthesia can be used to desensitize the reflex
Transnasal flexible laryngoscopy:
a flexible endoscope is passed through?
it allows assessment of ?
what can be sampled
nasal cavity
vocal fold function during more complex vocal tasks
-speech and song production
Visual Examination:
both oral and flexible laryngoscopic techniques can be coupled with ?
videostroboscopic equipment
instrumental assessment: it is important to quantify the function of the following systems as one or more may be impaired: - - -
the most important consideration in the selection of any instrument used to evaluate voice are that they meet criteria of ?
respiratory
laryngeal
supralaryngeal
relaible and valid
Instrumental assessment: categories of instrumental assessment includw - - - -
imaging
aerodynamics
acoustics
perceptual tools
Digital laryngostroboscopy:
systems are currently available for
they provide excellent?
- allow retrieval for
- allow ?
imaging larynx
image quality
- images for later examination
- pre to post laryngeal image following treatment
Laryngostroboscopy:
imaging the larynx using a ?
-takes advantage of using ?
the light source must be ?
takes advantage of ? known as ?
strobe light
interrupted light to make objects appear as if they are moving in slow motion
high quality and able to flash at rate of 5 microseconds
talbot’s law, known as persistence of vision
Parameters that are rated from a videostroboscopic exam:
glottal closure:
supraglottic activity
vertical level of approximation:
vocal fold edge
degree to which vocal folds close during maximum adduction during phonation
degree of anteroposterior and lateral compression during phonation
degree to which vocal folds meet on same vertical plane during phonation
smoothness of vocal fold edge
Paramters rated from videostroboscopic exam:
vocal fold mobility:
amplitude of vibration:
mucosal wave:
non-vibration portion:
degree of movement during phonation
degree of movement from medial to lateral aspects
assessment of degree of traveling wave that is present on superior surface of vocal fold during phonation
identification of portions of the vocal fold that are non-moving during phonation
Paramters rated from videostroboscopic exam:
phase closure: degree to which vocal folds ?
periodicity: regularity of ?
overall laryngeal function:
move together during vocal fold closure during phonation
successive cycles of vibration during phonation
general impression of laryngeal function during phonation r
Videokymography:
another type of? that provides
by using ? located to transverse glottis, the line images are portrayed in real time and ? can be tracked, allowing for measurement of ? and time measurements of ?
digital recording technique/ info about vocal fold motion
reference line/ vocal fold movement/ upper and lower vocal fold margin movement/ ope and closed phases.
High speech digital videoendoscopy:
can occur at a rate of up to ? allowing examinar to see the ? in ?
never made it into daily clinical regime because
2000-4000 frames per second/vocal fold vibration in real time
process large and analysis time consuming
