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Voice > Evaluation of Voice > Flashcards

Evaluation of Voice Flashcards

1
Q

The diagnostic evaluation is a ? therapy tool

the effectiveness of the evaluation will dictate the ?

A

primary therapy

success or failure of therapy

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2
Q

Primary objectives of the voice evaluation:

identify

describe the ?

develop the ?

A

causes

present vocal components

management plan

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3
Q

Secondary objectives:

patient

patient

establish

A

education

motivation

credibility of voice pathologist

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4
Q

ICF- what does it ean

-
-

A

international classification of functioning disability and health

body functions and structures

activities and participation

influence of environmental and personal factors of impairment

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5
Q

Environmental factors are made up of ?

personal factors can be many and as described are not ?

A

physical
social
attitudinal

acknowledged as co-occuring with voice disorder

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6
Q

Diagnosis - the 5 D’s

determine 
determine 
determine 
determine 
determine
A

etiologic factors related to disorder

disorder severity

clinical course

likely response to treatment

actual response to treatment

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7
Q

Specialty of otolaryngology:

the otolaryngologist, or ENT determines the ? which includes ?

A

structural condition of the vocal folds/ visualizing the vocal folds

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8
Q

Case history is the clinician’s time in which to explore ?

A

nature and timeline of patient’s presenting symptoms

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9
Q 
Data collection phase: 
collect information about the history of 
-
-
-
-

obtain a list of the ?

A 
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

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10
Q

The physical exam:

-
-

palpates the ?

palpates the ? under the inner surface of the ? and the ? in front of the ?

A

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

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11
Q

An oral peripheral and cranial nerve exam checks the structures and function of the ? with specific attention to the ?

A

head and neck

articulators including those of face within mouth and larynx

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12
Q

Visual Examination:
otolaryngologist ?

vocal fold movement CANNOT

the vocal folds move faster than

A

completed this exam

be assessed with a mirror examination

human eye can resolve

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13
Q

Oral rigid laryngoscopy:

endoscope: instrument

oral endsoscope: placed into ?
advantage of?

if patient cannot tolerate because of gagging?

A

passed into the body

back of mouth

increased maginifcation

topical anasthesia can be used to desensitize the reflex

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14
Q

Transnasal flexible laryngoscopy:

a flexible endoscope is passed through?

it allows assessment of ?
what can be sampled

A

nasal cavity

vocal fold function during more complex vocal tasks
-speech and song production

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15
Q

Visual Examination:

both oral and flexible laryngoscopic techniques can be coupled with ?

A

videostroboscopic equipment

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16
Q 
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 ?

A

respiratory
laryngeal
supralaryngeal

relaible and valid

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17
Q 
Instrumental assessment: 
categories of instrumental assessment includw 
-
-
-
-
A

imaging
aerodynamics
acoustics
perceptual tools

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18
Q

Digital laryngostroboscopy:
systems are currently available for

they provide excellent?

  • allow retrieval for
  • allow ?
A

imaging larynx

image quality

  • images for later examination
  • pre to post laryngeal image following treatment
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19
Q

Laryngostroboscopy:
imaging the larynx using a ?
-takes advantage of using ?

the light source must be ?

takes advantage of ? known as ?

A

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

20
Q

Parameters that are rated from a videostroboscopic exam:
glottal closure:

supraglottic activity

vertical level of approximation:

vocal fold edge

A

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

21
Q

Paramters rated from videostroboscopic exam:
vocal fold mobility:

amplitude of vibration:

mucosal wave:

non-vibration portion:

A

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

22
Q

Paramters rated from videostroboscopic exam:
phase closure: degree to which vocal folds ?

periodicity: regularity of ?

overall laryngeal function:

A

move together during vocal fold closure during phonation

successive cycles of vibration during phonation

general impression of laryngeal function during phonation r

23
Q

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 ?

A

digital recording technique/ info about vocal fold motion

reference line/ vocal fold movement/ upper and lower vocal fold margin movement/ ope and closed phases.

24
Q

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

A

2000-4000 frames per second/vocal fold vibration in real time

process large and analysis time consuming

25
Q

aerodynamics: branch of science concerned with

A

study of gas motion in objects and forces that are created

26
Q

General methods of collection of aerodynamic signals:
rothenberg intorudced ?
a system that allows ?

circumferential design minimizes ?when compard to ?

A

circumferentially vented pneumotackograph facemask

airflow to be collected at the mouth

sound distortion and loss of high frequency fidelity/ funnel type

27
Q

General methods for collection of aerodynamic signals:
a differential pressure transducer measures the pressure by calculating ?

systems like the Aeroview and PECRl allow for measurement of

A

difference between pressure before a resistance and pressure after a resistance

measurement of average airflow

28
Q

Average Airflow:
average airflow during sustained vowel production ranges form
- in men
-….. in women
-average data reported as ? respectively

an average airflow signal provides a general idea of ? but does not give detail about the ?

A

40-320 cc/sec
50-220 cc/sec

119 cc/sec and 115 cc/sec respectively

laryngeal function/ flow modulated at level of glottis

29
Q

Estimated subglottal pressure:
subglottal air pressure is the amount of pressure ?

in order to directly measure subglottal air pressure a pressure transducer is connected to a ? which is attached to a needle and inserted into the ?

A

directly below vocal folds

thin, relatively short piece of polythylene tubing/ circothyroid membrane

30
Q

Estimated subglottal pressure:
indirect measurement of subglottal pressure places a small piece of tubing between lips which is attached to ?

the patient is asked to produce a string of ? cocnisting of ? at a rate of ?

A

differential pressure trasnducer

bilabial syllables / voiceless stop /p/ followed by vowel /i/ at constant pitch and rate of 1.5 syllables per second

31
Q

Estimated laryngeal airway resistance:
requires the accurate measurement of ? as determined from the?

is calculated by dividing ?

A

average airflow and estimated subglottal pressure / intra-oral air pressure signal during /pi/ syllable

value of estimated subglottal pressure by average airflow value

32
Q

Inverse filtering:
in order to obtain estimate of airflow modulated by vocal folds during voicing…. must be completed to obtain estimate of glottal airflow

benefit of rothenberg’s circumferentially vented mask design:
preservation of ?

A

inverse filtering of oral airflow waveform

vowel quality because of high bandwidth of systemm on order of 3KHz

33
Q

Airflow open quotient:

provides duration information about the ? relative to

A

length of time glottis is open/ duration of entire cycle of vocal fold vibration

34
Q

Maximum flow declination rate:

measured as the maximum ?

A

negative peak from first derivative of glottal airflow waveform

35
Q

peak glottal airflow:

related to

A

maximum glottal area during vocal fold vibration

36
Q

alternating glottal airflow:

chanes in ? affect alternating airflow by altering the ?

A

vocal fold tension and stiffness/ displacement of vocal folds during voicing

37
Q

Minimum glottal airflow:

relates to the amount of airflow through the glottis during

A

closed phase of vocal fold vibration

38
Q

Laryngeal aerodynamics of developing larynx:
children and adults are different with regard to ?
predicted that aerdodynamic measures would ?

A

laryngeal size

reflect known changes in laryngeal anatomy

39
Q

Laryngeal aerodynamics as a function of aging:
aging results in ? such as ?

these anatomical degenerations with aging influence the ?

A

changes to larynx/ degeneration of cartilaginous framework, vocal fold tissue, motor innervation to larynx

biomechanical function of larynx affecting laryngeal aerodynamics

40
Q

Laryngeal aerodynamics as a function of sex:
the resultant aerodynamics is a reflection of distinctions in ? documented between men and women related well to the perception that the female voice is

A

glottal area and vibratory pattern differences

weaker and breathier than adult male voice

41
Q

goals of acoustic analysis: despite advantages of acoustic analysis, acoustic measures can easily be affected by variables other than voice itself

-
-

A

recording procedures
elicitation instructions
environmental interference

42
Q

Recording for acoustic analysis:

accuracy of acoustic measures of voice is critically dependent on fidelity of ?

A

recordign equipment

43
Q

modern instrumentation for acoustic recording relies on ?

sampling rate reflects how often

A

digital tech.

voice signal is sampled in time

44
Q

quantization level reflects the number of ?

A

steps used to represent changes in amplitude of signal

45
Q

errors when recording for acoustic analysis:
peak clipping occurs when signal intensity is ? that it cannot be ?

a second kind of error occurs when the recording fails to use ?

A

so high/ correctly represented within quantization levels available for recording

available quantization levels adequately

Voice (6 decks)

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