Exam 1- Ch. 1-4 Flashcards

Question

Phonotraumatic etiologies

Answer 1

Shouting Loud talking Screaming Vocal noises (child imitating a truck, etc.) Chronic coughing/throat clearing

Answer 2

Laryngectomy Glossectomy Mandibulectomy Palatal surgery Other head and neck combinations

Answer 3

“sinus”/Allergies Respiratory illnesses/Frequent URI Gastrointestinal disorders Emotional disorders Hormonal imbalance Arthritis Smoking/Alcohol/drug abuse

Answer 4

Cleft palate Velopharyngeal insufficiency Deafness/HOH Cerebral palsy Neurologic disorders

Answer 5

Environmental/life stress Identity conflict

Answer 6

Bilateral, “relatively” symmetrical lesions occurring on the medial edge between ant. 1/3 and posterior 2/3’s of VFs Causes Mild to Moderate Dysphonia Roughness, breathiness, increased muscular tension. Severity depends upon: Size, time since onset, degree of inflammation.

Answer 7

First line = voice therapy, Surgical Removal by “skilled” laryngologist second option

Answer 8

Fluid-filled, exophytic lesion composed of gelatinous material in SLLP (typically located on middle third of the VF). Often unilateral but can be bilateral. Etiology: Phonotrauma Mild to severe dysphonia depending on: Size, type, and location

Answer 9

Voice Conservation/Rehab (if small enough) Phonosurgery (and voice rehab)

Answer 10

Fluid-filled, typically unilateral, sessile lesions on medial edge of the VF Congenital or Acquired Embedded in SLLP, but often extend into ILLP and DLLP (i.e., the vocal ligament). No clear etiology, but… Mucous gland blockage, and/or Phonotrauma. increase stiffness of VF

Answer 11

Surgical excision/dissection of the cyst off of the vocal ligament

Answer 12

SLLP becomes filled with viscous, gelatinous fluid. Etiologies: Chronic Phonotrauma, Smoking. Causes increased mass and stiffness. Signature low pitch and husky hoarse “smoker’s” voice.

Answer 13

Surgery with Pre- and post-operative voice therapy.

Answer 14

Increases stiffness of VFs Reduced oscillation = reduced mucosal wave during VF vibration. Reduces glottic closure in severe cases Effects on voice vary depending upon severity, extent, and location of scar.

Answer 15

No accepted/effective behavioral or phonosurgical treatment.

Answer 16

Special form of scarring that forms a “ridge” along the SLLP that produces bowing Unilateral or Bilateral Etiology unknown

Answer 17

Granulomas- unilateral or bilateral, lesions related to tissue irritation in the posterior larynx typically on medial surface of arytenoid cartilage(s). Contact ulcer- ulcerated lesion on the same site often on opposite side of granuloma. S/S: Pain, sore throat, with or w/o voice change Etiologies: Mechanical (intubation) Chemical (reflux) Persistent Voice Misuse

Answer 18

Medical: Antireflux Regimen, Intracordal Botox injection Behavioral: Voice Therapy Surgical (if fail medical and/or behavioral management).

Answer 19

“white plaque”, Thick substance on superior surface of VFs in diffuse white patches.

Answer 20

“excessive keratin”, Buildup of keratinized tissue, rough, irregular VF margins.

Answer 21

“thickened and red,” Due to combination of hyperfunctional voice use and chemical irritation especially alcohol and tobacco use.

Answer 22

Wart-like growths that develop in the epithelium and invade deeper in the LP and vocalis muscle. Can grow rapidly and in large clusters and compromise the airway. Etiology: HPV Lesions can affect cover, transition, and body of the VFs increase stiffness, compromise vibratory fxn, and cause severe dysphonia.

Answer 23

Surgical, but recurrence is common requiring multiple de-bulking surgeries (increased likelihood of VF scarring). Pharmacotherapy (as a primary or secondary approach)

Answer 24

fibrous tissue overgrowth that narrows the airway

Answer 25

acquired scar across medial edges of the VFs beginning in the anterior commissure and extending posteriorly. Etiology: Subglottic Stenosis: Congenital, Post-intubation scarring, reflux. Glottic Stenosis/Web: Congenital or Acquired Treatment: Surgery

Answer 26

caused by traumatic injury to small blood vessels of the VF; focal or diffuse discoloration of VF. Etiology: intense screaming, singing, coughing, crying. Hemorrhage = small capillary on surface of VF ruptures abruptly and bleeds into SLLP. Hematoma = accumulation of blood that has leaked from the ruptured vessel. Varix = mass of blood capillaries that appears as small, longstanding blood blister that has hardened over time with an adynamic VF segment. Ectasia = larger collection of varices. Vascular injuries have potential to increase stiffness of the cover, with localized scarring in more severe cases. Voice quality can vary from severe at time of bleed (acutely) to mild later. Small varices or ectasias may have negligible effects on voice

Answer 27

Aggressive Voice Conservation (complete voice rest). Medical (Steroids). Laser Cauterization Surgery: Microexcision of persistent varix.

Answer 28

Post-pubescent males who speak in falsetto or near top of their modal frequency range. Voice weak, often breathy or raspy, unable to increase intensity or shout. Etiology poorly understood, but… Resistance to puberty, Feminine self-identification, Desire to maintain childhood soprano singing voice, Embarrassment when voice lowers dramatically Behavioral voice therapy usually effective

Answer 29

Post-adolescent females with higher-than-normal pitch, breathy voice, child-like speech distortions and prosody Etiology unknown, but… Women who resisted transition into adulthood or, Habituated the altered laryngeal and vocal tract posture.

Answer 30

related to processes of laryngeal aging. “older” sounding voice… Thin, muffled voice quality, Decreased loudness, Increased breathiness, Pitch instability Lack of vocal endurance and flexibility. Classic laryngeal appearance is a slightly bowed glottic configuration presumably related to “thinned or atrophic” VFs. Voice rehabilitative therapy can be effective.

Answer 31

movement of fluid flows from a lower pressure than the flow that surrounds it tells us that as the breath from the lungs through the trachea and passes through the glottis, the pressure of the glottis becomes lesser than the pressure surrounding it causing the VF to adduct The makeup and recoil of the tissues than the changes in pressure; the initial pressure subglottally is what initiates oscillation initially

Answer 32

polyp, nodule, etc.

Answer 33

spasmodic dysphonia, dysarthria

Answer 34

functional dysphonia

Answer 35

Manuel Garcia

Answer 36

Pressed onset (hard attack) Breathy onset Balanced onset

Answer 37

will damage voice over time

Answer 38

air is preceding muscle adduction

Answer 39

No pitch and register are not directly correlated

Answer 40

Phonation starts with inhalation, the main inspiratory muscles are the external intercostals and the diaphragm. the diaphragm contracts downward compressing the abdominal viscera creating a pressure vacuum pulling air into the lungs. Inspiration is complete and expiration will be initiated which is what causes the vocal folds to vibrate. the main expiratory muscles are the internal intercostals and the diaphragm. at onset of expiration a recoil occurs causing the diaphragm to move back up to resting point and this causes a buildup of positive pressure subglottally. the pressure overcomes the resistance of the vocal folds causing them to abduct and vibrate for vocalization. after expiration the buildup of pressure has subsided causing the folds to adduct completing the cycle of phonation.

Answer 41

Previously thought that pressure changes subglottally cause the folds to abduct and adduct; but now with the myo theory we understand that the pressure change is not as big of a factor in the adduction of the folds because of elastic recoil forces and that they cause a big part of bringing the folds back to midline