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Voice and Upper Airways Disorders > Exam 2 Review > Flashcards

Exam 2 Review Flashcards

1
Q

differentiate between role of SLP and ENT in diagnosis of voice disorders resulting from additive lesions

A
  • ENT diagnoses the organic lesions or structural changes to the vfs
  • SLP diagnoses and treats the dysphonia or voice disorder that results from the vocal pathology
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2
Q

chronic laryngitis

A

any pathologic condition characterized by the long-standing inflammation of the laryngela mucosa secondary to laryngeal trauma

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3
Q

difference between chronic laryngitis and acute laryngitis

A
  • chronic laryngitis is directly related to phono-trauma
  • acute laryngitis is bacterial or viral
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4
Q

chronic laryngitis is a…

A

starter lesion because it can worsen into other conditions

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5
Q

SLP’s role with chronic laryngitis

A

voice therapy is highly effective frontline primary treatment

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6
Q

vocal nodules

A

localized benign growths of the vfs typically occurring at the mid point of the vfs

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7
Q

vocal nodules occur at the midpoint of the vfs because…

A

it’s the point of maximum impact

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8
Q

vocal nodules progress from ___ ___ lesions to ___ ___ lesions similar to ___

A

soft pliable, hard fibrotic, caluses

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9
Q

SLP’s role with vocal nodules

A
  • voice therapy is highly effective to cure and prevent recurrence
  • surgery may be required for more mature lesions
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10
Q

polyps

A

benign, soft fluid filled epithelial lesions that appear on the vf margins secondary to laryngeal trauma

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11
Q

2 types of polyps

A
  1. sessile polyps
  2. pedunculated polyps
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12
Q

sessile polyps

A

broad-based polyps that closely adherre to the vf mucosa and involve it to varying extents

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13
Q

pedunculated polyps

A

attached to the vf by a slim neck or stalk-like appendage

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14
Q

polyps are more like blisters and never…

A

become fibrotic

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15
Q

unlike nodules, polyps can…

A

occur after 1 instance of phono-trauma

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16
Q

SLP’s role with polyps

A
  • beneficial for small sessile
  • removing polyp might be more effective (required for larger and pedunculated)
  • reduce any compensatory strategies to prevent recurrence
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17
Q

Reinke’s edema

A

formation of diffuse polypoid swelling caused by the accumulation of fluid under the vf cover in Reinke’s space along the entire length of the membraneous vf

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18
Q

Reinke’s space

A

space between superficial layer and epithelium

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19
Q

Reinke’s edema takes up…

A

the entire length of the vf

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20
Q

etiology for Reinke’s edema

A

history of smoking and alcohol comsumption

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21
Q

SLP’s role for Reinke’s edema

A
  • functionally best hygenic voice possible
  • surgery indicated to repair as best they can
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22
Q

contact ulcers

A

benign lesions in the posterior glottis in the area of the arytenoids

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23
Q

contact ulcers can be…

A

vocally assymptomatic until healing begins

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24
Q

most common symptom of contact ulcers

A

burning pain

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25
Q

SLP’s role for contact ulcers

A
  • voice therapy is frontline treatment
  • rarely surgery because it’s too complicated
  • work on reducing size of lesion and preventing recurrence
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26
Q

sulcus vocalis

A

relatively rare laryngeal condition characterized by a furrow along the upper-medial edge of the vf

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27
Q

sulcus vocalis has varying…

A

lengths and depths

28
Q

sulcus vocalis is caused by…

A

a lack of lamina propria on those areas so the cover as attached directly to the muscle

29
Q

best to diagnoses sulcus vocalis on ___ where…

A

inhalation, we see vf having the appearance of being split in 2

30
Q

SLP’s role for sulcus vocalis

A
  • breaking hyperfunctional habit that arise because of this
  • surgery performed to fill in the furrow
31
Q

intracordal cysts

A

fluid-filled lesions that usually appear on the margins of the true vfs and are encased in an epithelial shell causing them to be encapsulated

32
Q

intracordal cysts appear on vf edge and distort it, but…

A

are not actually on the edge

33
Q

intracordal cysts are not directly related to phono-trauma, but…

A

they do cause phono-trauma

34
Q

can intracordal cysts recurr?

35
Q

SLP’s role for intracordal cysts

A

vocal improvement and address any hyperfunctional behavior

36
Q

reasons why voice therapy is preferrable to surgery

A
  • there is less time loss from work, vocally demanding jobs especially
  • can be an effective non-traumatic treatment option
  • most cost effective, depending on insurance
  • biggest disadvantage of surgery is nonremoval of the behavior that caused the lesion or cause of lesion to recurr
37
Q

phono-trauma

A
  • any vocal behavior that can have a traumatic effect on the vfs
  • encompasses vocal abuse and vocal misuse
38
Q

all forms of ___ ___ could be considered ___ ___, but not all ___ ___ are ___ ___

A

vocal misuse, vocal abuse
vocal abuses, vocal misuses

39
Q

indirect treatment approaches

A
  • consultation model
  • clinical surrogates
  • inservice programs
40
Q

consultation model

A

providing the patient with information (reading material, videotapes, etc.) and allowing them to work on their own for the treatment of the voice disorder
- highly motivated adult with a very mild voice disorder

41
Q

clinical surrogates

A

provides information and activity sheets to someone other than the patient who is willing and able to implement them (teachers, parents)
- vocal hygiene and prevention of vocal abuse type programs

42
Q

inservice programs

A

dissemination of information concerning the prevention of voice disorders to interested groups (teachers, cheerleaders, telemarketers, etc.) in a brief manner

43
Q

ventricular dysphonia

A
  • when the vetricular folds (false vfs) compress and squeeze over the true vfs
  • characterized by a rough, low-pitched voice quality
44
Q

6 steps of a vocal abuse/misuse reduction program

A
  1. identify the patterns/behaviors demonstrated by the patient related to vocal misuse/abuse
  2. a baseline of occurrence should be identified by either direct observation of the client or the client tracking and monitoring outside the clinic environment
  3. make the patient aware of the impact these abuses have on their voice and how they might contribute to an additive lesion
  4. discuss the identified abuses with the patient, emphasizing the need to reduce their daily frequency
  5. plot the daily occurrence of vocal abuse/misuse on a graph
  6. have the patient bring these graphs to therapy and discuss
45
Q

direct treatment approach

A
  • symptomatic voice therapy
  • lifestyle and environmental modification
  • physiologic voice therapy
  • holistic voice therapy
46
Q

symptomatic voice therapy

A

involves the direct modification of overt behavioral characteristics of the voice disorder

47
Q

lifestyle and environmental modification

A

involves analysis of precipitating and perpetuating factors associated with the person’s lifestyle/environment
- working with them and their family to make necessary modifications, implementing these modifications, and monitoring their progress

48
Q

physiologic voice therapy

A

addresses the psychosocial aspects of voice use through the use of psychosocial goals and the use of emotional or cognitive retraining as a way of changing voice use

49
Q

holistic voice therapy

A

draws on all the approaches mentioned above implementing them sequentially or concurrently based on the patient’s most compelling needs to set the order of priority

50
Q

complete vocal rest

A

elimination of all activities that either adduct the vfs into forced approximation with each other or cause the vfs to vibrate and result in the production of sound

51
Q

modified vocal rest

A

the use of voice is significantly reduced but not completely eliminated

52
Q

parameters which should be addressed as part of the case history when having the client describe their voice disorder

A
  • patient’s description of the voice disorder
  • other people’s reaction to the voice disorder
  • patient’s rating of the severity of the voice disorder
  • patient’s description of the effects, causation, onset, and course of the voice disorder
53
Q

client related factors that might influence the selection of a vocal remediation program

A
  • age
  • type/severity of the disorder
  • personality
  • their understanding of the problem and precipitating factors
  • commitment to change
54
Q

clinician related factors that might influence the selection of a vocal remediation program

A
  • training
  • previous experience
  • interest in voice disorders
  • confidence level
  • personality
55
Q

diplophonia

A
  • production of 2 audibly different pitches during phonation
  • can result from vf with polyp vibrating at a slower rate than the vf without a polyp
56
Q

responsibilities of the SLP during counseling activities

A
  • receiving information
  • giving information
  • clarifying
  • helping to change behavior
57
Q

responsibilities of the SLP during counseling activities: receiving information

A

the SLP should actively and nonjudgmentally listen for the real meaning of the patient’s message, without planning what to say next, and then restate in his/her own words what the patient has said

58
Q

responsibilities of the SLP during counseling activities: giving information

A

this is the easiest of the counselor functions (because of the expertise we bring to the task) and involves the provision of information based on the patient’s needs (must remember, however, that the patient can only process so much information at 1 time)

59
Q

responsibilities of the SLP during counseling activities: clarifying

A

assist the patient in perceiving more clearly and to deal more constructively with issues impacting their voice problem

60
Q

responsibilities of the SLP during counseling activities: helping to change behavior

A

to do this you must exercise all of the above, with the first step being to clearly explain the target behavior and its potential benefit, and incorporating discussion, practice, observation, and role-playin

61
Q

vocal fatigue

A
  • talking becomes a more effortful, tiring experience as the day goes on
  • quality of voice progressively deteriorates
62
Q

advantages of vocal rest programs

A
  • usually see a rapid reduction in the size and severity of the laryngeal lesion
  • it allows the individual the opportunity to identify those situations that promote
  • allows the therapist to determine the individual’s commitment to the process of voice improvement
63
Q

disadvantages of vocal rest programs

A
  • for those who use their voices professionally, it may be financially impossible for them to implement such a program
  • it is an extremely difficult task for the average person to adhere to and is even more difficult for those who misuse their voice
  • some patients become depressed with continued vocal rest
64
Q

most important determinations to be made from a voice evaluation

A
  1. detailed description of the patient’s voice characteristics and how they vary over time
  2. determination of how severe the patient’s voice disorder is
  3. determination as to whether the patient would benefit from a program of voice therapy
65
Q

prognostic considerations which might assist in helping us determine whether a program of voice therapy will be successful

A
  • prognosis for improved voice is generally best for patients who report a more acute onset
  • prognosis is poorer for patients who report a long-term, chronic dysphonia
66
Q

prognosis for improved voice is generally best for patients who report a more acute onset

A

those that seek help sooner often recognize the voice immediate impact their voice disorder has on daily activities, they are generally well motivated and usually quite anxious to be rid of the restrictions imposed by the dysphonia

67
Q

prognosis is poorer for patients who report a long-term, chronic dysphonia

A
  • often these patients have had time to adapt to the gradual changes in their voice and are relatively undisturbed by the dysphonia
  • if you are uncertain as to the prognosis for improvement or the benefits of therapy, the recommendation of a trial period of therapy is accetable

Voice and Upper Airways Disorders (19 decks)

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