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Voice Disorders > Functional Voice disorders > Flashcards

Functional Voice disorders Flashcards

1
Q

How are functional voice disorders characterized?

A
  • tension
  • hyperfunction
  • larynx “riding high”
  • anxiety
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2
Q

_______ voice disorders can be controlled, but not _______ voice disorders.

A

Functional

neurogenic

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3
Q

What percentage of functional voice disorders comprise of dysphonia cases?

A

10%

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4
Q

Functional voice disorders occurs predominantly in what gender and what type of personality

A

women

type A

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5
Q

What can cause functional voice disorders

A
  • upper respiratory infection
  • stressful/traumatic event
  • idiopathic
  • organic voice disorder
  • neurogenic
  • psychosocial (mood, anxiety, adjustment)
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6
Q

What structural pathology is present in functional voice disorders?

A

There is no structural pathology present in functional voice disorders unless, it is caused by an organic voice disorder.

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7
Q

What are the classification of etiologies for functional voice disorders?

A

1-Psychogenic: caused by underlying psychological factors
2-Neurogenic: Parkinson’s disease: Basal ganglia not making dopamine; thyroid doesn’t get the dopamine
3-misuse/abuse: caused by hyperfunction
o Excessive throat clearing
o Excessive/inappropriate singing/performing

4-organic: compensatory hyperfunction as a result of organic pathology
o Cancer
o Nodules
5 - Idiopathic

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8
Q

What are the four functional voice disorders?

A
  1. Puberphonia/falsetto/mutational falsetto
  2. Functional aphonia
  3. Functional dyshonia/muscle tension dysphonia
  4. Paradoxical VF movement (PVFM)/PVCD/VCD
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9
Q

What is puberphonia?

A

A pitch control disorder, pitch is either too high or there are breaks in pitch.

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10
Q

_______ lower is normal development.

A

1 octave

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11
Q

Who is usually diagnosed with puberphonia

A

Male puberty/post adolescent puberty males

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12
Q

What usually causes puberphonia?

A

Emotional stress/psychogenic

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13
Q

What happens to the larynx in puberphonia?

A
  • The larynx “rides high” because it was not dropped in puberty
  • but there is nothing wrong with the larynx
  • Not due to anatomic immaturity of larynx
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14
Q

A 20 year old male will be diagnosed with puberphonia if he has a frequency of _____ instead of ______.

A

200 Hz
120 Hz

(Remember make sure the larynx has been examined before diagnosing)

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15
Q

What are the larynx features of the visual assessment of puberphonia (laryngeal characteristic of high pitch)?

A
  • incomplete glottal closure
  • increased vocal fold stiffness
  • decreased vibratory amplitude
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16
Q

What is functional dysphonia also known as?

A

Muscle tension dysphonia

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17
Q

What is muscle tension dysphonia?

A
  • high muscle tension
  • Excessive tension of laryngeal/extralaryngeal muscles
  • Pulls muscles from neck and chest to make voice
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18
Q

What kind of breathing occurs with functional dysphonia/muscle tension dysphonia?

A

chest breathing/clavicular breathing: shallow breathing from excessive use of accessory muscles

19
Q

What are characteristics of functional dysphonia (muscle tension dysphonia)?

A
  • increased vocal effort
  • vocal fatigue
  • hyperfunction: Ventricular compression, ventricular phonation, anterior - posterior press
20
Q

What is found in the patient history of clients with MTD? (Book pg. 170)

A
  • psychogenic factors: stress, anxiety, depression

- high vocal demand

21
Q

What are the larynx features of the visual assessment of functional dysphonia/muscle tension dysphonia?

A
  • Excessive glottic and supraglottic medial contraction
  • anterior posterior contraction of the supraglottal musculature including arytenoids
  • Psychogenic bowing of vocal folds
  • decreased Vibratory amplitude of vocal folds
22
Q

what is bowing of vocal folds?

A

Vocal fold bowing occurs when one or both of the vocal folds become atrophied or weak and a gap forms between the vocal fords, which prevents them from closing completely and vibrating normally

23
Q

What is paradoxical vocal fold movement?

A
  • Vocal folds are not moving as they should when they are breathing
  • Vocal folds adduct when you inhale and abduct when you exhale
  • ———–Trying to get air in but VF are coming together causing inspiratory stridor
24
Q

What happens when somebody has severe Paradoxical vocal fold movement?

A

Vocal folds completely adduct so client will stop breathing

25
Q

Paradoxical vocal fold movement (PVFM) is often misdiagnosed as what?

A

PVFM is often misdiagnosed as asthma because of the wheezing that occurs during inspiration and expiration.

26
Q

What is a synonymous descriptor for paradoxical vocal fold movement?

A

episodic paroxysmal laryngospasm

27
Q

What is episodic paroxysmal laryngospasm? (Dr. C called it laryngospasm)

A

forceful vocal fold adduction/spasm starts during inspiration and may carry over into the expiratory phase of breathing.

28
Q

What are the etiologies of paradoxical vocal fold movement?

A
  • psychogenic (often)

- neurogenic (rare)

29
Q

________ ________ often co-exists with psychogenic instead of directly causing PVFM.

A

laryngopharyngeal reflux

30
Q

What is laryngopharyngeal reflux?

A

Stomach acid reflux shoots up into esophagus and gets to the larynx burning the larynx and vocal folds. (Carmichael notes) (Book text is similar: pg. 146)

31
Q

When do you see LPR in PVFM?

A

When you scope the client.

32
Q

What are the symptoms of PVFM?

A
  • dyspnea: problems with breathing
  • inspiratory stridor (VFs adduct on inspiration)
  • may be exercise induced
  • may or may not have dysphonia
  • may have chronic cough
33
Q

How does an SLP induce PVFM?

A

By asking the client to exercise

34
Q

Wheh does PVFM usually occur?

A

When client is under pressure or stress.

35
Q

PVFM is usually _______.

A

intermittent.

36
Q

Functional dysphonia looks like what neurogenic disorder?

A

Spasmodic dysphonia

37
Q

What conditions are associated with muscle tension dysphonia?

A 
-organic disorders:
laryngitis
nodules
polyps
-laryngeal pharyngeal reflux (book pg 170)
38
Q

What is functional aphonia?

A

Whispering or shrill-sounding voice

39
Q

What used to be the term for functional aphonia?

A

hysterical syndrome
conversion symptom
conversion hysteria

40
Q

How long does functional aphonia usually last?

A

may be temporary or intermittent

41
Q

What percentage of functional aphonia cases coexist with psychiatric disorders?

A

80%

42
Q

What is the percentage that tend to fake functional aphonia?

A

20%

43
Q

How can the clinician find out if the patient is faking functional aphonia?

A

Look at larynx and ask client to say “eeeee”. Ask client to cough or clear throat; if vocal folds come together, client is faking it.

44
Q

If vocal folds don’t get together during functional aphonia then they _____ come together when client clears throat or cough.

A

can’t

Voice Disorders (6 decks)

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