Homework Flashcards
- List and describe the biological functions of the voice
The primary biological function of the larynx is airway protection. It prevents foreign items from entering the trachea and blocking it, protecting the airway from water, food, etc that would damage the lungs
- List and describe the emotional functions of the voice
The voice conveys to listeners information about the emotions the speaker is experiencing (ex: sadness, happiness, fear).
- List and describe the linguistic functions of the larynx:
The larynx provides linguistic information both in the way the voice sounds (emotion) and based on how stress and varying pitch are applied throughout an utterance.
- What are the main categories of voice disorders (described in the Boone et al. text book)?
- Functional
- Organic
- Neurogenic
- Describe at least one difference between each of the main categories of voice disorders?
Functional voice disorders result from damage do to how the voice is being habitually used. Organic voice disorders, in contrast, result from structural deviation or disease affecting the structure, and neurogenic result from some type of neurological damage
- What is the incidence and Prevalence of voice disorders in the general population?
Lifetime, 30%. At one point in time, 7%
- What is the incidence and Prevalence of voice disorders in Children?
As low as 4%, as high as 20-30%.
What is the incidence and Prevalence of voice disorders in the elderly?
20-30%
What is the incidence and prevalence of voice disorders in professional voice uses?
4%-57.7%
Who manages voice disorders professionally?
? Counselor/psychologist (in psychogenic voice disorders), ENT, respiratory therapist, surgeon.
- Can emotions challenge the normal voice? If so, how
. The voice conveys to listeners information about the emotions the speaker is experiencing. In cases of fear, for instance, this can cause the larynx to be raised. This raised larynx alters the sound of the voice, making it crackly, strained, etc
- Name 4 contributing factors that are involved with the onset, maintenance, and rehabilitation of a voice disorder:
Guess:. Vocal hygiene, vocal quality, respiration, environmental factors
- What two things can increased circulation with exercise potentially cause?
a. Greater mental strength
b. Increased physiologic power
- Define the terms intrinsic and extrinsic factors as they relate to health, and give an example of each. (guess)
a. Intrinsic—factors in the body such as genetics
b. Extrinsic—external factors in the environment, such as second hand smoke exposure
- Identify the importance of the case history process:
a. Gathering case history information helps you get a more full picture of the issue and select which tests to administer. Without gathering a case history, you could miss vital information, which could lead to a misdiagnosis.
- Voice recovery can vary dramatically from person to person. List 5 factors that may contribute to recovery time.
a. Ability to heal
b. State of mind
c. Previous level of vocal use
d. Current demands of vocal use
e. Compliance with lifestyle and therapy demands
f. Choice of therapy
- As a clinician what should you explain to the patient about the inhalation of cigarette smoke?
a. Cigarette smoke irritates the lining of the nose, throat, and lower airway resulting in decreased mucus, which causes inflammation of the upper and lower respiratory tract. This could be causing or exacerbating your voice issue. It can also lead to cancer and is highly addictive.
- Define the term diuretic and give a common example of one agent classified as a diuretic.
a. A diuretic causes the body to expel liquids more frequently, thus possibly leading to dehydration if enough water isn’t consumed in compensation.
b. Coffee is a diuretic
- Name 3 symptoms of vocal fatigue, identify who is susceptible to it:
i. Dysphonia
ii. Periods of voice loss
iii. Odynophonia—soreness or pain in the throat following prolonged voice use
b. Professional voice users most vulnerable (especially if using lower than natural pitch)
- If a patient increased their water intake, explain the effect it will have on their body.
a. Body wide-better brain function, higher energy.
b. More fluid vocal fold movement resulting in less effort when voicing, less lung pressure needed to initiate voicing.
- Explain the difference between external and internal hydration and what can you tell your patient’s about how to increase their hydration.
a. Internal hydration is the state of water balance in an individual.
b. External hydration is the layer of fluid that covers the vocal folds outer surface
c. Drinking more water can improve internal hydration, and avoiding smoking, breathing through your mouth, and inhaling dry air can improve external hydration.
Compare an assessment and a screening
A screening is a very brief, pass/fail procedure that simply tells about if there is a concern about a possible issue which should be further examined. An assessment is a much longer, more detailed procedure which includes both non-instrumental and possibly instrumental voice eval.
- What should be included in the history and physical examination of a patient with a voice disorder? What are a few questions you may expect to ask in the history portion of your non-clinical assessment?
A case history should include a description of the problem and cause, the onset and duration of the problem, variability of the problem, description of vocal demands, as well as additional information such as family history and previous exposure to therapy.
- What are the different laryngeal examination methods? What are the advantages and disadvantages? Do some appear more instrumental rather than non-instrumental?
Auditory perceptual ratings, which include: Voice handicap index, Consensus Auditory-Perceptual Evaluation of Voice, and the oral mech exam, which includes visual examination of the larynx through laryngoscopy, laryngeal stroboscopy, etc.
- What does a laryngologist specialize in? What is their role as it relates to voice disorders?
Diagnosing laryngeal pathology. They look at the anatomical structure and refer to SLPs who then treat the voice disorder. Or, SLPs refer to them to look at the structure and make a diagnosis before SLPs continue with treatment.
- What is the role of the speech language pathologist as it relates to voice disorders?
SLPs diagnose voice disorders along with the ENT? and do therapy to help improve the disorder.
- Give 3 examples of professionals who would be on a voice care team?
- ENT
- SLP
- Primary Care Physician
Describe the importance of collecting a clinical case history
: The case history helps gather information which is valuable to identifying the issue and if it is functional in nature. It helps with narrowing down and forming a hypothesis about where the pathology may be.
- Provide 5 examples of important items gathered during the data collection phase of the evaluation
a. Lung capacity
b. S/Z ratio
c. Maximum Phonation Tme
d. Vocal perturbation measures
e. Vocal Noise Measures
Are behavioral observations important? Why or why not.
Yes. They tell a lot about patients, including how they interact with others, if they have anxiety that may be impacting their voice, etc.
- What is the purpose of an oral peripheral examination with a voice assessment?
To determine if there are any structural abnormalities or neurological deficits which may be responsible for the voice issue and need to be examined more closely by an ENT.
- What should the clinician pay specific attention to during an oral peripheral examination?
Neck tension, movement of the larynx, appearance of the structures
- What distinguishes an oral peripheral examination from a cranial nerve examination?
An oral peripheral examination is concerned with the surface anatomy and any deviations from it. However, it can often include elements of a cranial nerve exam inside of it (I think). A cranial nerve exam is focused specifically on testing the functioning of the various cranial nerves through very specific tasks. It often involves asking the client to do something or creating some sort of sensation and seeing if it is received. It can also test reflexes, such as the gag reflex.
Cranial nerves involved with voice and their description
Cranial Nerve Major Function CN VII Facial Motor: Face Sensory: ant. 2/3 of tongue CN VIII Vestibulocohlear Special sensory: hearing CN IX Glossopharyngeal Motor: Pharynx Sensory: post. 1/3 of tongue, pharynx CN X Vagus Motor: Larynx and pharynx Sensory: larynx, viscera CN XII Hypoglossal Motor: Tongue muscles
- One tool for examining laryngeal function via the oral cavity is:
Laryngoscope
- What joint statement was developed by the American Academy of Otolaryngology voice and Swallow Committee and the Special Interest Division on Voice and Voice Disorders of the American Speech-Language and Hearing Association?
It says that clinicians with special training in laryngoscopy are qualified to use it.
- The most important considerations in the selection of any instrument used to evaluate voice are that they meet the criteria of being:
a. Reliable
b. Valid
- What is QOL measure that is reliable and valid?
Voice handicap index
- What does the s/z ratio measure? What is the procedure?
The s/z ratio measures laryngeal airflow. The procedure is done by having the client produce /s/ and /z/ as long as possible through three different trials. This produces the ratio. If it is close to 1 it is a good sign. If it is further from 1, it suggests some type of issue.
- Is it appropriate to do a non-instrumental examination prior to referring for an instrumental examination? Why or why not?
It is appropriate to do a non-instrumental examination beforehand, because it helps gather information and determine if an instrumental examination is actually needed.
- Should Doctors orders be obtained to evaluate and treat a voice client? Is it always appropriate to do an instrumental evaluation before starting treatment with a voice patient?
Evaluation can sometimes be done to evaluate a voice client. However, an evaluation from a doctor should certainly be done before treating the client, in order to make certain there are no organic causes. An instrumental evaluation takes place when the results of a non-instrumental evaluation continue to indicate an issue.
- What is the benefit of using a laryngoscopic procedure?
It improves the accuracy of diagnosis due to being able to physically the vocal structure. This leads to better treatment prognosis.
- List 5 of the most routinely obtained acoustic measures and briefly describe each one:
a. Maximum Phonational Frequency Range—lowest to highest frequency the voice can do
b. Fundamental frequency—vocal fold’s rate of vibration
c. Average/habitual intensity—The average intensity used by the speaking in most vocalizations
d. Intensity variability—The range of intensities used in connected speech
e. Vocal perturbation (jitter and shimmer)—cycle to cycle vocal signal variability
- Define Average fundamental frequency (F0):
The rate of vibration of the vocal folds expressed in Hz. Typically elicited with isolated vowels, and reading or connected speech.
- What is the difference between average fundamental frequency and speaking fundamental frequency?
Speaking fundamental frequency is the average fundamental frequency when it is reported with connected speech.
- What is frequency variability? What would you look for clinically?
Frequency variability is the changes in pitch which occur in a persons voice during typical conversation. Typically 25-30 Hz. Measured with standard deviation?
