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Voice and Upper Airways Disorders > Hypertension and Muscle Dysphonia > Flashcards

Hypertension and Muscle Dysphonia Flashcards

1
Q

medial compression

A

the force that 1 vf exerts on the other

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2
Q

perfect amount of medial compression

A

enough to hold the air under the vfs but also be set into motion with the least amount of effort

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3
Q

hypofunction

A
  • vfs are blown apart and don’t provide enough resistance
  • breathy quality
  • decreased utterance lenght
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4
Q

hyperfunction

A
  • vfs are offering too much resistance to the outgoing airstream
  • takes a lot of effort
  • once there is vibration, it is very tense resulting in strained or stangled vocal quality
  • wastage of air
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5
Q

terminology for voice disorders

A

different people will use different words for the same thing

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6
Q

SLP rules with hypertension

A

all voice disorders must have a doctoral diagnosis before treatment, and you cannot make the medical diagnosis

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7
Q

hoarseness of more than 2 weeks

A
  • they need to go see a doctor
  • could be a sign of neuromuscular disorder (thyroid disorder)
  • could be nodules, polyps, chronic laryngitis, cancer
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8
Q

ulcer for more than 2 weeks

A

they need to go see a doctor

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9
Q

2 types of dysphonia

A
  1. primary MTD
  2. secondary MTD
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10
Q

primary MTD

A
  • functional disorder
  • there is nothing wrong with the vfs (anatomically typical), but patient uses hyperfunctional voice habitually
  • can unintentionally become a habit because of work and psychological effects
  • we have to break that phonatory set so that they can habituate a new phonatory set
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11
Q

secondary MTD

A
  • a compensatory strategy for some organic problem
  • if the vfs are atypical, phonation is going to be atypical
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12
Q

2 step therapy approach for secondary MTD

A
  1. set the stage for the vf anatomy to normalize
  2. habituate a less effortful pattern
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13
Q

signs during diagnostic and what to do

A
  • giving client a hearing test
  • if they have habituated the pattern, you need to help them break that habit
  • perceptual evaluation
  • CAPE-V
  • looking component during evaluation
  • when running out of air, patient will squeeze causing tension
  • patient’s neck
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14
Q

giving client a hearing test

A
  • sometimes it might just be poor hearing
  • not closing the feedback loop
  • getting louder so that they can hear themselves
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15
Q

perceptual evaluation

A
  • listen for typical to somewhat elevated pitch
  • listen for typical to elevated loudness
  • listen for quality: harsh, tense, strained, strangled
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16
Q

looking component during evaluation

A
  • posture
  • tense or relaxed when standing
  • tense or relaxed when sitting
  • if body is tense, so will larynx
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17
Q

looking component during evaluation: watch breathing

A
  • may find inefficient breathing
  • clavicure breathing
  • also means inefficient breath support
  • common for gasping or big breaths to occur if patient uses inefficient breathing techniques
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18
Q

the patient’s neck

A
  • we do not touch the neck, we palpate the neck
  • feeling with fingertips
  • when palpating, looking for areas of nodularity
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19
Q

neck: feeling with fingertips

A
  1. muscles on the sides of the neck (do they have a little give or are they rigid)
  2. move the larynx
  3. check the position by finding the gap between superior horn and greater horn (if gap is not found, larynx is elevated)
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20
Q

asking the patient questions

A
  • if they don’t answer them in some manner
  • could report that talking is an effort and get tired the longer that they talk
  • asking patient about vocal fatigue
  • any pain, tightness, or earache?
  • any tension in your upper shoulders or upper chest?
  • if it feels like there’s something in your throat
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21
Q

asking patient about vocal fatigue

A
  • detrioration in vocal quality as the day goes on
  • better voice in the morning than later in the day
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22
Q

any pain, tightness, or earache?

A

muscle insertion

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23
Q

any tension in your upper shoulders or upper chest?

A

muscle insertion

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24
Q

if it feels like there’s something in your throat

A

globus sensation, which is a nervous lamp in your throat

25
Q

holistic approach to therapy

A
  • using many different facets
  • direct intervention to break habits
  • environmental and lifestyle modifications
26
Q

holistic approach to therapy: physiologic aspects

A

treat vfs like a muscle

27
Q

holistic approach to therapy: psychodynamic approach

A

always a psychosocial component

28
Q

holistic approach to therapy: facilatory techniques

A
  • facilitate voice production in a healthy manner
  • how to promote voice that is less effortful and free of tension
  • your client will only be as good at your techniques as your explaining, modeling, and coaching
  • confidential voice
29
Q

confidential voice

A
  • train your patient to use a breathy, low volume of voice
  • talk like there’s a baby in the room and you don’t want to wake them
  • talk to somebody like you’re standing 2-3ft from them
  • do not let the patient whisper
  • all about the airflow with relaxed vfs
  • can’t go to this immediately, vfs must be loosened up
30
Q

can’t go into confidential voice immediately, vfs must be loosened up

A
  • helps lower larynx
  • use the entire vocal tract
  • spread the voice out
  • hear an improved quality
31
Q

lips trills

A
  • train the person to make full use out of the resonatory tract and get the full voice out of the throat
  • warm-up and habit breaker for the session
  • break the habit of laryngeal only voice
  • articulators have to be properly relaxed
  • using hands to help motor learning
32
Q

lip trills: using hands to help motor learning

A

learning a skill by pairing it with a motor skill

33
Q

easy onset

A
  • direct technique to promote a less effortful technique
  • purpose is to start phonation off with a breathy attack
34
Q

easy onest: steps

A
  • start air flowing through the vfs before phonation
  • overtly pairing it with the /h/ and a vowel
  • as developed, slowly fade the /h/
  • habit breaker and trainer
  • make sure patient isn’t forcing the /h/
35
Q

yawn/sigh technique

A
  • start utterance with a yawn, which opens up the vocal tract and relaxes it
  • then sigh the utterance out
  • 1 continuous movement
36
Q

yawn/sigh technique could pair with ___ ___ and ___ ___

A

easy onset, continuous voicing

37
Q

how does the yawn/sigh technique pair with easy onset and continuous voicing?

A

yawn in and /h/ out during the sigh

38
Q

continuous voicing

A

keep voicing going throughout the entire utterance

39
Q

chant talking

A
  • start phonating and don’t stop
  • mouth is open a little bit more
  • expands the resonatory system, which facilitates production of lower pitch and larynx drops
  • analogous to the continuous voicing
40
Q

chewing

A
  • opens up the vocal tract while also dropping the larynx
  • not a facilitator, but good for starting the session
  • once movement is established, add the voice
41
Q

chewing: description

A

want to phonate as if you were chewing 3 saltines between your back molers

42
Q

humming

A
  • opens up the entire vocal tract
  • warm-up
  • brings voice into a forward focus
43
Q

humming: brings voice into a forward focus

A

voice not in the throat but the entire vocal tract including the areas in your head

44
Q

straw technique/semi-occluded phonation

A
  • start of the session
  • puts voice in the frontal focus
  • almost like playing a kazoo
45
Q

circumlaryngeal massage: step 1

A
  • locate the hyoid bone
  • then gently move the hyoid bone side to side
46
Q

circumlaryngeal massage: step 2

A

pressure in a circular motion

47
Q

circumlaryngeal massage: step 3

A
  • move to the thyroid cartilage
  • once located, put fingers across both sides and provide a low pressure massage downward
48
Q

circumlaryngeal massage: step 4

A
  • gently wiggle thyroid cartilage from side to side
  • clicking is normal
49
Q

circumlaryngeal massage: step 5

A
  • small circular motions on the side of thyroid cartilage
  • can gently hum or remain silent
50
Q

when completing the circumlaryngeal massage, apply

A

small amount of pressure with thumb and fore finger

51
Q

CM technique is not for SLP to perform on patient…

A

SLP teaches patient how to perform on themselves

52
Q

dynamic stretching is a good substitute for

A

circumlaryngeal massage

53
Q

dynamic stretching: step 1

A

grab onto the top of the shoulder and circle the shoulder around backward, then do the other side

54
Q

dynamic stretching: step 2

A
  • interlace hands with thumb hanging down and place behind the neck digging thumbs underneath the skull
  • then nod your head up and down gently on the axis vertebrae
  • then also side to side
55
Q

dynamic stretching: step 3

A

circles on the jaw up and back and near the cheek bones

56
Q

dynamic stretching: step 4

A
  • brings fingers up to temples up and backward and do circular motion
  • hands: 1 on top of the scalp, other behind
  • then circle scalp on the skull
57
Q

with dynamic stretching, you do not have to

A

complete the entire sequence

58
Q

may not be good as a primary relaxer because

A

it tenses other muscles

59
Q

relaxation (tense and then relax)

A
  • start with the bigger muscles and end with the smaller muscles
  • if unable to visualize, may not be a good technique

Voice and Upper Airways Disorders (19 decks)

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