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Nature of Disorders of Speech, Voice, Fluency and Swallowing > L11 Voice > Flashcards

L11 Voice Flashcards

1
Q

dysphonia

A

abnormal voice quality

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2
Q

aphonia

A

lack of voice

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3
Q

difference between voice disorder and problem

A
  • Disorder implies that there is some type of mental/physiological impairment
  • Problem is more related to when a person’s voice isn’t congruent to how the person wants it to perform - trans/non binary clients
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4
Q

vocal abuse

A
  • outdated term to describe when people engage in voice misuse leading to a voice disorder
  • judegemental
  • we now use vocal misuse
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5
Q

risk factors for developing a voice problem

A
  • age
  • sex
  • family
  • smoking
  • hearing
  • occupation
  • mental health issues
  • locking voice
  • acid reflux
  • poor posture
  • dehydration
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6
Q

voice characteristics

A
  • stamina
  • pitch
  • loudness
  • tremor
  • flexibility
  • quality
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7
Q

stamina abnormalities

A
  • Run out of breath when I talk
  • Phone calls hard
  • Group talk hard
  • Presentations hard
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8
Q

pitch abnormalities

A
  • Abnormally high/low
  • Monopitch
  • Pitch breaks
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9
Q

loudness abnormalities

A
  • Abnormally high/low
  • Monoloudness
  • Excess loudness variation
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10
Q

tremor

A

Jerky voice quality

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11
Q

flexibility abnormalities

A
  • Lack of dynamic range
  • Voice & pitch breaks
  • Can’t rapidly access voice
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12
Q

what does VTD stand for

A

vocal tract discomfort

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13
Q

signs/symptoms of VTD

A
  • Fatigue
  • Burning
  • Tickling
  • Dryness
  • Iriritability
  • Lump in throat (globus sensation)
  • Aching
  • Pain
  • Mucous
  • Difficulty catching breath
  • Tightness
  • Pushing to get voice out
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14
Q

four classifications of voice problems

A
  1. A lesion on the vocal fold membrane
  2. A neurological voice disorder
  3. A lack of glottic closure
  4. Reflux-related
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15
Q

organic voice disorders

A

aphonia or dysphonia as a result of organic changes to the larynx

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16
Q

characteristics of organic voice disorders

A
  • Mass lesions on the vocal folds
  • Tissue changes in the larynx
  • Alterations to cartilaginous structures
  • Nerve innervation problems
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17
Q

causes of organic voice disorders

A
  • Congenital or acquired
  • Infection
  • Trauma
  • Reflux
  • Other irritants
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18
Q

examples of organic voice disorders

A
  • vocal polyps
  • vocal cysts
  • reike’s oedema
  • laryngopharyngeal reflux
  • post-nasal drip
  • layngeal web
  • sulcus vocals
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19
Q

identify the voice disorder

A

vocal polyps

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20
Q

identify the vocal disorder

A

vocal cyst

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21
Q

identify the vocal disorder

A

reike’s oedema

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22
Q

identify the vocal disorder

A

laryngopharyngeal reflux

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23
Q

identify the vocal disorder

A

post nasal drip

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24
Q

identify the vocal disorder

A

laryngeal web

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25
Q

identify vocal disorder

A

sulcus vocalis

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26
Q

cause of vocal polyps

A

Trauma or environmental (e.g. irritants)

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27
Q

treatment for vocal polyps

A

SLT may help, but may not cure. If incurable, then needs surgery to remove

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28
Q

voice in vocal polyps

A

Rough, probably strained

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29
Q

cause of vocal cysts

A

May be trauma, or spontaneously develop. Could be a fluid-filled sac or plugged mucous-secreting gland

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30
Q

treatment for vocal cysts

A

Usually needs surgery and then SLT

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31
Q

voice with a vocal cyst

A

Rough

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32
Q

cuase of reike’s oedema

A

smoking

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33
Q

treatment for reike’s oedema

A

smoking cessation

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34
Q

voice quality with reike’s oedema

A

Rough, may have stridor

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35
Q

cause of laryngopharyngeal reflux

A

Dietary – pepsin (enzyme) adheres to larynx, activates in the presence of acid

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36
Q

treatment for laryngopharyngeal reflux

A

Gaviscon Advance / PPIs BD

37
Q

voice quality for laryngopharyngeal reflux

A

cuts in and out, may be rough

38
Q

cause of post-nasal drip

A

Nasal irritation. May be environmental (e.g. pollen), idiopathic or secondary to LPR

39
Q

treatment for post-nasal drip

A

Sinus rinsing +/- steroidal sprays

40
Q

voice quality with post-nasal drips

A

May cut in and out, variable quality. Strained or rough if coughing a lot

41
Q

cause of laryngeal web

A

Congenital. Generally only seen in paeds.

42
Q

treatment of laryngeal web

A

Surgical. Note – causes airway patency issues

43
Q

cause of sulcus vocalis

A

Unknown, but possible congenital or through repeated inflammatory processes

44
Q

treatment of sulcus vocalis

A

Surgical

45
Q

voice quality with sulcus vocalis

A

Breathy and possibly rough with likely higher-than-normal habitual pitch

46
Q

characteristics of neurogenic voice disorders

A
  • Depends on nerve lesion
  • Central lesions tend to involve other symptoms
  • Peripheral lesions tend to involve just the voice
47
Q

causes of neurogenic voice disorders

A
  • Acquired neurological diseases (e.g. MND, IPD, MS)
  • Trauma to the head/neck/throat
  • Post-infective (usually respiratory tract infection)
  • Latrogenic (i.e. caused by the doctor: heart/lung/throat surgery)
48
Q

examples of neurogenic voice disorders

A
  • dysarthrias
  • vocal paresis/paralysis
  • presbyphonia
  • spasmodic dysphonia
49
Q

identify the vocal disorder

A

Vocal Paresis/Paralysis

50
Q

identify the vocal disorder

A

Presbyphonia

51
Q

typical diseases causing flaccid dysarthria

A
  • Myasthenia Gravis
  • Motor Neuron Disease/Amyotrophic Lateral Sclerosis
  • Guillain-Barré syndrome
52
Q

voice quality with flaccid dysarthria

A
  • Incomplete glottal closure – sometimes none (aphonic)
  • Weak/slowed vocal fold movement
  • Monoloudness
53
Q

typical diseases that cause spastic dysarthria

A
  • Motor Neuron Disease/Amyotrophic Lateral Sclerosis
  • Cerebral palsy
  • Multiple sclerosis
54
Q

voice quality with spastic dysarthria

A
  • Monopitch, monoloudness
  • Low pitch, pitch breaks
  • Harsh vocal quality, breathy voice
55
Q

typical diseases causing ataxic dysarthria

A
  • Friedrich’s Ataxia
  • Multiple Sclerosis
56
Q

voice quality with ataxic dysarthria

A
  • Harsh vocal quality
  • Monopitch, monoloudness
  • Excess loudness variation
  • Vocal tremor
57
Q

typical diseases causing hypokinetic dysarthria

A
  • Parkinson’s Disease
  • Lewy Body Disease
  • Multiple System Atrophy (MSA)
58
Q

voice quality with hypokinetic dysarthria

A
  • Monopitch, monoloudness
  • Breathy voice (vocal bowing)
  • Low pitch
59
Q

typical dieases causing hyperkinetic dysarthria

A
  • Isolated causes
  • Essential tremor
60
Q

voice quality with hyperkinetic dysarthria

A
  • Monopitch, monoloudness
  • Strained-strangled voice quality
  • Voice breaks
  • Transient breathiness
61
Q

cause of vocal paresis/paralysis

A

Usually acute nerve injury/severing, but may be stroke-related

62
Q

treatment for vocal paresis/paralysis

A

Surgical medialization, voice strengthening

63
Q

voice quality with vocal paresis/paralysis

A

Breathy, low volume, reduced pitch range, increased vocal fatigue. Aphonia if bilateral.

64
Q

cause of presbyphonia

A

Normal, age-related changes

65
Q

treatment for presbyphonia

A

Voice strengthening.

66
Q

voice quality with presbyphonia

A

Breathy, low volume, reduced pitch range, increased vocal fatigue.

67
Q

cause of spasmodic dysphonia

A

Neurogenic, but may be exacerbated by stress. Vocal folds don’t adduct and abduct smoothly, they jerk randomly together

68
Q

treatment for spasmic dysphonia

A

Botox injections. Minimal benefit from SLT.

69
Q

voice quality with spasmodic dysphonia

A

Unstable, jerky quality.

  • Adductor type – harsh quality (90% of cases)
  • Abductor type – breathy, aesthenic
70
Q

functional voice disorders - muscle tension dysphonia

A

dysphonia that occurs as a result of disturbed psychological processes that lead to chronic patterns of misuse/dysfunction of the laryngeal musculature

71
Q

characteristics of functional voice disorders

A
  • Inefficient phonatory pattern
  • Habituated voice misuse
  • Psycho-social factors
  • Tension in intrinsic and extrinsic laryngeal muscles
72
Q

causes of functional voice disorders

A
  • Upper Respiratory Tract Infection (URTI)
  • Associated with organic voice disorder (by compensation)
  • Psychosocial stressors
73
Q

examples of functional voice disorders

A
  • vocal nodules
  • muscle tension dysphonia
74
Q

identify the vocal disorder

A

vocal nodules

75
Q

identify the vocal disorder

A

muscle tension dysphonia

76
Q

cause of vocal nodules

A

Usually phonotrauma (i.e. vocal abuse)

77
Q

treatment for vocal nodules

A

SLT input usually resolves, but entrenched/fibrotic
nodules may need surgery

78
Q

voice quality with vocal nodules

A

Rough, probably strained quality

79
Q

cause of muscle tension dysphonia

A

May be triggered by URTI, trauma or stress

80
Q

treatment for muscle tension dysphonia

A

SLT. (Almost) no role for ENT

81
Q

voice quality with muscle tension dysponia

A

rough, strain

82
Q

psychogenic disorder

A

a dysphonia (impaired or disordered voice) or aphonia (absent voice) where the causative or perpetuating factors are largely of psychological or emotional conflict

83
Q

classification of psychogenic disorders

A
  • classical conversion
  • cognitive behavioural conversion
  • habituated conversion
84
Q

classical conversion

psychogenic

A

Lack of conscious acceptance of psychological problems

85
Q

cognitive behavioural conversion

psychogenic

A

Conscious acceptance of issues, but avoidance of same due to desire to avoid conflict (internal or external)

86
Q

habituated conversion

psychogenic

A

As with type 2, but the source of anxiety is gone, while the musculoskeletal tension remains

87
Q

signs of psychogenic voice disorders

A
  • Low mood
  • Family/interpersonal difficulties
  • Mild-moderate depression
  • Difficulty expressing views/emotions
  • Stressful life events
  • Suppressing anger/frustration
  • Anxiety Burden of responsibility
  • Common to females
  • Over-commitment and helplessness
  • Near normal psychological adjustment
88
Q

Mutational Falsetto/Puberphonia

A
  • Males maintain a high-pitched falsetto voice after puberty
  • Often associated with maternal/parental attachment issues
89
Q

do SLTs diagnose voice problems

A

nope that’s an ENT job

Nature of Disorders of Speech, Voice, Fluency and Swallowing (12 decks)

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