Lecture 1 Foundation Flashcards
What is the primary function of the larynx?
Airway protection
How does the larynx protect the airway during swallow?
Epiglottis covers the trachea
How does the larynx protect the airway during voicing?
Vocal fold adduction
What are the secondary functions of the vocal folds?
Voicing, swallowing
What are 5 broad categories that can cause voicing difficulties? (Give example of each)
Anatomical deviation, (ex: polpys), disease (ex: laryngitis, laryngeal cancer), emotion (voice “tells on you”), misuse(screaming), overuse (profession)
What is the primary function of the airway?
Bringing air in and out (duh)
What are the ways in which the vocal folds can be altered?
Shape, tension, length
What are the “valves” of the entire oral mechanism and laryngeal vestibule?
[Vocal folds (true), false vocal folds, arytenoids, aryepiglottic folds, epiglottis, velopharyngeal port,] main 5 tongue, lips
What are the “valves” of the laryngeal vestibule?
True vocal folds, false vocal folds, arytenoids, epiglottis, velopharyngeal port
Explain the concept of “valves
in relation to the vocal mechanism
Closing the different
“valves” prevents the air from escaping. Opening them allows air to escape
What is the position of the vocal folds during inspiration?
Abducted
What is the position of the vocal folds during expiration?
Abducted, more closed than during inspiration
If you can hear audible sound during expiration, what does this tell you?
The vocal folds are not fully opening
What are the cavities involved in resonance of the voice?
Vocal folds(vibrating), pharynx, oral cavity, nasal cavity
How are voices different?
The difference in size of the pharynx, oral ccavity, nasal cavity, vocal folds
When do the aryepiglottic folds valve (adduct)?
Vigorous valving conditions (ex: severe coughing)
When do the false (ventricular folds) valve (adduct)?
Vigorous valving conditions (ex: severe coughing)
When do the true vocal cords (thyroarytenoid muscle) valve (adduct)?
Always during swallowing
What factors in the larynx can change based on our emotional state?
Vertical positioning of the larynx, relative relaxation of the vocal folds, posturing and relaxation of the muscles of the pharynx and tongue
What should we keep in mind with regards to emotion when treating a patient?
Treat the whole person, recognize voice changes with mood state and assess voice in various settings
How is meaning picked up in the voice?
Both the sound of the voice itself, and use of paralinguistic factors like stress.
What is the linguistic function of the voice?
To express linguistic meanings in addition to the words said, and to express emotion (tone of voice, prosody, pitch, stress)
Why is it difficult to establish normative incidence and prevalence data about voice disorders?
Practically everyone has had a temporary change in voice due to a cold
What is the range of prevalence numbers around children?
Some say as low as 4%, others as high as 20-30% (but data is lacking
What is the range of prevalence numbers around voice disorders in the elderly?
29% current 47% lifespan
What is the range of prevalence numbers around voice disorders in teachers?
Prevalence rates range from 4% to 57.7% (huge disparity) POINT: teachers and other professional voice users have much higher risk
What is the range of prevalence numbers around voice disorders in student SLPs?
12% in one study. Higher than average student population
What are the two types of functional voice disorders?
Muscle tension dysphonia and Psychogenic voice disorders
What is the most common voice disorder?
Muscle tension dysphonia
What is muscle tension dysphonia?
A functional voice disorder where the muscles of the vocal systems are overused (too much muscular effort to phonate. It can lead to issues over time such as polyps, nodules, etc.
What is psychogenic dysphonia?
Dysphonia resulting from some kind of psychological trauma. Not the person willfully not speaking normally. Typically needs some sort of counseling with it to see improvement
What is conversion aphonia?
Complete loss of voice after a trauma (psychogenic)
What are organic voice disorders?
Voice disorder resulting from a structural deviation of the vocal tract (ex: cleft palate, laryngeal cancer). Need surgical intervention, potential SLP intervention afterward
What is a neurogenic voice disorder?
A voice disorder with neurological origins (originating in the brain, nerves, etc.) Ex: paralyzed vocal cord after lesion effecting CN. Not typically fully treatable by SLP, but can maximize function
What are the typical elements of a voice assessment?
Case history, Viewing the structure, measuring of respiratory volume/performance, Acoustic measures of the voice, survey about patients perception of their voice/ its impact on life/profession, diagnostic probing (testing stimulability by introducing a voice technique)
How does emotion effect the larynx/voice?
Controlling respiration (shortness of breath), relaxation of the VF, posturing, relaxation of the muscles of the pharynx and tongue, raised height results in tight, tense position
How big of a gap should there typically be between the hyoid bone and the larynx?
1 finger
When do babies stop sounding “alike”?
After 6 months (sound like primary language, prosody colors vocalizations). Sound influenced by mood.
What is suprasegmental phonation?
vocal patterns throughout speech (ex: where pitch is applied, where stress is applied)
What is suprasegmental voicing?
jargon with suprasegmental aspects (pitch, stress, etc)
What percentage of adults have a voice disorder at a given time? Lifetime?
3-9%. 30%
What are the 7 causal classifications of voice disorders?
laryngeal problems-structural, inflammatory conditions, trauma or injury, systemic conditions, non-laryngeal aerodigestive disorders, psychiatric/psychological disorders, neurological disorders
What is the SLP’s role when treating organic voice disorders?
Improve physiological function after structural problem is stabilized
What is the SLP’s role when working with neurogenic voice disorders?
maximize function to near normal levels (can’t cure) Assess respiratory volumes, expiratory control, visualize paralyzed VF
What are symptoms of muscle tension dysphonia?
Gradual onset, eventual pain, discomfort in throat, fatigue, effort increase with voice use
What does an SLP refer to an ENT for?
ID of the problem, medical treatment
What does an ENT refer to an SLP for?
To evaluate and diagnose voice problem, respiration, phonation, and resonance components
What are other specialists SLPS may work with on an organic voice disorder?
Physical medicine, respiratory therapist, surgeon, nursing, ENT
How long does it typically take to treat puberphonia?
one to two visits
