Lecture 10 and 11 Therapy 2 and 3 Flashcards
This therapy techniques focuses on modification of deviant vocal symptoms such as breathiness, inappropriate pitch, loudness, etc.
Symptomatic Voice Therapy
What are some of the facilitating techniques for Symptomatic Voice Therapy?
A.) Laryngeal Massage
B.) Chewing
C.) Yawn-sigh
D.) Easy onset Linking
E.) All of the above
E - all of the above
*as well as: tongue stretches, supraglottic relaxation exercises, push-pull exercises, breathing exercises, altering habitual pitch and loudness
Symptomatic Voice Therapy is used for:
A.) decreasing extralaryngeal/supraglottic muscle tension
B.) decrease hard glottal attacks
C.) increase glottic closure
D.) All of the above
D - all of the above
What makes a hard glottal attack bad?
it is a forceful adduction of the vocal folds at the beginning of sound production, resulting in excessive medial compression of VFs which are then blown open forcefully
Match the techniques to their benefits:
A.) Easy Onset lowers larynx, releases suprglottic
squeezing
B.) Yawn-sigh continuous airflow;link vowels &
consonants; elim. glottal attacks
C.) Chewing trains continuous airflow
D.) Chant speak while chewing; disengages
laryngeal tension
Easy Onset - continous airflow; link vowels & consonants; elminates glottal attacks
Yawn-Sigh - lowers larynx, releases supraglottic squeezing, releases larynopharynx
Chewing - Speaking while chewing; disengages laryngeal tension
Chant - train continous air flow
Primary MTD and Secondary MTD can be assessed:
via _____, _______ and _____ palpation and ________.
laryngeal, neck, jaw, endoscopy
The following are ways to address Extralaryngeal Muscle Tension:
A.) Laryngeal massage
B.) Jaw Tension - massage
C.) Ragdoll Exercise
D.) Neck Relaxation Exercises
E.) All of the above
E - all of the above
*as well as: tongue - relaxation stretches, shoulders - relaxation stretches, and progressive relaxation
The order of circumlaryngeal massage a.k.a. digital manipulation
- ______
- Superior cornu of _____
- ______ space
- ______ area
- border of _________ muscle
- hyoid bone (point of major horns)
- TC -thyroid cartilage
- thyrohyoid space
- Suprhyoid
- Sternocleido
Endoscopic evidence of laryngeal muscle tension:
____ compression and _____ medialization
A-P (anterior-posterior)
FVF (false vocal folds)
Techniques to decrease intrinsic or supraglottic tensing:
HINT: Y. T. S. S.
Yawning - lowers larynx, opens supraglottic area
Tongue Stretching - relaxes base of tongue, opens supraglottic area
Slurping Spaghetti - round lips and inhale air; lowers larynx opens supraglottic area and abducts VFs
Silent Laughter - abducts FVFs
Name the different breathing exercises used in Voice Therapy:
HINT: S. S. P. S. S. L.
Sitting and leaning with forward foreams on knees
Standing with arms up and crossed over head
Pavone Exercise
Sustained /f/
Simple verbal instructions
Lying Flat
This type of breathing exercise helps elminate clavicular or shallow breathing
sitting and leaning forward
This type of breathing exercise encourages abdominal breathing and increased lower lateral rib expansion during inhalation
Arms over head
This breathing exercise teaches abdominal breathing and expanded rib posture, also adjusts overall posture including shoulder and lower back position
Pavone Exercise
This exercises forces abdominal inhalation
Sustained /f/ exercise
This exercise is meant to help increase VF adduction in hypofunctional patients (i.e. VF paralysis, paresis, bowing, presbylaryngis)
Push-Pull Exercise
Guidelines for Vocal Hygiene Goals:
______ Vocal Hygiene risks that are ______ to patient
____ _____ give them a ______ list that are not specific to them.
_______ is better when vocal hygiene program is ______ to patient and understands ______.
- Identify, specific
- Do not, laundry
- Compliance, specific, why
This type of therapy is aimed at the modification of the underlying physiology of the voice producing mechanisms: respiration, phonation, resonance
Physiologic Voice Therapy
Logic behind Physiological Voice Therapy:
Based on our expanded _________ of vocal function. _____ balance amongst respiratory support, ______ muscle strength, control and ______ and ______ modification of the laryngeal tone.
knowledge, improves, laryngeal, stamina, supraglottic
This exercise is a series of systematic voice manipulations, designed to strengthen and balance laryngeal musculature, and to improve the efficiency of the relationship among airflow, vocal fold vibration, and supraglottic treatment of phonation.
Vocal Function Exercises
The rationale behind the _____ _______ exercise is that it ______ laryngeal mechanics, ______ laryngeal musculature, ______ balance amongst phonatory systems, and may ______ glottic closure.
Vocal Function, recalibrates, strengthens, restores, improve
Match the tasks of Vocal Function Exercises according to the description:
A.) Warm Up pitch glides up on “oh”, “ol” or “nol”
B.) Expansion sustained ee on pitch w/extreme frontal
focus
C.) Contraction sustained phonation on five pitches
D.) Power pitch glides down on “oh”, “ol” or “nol”
Warm Up - sustained ee pitch w/extreme frontal focus
Expansion - pitch glides up on “oh”, “ol” or “nol”
Contraction - pitch glides down on “oh”, “ol” or “nol”
Power - sustained phonation on five pitches
True or False:
Vocal Function Exercises is useful for clients who only have hypofunctional disorders
False - works on clients who have either hypofunctional disorders or those who have phonotrauma and functional disorders
Hypofunctional - presbyphonia, paresis, and bowing
Phonotrauma & Functional Disorders - decreases medial compression, effective for vocal fatigue
The rationale for ______ ______ ______ exercise is that it facilitates ______ matching, increases _______ inertance, generates a ________ pressure, greater ______ drive, lowers _____ and ______ throat tension.
Semi-Occluded Vocal Tract, impedance, vocal tract (VT), back, respiratory, larynx, decreases
In Semi-Occluded Vocal Tract Exercises you use _____ straws or ______ straws for Hyperfunction.
regular, narrow
In Semi-Occluded Vocal Tract Exercises you use ____ straws for hypofunction.
wider diamter (boba)
True or False:
Resonant Voice Techniques is used for both hypo and hyperfunctional disorders
True
The rationale for the Lessace Masden Resonant Voice is that it may help with _______ matching in _______ (VF paralysis, and paresis) / ______ impact stress for ______ clients and ______ intensity or ease of _____ projection.
impedance, hypofunction, decreases, hyperfunctional, increases, vocal
The rationale for Accent Method is that _____ coordination of ______ and ________. May increase _____ Effect and ______ of ____ approximation for ______. It also _____ medial compression and teaches ______ _____.
improves, respiration, phonation, Bernoulli, increase, VF, hypofunction, decreases, flow phonation
This method requires you to keep sustained voiceless and voiced consonants, sustained vowels, then cv syllables, produced with different rhythmic patterns, and this is done while rhythmically rocking body forward or seated using a drum.
Accent Method
This therapy was specifically developed for patients with Parkinson’s, also been used for patients with CP, and TBI.
Lee Silverman Voice Therapy
The tasks involved in LSVT are:
- Sustained _____ phonation on _____
- _____ glides _____
- ______ glides ______
- Targeting adequate _______ for ______ phrases, sentences, _______ reading and ______ speech.
loud, ah, pitch, up, pitch, down, loudness, functional, paragraph, spontaneous
The rationale for this technique is it increases airflow, decreases medial compression of vocal folds
Flow Phonation
*focus on flowing, connected speech and frontal tone focus without constriction, tension or hard glottal attacks
*BEST for hyperfunction but can be used for hypofunction as well
The protocol for this technique varies but it includes: sustained voiceless and voiced fricatives, glides and nasal consonant in cv form, cup bubble exercise w/and w/o voice, gargle w/ and w/o voice, blowing on long strip of tissue paper w/o voice and then producing ‘oo’ and keep tissue aloft
Flow Phonation
The best therapy task sequence is:
Relaxation Exercises
Breathing Exercises
Voice Exercises
You use this type of ‘voicing’ after surgery
Confidential Voice
The rationale for Confidential Voice Casper is: the ____ remains slightly open, ______ close phase of vibration, _____ of laryngeal muscle tension.
glottis, decreased, absence
In Pre-Surgery care client should _____ adequate ____ support, ______ any extralayrngeal or ______ laryngeal muscle tension, _____ vocal hygiene issues, ___ post-surgical voice therapy technique
train, breath, eliminate, intrinsic, address, train
