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661 Final > lecture 12 - 17 > Flashcards

lecture 12 - 17 Flashcards

1
Q

list the five groups of phonosurgery

A

removal of pathological tissue; surgical correction of vocal fold(s); restoration of laryngeal neuromuscular function; surgical reconstruction for atypical larynx; laryngectomy

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2
Q

what do intrafold injection, thyroplasty, and arytenoid rotation remediate?

A

they are used to treat unilateral paralysis, bowing, glottic incompetency and are considered surgical corrections of vocal folds via vocal fold medialization

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3
Q

the goal of endolaryngeal microsurgery is ___

A

to remove benign / cancerous lesions by only taking as much tissue as necessary and preserving as much of the mucosa as possible

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4
Q

pharmacological treatment for vocal (essential) tremor includes ___

A

propronolol : beta blocker :: primidone : anticonvulsant

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5
Q

pharmacological treatment for vocal fold papilloma includes ___

A

interferons, indole 3 carbinol (suppresses growth), cidofovir (injective), methatrexate (chemo)

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6
Q

pharmacological treatment for spasmodic dysphonia includes ___

A

botox injections

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7
Q

what is the role of voice tx in the treatment of spasmodic dysphonia?

A

to eliminate negative compensatory strategies; to improve breath support; to decrease muscle tension in the face, head, neck, and shoulders

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8
Q

what are the therapy approaches used to treat vocal (essential) tremor?

A

decrease amplitude of tremors by: decreasing negative compensatory strategies, experimenting with pitch and loudness, staccato speech / easy onset, training breath support

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9
Q

in addition to voice, lee silverman voice tx improves ___

A

swallowing, articulation, glottic closure, vocal quality

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10
Q

describe lee silverman voice technique

A

used for parkinson’s pts: sustained LOUD phonation of /a/; pitch glides up and down; functional loud voice during conversation

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11
Q

what are the treatment approaches used to address TBI, hyperkinetic dysarthria, and cerebral palsy?

A

address breathing; teach easy onset / linking; utilize aspiration (air flow before voicing); use lee silverman voice therapy

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12
Q

describe the pediatric larynx anatomically

A

shorter vocal tract; velum and epiglottis are close in proximity; vocal folds are thicker and lack a vocal ligament; arytenoids are large; larynx is high in position; hyoid bone and thyroid cartilage are contiguous

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13
Q

describe the time line of lamina propria development in children

A

one layer at birth; all layers begin to develop at puberty and finish developing by age 17

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14
Q

describe acoustic-aerodynamic FINDINGS in children

A

sparse; increased jitter in children with nodules than w/o; increased jitter and shimmer in males than females; indiscernible pathological vs non pathological voice

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15
Q

describe acoustic-aerodynamic NORMS in children

A

f(0) is high; sub glottal pressure is 50-100% greater; lower mean airflow rates; lower maximum phonation times; less lung volume

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16
Q

describe respiratory differences in children

A

lung volume is less because rib excursion is greater and rib use vs abdominal use for breathing is greater; most kiddos are lateral breathers

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17
Q

name congenital disorders in children

A

laryngomalacia; laryngeal cleft; subglottic stenosis; anomalies, including: laryngeal paralysis, laryngeal web, congenital cyst, and vocal fold papilloma

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18
Q

describe laryngomalacia in children

A

CONGENITAL
soft laryngeal cartilages that may collapse into the airway during breathing; most common cause of infant inspiratory stridor

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19
Q

describe laryngeal cleft in children

A

CONGENITAL
may be genetic; a cleft on the posterior portion of the cricoid cartilage causes narrowing of the airway causing stridor, dyspnea, aspiration, and feeding difficulties; managed surgically

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20
Q

describe subglottic stenosis in children

A

CONGENITAL but may also be acquired
any narrowing of the tissue below the level of the glottis; third most common congenital condition in children, characterized by stridor, low pitch cough, nostril flaring, chest wall movement; managed surgically

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21
Q

describe acquired voice disorders in children

A

vocal fold nodules (most common); vocal fold paralysis via trauma to the RLN; laryngopharyngeal reflux

22
Q

adults who have had ___ have a greater risk for voice pxs as an adult

A

nodules as children

23
Q

describe vocal fold characteristics in persons older than 65 years of age

A

laryngeal cartilages calcify; decreased blood flow; lamina propria thickens (less : elastin-collagen :: more : fibrotic tissue); atrophy of sub mucous glands; atrophy of muscles; decreased neuronal firing rates for thyroarytenoid and cricothyroid

24
Q

name the most common disorders for the elderly voice

A

laryngeal cancer (men); vocal fold paralysis; edema; nodules and polyps (women)

25
Q

describe irritable larynx syndrome

A

hyperkinetic laryngeal dysfunction triggered by an internal or external force; causes laryngeal muscle spasms, airway obstruction, and episodic cough

26
Q

what are the suspected causes of irritable larynx syndrome?

A

viral infections in the central nervous system; abnormal regrowth of damaged sensory nerves; emotional states and defense reactions; asthma-like upper airway reactions

27
Q

which demographics are affected by irritable larynx syndrome?

A

85% women around age 50 of which 21% go on leave or disability

28
Q

what are the most common symptoms / characteristics of irritable larynx syndrome?

A

the most dominant symptom is laryngospasm (others include chronic cough, muscle tension dysphonia, globes sensation, extra laryngeal muscle tension)

29
Q

describe treatment of irritable larynx syndrome

A

three levels: minimize sensory stimuli and minimize exposure, reprogram maladaptive responses by decreasing muscle tension (utilizing pursed lip breathing), and reprogram the central nervous system via motor relearning and centrally active medications

30
Q

describe paradoxical vocal fold dysfunction motion

A

an upper airway disorder resulting in episodes of partial to complete vocal fold adduction during inhalation; decreased airway protection; not a disorder of vocal quality; often misdiagnosed as asthma

31
Q

treatment of paradoxical vocal fold dysfunction motion includes ___

A

breathing recovery training: body awareness training via relaxation activities, training abdominal breathing and rib expansion, rapid deep nasal sniff then complete exhalation

32
Q

how do we work on developing gender neutral pitch range?

A

gender ambiguous pitch range is 155 - 185 Hz; achieve this without strain or muscle tension and by using resonant voice tx

33
Q

what aspects of pitch do we work on in transgender voice tx?

A

comfortable sFo (speaking fundamental frequency) which is one semitone above and one semitone below the target sFo

34
Q

in ___ patients, hormone tx often lowers their habitual pitch

A

female to male trans*

35
Q

intonation: gender communication differences

A

women use more intonation and stress to emphasize meaning; men are monotone and use loudness to emphasize meaning

36
Q

resonance: gender communication differences

A

feminine resonance is in the head and towards the front (as seen in high, front spread vowels), accomplished via /i/-ification of vowels and lessac masden voice tx

37
Q

articulation: gender communication differences

A

women tend to elongate vowels, pronounce words with greater precision, demonstrate easy onset / linking, and have greater mouth opening and lip rounding

38
Q

rate and intensity: gender communication differences

A

men speak louder and faster; women pause more frequently and prolong individual phonemes

39
Q

syntax: gender communication differences

A

women use more tag clauses: “…i think” and conditional clauses: “unless…”

40
Q

pragmatics and discourse: gender communication differences

A

women are more elaborative, desire intimacy (proximity), seek consensus before making decisions, communicate to build relationships, provide feedback to their communication partner(s), and likely go back to abandoned topics-ideas

41
Q

who are professional voice users?

A

singers, actors, teachers, coaches, choreographers, receptionists, etc.

42
Q

what are some etiologies of voice disorders in actors and singers?

A

muscle tension, phonotrauma, poor-absent vocal training, poor performance-work environment; emotional reactions to life stressors, use of unnatural or character voices for extended periods of time

43
Q

describe vocology

A

the study of voice; the science and practice of voice habilitation with an emphasis on assisting in performing whatever function needs to be performed; aims to strengthen the voice to meet specific needs-demands

44
Q

which demographics are affected by laryngeal cancer?

A

typically 60-65 y/o men who have history of smoking and alcohol consumption; 3 men : 1 woman; smoking and alcohol increases risk by 22 times

45
Q

etiology / causal factors of laryngeal cancer

A

smoking and alcohol; environmental irritants; chemicals; asbestos

46
Q

signs and symptoms of laryngeal cancer

A

perceptual : hoarseness, stridor, coughing, swallowing pxs, globes sensation; throat clearing :: signs : lump in neck, tender laryngeal area, lumps, lesions on vocal fold(s)

47
Q

what are the components of diagnosis in laryngeal cancer?

A

head and neck exam; videostroboscopy; CT scans / MRIs; biopsy and histological analysis; x ryas; modified barium swallow

48
Q

describe treatment options of laryngeal cancer

A

radiation tx, chemotx, surgery, surgery AND radiation

49
Q

what are the side affects of radiation tx for laryngeal cancer?

A

loss of salivary / mucous glands; xerostomia; muscle atrophy; fibrosis of soft tissues; keratosis; edema; dysphagia; loss of taste; tooth damage; mucositis; scarring

50
Q

describe pre and post op roles of SLPS re: laryngeal cancer

A

pre op : educate the pt about surgery and surgery outcomes, address pt concerns, provide appropriate assessments, provide family support :: post op : review post op discussion, assess voice-speech-swallowing, discuss rehabilitation plan(s)

51
Q

what is a tracheal esophageal puncture?

A

TEP is a surgical procedure where a hole is made through the tracheal wall into the esophagus; a prosthesis-shunt is inserted to direct air into the esophagus; air enters the PE segment, creating sound that is then passed through the oral and nasal cavities to be resonated-articulated

52
Q

name the different methods of laryngeal speech

A

artificial larynges (pneumatic : tokyo speech aid :: electronic : cooper rand and elextrolarynx); esophageal speech; tracheoesophageal puncture

661 Final (2 decks)

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