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Voice Disorders > Organic Disorders > Flashcards

Organic Disorders Flashcards

1
Q

What are the characteristics of organic disorders vs functional disorders

A

Organic: Purely organic & Typically abnormal anatomy, tissue changes
Functional: May be wholly functional, may have organic factors, typically normal anatomy

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2
Q

What can functional misuse lead to?

A

organic changes

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3
Q

What is functional misuse?

A

inadequate breath support
hard glottal attack
supraglottal squeeze

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4
Q

What is the most frequently occurring voice disorders?

A

nodules

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5
Q

What are the organic classifications?

A
  1. Congenital - web, laryngomalacia
  2. Misuse/abuse: lifestyle - reflux (diet), Reinke’s edema (smoking), personality (nodules)
  3. Disease - cancer
  4. Trauma -cartilage dislocation
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6
Q

How many people miss a day at word due to a voice problem?

A

28 million people

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7
Q

What are vocal fold nodules?

A
  • bilateral
  • Benign mass on medial Vocal fold surfaces
  • develop at the margin or junction of the anterior and middle two thirds of the vocal fold
  • somewhat like callouses and blisters
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8
Q

What causes vocal fold nodules?

A 
-misuse/abuse: yelling
got sick, coughing
-throat clearing
-talking too loudly
-speaking/singing in a pitch outside the normal mode of phonation
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9
Q

What are the signs/symptoms of vocal fold nodules?

A
  • hoarseness
  • rough voice
  • increased vocal effort
  • vocal fatigue/strain
  • loss of upper range
  • voice variability
  • VF edema
  • hourglass closure
  • decrease VF vibration
  • hearing loss
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10
Q

How do people who have vocal fold nodules and a hearing loss talk?

A

loud

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11
Q

What is the hourglass closure?

A

Vocal folds meet in the middle but there is a gap in front and large gap posterior.

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12
Q

What is a posterior chink?

A

An opening in the posterior part of the vocal folds.

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13
Q

Why do vocal fold nodules impact higher pitches?

A

Vocal folds stretch to create higher pitch

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14
Q

What happens if a female has a posterior chink?

A

It’s okay for a female has a posterior chink but not male.

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15
Q

______ _____ turns into very soft vocal fold nodules.

A

Pre-nodular swelling

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16
Q

When do you start to see vocal fold nodules?

A

When they start to get hard.

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17
Q

How do the nodules impact the vocal folds?

A

Take up space and VF can’t touch.
There is air leak
voice is breathy and hoarse

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18
Q

Look at vocal fold nodule pictures

A

Label posterior chink

  • vocal fold edema around vocal fold nodules
  • VF edema
  • vascularity is being pushed to the surface
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19
Q

What is a polyp?

A

soft mass

  • usually unilateral
  • originates in the superficial layer of lamina propria
  • usually in the middle one third of the menbranous vocal fold
  • polyps stem off vocal folds
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20
Q

What is the etiology of a polyp?

A

misuse/abuse

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21
Q

What are the types of polyps?

A
  • Fibrous
  • hemorrhagic
  • pedunculated
  • sessile
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22
Q

What is a fibrous polyp?

A

Fluid filled; fluid clear to opaque

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23
Q

What is a sessile polyp?

A

blister like

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24
Q

What is a pedunculated polyp?

A

Foot-like projection

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25
Q

What is a hemorrhagic polyp?

A

Red blood filled

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26
Q

A polyp can cause an issue on the opposite vocal fold due to what?

A

reactive swelling (VF edema)

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27
Q

Can there be two polyps on the vocal folds?

A

Yes, in different locations.

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28
Q

If a polyp is pedunuculated there is a chance of what?

A

voice variability

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29
Q

What does yellow around the vocal folds indicate when there is a polyp or there was a poly?

A

It’s trying to heal or it’s on its way to heal.

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30
Q

What are the signs and symptoms of a vocal fold polyp?

A
  • hoarseness
  • rough voice
  • increased vocal effort
  • vocal fatigue/strain
  • breathing problems (dyspnea) depending on size
  • voice variability (especially if pedunculated)
  • VF edema (reactive swelling)
  • throat clearing
  • globus sensation (notes and book)
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31
Q

What does a patient with a polyp mean when they complain of global sensation?

A

They have a sensation of something in their throat.

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32
Q

_____ ______ is when a patient complains of feeling something in their throat?

A

Global sensation

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33
Q

Look at polyp pictures on power point and book.

A

Label:
-Pedunculated polyp
Fibrous polyp
-yellow area trying to heal

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34
Q

What is a cyst?

A

A benign mucous/fluid filled opaque lesion below vocal fold surface.
-anterior 2/3 posterior 1/3

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35
Q

What are the etiologies of cysts?

A
  • entrapment of vocal fold lining (under the lining)
  • plugged mucous-secreting gland
  • vocal misuse/abuse
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36
Q

What is a laryngocele?

A

cyst in laryngeal cavity

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37
Q

A _________ is a cyst in a laryngeal cavity.

A

laryngocele

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38
Q

What are the signs and symptoms of a patient with a cyst?

A
  • hoarseness
  • rough voice
  • increased vocal effort
  • vocal fatigue strain
  • vocal fold edema (reactive swelling)
  • throat clearing
  • globus sensation
  • no upper range
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39
Q

Cysts result typically from what?

A

misuse/abuse

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40
Q

What is the defining characteristic of a cyst?

A

Pretty round and spherical

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41
Q

What do you report when you cannot differentiate between a cyst or polyp on the right vocal fold?

A

A right vocal fold lesion

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42
Q

How can a cyst disappear?

A

More misuse/abuse

vocal rest

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43
Q

A ______ cyst can develop when there is damage to a gland.

A

ganglion

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44
Q

Look at cyst pictures on power point and book.

A

-cyst on superior surface

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45
Q

What is papilloma?

A

HPV wart-like benign growths of the larynx (papillomoatosis)

-it might not surface for a while

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46
Q

What are the etiologies of papilloma?

A
  • acquired at birth
  • oral sex
  • unknown
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47
Q

How can papilloma be cured?

A

It can never be cured.

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48
Q

How many strains of HPV can cause papillomatosis?

A

60

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49
Q

Look at papilloma pictures on power point and book.

A

Notice the anterior commisure

-supraglottal papilloma

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50
Q

What is a granuloma?

A
  • A benign polyp specifically on vocal process.
  • can be unilateral or bilateral
  • It’s a polyp but more defined
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51
Q

What muscle attached to the vocal process?

A

thyrovocalis muscle

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52
Q

A granuloma is a ______ but more defined.

A

polyp

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53
Q

What exacerbates a granuloma?

A

clearing of throat

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54
Q

What are the etiologies of a granuloma?

A
  • laryngopharyngeal reflux

- intubation due to surgery or coma

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55
Q

What can cause laryngopharyngeal reflux?

A 
Diet: -soda
- tomatoes 
- chocolate
- citrus 
-spicy foods
- high fat
- caffeine
- alcohol-
-dehydration
-lifestyle: smoking
-eating too late
eating too much at once
exercising too soon
being overweright
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56
Q

Explain how intubation can cause a granuloma?

A

Tube is placed down through larynx into trachea to help person breathe. The tube sits on back of larynx, tube rubs on vocal process area.

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57
Q

laryngopharyngeal reflux is also known as _____ reflux.

A

silent

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58
Q

What is the first tissue that gets affected by the laryngopharyngeal reflux?

A

Interarytenoid tissue, it gets bumpy (pacadermia) and purple

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59
Q

What happens when a granuloma is too big?

A

It can affect airway and cause breathing problems

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60
Q

What is the size of a granuloma?

A

All different sizes, the longer is there the bigger it will grow.

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61
Q

What causes dry cough which is a symptom of the presence of a granuloma?

A

laryngopharyngeal reflux can get into nasal cavity and cause post nasal drip and dry cough.

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62
Q

Where do granulomas develop?

A

vocal process

63
Q

How do you treat granulomas?

A

Surgery, but if it does not work address what causes the granuloma.

64
Q

What are the signs/symptoms of the presence of a granuloma?

A
  • globus sensation
  • heartburn/indigestion (reflux type)
  • excessive throat clearing
  • dry cough
  • post nasal drip
  • breathing problems (size dependent)
  • may be pedunculated.
65
Q

What are the organic disorders that can be pedunculated?

A

polyps and granulomas

66
Q

Look at pictures of granulomas.

A

Identify the granulomas on right vocal process and the one developing on left vocal process.

67
Q

Besides surgery, what is another way to treat granulomas?

A

Proton pump inhibition

68
Q

What happens if the granuloma is too big?

A

It will obstruct air way and cause breathing problems.

69
Q

A _____ _____ is a pre-granuloma.

A

contact ulcer

70
Q

What is a contact ulcer?

A
  • Pre-granuloma

- Raw sores on mucous membrane overlying vocal process of arytenoid

71
Q

What does a contact ulcer look like?

A

It starts looking white, then reddish, raw and mad.

72
Q

A contact ulcer can feel mild pain like a sore throat causing ____ _____.

A

throat clear

73
Q

What are the etiologies for a contact ulcer?

A
  • misuse/abuse
  • laryngopharyngeal reflux
  • smoking
  • intubation
74
Q

With a contact ulcer, erythema is evident where?

A

vocal process area

75
Q

What are the signs/symptoms of a contact ulcer?

A
  • hoarseness
  • globus sensation
  • mild pain when voicing or swallowing
  • throat clearing
  • erythema
76
Q

How often do speech pathologists see patients with sulcus vocalis?

A

Not too often, and it is not seen in children.

-Don’t come to clinic because they don’t always have voice problems.

77
Q

What is sulcus vocalis?

A

Thining or absence of superficial lamina propria

-ditch running through vocal fold

78
Q

_____ ______ is thinning or absence of superficial lamina propria or a ditch running thorough vocal fold.

A

sulcus vocalis

79
Q

Sulcus is latin for what?

A

cleft, furrow

80
Q

What is the etiology of sulcus vocalis?

A

unknown-developmental?
genetic?
post hemorrhage?
Book: linked to history of smoking

81
Q

Is sulcus vocalis unilateral or bilateral?

A

Both

82
Q

Look at pictures of sulcus vocalis.

A

Identify the bilateral sulcus vocalis.

identify unilateral sulcus vocalis

83
Q

What are the signs/symptoms of sulcus vocalis?

A

-may not have voice problems
-harsh voice
hoarseness
-high pitch
abnormal VF vibration

84
Q

When are sulcus vocalis disocvered?

A

When patients comes for another voice problem.

85
Q

How do you treat laryngomalacia?

A

Need surgery to fix it.

86
Q

Name congenital laryngeal conditions.

A
  • laryngomalacia
  • subglottal stenosis
  • esophageal atresia
  • tracheoesophageal fistula
87
Q

What is laryngomalacia?

A

Cartilage fails to stiffen which cause the collapse of epiglottis into airway.

88
Q

laryngomalacia causes ______ issues.

A

breathiness

89
Q

Diagnosis of laryngomalacia is by clinical manifestation of what?

A

inspiratory stridor

90
Q

Sometimes a person may _____ laryngomalacia.

A

outgrow

91
Q

What is subglottal stenosis?

A

Narrow subglottal space (Narrowing below the vocal folds/glottis)

92
Q

What is subglottal stenosis associated with?

A

malformed cricoid cartilage

93
Q

What causes acquired subglottal stenosis?

A

prolonged intubation (intubation trauma)

94
Q

______ ______ is a narrow subglottal space.

A

Subglottal stenosis

95
Q

What is esophageal atresia?

A

Occlusion of esophagus. Esophagus wasn’t connected to stomach.

  • Messed up sphincters
  • causes dysphagia
96
Q

Esophageal atresia can cause?

A

dysphagia

97
Q

_____ ______ is an occlusion of the esophagus; esophagus was not connected to stomach.

A

Esophageal atresia

98
Q

What is a tracheosophageal fistula?

A

Openings between trachea and esophagus. It may occur with esophageal pouch.

99
Q

Where does the tracheoesophageal fistula occur?

A

Back of trachea wall to front of esophagus wall.

100
Q

_____ ______ develops abnormally. Designed to be there for something to pass.

A

tracheoesophageal fistula

101
Q

What is the tracheoesophageal fistula designed for?

A

for something to pass.

102
Q

What can esophageal pouch co-occur with?

A

tracheoesophageal fistula

103
Q

What is a web?

A

Web of tissue across larynx, usually anterior

104
Q

Are webs usually seen anterior or posterior?

A

usually anterior, only seen posterior once.

105
Q

What are the etiologies of web?

A
  • congenital (more often)

- post surgical

106
Q

A _____ develops at the anterior commisure after laser surgery for papilloma.

A

web

107
Q

Why does a patient develop a web post-surgery?

A

Patient does not observe voice rest after surgery, tissue is raw, open and will attach.

108
Q

What signs/symptoms does a web display?

A

May not have voice problems

usually no problems breathing problems in adults.

109
Q

_____ is deterrent when you have a web.

A

Mytomicin C

110
Q

Look at pictures of webs.

A

Powerpoint and book

111
Q

Where does a hemorrhage occur?

A

Bleeding into superficial lamina propria

112
Q

What happens in a hemorrhage?

A

Blood vessels blow or bleed causing swelling or edema of vocal folds.

113
Q

In a hemorrhage what is bright red and what happens when it starts healing.

A
  • vocal folds are bright red

- it has a yellowish appearance when it’s healing

114
Q

What are the etiologies of a hemorrhage?

A

-misuse/abuse
medications (blood thinners) Coumadin, aspirin, ibuprofen
, pain killers

115
Q

What are the signs and symptoms of a hemorrhage?

A
  • hoarseness
  • VF erythema
  • VF edema
  • decreased vocal fold vibration
  • loss of pitch range
  • varix (varices): blood spot/blood vessels on vf
116
Q

What is varix?

A

blood spot/blood vessel on vocal folds present due to hemorrhage

117
Q

Look at hemorrhage pictures on power point and book.

A
  • Identify little lesion on right vocal fold
  • healing stages
  • erythema on left vocal fold
  • complete right vocal fold hemorrhage
118
Q

What is laryngitis?

A

Inflammation of vocal folds.

119
Q

________ is inflammation of vocal folds.

A

laryngitis

120
Q

What are the etiologies of laryngitis?

A
  • infection
  • laryngopharyngeal reflux
  • allergies
121
Q

What are signs and symptoms of laryngitis?

A
  • hoarseness
  • sore throat
  • cough fever
  • vf edema
  • erythema
122
Q

Look at laryngitis in vocal folds on power point.

A

Identify bumpy purple because of no vocal rest, more organic problem if they don’t let it heal
-Pinpoint nodules developing due to no vocal rest

123
Q

Reinke’s edema is also known as what?

A

polypoid corditis

124
Q

What is reinke’s edema?

A

Swelling of entire superficial lamina propria.

125
Q

The superficial lamina propria used to be called what?

A

Reinke’s layer

126
Q

What is the etiology of Reinke’s edema?

A

smoking

127
Q

What are the signs/symptoms of Reinke’s edema?

A
  • gravelly voice
  • low pitch (lower than appropriate pitch)
  • VF edema
  • impaired breathing (VF swell together)
128
Q

Why is the pitch lower than appropriate in Reinke’s edema?

A

Vocal folds are taking a lot of liquid which is increasing the mass of the vocal folds.

129
Q

Look at Reinke’s edema on power point and book.

A
  • Identify the vocal folds that have been drained.

- identify the airway

130
Q

Why does the swelling of the superficial lamina propria need to be reduced in reinke’s edema?

A

To check if there is cancer under all the fluid (edema).

131
Q

You always send ______ for biopsy.

A

Leukoplakia

132
Q

What is leukoplakia?

A
  • white patches/growths on epithelium

- precancerous

133
Q

What are the etiologies for leukoplakia?

A

smoking

chemical exposure

134
Q

What are the signs/symptoms of leukoplakia?

A
  • hoarseness
  • decreased vocal fold vibration
  • vocal fold edema
135
Q

In a patient with leukoplakia, where would you see a decrease of vocal fold vibration?

A

around leuokoplakia patches

136
Q

Why are the vocal folds not moving in leukoplakia?

A

Cancer is growing into muscle of vocal folds.

137
Q

What is the number one cause of leukoplakia?

A

smoking

138
Q

______ ______ has the same appearance as leukoplakia.

A

Candida fungus

139
Q

How can you differentiate between candida and leukoplakia?

A

Patient takes anti-fungal medications for 10-14 days. If it’s gone it was candida fungal infection. If it’s in the same areas, it’s leukoplakia.

140
Q

Candida fungus has the same appearance as what?

A

Leukoplakia.

141
Q

Look at pictures of leukoplakia on power point.

A
  • identify the swollen red area

- Identify the cluster that is probably cancer

142
Q

What are the different types of cancer?

A
  • Glottic (larynx-vocal folds)
  • Supraglottic
  • subglottic (below level of glottis)
143
Q

What is the most common type of cancer?

A

Glottic (larynx-vocal folds)

144
Q

What is the most rare form of cancer?

A

subglottic

145
Q

What are the etiologies for cancer?

A
  • smoking
  • heavy alcohol consumption
  • asbestos (lung cancer)
  • chemical exposure
146
Q

What are the signs/symptoms of cancer?

A
  • hoarseness
  • rough voice
  • pain
  • strain
  • difficulty/pain swallowing
147
Q

You _____ your risk of getting cancer if you’re a smoker or heavy drinker.

A

quadruple

148
Q

When do SLPs see a patient with cancer?

A

We see them when they can’t make a noise and have trouble breathing. May not voice/swallow.

149
Q

When do patients with cancer experience pain?

A

When swallowing and voicing

150
Q

Look at cancer pictures.

A

It can look like candida, white patches

-bloody

151
Q

What are the etiologies for laryngeal trauma?

A
  • hit in the neck
  • weight lifting
  • hemorrhage
  • foreign bodies
152
Q

What can help laryngeal trauma?

A

steroids

antibiotics

153
Q

Look at laryngeal trauma pictures on power point.

A

Identify healing

Identify hemorrhage due to a fishbone

Voice Disorders (6 decks)

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