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Organic Voice Disorders Flashcards

1
Q

Organic Voice Disorders are:

A
  • Purely organic

- Typically abnormal anatomy, tissue changes

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2
Q

Functional Voice Disorders are:

A
  • May be wholly functional
  • May have organic factors*
  • Typically normal anatomy
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3
Q

Examples of Functional misuse:

A
  • inadequate breath support
  • hard glottal attack
  • supraglottal squeeze
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4
Q

Functional misuse can lead to…

A

organic changes

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5
Q

Classification of Organic Voice Disorders (5):

A 
1 Congenital – web, laryngomalacia
2 Misuse/Abuse 
3 Lifestyle – reflux (diet), Reinke’s edema (smoking), personality (nodules)
4 Disease – cancer
5 Trauma – cartilage dislocation
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6
Q

Types of Organic Voice Disorders (14):

A
  1. Nodules
  2. Polyps
  3. Cysts
  4. Papilloma
  5. Granuloma
  6. Contact ulcer
  7. Sulcus vocalis
  8. Congenital
  9. Web
  10. Hemmorhage
  11. Laryngitis
  12. Reinke’s edema
  13. Leukoplakia
  14. Cancer
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7
Q

Vocal Fold Nodules (organic voice disorder):

A

Benign mass(es) on medial vf surface(s)

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8
Q

Etiology of Vocal Fold Nodules:

A

Etiologies: misuse/abuse

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9
Q

Signs/symptoms of Vocal Fold Nodules:

A
  1. hoarseness
  2. rough voice
  3. ↑ vocal effort
  4. vocal fatigue/strain
  5. loss of upper range
  6. voice variability
  7. vf edema
  8. hourglass closure
  9. ↓ vf vibration
    Can happen with:
    - “strong” personality
    - hearing loss
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10
Q

After 6 months of having Vocal Fold Nodules:

A

glottis closure pattern = hourglass closure. Hardened like a callus

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11
Q

Polyps (organic voice disorder):

A

Generally soft mass, usually unilateral

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12
Q

Etiologies of Polyps:

A

misuse/abuse

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13
Q

Types of Polyps (3):

A
  1. fibrous
  2. hemmorhagic
  3. pedunculated
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14
Q

Signs/symptoms of Polyps (8):

A
  1. hoarseness
  2. rough voice
  3. ↑ vocal effort
  4. vocal fatigue/strain
  5. breathing problems (depending on size)
  6. voice variability (especially if pedunculated)
  7. vf edema (reactive swelling)
  8. throat clearing
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15
Q

What is a Fibrous Polyp?

A

still colored like the vocal folds

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16
Q

What is a Hemorrhagic Polyp?

A

blood filled

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17
Q

What is a Pedunculated Polyp?

A

Hangs out like a foot off the polyp

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18
Q

Cyst (organic voice disorder):

A

Benign opaque mass originating below vf surface

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19
Q

Etiologies of Cysts (2):

A
  1. Entrapment of vf lining (under the lining) or plugged mucous-secreting gland
  2. Vocal misuse/abuse
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20
Q

Signs/symptoms of Cysts (6):

A
  1. hoarseness
  2. rough voice
  3. ↑ vocal effort
  4. vocal fatigue/strain
  5. vocal fold edema (reactive swelling)
  6. throat clearing
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21
Q

What is Laryngocele?

A

A cyst in the laryngeal cavity

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22
Q

Papilloma (organic voice disorder):

A

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

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23
Q

Etiologies of Papilloma (3):

A
  1. acquired at birth
  2. oral sex
  3. unknown
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24
Q

Signs/symptoms of Papilloma (7):

A
  1. hoarseness
  2. rough/scratchy voice
  3. cough/throat clear
  4. globus sensation
  5. breathing problems
  6. ↓ vf vibration
  7. scarring (recurrent)
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25
There are______ strains of HPV that cause laryngeal papillomatosis
more than 60
26
Granulomas (organic voice disorder):
Benign polyp on vocal process | Usually fibrous, may see some vascularity around it
27
Etiologies of Granulomas (4):
1. LPR (laryngo-pharyngeal reflux) 2. Diet (soda, tomatoes, chocolate, citrus, spicy foods, high fat, caffeine, alcohol, dehydration) 3. Lifestyle (smoking, eating too late, eating too much at once, exercising too soon, being overweight) 4. Intubation (surgery, coma) 5. bulimia (uncommon)
28
Signs/symptoms of Granulomas (7):
1. globus sensation (feel something in throat, feel like you need to clear it out) 2. heartburn/indigestion (reflux-type)(might not know it is happening bc it is happening at night) 3. excessive throat clearing (which can make it worse) 4. dry cough 5. post-nasal drip 6. breathing problems (size-dependent) 7. may be pedunculated
29
Why are Granulomos easy to diagnose?
Because of their location Located on the vocal processes (vocalic process and the lateral/muscular process)
30
What is LPR (laryngo-pharyngeal reflux)?
- Sometimes called “silent reflux” - Commonly occurs at night while you are laying down and doesn’t have to fight with gravity - Ask a patient: are you waking up with a sore throat in the morning? - If the acid reflux happens a lot, can get nasal congestion.
31
When the body is healing,
it sends mucus to coat and protect
32
How can Intubation cause granulomas?
Because the tube rubs against back of the larynxs creating a lesion = a granuloma
33
Treatment for Granulomas:
Mainly PPI (Proton Pump inhibitors) H2 blocker = tums (if really bad granuloma) * Really bad granuloma: PPI BID (2xday), and H2 blocker at bedtime * These will treat the granuloma no matter what the etiology for the granuloma bc PPI tend to “clean up” the larynx
34
Contact Ulcer (organic voice disorder):
Raw sores on mucous membrane overlying vocal process of arytenoid Same location as a granuloma. Contact ulcers can turn into a granuloma At first has a white appearance
35
Etiologies of Contact Ulcers (4):
1. misuse/abuse (slamming vocal fold together too hard) 2. LPR 3. smoking 4. intubation
36
Signs/symptoms of Contact Ulcers (5):
1. hoarseness 2. globus sensation 3. mild pain when voicing or swallowing 4. throat clearing 5. erythema (redness)
37
Which 2 organic voice disorders have the symptom of pain?
Contact Ulcers (may be described as a sore throat by the patient) Cancer (actually pain in the area affected)
38
What is erythema?
redness
39
Sulcus Vocalis (organic voice disorder):
Thinning or absence of superficial lamina propria> “ditch” Sulus (Latin) = cleft, furrow
40
Etiologies of Sulcus Vocalis:
Unknown – developmental? genetic? post hemmorhage/cyst?
41
Signs/symptoms of Sulcus Vocalis (6):
1. may not have voice probs 2. harsh voice 3. hoarseness 4. higher pitch 5. abnormal vf vibration 6. Superficial lamina propria either thinning OR absent 7. Never seen in children
42
What is a Sulcus?
A ditch running through the vocal fold
43
What is Stenosis?
narrowing
44
What is a Fistula?
a hole
45
What is a Tracheoesophageal fistula?
Hole in the back of the trachea and front of esophagus Foot or drink can get into the trachea, air can get in the esophagus * openings b/t trachea & esophagus * May co-occur w/ esophageal pouch
46
Congenital Organic Voice Disorders:
1. Laryngomalacia 2. Subglottal stenosis 3. Esophageal atresia 4. Tracheoesophageal fistula
47
What is a Laryngomalacia?
- Cartilage fails to stiffen - Collapse of epiglottis into airway - Stridor (inspiratory or expiratory) - May outgrow *A Congenital Organic Voice Disorder
48
What is Subglottal stenosis?
- Narrow subglottal space - Arrested dev’t of cricoid cart (soft or too small cricoid cart.) - Intubation trauma (usually prolonged intubation) *A Congenital Organic Voice Disorder
49
What is Esophageal atresia?
occlusion of esophagus
50
Laryngeal Web (organic voice disorder):
Web of tissue across larynx, usually anterior
51
Etiologies of Laryngeal Web (2):
- Congenital | - Post-surgical
52
Signs/symptoms of Laryngeal Web (3):
- May not have voice probs - Usually no probs breathing (Problems breathing if they are young/have a small airway or if the web is huge) - 99% of webs are anterior
53
What is Mitomycin C?
A deterrent for a laryngeal web | put there in surgery to avoid the tissue growing again
54
Hemmorhage (organic voice disorder):
Bleeding into superficial lamina propria
55
Etologies of Hemorrhaging (2):
- misuse/abuse | - medications (Coumadin, aspirin)
56
Signs/symptoms of Hemorrahaging:
- hoarseness - vf erythema - vf edema - ↓ vf vibration - loss of pitch range - varix (varices) (blood spots)
57
What is a Varix?
blood spot/blood vessel on vf
58
Why do we often see vascularity with edema?
Bc the extra fluid pushes the blood vessels to the surface
59
Laryngitis (organic voice disorder):
Inflammation of vocal folds | larynx is pissed
60
Etiologies of Laryngitis (3):
- infection (e.g. Upper-respiratory infection) - LPR - allergies
61
Signs/symptoms of Laryngitis (7):
- hoarseness - sore throat - cough (Dry cough) - fever - vf edema - erythema - Severe = no voice
62
Why do some develop nodules on top of laryngitis?
BC the person is pushing to get voice out. *Best thing you can do is vocal fold rest to heal and avoid getting nodules
63
Reinke’s Edema (organic voice disorder):
* a.k.a. polypoid corditis | - Swelling of entire superficial lamina propria (Reinke’s layer)
64
Etiologies of Reinke's Edema:
smoking (anything)
65
Signs/symptoms of Reinke's Edema (4):
- gravelly voice - low pitch - vf edema - impaired breathing - Could impair breathing if the reinke’s edema is so severe
66
Increase in mass of the vocal folds, there is a....
decrease in pitch
67
Leukoplakia (organic voice disorder):
- White patches/growths on epithelium - Pre-cancerous - May start out with Reinke’s edema and advance to this - Always sent for a biopsy - Can turn into laryngeal cancer
68
Etiologies of Leukoplakia (2):
- smoking (99%) | - chemical exposure (1%)
69
Signs/symptoms of Leukoplakia (3):
- hoarseness - ↓ vf vibration - vf edema
70
Cancer (organic voice disorder):
3 types: - Glottic (larynx-vocal folds) (most common) - Supraglottic (above the level of the vocal folds) - Subglottic (below the folds) (rare)
71
Etiologies of Cancer (3):
- smoking - heavy alcohol consumption - asbestos or chemical exposure
72
Signs/symptoms of Cancer (5):
- hoarseness - rough voice - pain (No longer a sore throat. PAIN! Worse when swallow) - strain - difficulty/pain swallowing - Irregularity (sign of cancer)
73
What's the #1 cause of laryngeal cancer?
smoking
74
How does one triple their chances of getting laryngeal cancer?
Smoking AND drinking heavily
75
Laryngeal Trauma (etiologies) (3):
- Hit in the neck - Weight lifting - Foreign bodies

Voice Disorders (5 decks)

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