quiz 2 Flashcards

voice evaluation part 1

1
Q

symptoms warranting voice evaluation

A
  • sudden change in voice
  • voice change lasting longer than 2 weeks
  • chronic voice problem
  • voice doesn’t function the way it used to
  • discomfort when voicing
  • excessive throat clearing
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2
Q

why should you never assume the cause of someone’s hoarseness?

A
  • the way a voice sounds is never indicative of a specific problem
  • similar sounding voices could be caused by completely different problems
  • should tell someone it’s okay you like your voice, but should get an evaluation just to make sure everything is okay
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3
Q

otolaryngologist

A
  • general ENT
  • undergrad degree, med school, 5 year residency, medical/surgical training
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4
Q

laryngologist

A
  • sub-specialist ENT
  • undergrad degree, med school, 5 year residency, 1 year fellowship, specialized medical/surgical training
  • voice, upper airway, swallowing disorders
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5
Q

focused voice history taking questions

A
  • chief complaint
  • onset
  • precipitating event
  • voice demands in every day life
  • done anything to try to improve it
  • anything ameliorating?
  • anything aggravating?
  • vary in severity?
  • breathing concerns?
  • swallowing concerns?
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6
Q

videostroboscopy

A
  • light source that can be used with either flexible or rigid scope
  • person holds laryngeal mic to neck and computer detects fundamental frequency
  • computer tells light to flash in next progressive moment in cycle and pieces them together
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7
Q

pros of videostroboscopy

A
  • allows for visualization of vibratory behavior of vocal folds
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8
Q

cons of videostroboscopy

A
  • cannot use on aperiodic voices
  • cannot assess onset or offset of phonation
  • expensive equipment
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9
Q

flexible vs. rigid scope

A
  • flexible scope passed through nares
  • rigid scope passed through mouth
  • just type of scope, can be used with any type of light source
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10
Q

pros of flexible scope

A
  • tolerated well by most patients
  • can assess connected speech and singing
  • can assess entire vocal tract
  • does not alter typical laryngeal behavior
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11
Q

cons of flexible scope

A
  • optics and magnification not as good as rigid
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12
Q

cons of rigid scope

A
  • poorly tolerated by most patients
  • cannot assess connected speech, only prolonged vowels
  • cannot assess entire vocal tract
  • may alter typical laryngeal behavior and cause gagging or muscle tension
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12
Q

pros of rigid scope

A
  • excellent lighting
  • excellent magnification
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13
Q

tasks for flexible scope exam

A
  • say your name
  • count to 5
  • go from low to high in voice
  • sniff 3x
  • sniff “ee” 3x
  • “eehee” 3x
  • “pottica” 3x
  • deep breath and hold “ee”
  • deep breath in
  • glissando up on “ee”
  • hold high note on “ee”
  • puff up your cheeks
  • look at base of tongue
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14
Q

rationale for say your name on exam

A
  • functional, autonomic speech
  • help get global view
  • identifies patient in recording
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15
Q

rationale for count to 5 on exam

A
  • autonomic speech
  • help get global view of patient’s voice
16
Q

rationale for going low to high on exam

A
  • assess VF elongation
  • assess VF symmetry
  • look at pharyngeal constriction
17
Q

rationale for sniff 3x on exam

A
  • assess vocal fold abduction
18
Q

rationale for sniff “ee” 3x on exam

A
  • assess coordination between phonation and breathing, vocal fold vibration to abduction
19
Q

rationale for “eehee” 3x on exam

A
  • assess coordination betweem voiced and voiceless sounds
20
Q

rationale for “pottica” on exam

A
  • overall coordination and motor speech
21
Q

rationale for deep breath in and hold “ee” on exam

A
  • maximum phonation time, breath support for phonation, build up of Psg and onset of phonation
22
Q

rationale for deep breath in on exam

A
  • VF abduction
23
Q

rationale for puff up cheeks on exam

A
  • look at pyriform sinuses