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
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
3
Q
otolaryngologist
A
- general ENT
- undergrad degree, med school, 5 year residency, medical/surgical training
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
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?
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
7
Q
pros of videostroboscopy
A
- allows for visualization of vibratory behavior of vocal folds
8
Q
cons of videostroboscopy
A
- cannot use on aperiodic voices
- cannot assess onset or offset of phonation
- expensive equipment
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
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
11
Q
cons of flexible scope
A
- optics and magnification not as good as rigid
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
12
Q
pros of rigid scope
A
- excellent lighting
- excellent magnification
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
14
Q
rationale for say your name on exam
A
- functional, autonomic speech
- help get global view
- identifies patient in recording
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
