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Voice > Specific Voice Disorders > Flashcards

Specific Voice Disorders Flashcards

1
Q

What is a tissue reaction to frictional trauma between the vocal folds?

A

Vocal nodules

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2
Q

What are the 3 stages of nodule development?

A

Stage 1, 2, and 3

Also prenodules

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3
Q

Describe Stage 1 of nodule development

A

Only on the free margin of the VF

Nodules are gelatinous and floppy

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4
Q

Describe Stage 2 of nodule development

A

Localized swelling or thickening on the edge of the vocal folds
Nodules appear grayish and translucent

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5
Q

Describe Stage 3 of nodule development

A

Nodules are hard, white, or gray; these nodules are chronic and longstanding.

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6
Q

What are the vocal characteristics associated with vocal nodules?

A

Harsh quality, breathy voice, limited pitch range, and lower pitch

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7
Q

Where do nodules most commonly occur?

A

Juncture of the anterior 1/3 and posterior 2/3 of the VF

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8
Q

What is the clinical management for nodules in Stage 1 or 2?

A

Voice therapy that may include counseling

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9
Q

What is the clinical management for Stage 3 nodules?

A

Therapy, counseling, may need surgery

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10
Q

With a ______ client, improvement should be noted within 2-3 weeks

A

Complaint

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11
Q

Where do we want to “place the voice”?

A

High in the facial mask instead of low in the throat

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12
Q

Placing the voice is trying to change the focus of what?

A

Resonance

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13
Q

What is the purpose of the yawn sigh?

A

To facilitate an easy onset

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14
Q

What are the causes of polyps?

A

URI, contaminants, vocal abuse or a single traumatic event

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15
Q

If polyps are due to vocal abuse, where might they be located?

A

Junction of the anterior 1/3 and the posterior 2/3 of the VF

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16
Q

What two types of polyps are there?

A

Pedunculated and sessile

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17
Q

What is the difference between pedunculated and sessile polyps?

A

Pedunculated are stalk-like and sessile are more broad-based.

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18
Q

Where all could polyps occur?

A

On the VF, supra- , and sub-glottally

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19
Q

What are the most common voice complaints for polyps?

A

Hoarseness, frequent throat clearing

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20
Q

What is the management protocol for polyps?

A

Surgery if they’re large; after surgery you can begin voice therapy

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21
Q

What are contact ulcers?

A

Benign lesions that develop on the vocal processes of the arytenoid cartilages

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22
Q

What are the most common causes of contact ulcers?

A

Vocal abuse, GERD, and irritation from intubation during surgery

23
Q

What are the symptoms of contact ulcers?

A

**Pain, throat tickle, need to clear throat, aching or dryness in the throat

24
Q

What are the 3 stages of development of contact ulcers?

A

1 - vocal fatigue & hoarseness, recovery overnight; redness and swelling between arytenoids
2 - continued hoarseness, fatigue and occasional pain; severe inflammation and early loss of mucosal covering
3 - severe and constant hoarseness, fatigue, and pain; mucosa is completely stripped, starting to see formation of granuloma

25
Q

What are the vocal characteristics of a contact ulcer?

A

Low pitch, hoarseness, persistent glottal attacks, and loud voice

26
Q

Treatment for contact ulcers?

A

Refer for gastrointestinal eval; vocal rehabilitation

27
Q

What is a papilloma?

A

Wart-like growth in the larynx

28
Q

What is a papilloma caused by?

A

DNA virus

29
Q

What is the primary concern of papillomas?

A

Constriction of the airway because they grow so fast

30
Q

What population do papillomas typically occur in?

A

Children; typically do not persist after adolescence

31
Q

Vocal characteristics of papillomas?

A

Hoarseness, aphonia, stridor, shortness of breath, and croupy-like cough

32
Q

What is the primary treatment for papillomas?

A

Medical - need surgery to preserve the airway

33
Q

What is a tissue web covering all or part of the glottis?

A

Laryngeal web

34
Q

How does a laryngeal web grow?

A

Anterior to posterior

35
Q

What might cause a laryngeal web?

A

It can be congenital or acquired (trauma or infection)

36
Q

What are the vocal characteristics of laryngeal web?

A

Higher than normal pitch (b/c of the shortened vibratory surface)
Harsh quality
Shortness of breath
Stridor

37
Q

What is the treatment for laryngeal web?

A

Always surgery!

38
Q

What is vocal fold paralysis?

A

The inability of one or both VF to move due to a lack of innervation of intrinsic muscles of the larynx

39
Q

In regards to VF paralysis, what does the label refer to?

A

It refers to what the affected VF CANNOT do

40
Q

In unilateral adductor paralysis, what is wrong with the VF?

A

One VF cannot adduct

41
Q

What are 90% of VF paralyses due to?

A

Damage to the vagus nerve or its branches (superior laryngeal or recurrent laryngeal)

42
Q

What is the difference between the superior laryngeal and recurrent laryngeal?

A

The muscles innervated - the superior laryngeal innervates the cricothyroid muscles, and the recurrent laryngeal innervates all other intrinsic muscles of the larynx.

43
Q

What happens to the VF/voice if the cricothryoid muscles are not innervated?

A

Can’t tense them or make pitch adjustments.

44
Q

If the recurrent laryngeal nerve is damaged, what difficulty will you have with the VF?

A

Ability to AD-duct and AB-duct

45
Q

If an individual has AD-ductor paralysis, what’s wrong the VF?

A

They can’t close/AD-duct

46
Q

What is usually the cause of unilateral adductor paralysis?

A

Trauma to the recurrent laryngeal nerve (surgical injury or trauma)

47
Q

What are the voice characteristics of unilateral adductor paralysis?

A

Dysphonic (harsh or hoarse)
Weakness
Breathiness
Loss of fine control for pitch change - may be monotone

48
Q

How would the voice sound in bilateral AD-ductor paralysis?

A

Would be completely breathy (because neither VF could AD-duct!) - it’s called paralytic aphonia

49
Q

What position are the VF in in bilateral AD-ductor paralysis?

A

Both folds are in the paramedian position and are unable to close

50
Q

What is the management of vocal fold paralysis?

A

Surgery, some sort of injection into the VF, a repositioning of the arytenoids, maybe some voice therapy

51
Q

What are some ways to increase the AD-duction of the VF? (think facilitating techniques)

A

Pushing technique (not well supported), head positioning, or lateral digital pressure

52
Q

What is the problem of the VF in AB-ductor paralysis?

A

The VF are almost primarily AD-ducted/stuck in the midline position; will not AB-duct to a full lateral position for full inspiration

53
Q

What is the primary problem associated with AB-ductor VF paralysis?

A

Breathing - the VF won’t open all the way!

54
Q

What does bilateral AB-ductor paralysis require?

A

An immediate tracheostomy because the person won’t be able to breathe!

Voice (8 decks)

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