- decreased muscle mass of velum - adeinectomy or tonsillectomy (these masses can help compensate for an inadequate velopharyngeal system) - paresis or paralysis of the velum (reduces mobility)

Swallowing/Voice/ Flashcards by Katie Cohen

What is Cul-de-Sac resonance?

Produced by backward retraction of the tongue
Tongue blocks some of the sound waves generated by the larynx and voice sounds muffled or hollow
- Deaf people and those with neurological disorders

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Describe Hypernasality (excessive nasality)

Person speaks with insufficient intraoral pressure

Impacts fricatives, affricates and stops - weak

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Causes of Hypernasality

Cleft palate/inadequate cleft repairs
Submucous cleft of the soft or hard palate
Velopharyngeal Insufficiency (VPI)

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Causes of VPI

decreased muscle mass of velum
adeinectomy or tonsillectomy (these masses can help compensate for an inadequate velopharyngeal system)
paresis or paralysis of the velum (reduces mobility)

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Causes of Hyponasality ( lack of appropriate nasal resonance on nasal sounds)

colds
-allergies
obstruction of nasal cavity
enlarged adenoids or tonsils (common in children)
deviated septum
NASOMETER CAN BE USED TO ASSESS

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Rate control devices, biofeedback and AAC are not relevant in the treatment of ______

Apraxia of Speech

- A metronome would be the best prosthetic management for AOS

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The _____________ is involved in preprogramming movement sequences already in motor memory

Supplementary motor area (SMA)

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The ______________ is the memory bank for skilled motor activities already learned

Premotor cortex

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Function of Pons, Midbrain, Medulla, oblongata

Pons - Relays impulses between the motor cortex and the cerebellum
Midbrain - Visual and auditory reflexes
Medulla oblongata- regulates vomiting, hiccuping, swallowing, coughing and sneezing

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Which cranial nerve would be responsible for contributing to shoulder weakness and head drooping, which may have an effect on resonance

Spinal Accessory

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The hypoglossal nerve innervates all of the intrinsic and extrinsic muscles of the tongue except the ______

Palatoglossus

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Tidal Volume (TV)

exhaled/inhaled during respiration

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Vital Capacity

volume that can be exhaled after maximum inhalation

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Inspiratory/Expiratory Reserve Volume

IRV can be inhaled above TV

ERV can be exhaled below TV

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Residual Volume

remains in lungs after maximum exhalation

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What is the dipper swallow?

Bolus is held on the floor of the mouth and picked up with tongue in oral stage (used for adults 60+)

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WHAT IS FREQUENCY PERTURBATION?

Jitter - variations in vocal frequency

Patients w/ tremor or hoarseness will sho large amounts of jitter

WHAT IS AMPLITUDE PERTURBATION?

Shimmer - cycle-to-cycle variations in vocal intensity
Patients with a rough voice (irregular VF vibration) show large amounts of shimmer
> 1dB of variation across vibratory cycles

What are the causes of diplophonia?

“Double voice” - different frequencies

A client with a unilateral polyp may have diplophonia

What is Electormyography used for?

To determine vocal fold pathology

Varifying excessive muscle activity in patients with spasmodic dysphonia

What is a granuloma?

Localized inflammatory, vascular lesion, usually composed of granular tissue in a firm, round sac
- cased by vocal abuse, intubation durign surgery, injury to larynx, GERD, contact ulcers

What is hemangioma?

Blood filled, soft, pliable sacs

What is leukoplakia?

Thin white patches on surface membrane of mucosa

What is hyperkeratosis?

Pinkish lesion that can appear in oral cavity, larynx, or pharynx

What is laryngomalacia?

"floppy cartilages" - causes stridor

What is laryngeal web?

membrane that grows across the anterior portion of the glottis - congenital or acquired

Nodules are typically _______

bilateral - result from prolonged vocal abuse - treated by voice therapy and surgery

Contact ulcers are seen in ________

Hard-driving patients who speak forcefully and talk excessively - frequently sound hoarse - surgery is not recommended

Client has been referred because of difficulties associated with partial submucous cleft palate accompanied by bifid uvula. You can probably expect to find:

Hypernasality accompanied by decreased intraoral pressure, leading to difficulties with adequate production of fricatives, affricates and plosives

The suprahyoid laryngeal muscles (elevators) are _______

digastrics, geniohyoids, mylohyoids, stylohyoids, hyoglossus and genioglossus

What is the injection method?

Type of esophageal speech in which the patient impounds air in the oral cavity, pushes it back into the esophagus, and vibrates the cricopharyngeus muscle.

What therapy would you provide to a patient with a damaged recurrent laryngeal nerve?

Strategies to improve vocal fold adduction

The Blom-Singer prosthetic device is used by laryngectomees to _______

shunt the air from the trachea to the esophagus so that the patient can speak on pulmonary air entering the esophagus

Patients with spasmodic dysphonia can be treated using _______

CO2 laser surgery, recurrent laryngeal nerve resection, BOTOX, voice therapy or a combination of these

Sound spectrography can be used to ________

obtain quantitative measures of voice

Mendelsohn maneuver

Elevate the larynx, widen cricopharyngeal opening, hold laryngeal elevation during swallowing

Effortful swallow

Increase posterior motion of tongue and increase pharyngeal pressure

Supraglottic swallow vs. super supraglottic swallow

supra - close airway at the level of the VF to prevent aspiration super-supra - close airway before and during swallow

Apraxia of speech is often associated with lesions in

Broca's area

Parkinson's disease speech and general presentation

Monopitch, harsh breathy voice, short rushes of speech, imprecise consonants, respiratory problems Mask-like face, slow voluntary movements, tremors in resting muscles, disturbed posture

Respiratory symptoms of dysarthria

Forced inhalations and exhalations which interrupt speech