The Voice And Voice Disorders

Question 1

The voice a

Answer 1

Vocal Pitch and the Pitch- Changing Mechanism
Vocal Loudness and the Loudness-Changing Mechanism
Disorders of Voice
The Evaluation and Intervention

Question 2

Pitch

Answer 2

Pitch
 *Perceptual correlate of Fo
 *Measured in hertz

Question 3

Optimal pitch level

Answer 3

Optimal pitch level
 *Most suitable pitch, determined by vocal fold structure
 *Men: 130 Hz
 *Women: 250 Hz
 *Children: up to 500 Hz
 At birth, larynx is high in neck
 *Vocal folds are about 3mm long

Question 4

Vocal folds
Gender

Answer 4

Male Vocal folds (17-20 mm) and thicken
 Female Vocal folds only lengthen (12.5-17
mm)

Question 5

Monotone voice

Answer 5

Monotone Voice
 *Result of not varying habitual speaking
frequency
 Pitch Change
 *Lengthening and tensing increases pitch
 *Relaxing intrinsic muscles decreases pitch

Question 6

Vocal Loudness

Answer 6

Vocal Loudness
*Perceptual correlate of intensity
 *Measured in decibels (dB)
Changes in vocal loudness
 Require vocal folds to stay together longer
Alveolar pressure is major determinant

Question 7

Deviations in quality, pitch and loudness, flexibility

Answer 7

Deviations in quality, pitch and loudness, flexibility
 Children
 *Usually related to vocal abuse/misuse
 *Temporary
 Adults
 *More variable
 Differential Diagnosis
 *Perceptual Signs and case history

Question 8

Disorders of Vocal Pitch

Answer 8

Disorders of Vocal Pitch  *Monopitch
 *Inappropriate Pitch
 *Pitch Breaks

Question 9

Disorders of Vocal Loudness

Answer 9

Disorders of Vocal Loudness  *Monoloudness
 *Loudness Variations

Question 10

 Disorders of Vocal Quality
*

Answer 10

 Disorders of Vocal Quality
*Breathiness
*Vocal Tremor *Strain and Struggle

Question 11

Nonphonatory Vocal Disorders

Answer 11

Stridor
Excessive Throat Clearing Consistent Aphonia *Episodic Aphonia

Question 12

Vocal Misuse and Abuse

Answer 12

Vocal Misuse and Abuse
 *Contribute to structural damage  *Abuse is harder than misuse
 *Can result in:
 **Vocal Nodules
 **Contact Ulcers
 **Vocal Polyps
 *Sessile
 *Pendunculated
 **Acute and chronic Laryngitis

Question 13

Associated with Medical or Physical Conditions

Answer 13

Associated with Medical or Physical Conditions
*CNS Disorders **Dysarthria
*Muscle weakness, discoordination, tremor, paralysis
*Result in
*HYPOADDUCTION *HYPERADDUCTION

Question 14

Hypoadduction

Answer 14

Hypoadduction
*Parkinson’s Disease
**Voice symptoms
*Monopitch, monoloudness, harshness, breathiness

Question 15

Vocal Fold Paralysis

Answer 15

Unilateral
**Diphophonia
*Bilateral **Weakorabsentvoice

Question 16

Hyperadduction

Answer 16

Hyperadduction
 *Spastic Dysarthria
 *Voice Symptoms
 **Harshness, pitch breaks, strained/struggled

Question 17

Spasmodic Dysphonia

Answer 17

Spasmodic Dysphonia
 *Voice Symptoms
 **Strained, effortful, tight voice
 **Intermittent voice stoppages

Question 18

Laryngeal cancer

Answer 18

Laryngeal Cancer
 *Esophageal Speech
 *Electrolarynx
 *Tracheoesophageal Shun

Question 19

Voice Disorders associated with psychological or stress

Answer 19

Voice Disorders associated with psychological or stress conditions (psychogenic voice disorders)
Conversion Disorders Conversion Aphonia

Question 20

Evaluation

Answer 20

Otolaryngologist Evaluation First
 *Endoscopic Evaluation
 *Biopsy if laryngeal cancer is suspected
 SLP
 *Case History
 *Natureofthedisorder,howitaffectsthe individual, developmental history and duration, social/vocational use of voice, overall physical and psychological condition
 *Perceptual Evaluation
 **Pitch, Loudness, Voice Characteristics

Question 21

Intervention

Answer 21

 Intervention for misuse/abuse
 *Restore healthy vocal function
 *Identify and eliminate abusive behaviors
 *Vocal hygiene
 *Surgical Intervention
 *Environmental changes
 Intervention for medical/physical conditions  *Best or alternative voice
 *Assess effects of medication or surgery
 *Voice therapy has limited effectivenes

Intervention for psychological/stress conditions
 *Treatment is effective if individual is convinced there is nothing physically wrong
 *Voice can return to normal quickly
 *Psychiatric referral often not needed
 Efficacy of voice therapy
 *Most voice disorders respond well to treatment