The Voice And Voice Disorders Flashcards
The voice a
Vocal Pitch and the Pitch- Changing Mechanism
Vocal Loudness and the Loudness-Changing Mechanism
Disorders of Voice
The Evaluation and Intervention
Pitch
Pitch
*Perceptual correlate of Fo
*Measured in hertz
Optimal pitch level
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
Vocal folds
Gender
Male Vocal folds (17-20 mm) and thicken
Female Vocal folds only lengthen (12.5-17
mm)
Monotone voice
Monotone Voice
*Result of not varying habitual speaking
frequency
Pitch Change
*Lengthening and tensing increases pitch
*Relaxing intrinsic muscles decreases pitch
Vocal Loudness
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
Deviations in quality, pitch and loudness, flexibility
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
Disorders of Vocal Pitch
Disorders of Vocal Pitch *Monopitch
*Inappropriate Pitch
*Pitch Breaks
Disorders of Vocal Loudness
Disorders of Vocal Loudness *Monoloudness
*Loudness Variations
Disorders of Vocal Quality
*
Disorders of Vocal Quality
*Breathiness
*Vocal Tremor *Strain and Struggle
Nonphonatory Vocal Disorders
Stridor
Excessive Throat Clearing Consistent Aphonia *Episodic Aphonia
Vocal Misuse and Abuse
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
Associated with Medical or Physical Conditions
Associated with Medical or Physical Conditions
*CNS Disorders **Dysarthria
*Muscle weakness, discoordination, tremor, paralysis
*Result in
*HYPOADDUCTION *HYPERADDUCTION
Hypoadduction
Hypoadduction
*Parkinson’s Disease
**Voice symptoms
*Monopitch, monoloudness, harshness, breathiness
Vocal Fold Paralysis
Unilateral
**Diphophonia
*Bilateral **Weakorabsentvoice
Hyperadduction
Hyperadduction
*Spastic Dysarthria
*Voice Symptoms
**Harshness, pitch breaks, strained/struggled
Spasmodic Dysphonia
Spasmodic Dysphonia
*Voice Symptoms
**Strained, effortful, tight voice
**Intermittent voice stoppages
Laryngeal cancer
Laryngeal Cancer
*Esophageal Speech
*Electrolarynx
*Tracheoesophageal Shun
Voice Disorders associated with psychological or stress
Voice Disorders associated with psychological or stress conditions (psychogenic voice disorders)
Conversion Disorders Conversion Aphonia
Evaluation
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
Intervention
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
