Tx Flashcards

1
Q

what are the five voice tx philosophies?

A

hygienic, symptomatic, psychogenic, physiologic, eclectic

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2
Q

hygienic voice tx: concept, proponents, and weakness

A

c: voice px has a direct behavioral cause
p: eliminate-change bx and voice will improve
w: cause of voice px may not be the precipitating factor

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3
Q

symptomatic voice tx: concept, proponents, and weakness

A

c: modify deviant vocal symptoms (breathiness, hard glottal attacks, etc.)
p: use voice tx facilitating techniques (yawn-sigh, chanting, etc.)
w: symptom(s) may not be the cause

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4
Q

psychogenic voice tx: concept, proponents, and weakness

A

c: voice px is related to emotional-psychosocial px
p: treat the psychosocial px and voice will improve
w: psychosocial pas may be overstated

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5
Q

physiologic voice tx: concept, proponents, and weakness

A

c: modify pt’s underlying physiological mechanisms (subsystems)
p: improve balance between respiration, phonation, and resonance (resonant voice, lee silverman, etc.)
w: does not account for bx

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6
Q

eclectic voice tx: concept, proponents, and weakness

A

c: any combination of voice tx (hygienic, symptomatic, psychogenic, physiologic)
p: use what’s most effective
w: every pt is unique

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7
Q

list the guidelines of voice tx

A

patient education; focus on kinesthetics of voice production; use audio-visual feedback; do not rush; model tx tasks; record-document ssns; provide specific home practice

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8
Q

list contributing factors of prognosis

A

whether or not the pt: recognizes they have a px, is compliant to the tx plan, is willing to change-stop bus, has psychiatric pxs, is remediable, has appropriate expectations, is generally healthy

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9
Q

name the symptomatic voice tx techniques

A

digital manipulation; yawn-sigh; chewing; easy onset / linking; tongue stretch / supraglottic relaxation; push-pull; chanting; breathing; altering habitual pitch-loudness

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10
Q

symptomatic voice tx techniques are most commonly used to ___

A

decrease extralaryngeal-supraglottic muscle tension; decrease hard glottal attacks; increase glottic closure

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11
Q

describe easy onset / linking

A

SYMPTOMATIC

trains continuous airflow to help eliminate glottal attacks as in “…i’ll-have-eggs-over-easy”

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12
Q

describe yawn-sigh

A

SYMPTOMATIC

fake yawn then produce /h/ to lower larynx and release supraglottic squeezing as in opens mouth “…hi”

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13
Q

describe chewing

A

SYMPTOMATIC

speaking while “chewing” to disengage laryngeal tension

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14
Q

describe chanting

A

SYMPTOMATIC

trains continuous airflow to help eliminate glottal attacks as in “ninety-seven ninety-eight ninety-nine”

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15
Q

describe digital manipulation

A

SYMPTOMATIC

palpate pt to assess for muscle tension (intrinsic, extrinsic, or both) and to massage pt

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16
Q

anterior-posterior compression and false vocal fold medialization are indicative of ___

A

supraglottic squeezing, which is ALWAYS a sign of tension

17
Q

SYMPTOMATIC

yawns and “slurping spaghetti” : lowers larynx and opens supraglottic area :: silent laughter : ___

A

ABducts false vocal folds

18
Q

describe tongue stretches

A

SYMPTOMATIC

relaxes base of the tongue and opens supraglottic area

19
Q

the rag doll exercise is used to ___

A

decrease neck and shoulder tension and to train abdominal / lower back breathing

20
Q

name exercises that help to establish abdominal breathing

A

sitting and leaning with forearms on knees; standing with arms crossed overhead; pavone; sustained /f/; prone position

21
Q

describe pavone

A

start with arms down and palms facing inward, raise arms with palms facing forward, then continue raising arms with palms facing up

teaches abdominal breathing and ideal posture

22
Q

describe sustained /f/

A

posture /f/, breathe in, then exhale until completely out of breath

forces abdominal inhalation and has good feedback

23
Q

describe push-pull

A

pt pushes palms together and produces a short staccato vowel or /m/ initial cv syllable

increases vocal fold adduction; good for hypo functional pts and pts with vocal fold paralysis-paresis, bowing, presbylarynges, etc.

24
Q

name the physiologic voice tx techniques

A

vocal function exercises; lessac marsden resonant voice tx; accent method; flow phonation; lee silverman voice tx; semi-occluded vocal tract exercises

25
Q

physiologic voice tx improves ___

A

BALANCE amongst: respiratory support, laryngeal muscle strength; control-stamina; supraglottic modification of the laryngeal tone

26
Q

in physiologic voice tx, the cause of voice disturbance may be ___

A

mechanical, neurological, or psychological

27
Q

describe vocal function exercises

A

PHYSIOLOGIC
warm up : sustained /i/ with frontal focus :: expansion : pitch glides up on /o, ol, nol/ :: contraction : pitch glides down on /o, ol, nol/ :: power : sustained phonation on five pitches

rationale: recalibrates-strengthens larynx; improves glottic closure

28
Q

describe semi-occluded vocal tract exercises

A

PHYSIOLOGIC
glides, revving, speech, and vowel prolongations using drinking straws

rationale: necessitates a greater respiratory drive, increases vocal fold closure, lowers-relaxes larynx, and trains frontal focus

29
Q

describe resonant voice

A

PHYSIOLOGIC
frontal tone placement of /m, n, j, r, z/ in syllables-words-sentences

rationale: allows pt to appropriately increase loudness; decreases hyperfunction and decreases vocal fold medial compression

30
Q

describe accent method

A

PHYSIOLOGIC
produced sustained consonants-vowels while rocking back and forth (ha, yay, hay, sa, who, fa, etc.)

rationale: improves coordination between respiration and phonation; decreases medial compression and teaches flow phonation

31
Q

describe lee silverman

A

PHYSIOLOGIC
sustained, loud phonation of (ahh); pitch glides up and down; targeting adequate loudness from phrases to spontaneous speech

32
Q

describe flow phonation

A

PHYSIOLOGIC

cup bubbles with and w/o voicing; blowing tissue paper (bernoulli effect) with and w/o voicing; gargling

33
Q

what is the best therapy task sequence (order)?

A

relaxation exercises, breathing exercises, voice exercises

34
Q

list the guidelines for vocal hygiene goals

A

identify vocal hygiene risks that are specific to the pt; no laundry lists; make sure the pt understands why

35
Q

describe post-surgical voice care

A

voice rest for 7 - 10 days; review pre-surgery recommendations (train adequate breath support; eliminate muscle tension; address vocal hygiene issues)

after rest: begin glides and semi-occluded vocal tract exercises; train confidential voice; train resonant voice tx

36
Q

describe confidential voice

A
PHYSIOLOGIC
breathy phonation (soft intensity speech with minimal voicing) to decrease medial compression and impact stress; use post surgery or after severe phono trauma
37
Q

hyperfunction vs hypofunction

which one is facilitated by using a larger-diameter straw during semi-occluded vocal tract exercises?

A

hypofunction