VD Test One Functional Voice Disorder

Question 1

What is a functional voice disorder?

Answer 1

the absence of current organic pathology, without obvious psychogenic or neurologic etiology.

Question 2

Is muscle tension dysphonia common?

Answer 2

YES

Question 3

What does persistent MTD result from?

Answer 3

excessive laryngeal and related musculoskeletal tension and associated hyperfunctional true and/or false vocal fold vibratory patterns

Question 4

How can MTD be categorized?

Answer 4

primary or secondary

Question 5

Determining whether MTD is primary or secondary what is it based on?

Answer 5

whether organic pathologic conditions contribute to trigger the muscle tension behavior

Question 6

What is PRIMARY MTD?

Answer 6

• dysphonia in the absence of current organic pathology

- excessive, atypical or abnormal laryngeal muscle movements

Question 7

What is SECONDARY MTD?

Answer 7

• compensatory response to the primary etiology

- excessive, atypical or abnormal laryngeal muscle movements

Question 8

Name 5 factors that contribute to MTD?

Answer 8

1. deviant body posture and misuse of neck and shoulder muscles
2. high stress levels
3. excessive voice use
4. persistently loud voice use
5. laryngopharyngeal reflux disease

Question 9

List 3 benign laryngeal pathologies resulting from MTD

Answer 9

1. vocal fold nodules
2. vocal fold polyps
3. reinke’s edema

Question 10

Where do you often find vocal fold nodules?

Answer 10

glottal margin of each fold (anterior middle third junction

Question 11

What does a vocal fold nodule look like in the early stage?

Answer 11

soft/pliable, reddish

Question 12

What does an aged/chronic nodule look like?

Answer 12

hard and white

Question 13

What causes vocal fold nodules?

Answer 13

continuous abuse of the larynx and misuse of the voice

1. compensatory muscular tension
2. increased laryngeal effort
3. excess vocalis tension
4. increase pressure to force air through constricted folds
5. incoordination of respiration/phonation
6. hearing loss

Question 14

What are some psychological factors that can cause vocal fold nodules?

Answer 14

stress, lifestyle, tension with individuals

Question 15

What are the voice symptoms of VF nodules?

Answer 15

• VF is stiff and more massive, and vibration is aperiodic; posterior glottal chink may be observed with hourglass closure
• large nodules may cause trouble breathing (dyspnea)

Question 16

List 6 descriptions for what happens to the acoustics of one’s voice from VF nodules?

Answer 16

1. breathiness and air wastage
2. hoarse voice quality
3. decreased Fo and pitch range
4. decreased habitual loudness and dynamic range
5. increased perturbation rates, jitter/shimmer
6. vocal fatigue, frequent throat clearing

Question 17

What aerodynamic features occur because of VF nodules?

Answer 17

higher than normal air flows

Question 18

Ask someone about nodule questions on slide treatment of nodules????

Answer 18

??????

Question 19

When working with a patient with VF nodules, what behaviors do you address through reduction/elimination?

Answer 19

1. smoking
2. excess volume
3. vocal abuse at public events
4. singing style

Question 20

What should patient increase with VF nodules?

Answer 20

hydration

Question 21

How long will it take a nodule to go away?

Answer 21

as long as it took to develop

Question 22

What is a vocal fold polyp?

Answer 22

localized, fluid filled sac on the VF

Question 23

What is a pedunculated polyp?

Answer 23

attached by slim stalk

Question 24

What is a sessile polyp?

Answer 24

blister adhere to mucosa

Question 25

What is a hemorrhagic polyp?

Answer 25

blood filled

Question 26

Where is a polyp usually located?

Answer 26

- free of margin from TVF - usually unilateral (90%), can be bilateral - arise at same location as nodules

Question 27

Where do polyps usually arise?

Answer 27

on superficial lamina propria, but deeper than nodules

Question 28

What are nodules typically due to?

Answer 28

vocal abuse

Question 29

What is a polyp usually due to?

Answer 29

a single event

Question 30

What can a polyp do spontaneously?

Answer 30

heal

Question 31

What are 5 things that can happen to one's voice with polyps?

Answer 31

1. similar to those of a nodule 2. incomplete VF closure 3. decreased phonation time 4. decreases pitch 5. reduced dynamic range

Question 32

How can a polyp be treated?

Answer 32

with surgery

Question 33

Surgery and then voice treatment? OR Voice treatment and then surgery?

Answer 33

Surgery and then voice treatment

Question 34

What are the 4 steps of micro-flap surgery to remove a polyp?

Answer 34

1. small incision 2. raise flap 3. remove contents via suction 4. lay flap down

Question 35

What is the goal of polyp micro-flap surgery?

Answer 35

1. save as much superficial lamina propria as possible | 2. disrupt the glottal margin as little as possible

Question 36

In voice therapy for polyps, what is recommended?

Answer 36

``` reduce secondary habits such as.... 1. overdriving 2. hard voice onset 3. secondary strain Reduce 1. abusive habits Voice therapy 1. after surgery Keep up good.... 1. vocal hygiene ```

Question 37

What does reinke's edema usually look like?

Answer 37

1. usually bilateral and asymmetric 2. folds appear fluid filled 3. extreme cases confused with polyps 4. in stobe, folds appear stiff

Question 38

What is the cause of Reinke's edema?

Answer 38

1. hyper-function 2. smoking 3. extreme allergies

Question 39

What gender is reinke's edema more common in?

Answer 39

females

Question 40

What happens to Fo with reinke's edema?

Answer 40

decreases

Question 41

What decreases and what extends in patients with RE?

Answer 41

decrease range | extension of low end

Question 42

What happens to perturbation in patients with RE?

Answer 42

increases

Question 43

What happens to periodicity of voice in patients with RE?

Answer 43

become aperiodic

Question 44

What is greater than normal in patients with RE?

Answer 44

greater than normal flow loops

Question 45

List recommendations of therapy for RE and other related conditions.

Answer 45

1. reduce abuse 2. decrease intensity 3. noise in talking environments 4. decrease/stop "throat clearing" 5. limited vocal rest, 3 - 4 weeks 6. increase hydration 7. re-eval in 3 - 4 weeks

Question 46

What is success of voice therapy for RE highly dependent on?

Answer 46

eliminating the cause of the problem, such as smoking