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SPA Exams > Voice > Flashcards

Voice Flashcards

1
Q

Sulchus Vocalis

A

Etiology: Unknown, either congenital or acquired
Location: Both Uni and bi
Physical Characteristics: Spindle opening.
Voice: breathy, reduced loudness, hoarse
Treatments: voice therapy (pitch shift down) or surgery

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2
Q

Contact Ulcer

A

Etiology: 1. Intubation 2. GERD 3. Vocal abuse
Location: Posterior 1/3 on cartilaginous portion, typically unilateral
Physical Characteristics:
Voice: n/a
Treatments: Therapy not usually surgery

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3
Q

Vocal abuse

A

Hard glottal attacks
Excessive coughing
Throat clearing
Habitually loud voice

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4
Q

Contact granulomas

A

Occur with contact ulcers or alone
Etiology: GERD, intubation, vocal abuse.
Location: posterior 1/3 on cartilaginous portion
Physical characteristics: depression in VF, sometimes opposite contact ulcers
Treatments: therapy, not surgery

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5
Q

Cancer

A

Etiology: Most commonly long term smoking in addition to alcohol abuse.
Location: Varies, supraglottically, glottically, or subglottically
Physical characteristics: Bulky lesion, ranges depending on stage: TNM
T= size of the lesion 1-4
N= local spread of the disease into the neck, 1-3
M=metastasis, distant spread either 0 or 1 (most commonly into lung)
Treatments: Chemoradiation, surgery
Vocal characteristics:

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6
Q

Leukoplakia

A

aka Hyperkeratosis (pinkish)
Etiology: Smoking or other irritants
Location: larynx, oral cavity, pharynx etc.
Physical characteristics: white patchy flat “cottage cheese”
Treatments: Eliminate irritant and scrape off lesions
Vocal characteristics:

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7
Q

Endocrine changes

A

Etiology: Endocrine dysfunction, hyperfunction of pituitary gland or adrenal glands, hypothyroidism, menstrual changes, menopause.
Location: Vocal folds, glands
Physical characteristics: Increased mass of vocal folds
Treatments: Endocrine therapy
Vocal characteristics: Higher or lower than normal pitch

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8
Q

Hemangioma

A

Similar to granulomas, but soft.
Etiology: vocal hyperfunction, hyperacidity and intubation.
Location: Posterior aspect of vocal folds (difference from polyp which is anterior)
Physical characteristics: Soft blood-filled lesion
Treatments: Surgery with vocal hygeine
Vocal characteristics:

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9
Q

Infectious Laryngitis

A

Etiology: Infection
Location: Larynx
Physical characteristics: Edema, irritation, fever, URI, headache.
Treatments: Rest, increased fluid intake, antibiotics.
Vocal characteristics: Dysphonia or aphonia

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10
Q

Laryngectomy

A

Partial or complete resection of the larynx.
Stoma
Manages T3 or T4 tumors

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11
Q

Papilloma

A 
Etiology: HPV
Location: Anywhere
Physical characteristics: wart like growths
Treatments: Surgery
Vocal characteristics:
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12
Q

Pubertal changes

A

Before 9 years male and female voices have the same frequency of 265 Hz.
Females have 4 note drop.
Males have an 8 note drop

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13
Q

Web

A

Etiology: Congenital- glottal membrane fails to separate during embryonic development. Acquired- bilatera trauma to medial edges of vocal folds
Location: most common anteriorly due to proximity.
Physical characteristics: Lesion formed between 2 vocal folds, respiration difficulty.
Treatments: Surgery with keel and voice therapy after surgery.
Vocal characteristics: dysphonia, high pitched, rough sounding

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14
Q

What does the vagus nerve innervate?

A 
Striated muscles of the soft palate
Most striated muscles of the pharynx
All striated muscles of the larynx
Smooth muscles of pharynx
Smooth muscles of larynx
Sensory:
taste at root of tongue
epiglottis
Larynx
trachea
esophagus
skin behind ear
external acoustic meatus
tympanic membrane
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15
Q

Where does the Vagus nerve exit the skull?

A

Jugular foramen

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16
Q

What houses the vagus nerve as it travels through the neck?

A

Carotid sheath

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17
Q

What is the inferior sensory ganglion?

A

It allows communication with CNs VII, IX, X, XII and XII

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18
Q

What does the pharyngeal branch innervate?

A

Motor

Pharyngeal plexus, pharyngeal muscles, soft palate (except tensor vili palatini V)

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19
Q

What does the superior laryngeal nerve enervate?

A

Motor and sensory

  • Internal Branch: Sensory to mucous membranes of the base of the tongue, epiglottis, pharynx and larynx and some glands
  • External Branch: Cricothyroid muscle
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20
Q

What does the recurrent laryngeal nerve enervate?

A

Motor to all intrinsic muscles of the larynx (except cricothyroid [SLN])
Sensory to true vocal folds, subglottic region and trachea
Movement of vocal folds

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21
Q

How can the SLN be damaged?

A

Strangulation, thyroid surgery

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22
Q

How can the RLN be damaged?

A

Thyroid surgery

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23
Q

Abduction

A

Movement of the vocal folds laterally, away from the midline of the laryngeal airway.

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24
Q

Adduction

A

Movement of the vocal folds medially, toward the midline of the laryngeal airway.

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25
Q

Amplitude perturbation

A

Shimmer

Irregularity of vocal fold vibration manifested by cycle to cycle variation in amplitude.

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26
Q

Shimmer

A

Amplitude perturbation.

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27
Q

Aphonia

A

Absence of a definable laryngeal tone.
Breathy
Whispered

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28
Q

Dysphonia

A

Abnormal voice, as judged by the listener, involving either pitch, loudness, quality, flexibility or a combination.

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29
Q

Fundamental frequency

A

F0

The rate at which a waveform is repeated per unit time

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30
Q

Frequency perturbation

A

Jitter

Refers to the irregularity of vocal fold vibration manifested by cycle to cycle variation in fundamental frequency

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31
Q

Functional voice disorder

A

No identifiable organic etiology for the dysphonia

Voice disorder that is the result of abnormal function.

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32
Q

Glottis

A

The space between and bordered by the vocal folds

33
Q

Habitual pitch

A

Speaking pitch

The most frequently occurring or modal pitch level used by the speaker.

34
Q

Loudness

A

The perceptual correlate to intensity

35
Q

Maximum phonation time

A

Vowel sustaining period possible following deep inspiration and vocalizing at a comfortable pitch and loudness.
Established norms are then applied to assess adequacy of performance

36
Q

Modal Register

A

May be divided into chest, middle and head
Encompasses the rance of notes employed in speech
This is the register used in speech.

37
Q

Mute

A

Inability to phonate or articulate.

38
Q

Organic voice disorder

A

Visible pathology
Caused by a structural, anatomic or physiologic disease.
Either a disease of the larynx itself or of a remote systemic illness which impairs laryngeal structure or function.
Nodules, lesions

39
Q

Perceptual aspects of voice

A

Characteristics of voice perceived by the listener.
Subjective in nature
Clinically, paired with the history serving as an initial guidepost in the process of differential diagnosis

40
Q

Phonation

A

Physical act of sound production by means of vocal fold interaction with the exhaled airstream
Puffs of air are released within an audible frequency range which resonate in the supraglottic cavities.

41
Q

Phonation breaks

A

Sudden and temporary loss of voice which may occur at a syllable, word, phrase, or sentence level
Etiology: hyperfunction, lesion, reduced subglottic air, mucus on vocal folds, edema

42
Q

Phonation range

A

Dynamic range
Difference between lowest sustained tone in the modal register and the highest in falsetto.
Measured in Hz, and converted to whole notes or semitones for recording and norms comparison.

43
Q

Pitch

A

The perceptual correlate of F0

44
Q

Pitch break

A

Rapid shift of frequency, unexplained and uncontrolled in an upward or downward direction.
Readily perceived.
May occur as a result of laryngeal pathology or an accompaniment to conditions that involve some loss of neural control of phonation.

45
Q

Symptom

A 
A voice complaint.
What patient reports about a problem and its characteristics
8 primary symptoms or voice problems
Hoarseness
Vocal fatigue
Breathiness
Reduced phonational range
Aphonia
Pitch Breaks/High pitch
Strain/Struggling voice
Tremor
46
Q

Videolaryngoscopy

A

Method of evaluating and documenting the physiologic and pathologic conditions of the pharynx and larynx using a laryngoscope and specialized video equipment

47
Q

Voice

A

Audible sound produced by phonation

48
Q

Vocal folds

A

Shelves of thyroarytenoid muscle covered with mucous membrane and fibroelastic tissue which project into the laryngeal airway

49
Q

Vocal fry

A

Creak, chest register
Low pitched rough voice
May be present in everyday speech
Frequent in vocal strain and abuse

50
Q

Vocal hyperfunction

A

Classification of a voice disorder according to the position of the vocal folds in an over adducted posture during phonation

51
Q

Vocal hypofunction

A

Classification of a voice disorder according to the position of the vocal folds in an under adducted posture during phonation

52
Q

Vocal parameters

A

The elements of voice
Pitch: the perceptual correlate of frequency
Loudness: the perceptual correlate of intensity
Quality: The perceptual correlate of complexity
Flexibility: The perceptual correlate of frequency, intensity and complexity variations

53
Q

Vocal registers

A

Fry or pulse-low
Modal-Chest, middle and head (speaking)
Falsetto-high

54
Q

Falsetto

A

Puberphonia
Treatments: Therapy
Vocal characteristics: Immature, high voice
Physical characteristics: larynx looks normal

55
Q

Functional aphonia

A

Treatments: Therapy

Vocal characteristics: Whispered, high pitched shrill voice. Usually have normal laugh/cry

56
Q

Functional dysphonia

A

Treatments: Therapy
Vocal characteristics:
Physical characteristics: Feeling of fullness or pain in the larynx, tightness in chest or laryngeal area, neck tightness

57
Q

Muscle Tension Dysphonia

A

Type of functional dysphonia
Similar to adductor spasmodic dysphonia, but responds to treatment.
Physical characteristics: Partial closure of the ventricular folds from side to side.
A–>P compression of larynx
Sphincter-like closure of supraglottic larynx
Posterior tongue carriage
Vocal characteristics: strained/strangled

58
Q

Diplophonia

A

Double voice/pitch
2 distinct voice sources
Caused by the vocal fold vibrating at a different rate due to difference in mass or tension.
Treatment: therapy.

59
Q

Thickening

A 
Edema may be focal or generalized
2 Types: Swelling due to trauma
Chronic irritation or abuse
May be precursor to polyp or nodule
Treated with vocal hygiene and removal of irritation
60
Q

Reinke’s Edema

A

aka polypoid degeneration
Diffuse thickening secondary to chronic abuse and or smoking.
Voice is low in pitch
Reinke’s space becomes fluid filled
If caused by abuse and misuse can be treated with therapy.
If caused by smoking must be remedied surgically

61
Q

Vocal polyps

A

Often unilateral on the anterior 2/3 of the folds
Soft and fluid filled (hemorragic-filled with blood)
Result of single instance of abuse and misuse.
Sessile polyps are broad based and respond to therapy and vocal hygiene.
Pedunculated polyps are on a stalk and must be removed surgically

62
Q

Vocal nodules

A 
Most common benign lesion
Typically bilateral at the anterior middle-third juncture.
Result of long term abuse and misuse
Hourglass closure
Lower pitch, breathy hoarse voice
63
Q

Traumatic laryngitis

A

aka functional laryngitis
Etiology: Excessive and strained vocalizations, may be due to long term exposure to irritant
Vocal characteristics: hoarse, breathy, reduced in volume.
Treatment: Vocal rest

64
Q

Ventricular Dysphonia

A

aka Ventricular phonation
Vocal characteristics: low pitch, rough and breathy, lacks pitch variability.
Ventricular folds are approximated during phonation.
Treatment: Therapy

65
Q

Videostroboscopy

A 
Contact microphone
Endoscope
Light source
Monitor
Keyboard
Software
Camera
Hard drive
Printer
Lens adapter
Camera head
External microphone
Equipment cart
66
Q

Vocal range

A

Typically 16 notes, 24 for singers

67
Q

Neurogenic voice disorder

A

Result of central or peripheral nerve damage
Majority are peripheral
Paralysis or paresis

68
Q

Divisions of respiratory tract

A

Upper: level above larynx
Lower: below larynx

69
Q

Trachea

A

From larynx at C6 to carina (branching of bronchi)

Cartilaginous rings and muscle, fibroelastic membrane, intratracheal membrane and epithelium

70
Q

Glottal Fry

A

Start low and go lower
Use for pathologies with hyperfunction: ventricular phonation, paradoxical vocal fold dysfunction, muscular tension dysphonia, nodules

71
Q

Laryngeal Massage

A

Start under mandible and massage down focusing on areas of spasm
Use for functional voice disorders (nodules, polyps)

72
Q

Yawn sigh

A

Minimizes vocal hyperfunction, drops the larynx and moves the tongue forward.
Good for functional dysphonia, spasmodic dysphonia, vocal fold thickening, nodules, polyps

73
Q

Nasal Focus

A

Put finger on nose to bring focus to the nasal area and lips. Start with syllable hums and increase in length with nasal sounds.
Use this for polyps, nodules and ventricular phonation

74
Q

Nasal Glide Stimulation

A

Uses words containing nasals and glides and continuous voicing
Use with functional dysphonia, spasmodic dysphonia, vocal fold thickening, nodules, polyps.

75
Q

Pitch shift

A

Within a normal range start low and move pitch up or vice versa, can be used with nasal focus or visipitch,
Use with ventricular phonation sulcus vocalis, presbylarynx

76
Q

Chant-talk

A

Pitch and loudness are kept constant, words run together with no stress or prosody. Often combo with nasal focus.
Use for hyperfunction, phonation and pitch breaks and nodules and polyps.

77
Q

Pitch inflections

A

Shift the focus of inflection between words (I want it, I want it, I want it).
Used to tread mono-pitch and mono-loudness resulting from dysarthria and functional dysphonia.

78
Q

Visual Feedback

A

Visi-pitch-use with hearing impaired

79
Q

Digital Manipulation

A

Grab larynx and pull down.

Use with puberphonia

SPA Exams (10 decks)

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