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Nature of disorders > Voice > Flashcards

Voice Flashcards

1
Q

voice disorder

A

when quality, pitch, loudness or flexibility differs from the
voice of others of similar age, sex & cultural group

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2
Q

dysphonia

A

abnormal voice quality

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3
Q

aphonia

A

lack of voice

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4
Q

professions associated with voice problems

A
  • teachers
  • uni students
  • student teachers
  • call centre operators
  • singers
  • elderly/nursing home
  • drill sergeants
  • tour guides
  • priests
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5
Q

causes of organic voice disorders

A
  • Congenital or acquired
  • Infection
  • Trauma
  • Reflux
  • Other irritant
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6
Q

reinke’s oedema

A

Cause: Smoking
Feature: abnormal fluid accumulation = swelling and thickening of VCs
Treatment: Smoking cessation
Voice: Rough, may have stridor

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7
Q

vocal cysts

A

Cause: May be trauma, or spontaneously develop. Could be a fluid-filled sac or
plugged mucous-secreting gland. Note – cysts are submucosal and may only be seen
on stroboscopy.
Treatment: Usually needs surgery and then SLT
Voice: Rough.

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8
Q

vocal polyps

A

Cause: Trauma or environmental (e.g. irritants)
Features: growths on VCs
Treatment: SLT may help, but may not cure. If incurable, then needs surgery to remove
Voice: Rough, probably strained

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9
Q

how are voice disorders charactericed visually?

A

endoscopy or videostroboscopy

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10
Q

laryngopharyngeal reflux

A
  • Cause: Dietary – pepsin (enzyme) adheres to larynx, activates in the presence of acid
  • Treatment: Gaviscon Advance / PPIs BD
  • Voice: Cuts in and out, may be rough
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11
Q

are men or women more likely to have voice disorders?

A

women

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12
Q

is socio-economic status related to voice disorders?

A

no

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13
Q

are girls or boys more likely to have voice disorders?

A

boys

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14
Q

family affect on voice problems in children?

A

having an older sibling = more likely

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15
Q

how does mental health affect voice?

A

stressful life events and psychological problems predispose to voice problems

  • usually contributory factors to psychogenic voice disorders
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16
Q

characteristics of dysphonia

A

hoarse, breathy, weak, rough, croaky, high/low, strained

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17
Q

voice characteristics

A

pitch, loudness, tremor, flexibility, stamina, quality

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18
Q

vocal tract discomfort characteristics

A

Fatigue Aching
Burning Pain
Tickling Mucous
Dryness Difficulty catching breath
Irritability Tightness
Lump in the throat (globus sensation) Pushing to get voice out

19
Q

posture is important for…

A

voice production

20
Q

post-nasal drip

A

Cause: Nasal irritation. May be environmental (e.g. pollen), idiopathic or secondary to LPR
Treatment: Sinus rinsing +/- steroidal sprays
Voice: May cut in and out, variable quality. Strained or rough if coughing a lot

21
Q

laryngeal web

A

Cause: Congenital. Generally only seen in paeds.
Treatment: Surgical. Note – causes airway patency issues
Voice: May be rough/strained, breathing may be stridorous, resonance may be ‘off’

22
Q

sulcus vocalis

A

Cause: Unknown, but possible congenital or through repeated inflammatory processes
Features: groove on vocal fold
Treatment: Surgical
Voice: Breathy and possibly rough with likely higher-than-normal habitual pitch

23
Q

neurogenic voice disorders characteristics depend on…

A

location of nerve lesion

Central lesions tend to involve other symptoms
Peripheral lesions tend to involve just the voice

24
Q

cause of neurogenic voice disorders

A

Acquired neurological diseases (e.g. MND, IPD, MS)
Trauma to the head/neck/throat
Post-infective (usually respiratory tract infection)
Iatrogenic (i.e. caused by the doctor: heart/lung/throat surgery)

25
Q

vocal paresis/paralysis

A

Cause: Usually acute nerve injury/severing, but may be stroke-related
Treatment: Surgical medialization, voice strengthening
Voice: Breathy, low volume, reduced pitch range, increased vocal fatigue. Aphonia if bilateral

26
Q

presbyphonia

A

Cause: Normal, age-related changes
Features: muscle atrophy, loss of elasticity, mucosal thinning, changes in hydration
Treatment: Voice strengthening.
Voice: Breathy, low volume, reduced pitch range, increased vocal fatigue.

27
Q

most common voice disorders

A

muscle tension voice disorders (MTVD)

28
Q

causes of MTVD?

A
  • Upper Respiratory Tract Infection (URTI)
  • Associated with organic voice disorder (by compensation)
  • Psychosocial stressors
29
Q

vocal nodules

A

Cause: Usually phonotrauma (i.e. vocal abuse)
Intervention: SLT input usually resolves, but entrenched/fibrotic
nodules may need surgery
Voice: Rough, probably strained quality

30
Q

muscle tension dysphonia

A

Cause: May be triggered by URTI, trauma or stress
Treatment: SLT. (Almost) no role for ENT
Voice: Rough, strained
- supraglottic squeeze
- stiff, tense VCs

31
Q

supraglottic squeeze

A

squeezing of space above glottis- lateral squeeze and anteroposterior squeeze

32
Q

can there be physical causes co-occurring with psychogenic voice disorders?

A

yes

33
Q

classifying psychogenic disorders

A

Type 1: classical (hysterical) conversion
Type 2: Cognitive Behavioural Conversion
Type 3: Habituated Conversion

34
Q

Type 1: Classical (Hysterical) Conversion

A

 5% of patients
 Lack of conscious acceptance of psychological problems
 La belle indifference

35
Q

Type 2: Cognitive Behavioural Conversion

A

 95% of patients
 Conscious acceptance of issues, but avoidance of same due to desire to avoid conflict (internal or external)

36
Q

Type 3: Habituated Conversion

A

 As with type 2, but the source of anxiety is gone, while the musculoskeletal tension remains

37
Q

Common features of PVDs

A

Low mood
Family/interpersonal difficulties
Mild-moderate depression
Difficulty expressing views/emotions
Stressful life events
Suppressing anger/frustration
Anxiety
Burden of responsibility
Common to females
Over-commitment and helplessness
Near normal psychological adjustment

38
Q

mutational falsetto/puberphonia

A
  • one of the most common psychogenic voice disorders
  • Males maintain a high-pitched falsetto voice after puberty
  • Often associated with maternal/parental attachment issues
39
Q

classification of voice problems

A

hyperfunctional, functional, organic, MTD, supraglottic squeeze, glottal insufficiency

40
Q

comprensensatory mechanisms make a person’s voice…

A

worse over time, not suddenly

41
Q

distress associated with voice problems

A

psychological distress, anxiety, depression, stress (can precede voice problems, and make problem worse)

42
Q

biopsychosocial model

A

health includes: psychological, sociological, biological

43
Q
A

Nature of disorders (6 decks)

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