Voice

Question 1

Nasalization

Answer 1

communication between the vocal tract and the nasal passageway

Question 2

Hypernasality

Answer 2

presence of nasal resonance during the production of nonnasal voiced sounds, particularly vowels, and diphthongs.
To assess hypernasality, a completely nonnasal phrase loaded with voiced sounds
is required

Question 3

Hyponasality

Answer 3

occurs when there is insufficient nasal resonance on nasal sounds due to a blockage in the nasopharynx or nasal cavity

Question 4

Denasality

Answer 4

e lack of nasal resonance on sounds that should be nasalized and, as such, can occur only on /m/, /n/, and /ŋ/. For evaluation of denasality, a phrase loaded with nasal sounds is ideal

Question 5

Hoarseness

Answer 5

combination of breathy
and harsh qualities. It’s caused by
irregular vocal fold vibration,
making the voice sound breathy,
low-pitched, and husky

Question 6

Pitch

Answer 6

perception of fundamental frequency

Question 7

Roughness

Answer 7

perception of irregularity of voice

Question 8

Breathiness

Answer 8

perception in air escaping voice

Question 9

Strain

Answer 9

perception of excessive vocal effort

Question 10

Indirect Laryngoscopy

Answer 10

1. examine the larynx and vocal folds
   indirectly, aiding in identifying voice disorders and laryngeal issues.
2. observes:
   -Vocal Fold Mobility
   -Structural Anomalies
   - Mucosal Wave Action
   -Symmetry and Closure

Question 11

Direct Laryngoscopy

Answer 11

1. invasive procedure that allows for a close examination of the larynx
   using a laryngoscope, which is inserted through the mouth and into the pharynx under general anesthesia.
2. Primarily used for detailed inspection, biopsy, and surgical interventions within the larynx.
3. Observes:
   Structural Assessment
   Biopsy Capability
   Surgical Interventions

Question 12

Flexible or Rigid Endoscopy with Videostroboscopy

Answer 12

• advanced diagnostic procedure combining endoscopy with
  stroboscopic lighting to visualize the vocal folds’ vibratory patterns in slow motion
• observes:
  Vibratory Patterns
  Vocal Fold Amplitude
  Glottal Closure
  Mucosal Wave
  Lesions or Neoplasms

Question 13

Jitter

Answer 13

tiny, usually unintended changes in
how fast your vocal folds vibrate when you talk or sing

Question 14

Shimmer

Answer 14

fluctuation in your voice’s volume: small, often
unintentional changes in how loud your vocal folds make sounds as you talk or
sing

Question 15

Harshness

Answer 15

excessive muscular tension and effort. It occurs when vocal folds are adducted too tightly, producing a rough, unpleasant, and “gravelly” sound.

Question 16

Cul De Sac Resonance

Answer 16

resonance disorder that occurs when sound becomes trapped in a cavity, such as the throat, nose, or mouth, and is unable to exit. This is usually due to an obstruction in the vocal tract

Question 17

FUNDAMENTAL FREQUENCY

Answer 17

Males: 100-150 Hz
Average 125 Hz
Females: 180-250 Hz
Average 200

Question 18

MAXIMUM PHONATION TIME

Answer 18

Max time a tone can be sustained on a single breath
Males: 20 seconds
Females: 15 seconds
Children: 10 seconds

Question 19

S:Z RATIO

Answer 19

Should be 1.0
How long a patient
can hold out /s/ v.s. /z/
Above 1.4 is indicative of pathology

Question 20

Vocal Nodules

Answer 20

1. Small nodes that develop on the superficial layer of the lamina propria
2. Cause: vocal abuse or misuse
3. TX: Behavioral voice therapy

Question 21

Vocal Polyps

Answer 21

1. Masses that grow and bulge from surrounding tissue in the middle 1/3rd of the superficial lamina propria.
2. Cause: Traumatic use of the vocal folds
3. TX: Vocal rest and change in vocal habits

Question 22

Cysts

Answer 22

1. Unilateral, benign and filled with mucus like fluid cyst on the
   membranous portion of the vocal folds
2. Cause: Vocal misuse or abuse
3. TX: Surgical intervention is usually most effective

Question 23

Granulomas

Answer 23

1. Localized, inflammatory, vascular lesion on the vocal process of the arytenoid cartilages
2. Cause: Vocal strain, intubation, injury to the larynx & Laryngopharyngeal Reflux (LPR)
3. TX: Surgery, voice therapy or both

Question 24

Contact Ulcers

Answer 24

1. Sores or crater-like area of ulcerated, granulated tissue that
   develops (usually bilaterally) along the posterior third of the
   glottal margin
2. Cause: Constant low pitch phonation, GERD, intubation
3. Medical treatment (to fix
   GERD) & voice therapy

Question 25

Vocal Fold Thickening

Answer 25

1. Vocal folds thicken along the anterior two-thirds of the glottal margin 2. Cause: Vocal misuse or abuse 3. Tx: Change in vocal habits

Question 26

Traumatic Laryngitis

Answer 26

1. Vocal folds become swollen causing the voice to be hoarse and low pitched with pitch breaks 2. Cause: Vocal misuse or abuse 3. Tx: Vocal rest and change in vocal habits

Question 27

Hemangioma

Answer 27

1. Similar to granulomas but are soft, pliable and filled with blood 2. Cause: Acquired: posterior glottal area creating hoarse vocal quality Congenial: subglottic region creating stridor 3. Tx: Surgical intervention followed up by voice therapy

Question 28

Reinke's Edema

Answer 28

1. Fluid builds up in the superficial lamina propria causing swelling 2. Cause: Continuous vocal abuse, exposure to cigarette smoke & Laryngopharyngeal Reflux (LPR) 3. Tx: Reduction or elimination of exposure to toxins and irritants

Question 29

Varices

Answer 29

1. Distended and prominent veins usually at the mid portion of the superficial lamina propria 2. Cause: Phonotrauma 3. Tx: Vocal rest & vocal hygine education

Question 30

Vocal Fold Hemorrhage

Answer 30

1. Blood vessels burst within the vocal folds. Depending on the severity of the bleeding, the voice can sound hoarse and can range from mildly dysphonic to aphonic. 2. Cause: Phonotrauma 3. Tx: After hemorrhage is healed, remaining vocal issues can be treated through vocal fold augmentation

Question 31

Hyperkeratosis

Answer 31

1.Rough, pinkish lesion that can appear in the oral cavity, larynx or pharynx. May involve the epithelial cover as well as the superficial layer of lamina propria 2. Cause: Tissue irritation, smoking, GERD or vocal abuse 3. Tx: Eliminating irritants, ablative surgery and/or voice therapy

Question 32

Leukoplakia

Answer 32

1. Benign growths of thick whitish patches on the surface of the membrane of the mucosa 2. Cause: Tissue irritation by smoking, alcohol or vocal abuse 2. Tx: Combination of eliminating irritants, surgery and voice therapy

Question 33

Laryngomalacia

Answer 33

1. Soft 'floppy' laryngeal cartilage. Most common cause of stridor in infants 2. Cause: The epiglottis is very soft a pliable due to abnormal development so when the child breathes, the epiglottis resists the airstream 3. Tx: Usually resolves spontaneously. More severe cases may require surgery

Question 34

Subglottal stenosis

Answer 34

1. Narrowing of the subglottic space 2. Cause: Congenital: arrested development of the conus elasticus or interruption of the cricoid cartilage during embryological development Acquired: endotracheal intubation 3. Tx: Surgery and vocal intervention

Question 35

Papiloma

Answer 35

1. Wart-like growths that are pink, white, or both and may be found anywhere in the airway. Can cause hoarseness, breathiness and low pitch 2. Cause: Human Papilloma Virus (HPV) 3. Tx: Multiple surgeries followed by voice therapy

Question 36

Laryngeal Web

Answer 36

1. A membrane that grows across the anterior portion of the glottis. Will cause difficulty breathing and inspiratory stridor 2. Cause: Congenital: present at birth Acquired: due to trauma to the inner edges of the vocal folds 3. TX: Congenital: immediate surgery followed by tracheotomy Acquired: surgery to remove the web followed by voice therapy

Question 37

Sulcus Vocalis

Answer 37

1. Thinning and bowing of the superficial lamina propria of the vocal folds. Can be unilateral or bilateral 2. Cause: Unknown 3. Tx: Surgical augmentation using fats or fascia

Question 38

Ankylosis

Answer 38

1. Stiffening of the joints. The movement of the arytenoid is restricted because of a bone-joint disease 2. Cause: Arthritis or cancer 3. Tx: Treat the cause first

Question 39

Structural Voice Disorder

Answer 39

- physical changes of vocal mechanism - ie cysts, growths, laryngeal trauma, ulcers, lesions, edema, laryngitis, glottal stenosis

Question 40

Neurogenic Voice Disorder

Answer 40

- innervation to structures is impaired/damaged ie Spasmodic Dysphonia, PD, MG, ALS, vocal tremor

Question 41

Functional Vocal Misuse

Answer 41

- normal structure, improper use/misuse ie muscle tension dysphonia, vocal fatigue, diplophonia

Question 42

Psychogenic Voice Disorder

Answer 42

- normal structure, psychological cause ie conversion dysphonia, conversion aphonia, puberphonia

Question 43

Aryepiglottic Folds

Answer 43

acts as a sphincter for the laryngeal inlet, preventing food or liquid from entering the lower respiratory tract

Question 44

Cover Body theory of Phonation

Answer 44

cover-body theory of phonation states that the epithelium and the superficial, inter- mediate, and deep layers of the lamina propria vibrate as a"cover" on a relatively stationary "body" This bodyis composed ofthe remainder of the TA muscle.

Question 45

PVFM (Paradoxical Vocal Fold Motion)

Answer 45

also known as vocal cord dysfunction or laryngospasms, is a voice disorder that causes breathing difficulties when the vocal cords close instead of opening during inhalation.