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Comps > Voice > Flashcards

Voice Flashcards

0
Q 
Spastic dysphonia
1.
2. 
3.
4.
A
  1. Strained-strangled vocal quality
  2. Reduced control of expiration
  3. Pitch breaks
  4. Mono pitch
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1
Q

Flaccid dysphonia:
1.
2.
3.

A
  1. Breathy vocal quality
  2. Nasal emission
  3. Audible inspiration
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2
Q 
Hypokinetic dysphonia
1.
2. 
3.
4.
A
  1. Breathy harsh VQ
  2. Reduced vocal intensity
  3. Vocal tremor
  4. Shallow inspiration
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3
Q 
Hyperkinetic dysphonia
1.
2. 
3. 
4.
A
  1. Strained-strangled VQ 2. Voice arrests
  2. Excessively loud
  3. Variable rate of speech
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4
Q

Ataxic dysphonia
1.
2.
3.

A
  1. Slurred articulation
  2. Slowed speech
  3. Vocal tremor
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5
Q

Assessment:

A
  1. OM/CN Exam
  2. Case History
    a. Diet – Citrus? Acidic?
    b. Sleep
    c. Fatigue
    d. Vocal use
    e. Medication?
    f. Water consumption?
    g. Onset? Sudden = psychogenic/malingering; Gradual = organic (nodules, ALS, etc)
  3. Vocal Quality
  4. Pitch – up and down glides
  5. Loudness – up and down glides
  6. Resonance
  7. Endurance = MPT or count 1-100 (MG?)
  8. MSTD = laryngeal elevation, pain, reduced ROM
  9. Habitual Pitch = appropriate pitch for age and gender; anchored by coughing
  10. *Best perceptual tool for eval of pitch, intensity, quality, and endurance = prolonged vowel 11.

Objective Evaluation
a. Direct Laryngoscopy – very invasive; under anesthesia; good for surgery
b. Mirror Laryngoscopy – good for viewing masses
c. Endoscopy – can view anatomy and physiology (w/ stroboscopy)

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6
Q

Things to gather on case history:

A

a. Diet – Citrus? Acidic?
b. Sleep
c. Fatigue
d. Vocal use
e. Medication?
f. Water consumption?
g. Onset? Sudden = psychogenic/malingering; Gradual = organic (nodules, ALS, etc)

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7
Q

Objective evaluation of voice:

A

a. Direct Laryngoscopy – very invasive; under anesthesia; good for surgery

b. Mirror Laryngoscopy – good for viewing masses

c. Endoscopy – can view anatomy and physiology (w/ stroboscopy)

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8
Q

Perceptual evaluation of voice

A

Vocal Quality

Pitch – up and down glides

Loudness – up and down glides

Resonance

Habitual Pitch = appropriate pitch for age and gender; anchored by coughing

*Best perceptual tool for eval of pitch, intensity, quality, and endurance = prolonged vowel

*** ear is best tool

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9
Q

Treatment

auditory training:

A

Trying the patient to listen to their own voice and compared to others. Discussed the differences

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10
Q

Abductor SD-

Treatment:
A)
B)
C)
D)
A

The posterior cricoarytenoid contracts and forces the vocal folds open. Often occurs during speech when it is not supposed to.

A) humming
B) continuous voicing-all sounds are voiced
C) personal amplification system
D) Botox injection in PCA- hard to inject due to location/often not very successful

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11
Q

Abductor spasmodic dysphonia:

Treatment:
1.
2.
3.
4.
A

The thorough arytenoid spasms in the vocal folds are forced closed resulting in a very strained/strangled vocal quality

  1. Easy onset
  2. Breathing exercises
  3. Airflow
  4. Botox injections into the fire arytenoid is the gold standard for ADSD** research suggests that SLP is not always good conjunctive therapy
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12
Q

Nodules:

Treatment options:

A

Blisters that form on the anterior to middle one third of the vocal folds. Caused by repeated slamming together of the vocal folds.

  1. Vocal hygiene/vocal diary
  2. Treat Gerd
  3. Laryngeal massage for MSTD
  4. Reduce abusive behaviors
  5. Easy onset
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13
Q

Contact ulcers:

Treatment options:

A

Form on the posterior one third of the vocal folds

  1. Vocal hygiene/vocal diary
  2. Treat Gerd
  3. Laryngeal massage for MSTD
  4. Reduce abusive behaviors
  5. Easy onset
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14
Q

ALS:

treatment options:

A

Start training immediately for AAC use if they wish

discuss alternative feeding methods

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15
Q

Puberphonia:

treatment:

A

a. Counseling
b. Laryngeal massage
c. Train optimum pitch (m-hmm)
d. Glottal adduction
e. Suprasegmentals

16
Q

Flaccid dysphonia

Treatment:

A

a. Medialization or Nerve Anastomoses – gold standard
b. Glottal adduction exercises – for mild/moderate dysphonia
c. Vocal Fold Bowing – adduction exercises should be given as a trial prior to surgery

17
Q

Parkinson’s disease

A

a. LSVT – think loud; them the patient to talk 2x as loud; not with HTN
b. OM tasks to reduce masked facies
c. Lip and tongue exercises
d. Voice Intensity Training – glottal adduction and breathing exercises – also help with
swallowing

18
Q

PVFD- paradoxical vocal fold dysfunction

Treatment:

A

a. Reduce MSTD
b. Inhale slowly through nose to maximize glottal opening
c. Teach to forcefully exhale when they feel closing about to occur
d. Reduce anxiety – psychological counseling
e. Train breathing patterns for sports

19
Q

Myasthenia gravis

treatment:

A

a. Tensilon; anti-acetylinestrase

20
Q

Pseudobulbar Palsy

Treatment:

A

Pseudobulbar Palsy:

a. Botox/bacolofen pump
b. Breathy onset
c. Breathing exercises
d. Palatal lift

Comps (5 decks)

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