Voice Flashcards
The ____________________adduct the vocal processes and membranous vocal folds, while the ______________________adduct the cartilaginous or posterior glottis
lateral cricoarytenoids ; interarytenoids
The cricothyroid muscle is responsible for increases in frequency and is innervated by the recurrent laryngeal nerve
False
When the thyroarytenoid muscles contract they
shorten the vocal folds, increase medial compression by bulking the vocal folds, can increase or decrease frequency
Changes in the composition of the___________can result in a decreased mucosal wave
superficial lamina propria
The deep layer of the laminia propria is composed of mainly elastin fibers and interstitial fluids.
False
The basement membrane zone is responsible for attachment of the _________to the ____________.
epithelium; superficial lamina propria
The superior laryngeal nerve is a branch of cranial nerve ___and provides motor innervation to _______and carries sensory information from the ______________________.
CN X ; the cricothyroid ; supraglottic area
The geniohyoid and mylohyoid muscles are ____________ and function to ______ the hyoid and larynx
suprahyoid muscles ; elevate
The recurrent laryngeal nerve innervates _________. Injury to the recurrent laryngeal nerve is more common on the ______side
all laryngeal muscles except cricothyroid ; left
The _________ and _________ muscles have their insertions on the _________ of the ________ cartilage
posterior cricoarytenoid and lateral cricoarytenoid ; muscular processes ; arytenoid
Elastic recoil plays an important role in vocal fold closure during vibration
True
The aerodynamic force that is responsible for opening the vocal folds is _______, while the aerodynamic force which helps to close the vocal folds is __________ that results from the __________
subglottal pressure ; negative pressure ; Bernoulli Effect
The Body - Cover Model of Frequency Control states that during high intensity phonation contraction of the TA muscle
will increase pitch as long as the cricothyroid muscle is not at maximum activity
Fundamental frequency of vocal fold vibration depends on
vocal fold length, mass, and elasticity
The convergent glottal shape occurs when the vocal folds are _____ and the net tissue velocity (i.e. movement) is ________.
opening; outward
In the One Mass Model (Vocal Tract Inertance) of vocal fold vibration, sustained phonation is driven by
alternating positive and negative supraglottic and transglottic (intraglottic) pressures
A vocal register is
a series of pitches perceived to be of the same timbre or quality, a series of pitches produced in the same physiological manner
Vocal quality (i.e. roughness, breathiness etc.) is determined by
degree of glottic closure and periodicity of VF vibration
The mucosal wave is an apparent sliding motion of the vocal fold cover over the vocal fold body.
True
In order to produce high vocal intensity (loud phonation)
the vocal folds must adduct completely, the closed phase of vibration must be longer than the open phase, respiratory drive must be adequate and subglottal pressure relatively high, the vocal folds must close rapidly
Intrinsic laryngeal muscle tension may be observed during endoscopic exam as
anterior - posterior compression, medial-lateral compression, and supraglottic compression or sphinctering
Puberphonia is a ________ disorder and is characterized by _______ phonation.
Functional; high pitch
Paradoxical VF Movement occurs when
the VFs ADduct during inhalation
Essential Tremor is a/an
Neurological disorder
ABductor spasmodic dysphonia is characterized by
breathiness and difficulty transitioning from voiceless stops to vowels
Bilateral VF adductor paralysis results in
the inability to adduct or close the VFs, risks to airway safety during swallowing
The cause/s of VF granulomas is/are
Intubation injury, acid reflux, vocal abuse/misuse
MALES
Sulcus vocalis
is a longitudinal groove along the entire medial VF edge, may be due to a ruptured cyst or may be congenital
Laryngomalacia
results in soft, floppy laryngeal cartilages that collapse into the airway
usually resolves with maturity
is characterized by inspiratory stridor
Reinke’s edema is
Very often related to smoking
Vocal fold nodules are typically
Bilateral, occur on Superficial Lamina Propria (SLP)
Vocal fold cysts will cause the mucosal wave to be__________ or ________, while Reinke’s edema may cause the mucosal wave to be ________________.
Decreased or absent; increased
VF hemorrhage will cause increased VF
stiffness
You are about to perform a videostroboscopic exam on a patient with nodules. What might you expect to observe ?
Hourglass closure
T/F: Muscle tension dysphonia can occur alone as a primary disorder without the presence of a lesion on the vocal folds or other existing vocal fold pathology, or it can be secondary to primary vocal fold pathology such as vocal fold nodules or vocal fold paralysis.
True
T/F: A unilateral cerebral stroke can result in unilateral VF paralysis.
False
T/F: Vocal Fold cysts may be due to vocal abuse/misuse, the result of which is a blocked mucous gland, or they may be congenital.
True
T/F: During a videostroboscopic exam, the ‘locked’ mode is used to assess the periodicity of VF vibration. If the VF vibration is aperiodic, the VFs will appear to ‘stand still’ and will not change position.
False
T/F: Phase asymmetry is when the duration of the open phase of the VF vibratory cycle is greater than, or less than, the duration of the closed phase of the vibratory cycle.
False
T/F: The vocal fold vibration that is recorded and viewed during videostroboscopy is ‘real time’ vocal fold vibration, i.e. you are able to see each individual vocal fold vibration in its entirety.
False
Laryngeal webs
can be congenital, acquired post-surgically, or after trauma
result in stridor
are an organic disorder
Which of the following would most typically characterize the vocal quality of a person with Parkinson’s disease?
breathy and monotone with decreased loudness
Who is LSVT used for?
Parkinsons
Cerebral Palsy
TBI
a. Sustained loud /a/
b. Pitch glides up and down
c. Use of loud voice for functional phrases, sentences, paragraphs, conversation
d. Take use of loud voice out of clinic into public settings
T/F: VF nodules accounts for 50% of acquired pediatric disorders.
True
Trauma to the RLN will cause?
VF paralysis
T/F: adults who had nodules as children have a greater risk for voice problems as an adult.
True
What are the most common disorders for elderly?
Laryngeal cancer (men)
VF paralysis
Edema
Nodules & polyps (> in women)
Vocal Function Exercises are used for:
- hyperfunction disorders (phonotrauma, functional disorders)
- hypofunctional disorders (presbylaryngis, vocal fold paresis, unilateral VF paralysis)
Resonance Tx is used for:
Hyperfunctional
Hypofunctional
(decrease hyperfunction, decrease VF medial compression; increases loudness/ability to project)
Accent method is used for:
Hyperfunctional
Hypofunctional
Focuses on abdominal breathing, aspirated vocal onset, rhythmic intonation in speech, appropriate pitch and loudness
Flow Phonation is used for:
decreases medial compression, decreases laryngeal tension and may eliminate hard glottal attacks
Eclectic Voice Therapy is used for:
Hyperfunctional
Decrease medial compression of VFs, eliminate muscle tension, increase breath support
What is the only muscle innervated by the SLN?
cricothyroid
What are the 5 vocal fold layers?
epithelium, superficial lamina propria, intermediate lamina propria, deep lamina propria, thyroarytenoid
Every Singer is Down Town
Characteristics of Nodules.
bilateral ant ⅓ post ⅔ , no diplophonia, chronic misuse, hourglass, decreased MW and amp, occur in SLP
Characteristics of polyps.
superficial lamina propria, typically unilateral, false vocal, diplophonia, sessile/pedunculated, hourglass or irregular, increased or decreased MW
Characteristics of Edema.
can be unilateral or bilateral, decrease in pitch range, loss of high pitch, dry throat, fatigue, usually complete closure
Characteristics of VF hemorrhage
decreased pitch, dysphonia/hoarseness, decreased mucosal wave, decreased amplitude of vibration, looks like a “bruise”
Characteristics of VF cysts
nilateral, women, mucosal wave absent in cyst region, require surgery, decreased loudness, breathy
Botox injections are used for?
spasmodic dysphonia
Unilateral VF paralysis is a lesion to?
RLN
T/F: A vocal fold cyst always requires surgery?
True
What type of onset is a polyp?
acute onset
List the three types of spasmodic dysphonia
adductor, abductor, and mixed
What is electoglottography?
an indirect measurement of VF contact areas
What is a jitter?
cycle to cycle variation in the frequency, ie. period of vocal fold vibration
What is a shimmer?
cycle to cycle variation in the amplitude of vocal fold vibration
Electomyography is used to….
differentiate VF paralysis from arytenoid fixtaion
measure activity in the laryngeal muscles
