Voice

Question 1

CAPE-V

Answer 1

Kempster et. al, 2009. Grades the voice quality on Roughness, Breathiness, Strain, Pitch, Loudness and overall Severity

Question 2

VHI-10

Answer 2

Voice Handicap Index -10 (Rosen et. al, 2004). Grades degree of impairment to a patient’s quality of life. Good to compare pre/post treatment.

Question 3

Paediatric VHI

Answer 3

Paediatric VHI (Zur et. al., 2006). Parents score the impact of the voice disorder on their child’s life.

Question 4

VAPP

Answer 4

Voice Activity & Participation Profile (Ma & Yiu, 2001). Good for professional voice users to score the impact of the disorder on activities and participation.

Question 5

What does the Posterior cricoarytenoid muscle do?

Answer 5

The only muscle to open the vocal folds, By rotating the arytenoid cartilages laterally and widening the rima glottis.

Question 6

What do the laryngeal adductor muscles do?

Answer 6

Close the vocal folds
Lateral cricoarytenoid muscles are the major adductors of the vocal folds. This narrows the rima glottis, modulating the tone and volume of speech.

transverse and oblique arytenoids muscles adduct the arytenoid cartilages, closing the posterior portion of rima glottis. This narrows the laryngeal inlet.

Question 7

How does the pitch-raising muscle actually work to increase pitch? What is its physical action?

Answer 7

The cricothyroid muscle contracts causing the vocal folds to lengthen (Stemple p.49). It draws the thyroid down and forward, closer to cricoid cartilage, resulting in lengthening and tensing of the vocal folds

Question 8

Why is maximum phonation time (MPT) a useful measure in a voice assessment?

Answer 8

MPT gives an indication of respiration quality during speech.
You might see reduced MPT if there are glottal gaps and inefficient vocal fold vibration. It can be used as a tool to demonstrate voice improvement with pre-test and post-test measures.

Question 9

Why are extrinsic laryngeal muscles important for voice? What are some of the implications for voice disorders?

Answer 9

Extrinsic laryngeal muscles elevate and depress the larynx for airway protection. The suprahyoids elevate the muscles, allowing the epiglottis to close over the glottis for airway protection and changing the shape of the supraglottal vocal tract, which then modifies pitch, loudness and quality. The infrahyoids depress the larynx. If particular muscles are too tight or don’t contract, this function is impaired. Ie. The epiglottis may not cover the airway.

“Laryngeal elevation during phonation may be a sign of excessive intrinsic laryngeal muscle tension and is an accurate indicator of hyperfunctional voice use. (Stemple et al., 2020, p.31-32).

Question 10

Why do we say that the cricothyroid muscle acts on the voice “indirectly”?

Answer 10

It aids with phonation as it moves the thyroid forward and tenses the vocal cords.

Question 11

The Rainbow Passage

Answer 11

(Fairbanks, 1960)
• Use for perceptual description of voice production.
• Look for breathing patterns, listen for voice quality.
• Good because it is phonemically balanced
• Norms available for av. speaking F0 acoustic analysis.

Question 12

Vowel Prolongation

Answer 12

Produce vowel for comfortable amount of time.
• looking for stability of tone
• auditory-perceptual rating and acoustic analysis - F0 standard deviation

Question 13

s/z ratio. Describe how it is done and what it is looking for.

Answer 13

• timing the client’s sustained production of /s/ and /z/ at their modal pitch and normal volume. The client must be coached to inhale deeply and sustain the production for as long and clearly as possible. This should be attempted 2-3 times and the longest productions of each phoneme divided to calculate the S/Z ratio.
  • S/Z ratios are useful for indicating possible laryngeal mass lesions (Stemple et al., 2020).
  • effect of voicing on air control.
  • producing longer /s/ than /z/, indicates insufficient and/or inefficient vocal fold closure.
  • norms available (1.4 is considered normal)

Question 14

Palpation

Answer 14

Feel larynx on yawning, swallowing, at rest and phonation (counting to ten at modal pitch with a 2 sec break inbetween each number).
• palpating for laryngeal movement on phonation
• perceptual assessment
• observe if there is any asymmetry in the use of the muscles, if the larynx elevates/lowers appropriately and for excessive muscle tension.
• observe for signs of pain during the palpation and ask for feedback if there are any areas that hurt

Question 15

What are functional voice disorders?

Answer 15

disorder due to disorganisation of movement or phonotrauma (vocal behaviours that abuse the laryngeal mechanism eg. yelling)

Question 16

What are functional neurological voice disorders?

Answer 16

Psychological trigger for vocal dysfunction; aphonic, dysphonic, puberphonia (falsetto- voice not developed during puberty),
Loss of volitional control
Psycho-social factors linked with onset
Symptoms inconsistent with appearance of larynx & symptoms reversible
Often develops after Upper Respiratory Track Infection Onset is sudden, variable with intermittent episodes Normal or improved phonation cannot be produced voluntarily
Resolves quickly and immediately with return to normal voice after attention to psycho-social issues

Question 17

Neurogenic Voice disorders:

Answer 17

Disorder of neurological origin; parkinsons, spasmodic dysphonia, tremor, vocal fold paralysis