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Swallowing and Voice > Voice aetiology, signs and symptoms > Flashcards

Voice aetiology, signs and symptoms Flashcards

1
Q

Who are particularly at risk of voice disorders? (4)

A
  • Teachers: excessive use, loud speech, talking over background noise, often frequent but short-lived issues
  • Singers: excessive use, loud speech,
  • Children: excessive use, loud speech, yelling, harsh ‘sound effects’
  • Elderly: associated with ageing, medications, most commonly laryngitis, nonspecific dysphonia and benign VF lesions

‘Prolonged vocal use’ ‘Increased vocal load’

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2
Q

Why is there a higher rate of voice disorders in females than males? (3)

A
  • Shorter vocal folds and produce a higher f0
  • Less tissue mass to dampen vibratory force
  • Less hyaluronic acid in SLLP, role in wound repair
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3
Q

Conditions associated with increased incidence of voice disorders (6)

A
  • Sinus infections
  • Oesophageal reflux
  • Recurrent upper respiratory infections
  • Asthma
  • Respiratory allergies
  • Multiple chemical exposures
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4
Q

Attitudes towards people with voice disorders

A
  • Considered rigid, dishonest, passive
  • Children with voice disorders could be disadvantaged in oral assessments
  • Deviant voice could lead to listener’s false estimations of a child’s non-speech characteristics
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5
Q

When do we treat voice disorders?

A
  • Just because we perceive an impairment doesn’t mean anything needs to be done
  • Weight up signs (observable) vs symptoms (complaints)
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6
Q

Primary symptoms of voice problems (9)

A
  • Roughness
  • Vocal fatigue
  • Breathy voice
  • Reduced phonatory range
  • Aphonia
  • Pitch breaks/inappropriately high pitch
  • Strained/strangled
  • Tremor
  • Pain/other sensations
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7
Q

Voice roughness (2)

A

Complaint:
- Raspy
- Hoarse

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8
Q

Vocal fatigue (4)

A

Complaint:
- Tired after prolong vocalisation
- Continuing to talk is effortful
- Occasional hoarseness
- Worse at end of day

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9
Q

Breathiness (2)

A

Complaint:
- May be unable to say complete sentences without running out of air
- Difficulty being heard over noise

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10
Q

Reduced phonation range (3)

A

Complaint:
- Difficulty reaching higher pitches
- May experience tiredness or sore throat
- Usually associated with singers

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11
Q

Aphonia (3)

A

Complaint:
- Absence of voice
- Speakers in a whisper
- Variety of symptoms including dry throat, soreness, effortful

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12
Q

Pitch breaks/inappropriately high pitch (2)

A

Complaint:
- Periodic squeakiness or cracks in voice
- Often in male adolescents

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13
Q

Strained/strangled voice (5)

A
  • Difficulty phonating, inc inability to start or maintain
  • Tension/effort apparent
  • Can be easily fatigued
  • Hyperfunction of neck muscles
  • Entire larynx may compress
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14
Q

Tremor (3)

A
  • Wobbly or shaky
  • Unable to voluntarily produce sustained vowel
  • Usually regular vibration
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15
Q

Pain/other sensations (5)

A
  • Pain with voice production
  • Pain in neck
  • Lump in throat
  • Tension
  • Dryness
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16
Q

Perceptual signs of voice (5)

A
  1. Pitch
  2. Loudness
  3. Quality/clarity
  4. Other behaviours
  5. Aphonia
17
Q

Features of voice pitch (4)

A

Perceptual correlate of f0
- Monopitch
- Inappropriately high/low pitch
- Pitch breaks
- Reduced pitch range

18
Q

Features of voice loudness (3)

A

Perceptual correlate of intensity
- Monoloudness
- Excessive loudness variation
- Reduced loudness range

19
Q

Features of voice quality (7)

A
  • Rough: noisiness, lack clarity, often with breathiness/strain/tension
  • Breathiness: audible air escaping, lacks clarity, inadequate glottal closure
  • Strain: tension/effort, difficulty initiating/maintaining, increased muscle constriction
  • Tension: hard edge, muscle tension, can be combined with hard glottal attacks, often related to hyperfunctional use or compensatory behaviours
  • Tremor: rhythmic variations in pitch/loud, wobbly, typical in CNS dysfunction
  • Sudden interruption to voicing: unexpected changed quality/loud, sudden involuntary abduction or delayed abduction, usually neurological origin
  • Diplophonia: double voice, each VF functioning under diff levels of tension/mass, each vibrates at diff frequency
20
Q

Features of stridor

A
  • Noisy breathing, in or out
  • Potential blockage of airway
21
Q

Features of excessive throat clearing

A
  • Often accompanies voice disorder
  • Natural behaviour but considered a perceptual sign of voice disorder when consistent
  • May be attempt to clear mucus or something from throat
22
Q

Features of aphonia - consistent and inconsistent

A

Consistent aphonia:
- Usually perceived as whispering
- Can result from bilateral VF paralysis
- May be psychogenic
Inconsistent aphonia:
- Can be unpredictable involuntary breaks (secs long)
- Or can last longer periods (mins/hrs/days)
- Or gradual fading
- May be psychogenic or CNS based

23
Q

Common aetiologies of voice disorders (6)

A
  1. Phonotrauma
  2. Psychological stress
  3. Laryngeal surgery
  4. Other non-laryngeal surgery
  5. Drug side effects
  6. Acute and chronic illness
24
Q

What is phonotrauma?

A
  • Coughing and throat clearing: vigorous adduction causing irritation/damage, associated with respiratory diseases/medication side effects
  • Prolonged voice use (increased vocal load)
24
Q

How phonotrauma affects voice

A
  • Coughing and throat clearing: vigorous adduction causing irritation/damage, associated with respiratory diseases/medication side effects
  • Prolonged voice use (increased vocal load)
  • Shouting/screaming
  • Loud talking
  • Vocal noises, eg. growling
25
Q

Laryngeal surgeries affecting voice

A

Direct
- Laryngectomy (total, hemi, supraglottic)
- Glossectomy
- Mandibulectomy
Indirect
- Thyroid
- Cardiac
- Carotid arteries
- Lung
Intubation
- Trauma to mucosa of VF
- Constant pressure on VF can cause necrosis
- Nerve damage can lead to paralysis
- Arytenoid tissue scarring

26
Q

Acute and chronic illnesses affecting voice

A
  • Sinusitis
  • Respiratory illness
  • Medications
  • GI disorder
  • Endocrine disorder
  • Cardiac disease
  • Arthritis
27
Q

Medications affecting voice

A
  • Eg. antihistamines: reduced laryngeal secretions, mucosal drying
  • Eg. bronchial inhalers: irritant

Swallowing and Voice (11 decks)

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