Voice Disorders

Question 1

Hyperfunctional

Answer 1

Caused by excessive muscle action of VF mechanism
- Not enough airflow → tense, strained, rough, hoarse
- Most vocal fold lesions cause hyperfunctional voice disorders because laryngeal muscles and surrounding structures over-activate to compensate for lesion that is obstructing VF from adducting
properly
- Overuse of laryngeal muscles

Question 2

Hypofunctional

Answer 2

Caused by inefficient muscle action of vocal mechanism
- VF do not come together fully → causing excessive airflow and
creating a vocal quality that is breathy, reduced in loudness, and
possibly aphonic
- Vocal fold paresis or paralysis

Question 3

Why is VF closure necessary?

Answer 3

• Block entrance to trachea so foods, liquids and other things can’t enter
  lungs during swallowing
• Building adequate air pressure to assist in performance of biological
  functions
• Needed to begin the process of VF vibration

Question 4

Mucosal wave action

Answer 4

Occurs during phonation
- Critical to VF vibration
- The movement of mucous membrane of VF
- Vocal surgery can reduce mucosal wave action resulting in a voice that the
listener perceives as rough and gravelly (not a lot of mucus)
- Cover → epithelium and superficial lamina propria
- Transition → intermediate and deep layers of lamina propria

Question 5

CN X

Answer 5

Primary cranial nerve involved in laryngeal innervation

SLN
- Internal branch provides all sensory info to larynx above VF
- External branch supplies motor innervation to cricothyroid

RLN

• Supplies all motor innervation to all other intrinsic laryngeal muscles-
  transverse/interarytenoid, posterior cricoarytenoid, thyroarytenoid, lateral cricoarytenoid
• Supplies all sensory info below the vocal folds