Voice Disorders Flashcards
This is one of the classifications for a voice disorder in which results from misuse or abuse of the vocal mechanism
Phonotrauma
Another classification for a voice disorder in which is a result from a disease process or may be congenital
Organic
This classification refers to the muscular tensions that can be found in the vocal mechanism
Functional
A classification for a voice disorder in which results from an underlying psychological issue and there is no identifiable vocal pathology
Psychogenic
The last of the classifications for voice disorders in which is a result from either damage to the RLN or SLN, disease that affects these nerves, brain injury, and or lesion
Neurological
True or False: Vocal Fold Nodules are caused due to chronic or continuous misuse of the vocal folds.
True
True or False: Vocal Fold Nodules are always unilateral
False - always Bilateral
The following are descriptions about Vocal Fold Nodules except for:
A.) occurs bilaterally
B.) soft, gelatinous at first and then hardens due to more collagen and fibronectin
C.) Interferse with mucosal wave
D.) Occurs at juncture of anterior 2/3 and posterior 1/3 of vocal fold
D - Actually, occurs at anterior 1/3 and posterior 2/3 of vocal fold juncture
*Adds both mass and stiffness to vocal fold
*‘Hour glass glottic closure’
*Results in aperiodic vibration
What is this?
Soft Nodule
Vocal Fold Nodules:
Perceptual Characteristics: ________, _______, _____ _____, and ______/______
roughness, breathiness, decreased loudness, and vocal strain/effort
Vocal Fold Nodules:
Acoustic: decreased _______ and ________ ranges, increased _______/_______ perturbations, and increased ________ levels.
pitch and loudness ranges, increased frequency/intensity, noise
Vocal Fold Nodules:
Aerodynamics: _________ air flow rates, ________ subglottal pressure (Ps)
increased, increased
Stroboscopic Characteristic:
- Hour glass glottic closure
- Bilateral lesions at juncture of anterior 1/3 and posterior 2/3 of membranous VFs
- Decreased or absent mucosal wave in region
- Decreased amplitude of vibration
vocal fold nodule
True or False: Vocal Fold Nodules chronic or continuous misuse/abuse
True
*Excessive yelling, talking, screaming
*hard glottal attacks
*coughing or throat clearing
*laryngeal muscle tension
*incorrect singing
True or False: The possibility of a Vocal Fold Polyp to form increases if the Vocal Folds are already irritated
True
What is this?
Polyp
True or False: Vocal Fold Polyps are usually bilateral
False
*usually unilateral
All of the following are characteristics of Vocal Fold Polyps:
A.) Soft fluid filled growth of tissue in SLP
B.) Can be sessile or pedunculated
C.) Occur anywhere along membranous vocal fold, but are typically in same region as nodules
D.) Hour glass or irregular closure
E.) All of the above
E - All of the above
True or False: If the polyp is fluid-filled, the mass of the VF will increase and therfore decrease stiffness
True
Perceptual Characteristic:
______, _______, sometimes _________, and _______
rough, breathy, diplophonic, strained
Vocal Fold Polyp
Acoustic:
_______ pitch and ________ range, ______ frequency/intensity perturbations, _______ noise levels
decreased, loudness, increased, increased
Vocal Fold Polyp
Aerodynamic:
_______ air flow due to hourglass or irregular closure and _____ subglottal pressure
increased, increased
Vocal Fold Polyp
Videostroboscopic Characteristics
- increased mass, unilateral
- incomplete closure
- aperiodicity
- mucosal wave increased or decreased
Vocal Fold Polyp
Almost always related to smoking, build up of fluid in SLP, bilateral or unilateral,
Vocal Fold Edema or Reinke’s Edema
*increases mass of vocal folds (may increase or decrease stiffness)
What is this?
Reinke’s Edema
Perceptual:
_______ fundamental frequency, _______, ______ effort
low, roughness, vocal
Reinke’s Edema
Acoustic:
loss of _______ _______, _______ pitch range
high pitches, decreased
*Reinke’s Edema
Aerodynamics:
______ air flow, normal Ps
- increased*
- **Reinke’s Edema
Videostroboscopic
- bilateral swelling along entire membranous length of VFs
- complete glottic closure
- if unilateral, affected VF may interfere with vibratio of unaffected VF
- Phase asymmetry
- Decreased amplitude of vibration
- Mucosal wave: depends on degree of stiffness
Reinke’s Edema
Caused by trauma to vocal fold tissue, vocal folds are erythematous and swollen, voice is hoarse and low pitched, resolves within two days
Traumatic Laryngitis
What is this?
Acute Laryngitis
What is this?
Vocal Fold Hemorrhage
All of the following are causes for Vocal Fold Hemorrhage except for:
A.) Ruptured blood vessel in submucosal layer
B.) Usually by phonotrauma or trauma to VFs during surgery or medical procedure
C.) Use of anticoagulant medication decreases the risk
D.) Damaged by the blood
E.) All of the above exept for C
E - All of the above except for C
*rupture blood vessel, phonotrauma/trauma to VFs, use of anticoagulant medication increases the risk, and damaged by the blood
Perceptual:
______ to ______ ; _______ness
- dysphonia, aphonia; hoarse*
- ** Vocal Fold Hemorrhage
Acoustic:
_____ pitch and ______ range, _____ pitch and intensity perturbations
- decreased, intensity, increased*
- ** Vocal Fold Hemorrhage
Videostroboscopic:
- patchy red area on VF surface
- decreased mucosal wave
- decreased amplitude of vibration
*due to increased stiffness and mass
Vocal Fold Hemorrhage
Vascular lesion, originate at the SLP at mid membranous portion, related to phonotrauma, more prevalent in women
Vocal Fold Varices / Ectasia
Decreased mucosal wave due to increased VF stiffness, may or may not be perceptual symptoms, may cause decreased pitch range and some hoarseness
- Vocal Fold Varices/Ectasia*
- ** Vocal Fold Varices: superficial, enlarged and dilated veins
*Vocal Fold Ectasia: lesioned blood vessel, coelescent hemangiomatmous appearance
What is this?
Vocal Fold Varices
Due to blockage of glandular duct with subsequent retention of mucus, may occur after vocal abuse or can be congenital, usually unilateral and occurs more often in women
Vocal Fold Cysts
What is this?
Vocal Fold Cyst
Perceptual:
rough, breathy, might be low ______, ______ loudness
pitched, decreased
*Vocal Fold Cyst
Acoustic:
_______ pitch range, _______, _______ noise levels
decreased, aperiodicity, increased
*Vocal Fold Cyst
Aerodynamic:
______ airflow
increased
* Vocal Fold Cyst
Videostroboscopic:
_____ or _____ mucosal wave
______ amplitude of vibration
_______ VF mass/stiffness of VF cover
______ or hourglass closure
absent/ decreased, decreased, increased, irregular
*Vocal Fold Cyst
Muscle Tension Dysphonia is caused by the following:
A.) excessive extrinsic laryngeal muscle tension (supra and infrahyoid muscles and neck muscle)
B.) excessive internal/supraglottic laryngeal muscle tension
C.) by itself or secondary to a primary vocal pathology as a negative compensatory strategy
D.) All of the above
D - All of the above
Clinical signs of extrinsic laryngeal MTD on laryngeal palpation:
A.) elevated laryngeal height
B.) narrow, tense thyroid space
C.) tension in suprahyoid muscle
D.) Tense tight floor of mouth
E.) All of the above
E - all of the above
*tense, tight thyrohyoid muscles, inability to lateralize larynx (left to right), base of tongue tension
Videostroboscopic:
______ and ______ compression
______ compression
VF _______ and ______
_______ squeezing
_______ glottic closure, ______ gap or bowing
anterior, posterior, mediolateral, hyperadduction, foreshortening, supraglottic, incomplete, anterior
*Muscular Tension Dysphonia
What is this?
Muscular Tension Dysphonia with Supraglottic squeezing
Perceptual:
harsh, rough, breathy, tense, phonation breaks, normal pitch or elevated pitch, whispher, aphonia
MTD
The phenomena where the adduction of the false vocal folds are used for phonation
Ventricular Phonation
*It can be both primary or secondary disorder
*FVF vibration may cause diplophonia
Perceptual:
voice is rough and harsh, low pitched due to the mass of FVF or combined mass of true and false folds, breathy, monotone, decreased pitch range
Ventricular Phonation
Persistence of child-like voice quality after puberty
Puberphonia
Perceptual:
voice is high pitched, hoarse and breathy, decreased loudness, pitch lowers during heavy lifting or shouting
Puberphonia
Videostroboscopic:
Incomplete glottic glosure, stiff VFs, decreased amplitude
Puberphonia
Complete loss of voice (aphonia) with no underlying physical cause
Conversion Aphonia
The following are characteristics of Conversion Aphonia except for:
A.) nonphonatory VF movements are normal
B.) on phonation, VF movement is irregular and adduction inadequate to produce vibration
C.) Onset of aphonia is associated with fear, stress, or traumatic event
D.) Non-speech functions such as throat clearing, coughing, laughing, show normal VF movement
E.) All of the above
E - All of the above
Characterized by Vocal Fold adduction during quiet breathing
Paradoxical Vocal Cord Movement
Vocal fold adduction during inhalation
Paradoxical Vocal Fold Movement
Complain of throat tightness, neck tightness, chronic cough, stridor, wheezing, voice may be (hoarse, weak, breathy, strangled)
Paradoxical Vocal Cord Movement
