Voice disorders assessment Flashcards
subglottic space
The laryngeal space below the level of the glottis.
Supraglottic space
The laryngeal space above the level of the glottis.
Aditus
The opening into the larynx, corresponds to the aryepiglottic folds
Vestibule
The laryngeal space between the true and false vocal folds. Contains glands that keep the folds moiset.
Interarytenoid space
The space in the posterior larynx that appears when the vocal folds are open; often a place where damage from acid reflex is seem.
Cranial nerves involved in voice
Extrinsic laryngeal muscles are served by: Trigeminal nerve 5, facial 7, hypoglossal 12.
intrinsic muscles served by: Vagus 10 (has 3 branches- pharyngeal, superior laryngeal and recurrent laryngel)
Fundamental frequency
The number of times the vocal folds vibrate per second.
80-140 times per sec in adult males
175-250 times per second in adult females
240-300 times per second in children before puberty.
500 times er second in babies
Fundamental frequency range
The range of frequencies produced during vocal fold vibration.
Jitter
(frequency perturbation) cycle-by-cycle variation in the frequency of vocal fold vibration.
on a Visipitch normal jitter is below 1.0
Resonance (formant) frequencies
The frequencies enhanced by the vocal tract shape.
Shimmer
(intensity perturbation) - cycle-by-cycle variation in intensity of vocal fold vibration.
On a Visipitch normal shimmer is below approximately .4 dB
Maximum phonation time
The amount of time a speaker can maintain voice on one breath.
Adults= 20 secs
children 12-15
S/z ratio
The relationship between the maximum production of s and z (on one breath each).
normal= 1.0
Abnormal= 1.4
Word or syllable per minute rate
(time measure) The number of words or syllables that a speaker can produce on a
minute of connected speech.
Voice Disorders
Abnormal production and or absence of vocal quality, pitch, loudness, resonance and/or duration, given an individual’s age and/or sex
Factors that influence of the vocal fold vibration
Length
Mass
Tension
of the vocal folds
Aerodynamic-Myoelastic Theory and updated in the
Self-Oscillation Theory ** by Titze
The Vf is closed as you begin exhalation. They vibrate from the bottom up.
Bernoulli Effect***
pressure coming in from the lungs ****
Resonance
The sound bouncing of the structures and the way they do and where they do shapes the different sounds.
how the sound is shaped in the cavities to distinguish it from one sound to the other.
Functions of the Larynx
airway protection
phonation
thoracic fixation- traps air in the lungs to build pressure for working that requires force.
The external muscles of the larynx (Extrinsic muscles)
Elevates and depresses the larynx during swallowing
The internal muscles of the larynx (Intrinsic)
Plays a role in breathing and phonation.
Controls the shape of the glottis and length and tensions of the vocal folds.
Which branch of the vagus nerve provides motor innervation to the cricothyroid muscle of the larynx?
External laryngeal
During Force respiration, the glottis of the larynx is widened to increase airflow into the trachea. Which muscle contracts to produce this affect?
1.vocalis
2.lateral criocoarytenoid
3.Cricothyroid
4. Posterior cricoaytenoid
Posterior circoarytenoid
What is the function of the recurrent laryngeal nerve?
1. Motor innervation to the intrinisc muscles of the larynx?
2. Sensory innervation to the posterior part of the external auditory canal
3. Motor innervation to the muscles of the pahrynx
Parasympathetic innervation to the heart.
Motor innervation to the intrinsic muscles of the larynx
Damage to the recurrent laryngeal nerve can result in
Damage–> weaker movement
Bilateral damage–> vf will be paralyzed
If the nerves are cut–> vf will stay open
Components of a voice disorder evaluation
- Patient’s perception of their voice problem. (QOL measure
- Medical history
- Daily vocal usage patterns
- Previous attempts to deal with the voice problem.
- Analysis of speech-language sample
- Hearing screening
5.
Visipitch and why we use it
It tells us the range between the softest and loudest sound we can make. Checks how these vary when we talk or sing
It looks at
intensity and frequency variability
pitch and loudness
its an cost effective way of providing instant feedback.
