Voice Disorders: Part 1 Flashcards
_______ results from misuse or abuse of the vocal mechanism.
Phonotrauma
_______ results from a disease process or may be congenital.
Organic
_______ muscle tensions dysphonias.
Functional
_______ results from an underlying psychological issue and presents no identifiable vocal pathology.
Psychogenic
_______ results from damage to the RLN or SLN, disease processes that affect these nerves, or brain injuries or lesions.
Neurological
What are the 6 possible phonotrauma disorders?
- Vocal fold nodules
- Vocal fold polyps
- Reinke’s Edema
- Traumatic Laryngitis
- Vocal fold hemorrhage
- Vocal fold cysts
This is caused by: chronic/continuous abuse (yelling, hard glottal attacks, excessive coughing/throat clearing), excessive laryngeal muscle tension, incorrect singing technique, excessive strain which could result in increased medial compression and impact force.
Vocal Fold Nodules
Vocal Fold Nodules are…
- bilateral
- occur in SLP
- soft, gelatinious –> harden & fibrous
- occur at juncture of ant. 1/3 & post. 2/3 VF
- interfere w/ movement of mucosal wave
- hour glass glottic closure
- aperiodic vibration of VF
- more common in adult woman, more common in boys
Perceptual Characteristics of Vocal Fold Nodules
Roughness, breathiness, decreased loudness, vocal strain/effort
Acoustic Characteristics of Vocal Fold Nodules
Decreased pitch and loudness ranges, increased frequency/intensity perturbations, increased noise levels
Aerodynamic Characteristics of Vocal Fold Nodules
increased airflow rates, increased subglottal pressure
What are some patient complaints of vocal fold nodules?
Vocal fatigue, sensation of something in throat, vocal effort/strain, pain if muscle tension is present
Stroboscopic characteristics of Vocal Fold Nodules
- hourglass closure
- bilateral lesions at juncture of ant. 1/3 & post. 2/3 of membranous VFs.
- decreased or absent mucosal wave in region of nodule
- decreased amp. of vibration
Vocal fold polyps are caused be?
an isolated acute episode of vocal abuse OR a period of vocal abuse (ie: screaming @ a concert/sports event, excessiving yelling, screaming…).
*Possibility of occurrence increases if VFs are already irritated, inflamed or swollen.
Vocal fold polyps
Are soft fluid filled outgrowth of tissue in SLP, usually UNILATERAL.
- can be sessile (broad based) or pedunculated (narrow stem)
- can occur anywhere along membranous VFs, but usually occur in same area as nodes
- can be fluid, hemorrhagic or fibrous
- hour glass or irregular closure
- if fluid filled=add mass to VFs but decrease stiffness
- if hemorrhagic= stiffness is increased
- pt. complaints similar to those w/ nodes
Perceptual characteristics of polyps
rough, breathy, sometimes diplophonic, strained
Acoustic characteristics of polyps
decreased pitch & loudness ranges, incr. freq./intensity perturbations, incr. noise levels
Aerodynamic characteristics of polyps
incr. air flow due to hourglass or irregular closure & increased subglottal pressure
Videostroboscopic Characteristics of Polyps
- increased mass, unilateral
- incomplete closure- depends on size & type
- affected side vibrates @ decreased freq.
- aperiodicity (hoarseness)
- pedunculated may not affect vibration
- mucosal wave incr. or decr.
- amp. of vibration as above
______: is the natural reaction of laryngeal tissue to trauma or abuse :: _______: is almost always related to smoking & more common in females
Edema :: Reinke’s Edema
a build up of fluid in the superficial lamina propria layer (Reinke’s space) of VFs; can be bilateral or unilateral
Edema
Edema decreases mass of VFs but may decrease or incrase stiffness. T or F?
False; Edema increases mass of VFs
Perceptual characteristics of Reinke’s Edema
low fundamental frequency, roughness, vocal effort
Acoustic characteristics of Reinke’s Edema
loss of high pitches, decreased pitch range
Aerodynamic characterisics of Reinke’s Edema
increased air flow, normal Ps
Patient complaints of Reinke’s Edema
vocal fatigue, low pitch, dry throat, vocal effort
Videostroboscopic characteristics
- bilateral swelling along entire membranous length of VFs (can be unilateral)
- glottic closure is usually complete
- if unilateral, affected VF may interfere w/ vibration of unaffected VF
- phase asymmetry- especially if unilateral
- decreased amp. of vibration
- mucosal wave - depends on degree of stiffness
Traumatic Laryngitis is caused by?
trauma to vocal fold tissue, usually by excessive yelling, screaming or loud talking.
Characteristics of traumatic laryngitis
- VFs are erthematous (red) & swollen
- voice is hoarse, low pitched, & breathy
- resolves w/in a few days to 2 weeks
- may be accompanied by VF hemorrhage
Chronic laryngitis results if?
vocal abuse continues, particularly if patient w/ laryngitis is using more effort or straining to speak (negative compensatory strategies)
_______=ruptured blood vessel in submucosal layer due to damage to the small, delicate blood vessels of the VF layers. Can increase VF stiffness and mass.
VF hemorrhage
*VF tissues damaged by blood
What is the cause of VF hemorrhage?
usually phono trauma or trauma to VFs during surgery or medical procedure
What can increase risk of VF hemorrhage?
use of anticoagulant medicines like aspirin, ibuprofen & coumadin
Perceptual characteristics of VF hemorrhage
Dysphonia to aphonia; hoarseness
Acoustic characteristics of VF hemorrhage
decreased pitch & loudness ranges, increased pitch and intensity perturbations
Videostroboscopic characteristics of VF hemorrhage
- patchy red area on VF surface
- decreased mucosal wave
- decreased amp. of vibration
- non-vibratory portion @ hemorrhage site
