11/18-Voice Lecture 6 Flashcards
(38 cards)
How many lesions/disorder are there that cause hypo adduction?
6
What are the 6 lesions and disorders causing hypo adduction?
- lesions that damage vagal nuclei within the brainstem
- lesions that damage the superior and recurrent laryngeal nerve
- lesions of the superior laryngeal nerve only
- lesions of the inferior recurrent laryngeal nerve
- myasthenia gravis
- respiratory disorders that may co-exist with flaccid dysphonia
What may happen if there are lesions that damage vagal nuclei within the brainstem?
- may result in bilateral or unilateral vocal paralysis
- lesions affecting right AND left vagus nerves results in bilateral paresis or paralysis of the pharyngeal and laryngeal muscles
- affects sensory functions–can be very serious!
- when both folds are abducted and velum is involved, the airway is without it’s usual protection. Fortunately, unilateral lesions occur more frequently
What do lesions that damage the superior and recurrent laryngeal nerve branches but not the pharyngeal branch cause?
-do not create velar problems but can result in all or some of the laryngeal symptoms that may occur from uni-or bi-lateral lesions to the vagal nuclei within the brainstem
What do lesions of the superior laryngeal nerve only affect?
-affect the cricothyroid muscle and impact pitch
What may the client complain of if they have lesions to the internal branch of the superior laryngeal nerve?
-globus (a feeling of lump in throat)
What may be affected by lesions of the external branch of the superior laryngeal nerve?
- pitch control may be affected
- the ability of loudness
What may unilateral involvement of lesions to the superior laryngeal nerve cause?
persistent cough
globus
irritation
What may lesions of the inferior recurrent laryngeal nerve cause?
-cause paralysis of all intrinsic muscles of the larynx except for the cricothyroid, which assumes a compensatory function and acts as an abductor
What is Myasthenia Gravis?
neuromuscular disease that happens at an earlier age in females than in males
acquired autoimmune disorder
antibodies build up and block neurotransmission of receptor of neuromuscular function of skeletal muscles
What respiratory issues may also exist with flaccid dysphonia?
lesions of cervical, thoracic, or lumbar spinal nerves may result in weakness and atrophy of the speech muscles and flaccid dysarthria including dysphonia.
may be the result of trauma and tumors
What are the 12 dysphonias associated with increased muscle tone/hyperadduction, mixed patterns, and tremor?
- Dysarthric Dysphonia
- Amyotrophic Lateral Sclerosis (ALS)
- Chorea
- Hyperkinetic Dystonic Dysphoniaa
- Parkinsonism
- parkinson plus-syndromes (multiple system atrophy, shy-drager syndrome, progressive supranuclear palsy, pseudobulbar palsy, merge’s syndrome, tardive dyskenesia, wallenburg syndrome, cerebellar disorder)
- essential tremor
- Gilles de la Tourette Syndrome
- Vocal Apraxia
- Deep Cerebral and Brainstem lesions
- frontal lobe lesions
- multiple sclerosis
What is Dysarthric Dysphonia?
- known as spasmodic dysphonia
- increased muscle tone (spasticity) occurs even in the presence of weaknesses and paralysis of muscles in disorders of the upper motor neurons
What is Amyotrophic Lateral Sclerosis (ALS)?
-degenerative disease of bilateral corticobulbar tracts and lower neuron’s spasticity and flaccid paralysis occur
What is Chorea? (I think he said this is the same thing as Huntington’s)
- other form of dysphonia due to genetic disorder
- involuntary body movements
- unsteady gait
- memory issues
- general deterioration of motor control
- dysphagia
What is hyperkinetic Dystonic Dysphonia?
characterized by slow movements of speech and/or vocal mechanisms
non volitional spasms of the abductor and adductor laryngeal muscles
What is Parkinsonism?
disease syndrome
dysphonia
caused by loss of dopaminergic niagrostiatal neurons
What are the syndromes and disorders related to Parkinsonism?
- parkinson-plus syndromes
- multiple system atrophy (MSA)
- Shy-Drager Syndrome
- Progressive Supranuclear Palsy
- Pseudobulbar Palsy
- Meige’s Syndrome
- Tardive Dyskinesia
- Wallenburg Syndrome
What is Essential Tremor?
organic and/or essential tremor; may be accompanied by head, neck, face tremor.
Voice tremors occur on alternating contractions of the adductors and abductors
What is Gilles de la Tourette Syndrome?
tics and involuntary vocalizations
grunting, barking, swearing, and echolalia
What is vocal apraxia?
lesion in Broca’s Area of cerebral hemisphere
motor speech disorder
What are Deep cerebral and Brainstem lesions?
-dysphonia form diffuse, deep cerebral and brainstem lesions caused by:
- tumors
- Cerebrovascular accidents
- metabolic diseases
- subdural hematomas
- lack of oxygen (anoxia)
What are the dysphonia’s associated with frontal lobe lesion?
- dysphonia, aphonia, mutism associated with apathy and emotional change.
- may be associated with brain tumor
What is multiple Sclerosis (MS)?
- inflammatory disease of the central nervous system involves scarring/sclerosis of white matter
- lesions may be in cerebral cortex, brainstem, or spinal tracts
- loss of myelin on neurons
