final

Question 1

vocal fold paralysis

Answer 1

• disease / trauma to RLN on one side is most common form of VFP
• unilateral vocal fold paralysis
• PNS

Question 2

unilateral vocal fold paralysis

Answer 2

Etiology:
1. neoplastic (compresses vagus, RLN)
2. traumatic (surgery)
3. idiopathic

Tx:
- behavioral voice therapy temporary until medical intervention
- voice therapy:
- focus, half-swallow boom, head positioning, tuck-chin, digital manipulation, tongue protrusion /i/, yawn-sigh, pitch shift up, and inhalation phonation

Question 3

spasmodic dysphonia

Answer 3

• CNS
• idiopathic
• tx:
  
  • inject BTX-A
  • voice therapy: easy breath cycle, yawn-sigh relax
  • surgery

-most common: adductor SD

Question 4

essential voice tremor

Answer 4

• CNS
  -idiopathic
  Tx:
• BTX-A
• deep brain stimulation

Question 5

what is the purpose of voice screening?

Answer 5

The purpose of voice screenings is to help clinicians better identify and document those children in need of voice assessment and potential treatmen

Question 6

what are the three important perceptual judgments on the Consensus of Auditory Perceptual Evaluation (CAPE-V) and what is a definition for each? (e.g., Rough=sounds like there is something on the vocal folds)

Answer 6

Severity: global, integrated impression of voice deviance.
*Roughness: sounds like there is something on the vocal folds.
*Breathiness: audible air escape from the voice
*Strain: perception of excessive vocal effort (hyperfunction)
Pitch: perceptual correlate of fundamental frequency
Loudness: perceptual correlate of sound intensity

Question 7

laryngoscopy

Answer 7

is a medical procedure conducted by an Otolaryngologist or trained SLP that is used to obtain a view of the vocal folds and the glottis.

Question 8

Stroboscopy

Answer 8

incorporates the use of a stroboscopic (flashing) light/rapidly shuttered camera to result in the illusion of slow motion. Allows for observation of vibratory cycles.

Question 9

changes that occur across the lifespan: LAMINA PROPRIA

Answer 9

Infants:
- lamina propria is a single layer
- Mucosa is thinner
- Membranous and catilaginous layer are 50-50%

Adolescent
- No sex difference in VF length until 9-15 yrs old
- Lamnia propria differentiation

Elderly
- Lamina propria deterioration

Question 10

changes that occur across the lifespan: SIZE OF VOCAL FOLDS

Answer 10

Newborns (size of VF)
- 2.5 - 3.0 mm
Adults (size of VF)
- Male: 17-21
- Female: 11-15

Question 11

changes that occur across the lifespan: LARYNX IN PUBERTY IN MALES

Answer 11

• Laryngeal growth occurs in the last six months of change (age 17)
• Voice pitch level drop → male voice drops an octave

Question 12

changes that occur across the lifespan: CHANGE IN PITCH W/ ELDERLY ADULTS WHO ARE MALE & FEMALE

Answer 12

Males
- Fo rises in males in their 60’s and older
- VFs thins
Females
- Fo decreases in their 50s and older
- Larynx lowers

Question 13

changes that occur across the lifespan: OTHER CHANGES W/ AGING IN VOICE

Answer 13

Aging adults larynx
- Cartilages: ossify (harden)
- Joints: deteriorate
- Muscles: atrophy
- VF’s: glands in mucosa degenerate,

Question 14

What is Paradoxical Vocal Fold Motion (PVFM)?

Answer 14

• Complex disorder in which VF adduction occurs during inspiration; carrying over to expiratory phase
• Resulting in airway obstruction of the airway

Question 15

What are some of the other terms PVFM is also known as (aka)?

Answer 15

*Vocal cord dysfunction (VCD)
Paroxysomal vocal fold dysfunction
Inducible laryngeal obstruction
Factitious asthma / Pseudoasthma
*Emotional laryngeal wheezing
*Psychogenic stridor
Episodic Paroxysmal Laryngospasm
*Munchausen’s stridor (original name)

Question 16

What is the SLP role in helping clients/patients with PVFM (e.g., breathing)?

Answer 16

Breathing
Biofeedback
Weight exercise
Relaxation

Question 17

what is resonance?

Answer 17

-Resonance is what happens in the air-filled oral and nasal cavities (i.e., the main structures of resonance). Resonance is what happens to the airstream after respiration has supported phonation at the level of the vocal folds. Resonance occurs more with vowels than with consonants, as consonants are primarily articulated. Resonance can be divided into hypernasal (excessive air emission through the nares) vs. hyponasal (blockage in the nasal cavities

Question 18

What is a resonance disorder (e.g., cleft lip/palate; craniofacial differences)?

Answer 18

• hyper nasality
• hypo nasality

Question 19

what is HYPERNASALITY?

Answer 19

• An excessively undesirable amount of perceived nasal cavity
• resonance during the phonation of normally non-nasal vowels and non-nasal voiced consonants.

etiology:
- sub mucous cleft
-anatomic
- overt cleft palate w/ or w/o cleft lip

Question 20

what is HYPO-NASALITY ?

Answer 20

• Reduced or completely lacking nasal resonance, two types:
• A basic lack of nasal resonance for the three normally nasalized English phonemes: /m/, /n/, and /ŋ/ → (/b/, /d/, /g/); can affect vowels to some degree; can be temporary (cold virus; sinus infections)
• Cul de sac: anterior obstruction of nasal cavity

etiology:
- tumors
-inflammations
-adenoids

Question 21

What is the SLP role in helping clients/patients with resonance disorders (e.g., instrumentation and sentence types use to assess)?

Answer 21

• Oral-peripheral exam
• Perceptual analysis
• Instrumentation Assessments
• CAPE- V (sentences)

Question 22

instrumentation

Answer 22

• nasaometry; aerodynamics: indirect
• video-fluoroscopy; nasopharyngoscopy: direct

Question 23

CAPE-V

Answer 23

The CAPE-V elicites sustained vowels as well as connected speech productions in both sentence reading and spontaneous speech
Assess severity of : dysphonia, roughness, breathiness, strain, pitch & loudness using VAS