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Voice Disorders Dr. Cho > VD Test One Functional Voice Disorder > Flashcards

VD Test One Functional Voice Disorder Flashcards

1
Q

What is a functional voice disorder?

A

the absence of current organic pathology, without obvious psychogenic or neurologic etiology.

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2
Q

Is muscle tension dysphonia common?

A

YES

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3
Q

What does persistent MTD result from?

A

excessive laryngeal and related musculoskeletal tension and associated hyperfunctional true and/or false vocal fold vibratory patterns

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4
Q

How can MTD be categorized?

A

primary or secondary

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5
Q

Determining whether MTD is primary or secondary what is it based on?

A

whether organic pathologic conditions contribute to trigger the muscle tension behavior

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6
Q

What is PRIMARY MTD?

A
  • dysphonia in the absence of current organic pathology

- excessive, atypical or abnormal laryngeal muscle movements

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7
Q

What is SECONDARY MTD?

A
  • compensatory response to the primary etiology

- excessive, atypical or abnormal laryngeal muscle movements

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8
Q

Name 5 factors that contribute to MTD?

A
  1. deviant body posture and misuse of neck and shoulder muscles
  2. high stress levels
  3. excessive voice use
  4. persistently loud voice use
  5. laryngopharyngeal reflux disease
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9
Q

List 3 benign laryngeal pathologies resulting from MTD

A
  1. vocal fold nodules
  2. vocal fold polyps
  3. reinke’s edema
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10
Q

Where do you often find vocal fold nodules?

A

glottal margin of each fold (anterior middle third junction

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11
Q

What does a vocal fold nodule look like in the early stage?

A

soft/pliable, reddish

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12
Q

What does an aged/chronic nodule look like?

A

hard and white

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13
Q

What causes vocal fold nodules?

A

continuous abuse of the larynx and misuse of the voice

  1. compensatory muscular tension
  2. increased laryngeal effort
  3. excess vocalis tension
  4. increase pressure to force air through constricted folds
  5. incoordination of respiration/phonation
  6. hearing loss
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14
Q

What are some psychological factors that can cause vocal fold nodules?

A

stress, lifestyle, tension with individuals

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15
Q

What are the voice symptoms of VF nodules?

A
  • VF is stiff and more massive, and vibration is aperiodic; posterior glottal chink may be observed with hourglass closure
  • large nodules may cause trouble breathing (dyspnea)
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16
Q

List 6 descriptions for what happens to the acoustics of one’s voice from VF nodules?

A
  1. breathiness and air wastage
  2. hoarse voice quality
  3. decreased Fo and pitch range
  4. decreased habitual loudness and dynamic range
  5. increased perturbation rates, jitter/shimmer
  6. vocal fatigue, frequent throat clearing
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17
Q

What aerodynamic features occur because of VF nodules?

A

higher than normal air flows

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18
Q

Ask someone about nodule questions on slide treatment of nodules????

A

??????

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19
Q

When working with a patient with VF nodules, what behaviors do you address through reduction/elimination?

A
  1. smoking
  2. excess volume
  3. vocal abuse at public events
  4. singing style
20
Q

What should patient increase with VF nodules?

A

hydration

21
Q

How long will it take a nodule to go away?

A

as long as it took to develop

22
Q

What is a vocal fold polyp?

A

localized, fluid filled sac on the VF

23
Q

What is a pedunculated polyp?

A

attached by slim stalk

24
Q

What is a sessile polyp?

A

blister adhere to mucosa

25
Q

What is a hemorrhagic polyp?

A

blood filled

26
Q

Where is a polyp usually located?

A
  • free of margin from TVF
  • usually unilateral (90%), can be bilateral
  • arise at same location as nodules
27
Q

Where do polyps usually arise?

A

on superficial lamina propria, but deeper than nodules

28
Q

What are nodules typically due to?

A

vocal abuse

29
Q

What is a polyp usually due to?

A

a single event

30
Q

What can a polyp do spontaneously?

A

heal

31
Q

What are 5 things that can happen to one’s voice with polyps?

A
  1. similar to those of a nodule
  2. incomplete VF closure
  3. decreased phonation time
  4. decreases pitch
  5. reduced dynamic range
32
Q

How can a polyp be treated?

A

with surgery

33
Q

Surgery and then voice treatment? OR Voice treatment and then surgery?

A

Surgery and then voice treatment

34
Q

What are the 4 steps of micro-flap surgery to remove a polyp?

A
  1. small incision
  2. raise flap
  3. remove contents via suction
  4. lay flap down
35
Q

What is the goal of polyp micro-flap surgery?

A
  1. save as much superficial lamina propria as possible

2. disrupt the glottal margin as little as possible

36
Q

In voice therapy for polyps, what is recommended?

A 
reduce secondary habits such as....
1. overdriving
2. hard voice onset
3. secondary strain
Reduce
1. abusive habits
Voice therapy
1. after surgery
Keep up good....
1. vocal hygiene
37
Q

What does reinke’s edema usually look like?

A
  1. usually bilateral and asymmetric
  2. folds appear fluid filled
  3. extreme cases confused with polyps
  4. in stobe, folds appear stiff
38
Q

What is the cause of Reinke’s edema?

A
  1. hyper-function
  2. smoking
  3. extreme allergies
39
Q

What gender is reinke’s edema more common in?

A

females

40
Q

What happens to Fo with reinke’s edema?

A

decreases

41
Q

What decreases and what extends in patients with RE?

A

decrease range

extension of low end

42
Q

What happens to perturbation in patients with RE?

A

increases

43
Q

What happens to periodicity of voice in patients with RE?

A

become aperiodic

44
Q

What is greater than normal in patients with RE?

A

greater than normal flow loops

45
Q

List recommendations of therapy for RE and other related conditions.

A
  1. reduce abuse
  2. decrease intensity
  3. noise in talking environments
  4. decrease/stop “throat clearing”
  5. limited vocal rest, 3 - 4 weeks
  6. increase hydration
  7. re-eval in 3 - 4 weeks
46
Q

What is success of voice therapy for RE highly dependent on?

A

eliminating the cause of the problem, such as smoking

Voice Disorders Dr. Cho (9 decks)

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