Lecture 10 and 11 Therapy 2 and 3

Question 1

This therapy techniques focuses on modification of deviant vocal symptoms such as breathiness, inappropriate pitch, loudness, etc.

Answer 1

Symptomatic Voice Therapy

Question 2

What are some of the facilitating techniques for Symptomatic Voice Therapy?

A.) Laryngeal Massage

B.) Chewing

C.) Yawn-sigh

D.) Easy onset Linking

E.) All of the above

Answer 2

E - all of the above

*as well as: tongue stretches, supraglottic relaxation exercises, push-pull exercises, breathing exercises, altering habitual pitch and loudness

Question 3

Symptomatic Voice Therapy is used for:

A.) decreasing extralaryngeal/supraglottic muscle tension

B.) decrease hard glottal attacks

C.) increase glottic closure

D.) All of the above

Answer 3

D - all of the above

Question 4

What makes a hard glottal attack bad?

Answer 4

it is a forceful adduction of the vocal folds at the beginning of sound production, resulting in excessive medial compression of VFs which are then blown open forcefully

Question 5

Match the techniques to their benefits:

A.) Easy Onset lowers larynx, releases suprglottic
squeezing

B.) Yawn-sigh continuous airflow;link vowels &
consonants; elim. glottal attacks

C.) Chewing trains continuous airflow

D.) Chant speak while chewing; disengages
laryngeal tension

Answer 5

Easy Onset - continous airflow; link vowels & consonants; elminates glottal attacks

Yawn-Sigh - lowers larynx, releases supraglottic squeezing, releases larynopharynx

Chewing - Speaking while chewing; disengages laryngeal tension

Chant - train continous air flow

Question 6

Primary MTD and Secondary MTD can be assessed:

via _____, _______ and _____ palpation and ________.

Answer 6

laryngeal, neck, jaw, endoscopy

Question 7

The following are ways to address Extralaryngeal Muscle Tension:

A.) Laryngeal massage

B.) Jaw Tension - massage

C.) Ragdoll Exercise

D.) Neck Relaxation Exercises

E.) All of the above

Answer 7

E - all of the above

*as well as: tongue - relaxation stretches, shoulders - relaxation stretches, and progressive relaxation

Question 8

The order of circumlaryngeal massage a.k.a. digital manipulation

1. ______
2. Superior cornu of _____
3. ______ space
4. ______ area
5. border of _________ muscle

Answer 8

1. hyoid bone (point of major horns)
2. TC -thyroid cartilage
3. thyrohyoid space
4. Suprhyoid
5. Sternocleido

Question 9

Endoscopic evidence of laryngeal muscle tension:

____ compression and _____ medialization

Answer 9

A-P (anterior-posterior)

FVF (false vocal folds)

Question 10

Techniques to decrease intrinsic or supraglottic tensing:

HINT: Y. T. S. S.

Answer 10

Yawning - lowers larynx, opens supraglottic area

Tongue Stretching - relaxes base of tongue, opens supraglottic area

Slurping Spaghetti - round lips and inhale air; lowers larynx opens supraglottic area and abducts VFs

Silent Laughter - abducts FVFs

Question 11

Name the different breathing exercises used in Voice Therapy:

HINT: S. S. P. S. S. L.

Answer 11

Sitting and leaning with forward foreams on knees

Standing with arms up and crossed over head

Pavone Exercise

Sustained /f/

Simple verbal instructions

Lying Flat

Question 12

This type of breathing exercise helps elminate clavicular or shallow breathing

Answer 12

sitting and leaning forward

Question 13

This type of breathing exercise encourages abdominal breathing and increased lower lateral rib expansion during inhalation

Answer 13

Arms over head

Question 14

This breathing exercise teaches abdominal breathing and expanded rib posture, also adjusts overall posture including shoulder and lower back position

Answer 14

Pavone Exercise

Question 15

This exercises forces abdominal inhalation

Answer 15

Sustained /f/ exercise

Question 16

This exercise is meant to help increase VF adduction in hypofunctional patients (i.e. VF paralysis, paresis, bowing, presbylaryngis)

Answer 16

Push-Pull Exercise

Question 17

Guidelines for Vocal Hygiene Goals:

______ Vocal Hygiene risks that are ______ to patient

____ _____ give them a ______ list that are not specific to them.

_______ is better when vocal hygiene program is ______ to patient and understands ______.

Answer 17

• Identify, specific
• Do not, laundry
• Compliance, specific, why

Question 18

This type of therapy is aimed at the modification of the underlying physiology of the voice producing mechanisms: respiration, phonation, resonance

Answer 18

Physiologic Voice Therapy

Question 19

Logic behind Physiological Voice Therapy:

Based on our expanded _________ of vocal function. _____ balance amongst respiratory support, ______ muscle strength, control and ______ and ______ modification of the laryngeal tone.

Answer 19

knowledge, improves, laryngeal, stamina, supraglottic

Question 20

This exercise is a series of systematic voice manipulations, designed to strengthen and balance laryngeal musculature, and to improve the efficiency of the relationship among airflow, vocal fold vibration, and supraglottic treatment of phonation.

Answer 20

Vocal Function Exercises

Question 21

The rationale behind the _____ _______ exercise is that it ______ laryngeal mechanics, ______ laryngeal musculature, ______ balance amongst phonatory systems, and may ______ glottic closure.

Answer 21

Vocal Function, recalibrates, strengthens, restores, improve

Question 22

Match the tasks of Vocal Function Exercises according to the description:

A.) Warm Up pitch glides up on “oh”, “ol” or “nol”

B.) Expansion sustained ee on pitch w/extreme frontal
focus

C.) Contraction sustained phonation on five pitches

D.) Power pitch glides down on “oh”, “ol” or “nol”

Answer 22

Warm Up - sustained ee pitch w/extreme frontal focus

Expansion - pitch glides up on “oh”, “ol” or “nol”

Contraction - pitch glides down on “oh”, “ol” or “nol”

Power - sustained phonation on five pitches

Question 23

True or False:

Vocal Function Exercises is useful for clients who only have hypofunctional disorders

Answer 23

False - works on clients who have either hypofunctional disorders or those who have phonotrauma and functional disorders

Hypofunctional - presbyphonia, paresis, and bowing

Phonotrauma & Functional Disorders - decreases medial compression, effective for vocal fatigue

Question 24

The rationale for ______ ______ ______ exercise is that it facilitates ______ matching, increases _______ inertance, generates a ________ pressure, greater ______ drive, lowers _____ and ______ throat tension.

Answer 24

Semi-Occluded Vocal Tract, impedance, vocal tract (VT), back, respiratory, larynx, decreases

Question 25

In Semi-Occluded Vocal Tract Exercises you use _____ straws or ______ straws for Hyperfunction.

Answer 25

regular, narrow

Question 26

In Semi-Occluded Vocal Tract Exercises you use ____ straws for hypofunction.

Answer 26

wider diamter (boba)

Question 27

True or False:

Resonant Voice Techniques is used for both hypo and hyperfunctional disorders

Answer 27

True

Question 28

The rationale for the Lessace Masden Resonant Voice is that it may help with _______ matching in _______ (VF paralysis, and paresis) / ______ impact stress for ______ clients and ______ intensity or ease of _____ projection.

Answer 28

impedance, hypofunction, decreases, hyperfunctional, increases, vocal

Question 29

The rationale for Accent Method is that _____ coordination of ______ and ________. May increase _____ Effect and ______ of ____ approximation for ______. It also _____ medial compression and teaches ______ _____.

Answer 29

improves, respiration, phonation, Bernoulli, increase, VF, hypofunction, decreases, flow phonation

Question 30

This method requires you to keep sustained voiceless and voiced consonants, sustained vowels, then cv syllables, produced with different rhythmic patterns, and this is done while rhythmically rocking body forward or seated using a drum.

Answer 30

Accent Method

Question 31

This therapy was specifically developed for patients with Parkinson’s, also been used for patients with CP, and TBI.

Answer 31

Lee Silverman Voice Therapy

Question 32

The tasks involved in LSVT are:

1. Sustained _____ phonation on _____
2. _____ glides _____
3. ______ glides ______
4. Targeting adequate _______ for ______ phrases, sentences, _______ reading and ______ speech.

Answer 32

loud, ah, pitch, up, pitch, down, loudness, functional, paragraph, spontaneous

Question 33

The rationale for this technique is it increases airflow, decreases medial compression of vocal folds

Answer 33

Flow Phonation

*focus on flowing, connected speech and frontal tone focus without constriction, tension or hard glottal attacks

*BEST for hyperfunction but can be used for hypofunction as well

Question 34

The protocol for this technique varies but it includes: sustained voiceless and voiced fricatives, glides and nasal consonant in cv form, cup bubble exercise w/and w/o voice, gargle w/ and w/o voice, blowing on long strip of tissue paper w/o voice and then producing ‘oo’ and keep tissue aloft

Answer 34

Flow Phonation

Question 35

The best therapy task sequence is:

Answer 35

Relaxation Exercises

Breathing Exercises

Voice Exercises

Question 36

You use this type of ‘voicing’ after surgery

Answer 36

Confidential Voice

Question 37

The rationale for Confidential Voice Casper is: the ____ remains slightly open, ______ close phase of vibration, _____ of laryngeal muscle tension.

Answer 37

glottis, decreased, absence

Question 38

In Pre-Surgery care client should _____ adequate ____ support, ______ any extralayrngeal or ______ laryngeal muscle tension, _____ vocal hygiene issues, ___ post-surgical voice therapy technique

Answer 38

train, breath, eliminate, intrinsic, address, train