Perceptual assessment Flashcards
What is involved in the perceptual assessment of loudness?
Perception of how loud or soft voice is.
Determined by interaction between subglottal pressure and degree of adduction of vocal folds.
Soft voice - subglottal pressure and inadequate adduction of VF.
What is involved in the assessment of pitch?
Perception of how high or low a voice is.
Determined by speed of vibration of vocal folds
- High pitch - fast rate of vibration
- Low pitch - slow rate of vibration
Variations in pitch = intonation
Variations - monotone or excess variability
What is involved in the perception of quality?
How clear a voice sounds. Oates lists the following: Breathy Strained Rough Glottal fry Tremor Pitch breaks Phonation breaks Voice arrests Diplophonia Falsetto
What does breathy mean?
Audible air escape during phonation.
Due to incomplete adduction of VF.
Breathy + strained = whispery
Breathy + strained + rough = hoarse
What does strained mean?
Sounds like excessive vocal effort. Due to increased laryngeal muscle tension and constriction. True VF and/or false VF. Strained + breathy = whispery Strained + rough = harsh Strained + breath + rough = hoarse
What does rough mean?
Lack of clarity.
Due to irregular vibration of VF.
Rough + strained = harsh
Rough + breathy + strained = hoarse
What does glottal fry mean?
Rapid sense of low-pitched “pops” or “taps”.
Creaky quality.
Physiological basis - complex, not well understood.
Due to:
-Longer than normal closed phase of VF vibration
- Low frequency VF vibration
- Tightly adducted VF with free edges flaccid (slack)
- Low subglottal pressure
What is falsetto?
High pitched Thin, light quality, impression of immaturity Excess air escape at times Due to: - High frequency of VF vibration - Thinning of VF edge - Incomplete closure along length of VF
What are pitch breaks?
Sudden, short, unexpected and uncontrolled changes in pitch (up or down).
What is diplophonia?
Perception of 2 pitches occurring simultaneously in voice.
Physiology not understood.
What are phonation breaks?
Sudden, short, unexpected and uncontrolled breaks in voice.
Short duration.
Moment of turbulent air escape with no voice.
Due to:
- Sudden cessation of vibration of VF
What are voice arrests?
Voice stoppages.
Due to uncontrolled adduction of VF.
Specific characteristic of spasmodic dysphonia.
Voice sounds strained and strangled.
What is tremor?
Regular, rhythmical vibration in pitch or loudness of voice.
Voice sounds quavery.
Due to neurological impairment.
Not under voluntary control.
May be isolated symptom or part of generalised neurological disorder.
Due to:
- Alternating contractions of adductor and abductor muscles of VF
- Oscillatory movements of entire larynx in vertical direction
What is the CAPE-V?
Consensus Auditory-Perceptual Evaluation of Voice. Method: 2 vowel sounds 6 phonetically loaded sentences Running speech Assesses overall severity, roughness, breathiness, strain, pitch and loudness. Mild, moderate, severe. Consistent or intermittent?
What is the Voice Handicap Index?
Assesses patient’s perception of the relative impact of his/her voice disorder on daily activities.
