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COMDIS415 EXAM 2 > COMDIS415 VOICE DISORDERS PART 2 > Flashcards

COMDIS415 VOICE DISORDERS PART 2 Flashcards

(55 cards)

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1
Q

DYSPHONIA

A

Definition
Characterized by altered: Vocal quality
 Pitch
 Loudness
Vocal effort
Broad, clinical term used to describe abnormal functioning of voice

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2
Q

Auditory-perceptual symptom: vocal quality

A

voice quality - something is different
with their voice that you are able to
notice right away
- Heard as: roughness, breathiness, strained, strangled, hoarse, weak, wet/gurgly

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3
Q

Auditory-perceptual symptom: pitch

A

Heard as: too high, too low, pitch breaks, decreased pitch range

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4
Q

Decreased pitch range (upper)

A

pitch glides - start with lowest pitch
then have patient go up in pitch
easy with vowel ‘e’ rise

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5
Q

Auditory-perceptual symptom: loudness

A

Heard as: too high, too low, decreased range, unsteady volume

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6
Q

Auditory-perceptual symptom: vocal effort

A

Heard as: running out of breath quickly, frequent coughing/throat clearing
- throat clearing causes vocal folds to slam against each other, causes vocal nodules

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7
Q

CAUSES OF VOICE DISORDERS: ORGANIC (STRUCTURAL)

A

Vocal fold abnormalities (e.g., vocal nodules)
Inflammation of the larynx (e.g., arthritis, reflux)
Trauma to the larynx (e.g., from intubation, chemical exposure, external trauma)

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8
Q

CAUSES OF VOICE DISORDERS: ORGANIC (Neurogenic)

A

Laryngeal nerve paralysis
Parkinson’s Disease
Multiple Sclerosis

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9
Q

VOICE DISORDERS: FUNCTIONAL CAUSES

A

phonotrauma
muscle tension
vocal fatigue

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10
Q

Phonotrauma

A
  • Yelling
  • Screaming
  • Excessive throat-clearing
    work on in therapy: focus on breathing, vocal hygiene,
    relaxing muscles
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11
Q

Muscle Tension

A

Excessive squeezing,
tightness of laryngeal muscles

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12
Q

Vocal Fatigue

A

Due to effort or overuse

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13
Q

The process of inspiration is a passive process.

A

false, it is an active process

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14
Q

During rest breathing, the process of expiration is a passive process.

A

true, it recoils, so the diaphragm goes back into position

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15
Q

During speech breathing, the process of expiration is a passive process.

A

false, you have to control air flow that is coming out, so you talk in short breaths groups

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16
Q

Which statement is true of speech breathing?

A

We inhale more air

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17
Q

During inspiration

A

Thoracic volume increases causing a decrease in thoracic pressure

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18
Q

The inverse (opposite) relationship between thoracic volume and thoracic pressure is known as:

A

Boyle’s Law

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19
Q

What subglottal pressure is required for speech production at a comfortable volume?

A

6-8 cm H20

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20
Q

What subglottal presure is required for yelling/loud speech?

A

10-12 cm H20

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21
Q

What subglottal presure is required for minimum amount pressure needed for vibration?

A

3-4 cm h20

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22
Q
  1. Which statement accurately describes vital capacity:
A

a. It declines with age
b. It differs between males and females
c. It is dependent on level of physical activity and health status (e.g. history of smoking, recent illness)

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23
Q

On average, how many syllables per breath group is considered typical?

24
Q

During rest breathing, we pause to breath at linguistically-appropriate boundaries (e.g. a major syntactic boundary)

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A

False, we do not talk during rest breathing, only true at speech breathing

25
During vocal fold vibration, the vocal folds close: (Select all that apply)
a. Due to elastic recoil b. Due to the Bernoulli effect
26
During vocal fold vibration, the vocal folds open:
Because the pressure below the vocal folds is greater than the pressure above the vocal folds
27
Jitter
how stable frequency/pitch is Norms: 1.04% or lower
28
Shimmer
steady of amplitude (loudness) lower than 3.8%
29
harmonic to noise ratio
above 20
30
VOCAL NODULES CAUSE
Repeated phonotrauma to vocal folds  Folds rub together, get sore, and blister  Voice overuse  Use voice incorrectly
31
VOCAL NODULES SYMPTOMS
 Sound deeper, weaker, more breathy  Hoarse quality  Voice cuts out
32
VOCAL FOLD PARALYSIS OR PARESIS CAUSES
Nerve impulses to larynx are disrupted, muscle becomes paralyzed  Injury to vocal fold during surgery  Neck or chest injury  Stroke  Tumors  Neurological conditions
33
VOCAL FOLD PARALYSIS OR PARESIS SYMPTOMS
Usually, one vocal fold is paralyzed  Breathy, hoarse voice  Noisy breathing  Loss of vocal pitch and loudness  Frequent throat clearing
34
MEDIALIZATION THYROPLASTY | INJECTION OF BIOMATERIALS
Injections are done every 3-6 months
35
MUSCLE TENSION DYSPHONIA CAUSE
Laryngeal muscles become tense  Respiratory illness, allergies, reflux  Increased vocal demand  Stressful life events
36
MUSCLE TENSION DYSPHONIA SYMPTOMS
 Rough, hoarse, or raspy voice  Weak, breathy, airy or is only a whisper  Strained, pressed, squeezed, tight or tense  Voice suddenly cuts out  Pitch too high or too low  Pain or tension  Throat feels tired PRIMARY AND SECONDARY TYPES
37
WHO ASSESSES VOICE DISORDERS?
Primary care provider may send you to see an: Otolaryngologist – Ear, Nose, Throat Doctor  SLP
38
OTOLARYNGOLOGIST
Usually examines your vocal folds and larynx with a videostroboscopy Why is the videostroboscopy done?  Identify cause of voice dysfunction (inflammation, infection or injury?)  Assess the movement and function of vocal folds
39
SLP
 Assess the vocal characteristics related to respiration, phonation, and resonance:  Pitch  Loudness  Pitch range  Vocal endurance Uses:  Standardized measures  Nonstandardized measures
40
SLP: ASSESSING FOR VOICE DISORDERS
Case History  Self-Assessment Oral-Peripheral Exam Auditory-Perceptual Assessment Acoustic Assessment
41
CASE HISTORY & SELF-ASSESSMENT
We want to know: Individual’s description of voice problem, including onset and Variability of symptoms Individual’s assessment of how their voice problem affects them  Voice Handicap Index (VHI)  Voice-Related Quality of Life (V-RQOL)
42
ORAL-PERIPHERAL EXAM STRUCTURES
 Lips  Tongue  Jaw  Teeth  Hard & Soft Palates  Pharynx
43
ORAL-PERIPHERAL EXAM FUNCTION
Respiratory Breathing Patterns (single breath count)  Coordination of Respiration with Phonation  Maximum Phonation Time  Diadochokinetic Rates
44
maximum phonation time
ask patient to take breath and then hold “ah” for as long as you can at a comfortable loudness NORM: 20-25 SECS
45
AUDITORY-PERCEPTUAL ASSESSMENT SUBJECTIVE MEASURES
Assessing voice quality during the production of sustained vowels, sentences, and running speech  Roughness/Hoarseness  Breathiness – audible air escape in voice  Strain – perception of excessive vocal effort  Pitch – highness or lowness of tone in voice  Loudness – what’s the sound intensity?
46
ACOUSTIC ASSESSMENT
Vocal Amplitude  Measuring loudness and strength of the voice in decibels Fundamental Frequency  Measuring the vibration rate of the vocal folds in hertz COMPARE CLIENTS VOCAL AMPLITUDE + FUNDAMENTAL FREQS TO NORMS
47
SLP: ASSESSING FOR VOICE DISORDERS
Case History Self-Assessment Oral-Peripheral Exam Auditory-Perceptual Assessment Acoustic Assessment After thoroughly obtaining outcomes for these measures, and the physical findings from the ENT, you can make a diagnosis and recommend treatment
48
DIRECT APPROACH INTERVENTION
focus on manipulating the voice-producing mechanisms
49
Physiologic Voice Therapy
strive to balance the three subsystems of voice production (respiration, phonation, and resonance).
50
Accent Method
Facilitate abdominal breathing, reduce excessive muscular tension, normalize phonation patterns
51
Lee Silverman Voice Treatment (LSVT)
Initially developed for patients with Parkinson’s Disease, but used with other populations  Maximize phonatory and respiratory function
52
Resonant Voice Therapy
Increasing vibratory sensations on the lips, teeth or in the nose for easy phonation or easy voicing.
53
Indirect approaches
client education and counseling
54
Client education
Discussing normal physiology of voice production and the impact of voice disorders on function.  Providing information about the impact of vocal misuse and strategies for maintaining vocal health/vocal hygiene.
55
Counseling
Identifying and implementing strategies such as stress management to modify psychosocial factors that negatively affect vocal health.

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