ecu voice Flashcards
(88 cards)
1
Q
what is the function of the larynx
A
- respiration
- protect airways when swallowing
- sub-glottal pressure
2
Q
what are the average lengths of vocal folds for males and females
A
males: 16-17 mm
females 10-11 mm
3
Q
what is the mean fundamental frequency in males and females
A
males: 125. range 100-140
females: 225. range 180-250
4
Q
what are characteristics of the aging voice
A
- ossification of cartilages
- reduced flexibility
- atrophy, dystrophy, and edema
- synchrony and symmetry of folds affect vocal quality
- vocal fold boing
- decreased blood supply
5
Q
what is the visceral pleura
A
out surface of each lung
6
Q
what is the parietal pleura
A
lines the internal thoracic walls, mediastinum, and superior surface of the diaphragm
7
Q
what is the tidal volume
A
volume of air inspired or expired during normal inspiration
8
Q
what is inspiratory reserve volume
A
amount of air inspired forcefully after inspiration of normal tidal volume
9
Q
what is expiratory reserve volume
A
amount of air expired forcefully after normal tidal
10
Q
what is residual volume
A
volume of air that always remains in the respiratory passages after forceful inhalation or exhalation
11
Q
what is vital capacity
A
what you can inhale and exhale deeply
12
Q
what are the 3 paired cartilages
A
arytenoid
cuneiform
corniculate
13
Q
what are the 3 unpaired cartilages
A
thyroid
cricoid
epiglottis
14
Q
what are the laryngeal elevators
A
digastric
mylohyoid
stylohoid
geneohyoid
15
Q
what are the laryngeal depressors
A
thyrohyoid
omohyoid
sternohyoid
16
Q
which are the adductors
A
lateral cricoarytenoid
transverse and oblique arytenoid
17
Q
which is the abductor
A
posterior cricoarytenoid
18
Q
what does the cricothyroid do
A
lengthens and tenses the folds
19
Q
what makes up the body of the folds
A
thyroarytenoid and vocalis
20
Q
which is the only muscle not innervated by the recurrent laryngeal nerve
A
cricothyroid: innervation from external superior laryngeal
21
Q
what is the cricothyroid joint
A
tilts the inferior thyroid cornu to increase the disance between the anterior commisure and the vocal process
uses the vertical and oblique cricothyroid muscles
22
Q
what are 3 regions of the interior larynx
A
supraglotal
glotal
subglottal
23
Q
what makes up the cover
A
epithelium and superficial lamina propria (Reinke’s)
24
Q
what makes up the transition
A
intermediate and deep lamina propria
25
what makes up the body
vocalis
26
what is the cover body theory
cells in cover not tightly packed allowing for horizontal and vertical movement
cells in body tightly packed and dont move
transition layer balances movement of 2 layers
wave happens because of difference in properties betwee the 2 layers
27
what nerve innervate the epiglottis
pharyngeal nerve
28
what 3 properties of the folds affects pitch
mass
length
tension
29
how is loudness changed
subglottal pressure
adduction of folds
duration, degree, and speed of VF closure
30
what causes a breathy voice
incomplete glottal closure
31
what causes a hoarse voice
aperiodicity, mucosal wave abnormalities
32
what causes a strained voiced
supraglottal muscle tension
33
what is included in a voice eval by the SLP
1. case history and interview
2. oral mech
3. hearing screening
4. attitude survey (psychological)
5. perceptual assessment
6. stroboscopy
7. acoustic analysis
8. QOL assessment
9. aerodynamic assessment
10 EGG, EMG
11. resonance assessment
34
what is included in the case history
1. what is the problem
2. how has it affected the voice
3. onset and duration
4. variability vs consistency
5. associated symptoms
6. medical history including intubation, trauma, medications
7. list of physicians currently treating
8. allergies
9. throat claring and coughing habits
10. eating habits
11. history of asthma, stridor etc
12. psychological issues
13. voice use history
35
what is included in a subjective assessment
1. sustained vowel
2. continuous and spontaneous speech
3. reading sample
36
what voice qualities are assessed
1. loudness
2. pitch
3. quality
37
how is loudness assessed
loudness variability in continuous sample
| contrastive stress also used
38
how is pitch assessed
1. habitual pitch
2. pitch variability
3. pitch range
4. tremor
39
how is quality assessed
1. identify voice quality
| 2. define severity. mild, moderate, severe
40
what subjective and objective parameters are assessed
respiration
phonation
resonance
41
how is respiration subjectively assessed
1. look at type of breathing (clavicular, diaphragmatic, thoracic)
2. read a passage in one breath and count # of words (6-7)
3. max phonation duration ( 25-30 male, 15-20 female)
42
what acoustic measures are assessed
frequency
intensity
noise
perturbation
43
what are amplitude related measures
mean amplitude
intensity range
standard deviation of amplitude
shimmer
44
what are frequency related measures
mean fundamental frequency
range
standard deviation of Fo
Jitter
45
what are objective noise related measures
noise to harmonic ratio
| voice turbulence index
46
what is the noise to harmonic ratio
noise divided by harmonics ratio. closer to zero the better the voice
47
what is EGG
electroglottography
measures electrical resistance between 2 electrodes
less resistance when the VF are in contact
measures open, opening, closed, closing phases and period
48
what is the open quotient
open phase divided by time
| complete adduction = 0, abduction = 1
49
what is the closed quotient
closed phase divided by time
50
what is the only subjective aerodynamic assessment
s/z ratio
51
what are objective aerodynamic assessments
1. vital capacity
| 2. mean airflow rate ( amount of air/ max phonation duration)
52
what is the phonatory quotient
vital capacity/max phonation duration
53
how is variation in sound pressure level measured
patient produces string /pa pa pa? at usual, half usual, and twice usual loudness levels
54
how is voicing efficiency measured
patient repeats /a/ and /p/ (apapapap) with equal stress. Gives info about airway resistance
55
how does a stroboscopy work
microphone on neck records sound and measure the frequency
| strobe light synchronized with this value and emits flashes of light at lower frequency 1-2 Hz
56
what do you look for with a stroboscopy
```
symmetry
structure
periodicity
glottal closure patterns
muscle tension
movement of the VF and arytenoids
```
57
what are organic disorders
structural issues with anatomy
58
what are functional disorders
anatomy intact, function disturbed
59
what are nodules
```
masses on folds
always bilaterial
anterior 2/3, posterior 1/3 junction
repeated phonotrauma
symptoms: hoarseness, reduced pitch, reduced loudness
managed by voice rest and hygiene
```
60
what are polyps
```
unilateral mass due to phootrauma
have blood supply
sessile: on fold
pedunculated: hangs by stalk
symptoms: hoarseess, reduced pitch and loudness
treated by surgery
```
61
what is reinke's edema
edema in Reinke's space
| mostly induced by smoking and phonotrauma
62
what is a laryngeal cyst
mucous mass under mucosa within the superficial lamina propria
63
what is a granuloma
growths due to intubation usually in vocal process
64
what are contact ulcers
lesions in posterior VF due to reflux
65
what is a larygeal web
webbing of glottis due to irritation
primary symptom respiratory difficulty
voice is harsh and high pitched
can be congenital or due to trauma
66
what is sulcus vocalis
groove in VF of unknown cause
67
what is varix
superficial prominent vein that is enlarged and dilated
68
what is ectasia
fused lesioning of blood vessel on superficial lamina propria
69
what is puberphonia/mutational falsetto
unusual high pitch that persists beyond puberty
| symptoms: hoarseness, breathiness, pitch breaks, inadequat resoance, shallow breathing
70
what are the laryngoscopic findings with phonotrauma
1. lateral medial compression
2. anterior posterior compression
3. strain of supraglottal structures
4. hyper adduction
5. elevated laryngeal position
71
what does the superior laryngeal nerve innervate
internal: all sensory info to larynx
external: motor innervation to cricothyroid
72
what does the recurrent laryngeal nerve innervate
all sensory info below the folds
| motor innervation to all intrinsic laryngeal muscles except the cricothyroid
73
what are the characteristics of vocal fold paralysis
1. unilateral or bilateral
| 2. possible causes are surgery; neurological disease; head and neck trauma; viral infections; tumors
74
what are characteristics of bilateral adductor paralysis
1. both folds in paramedian position
2. airway protection an important issue, may need tube feeding
3. dysponic due to secondary muscle tension
4. breathy and weak voice
75
what are the characteristics of bilateral abductor paralysis
folds paralyzed in closed position
critical condition for respiration
sometime remove arytenoid or suture it in an open position
76
what are the characteristics of unliateral abductor paralysis
1. paralyzed fold remains at midline
2. voice quality mildly dysphonic with possible elevated loudness
3. may demonstrate stridor
77
what are the characteristics of unilateral adductor paralysis
1. affected fold fails to adduct to midline
| 2. voice quality varies depending on position and size of glottal gap during phonation
78
what are characteristics of superior laryngeal nerve paralysis
1. Internal: lose sensation of the bolus
| 2. external: cricothyroid unable to stretch vocal folds resulting in loss of pitch range and vocal fatigue
79
what are characteristics of spasmodis dysphonia
1. involuntary adductor or abductor spasms during phonation
| 2. symptoms: strained, strangled, and effortful voice production
80
how do you assess spasmodic dysphonia
1. undisrupted: singing, laughing, throat clearing, humming
2. vowels more affected. Assess by a sentence with predominantly vowel sounds ( We eat eggs every Easter)
3. treatment: Botox
81
what is organic voice tremor
1. essential tremor to larynx
2. gradual onset: typically 40-60 years
3. more frequent in males
4. may be hereditary
5. modulating tremor pf pitch and intensity during vowel prolongation
6. shaky or wobbly voice
7. limited success with Botox treatment
82
what are characteristics of myethenia gravis
1. autoimmune neuromuscular disorder. Antibodies block AcH receptors
2. weakness after 5-6 minutes
3. rest improves
83
what are characeristics of Parkinsonism
```
monopitch
reduced pitch
monoloudness
reduced loudness
festinating speech
tremor
diminished vocal fold movement due to rigidity
```
84
what are characteristics of Huntington's
1. harsh, monopitch, strain, voice arrests due to sudden adduction/abduction
2. increased jitter, shimmer
85
what are characteristics of cerebellar ataxia
1. hypotonia: reduced range of movement
2. harsh, monopitch, reduced pitch, strin
3. reduced speed of adduction and abduction
86
what are characteristics of MS
1. incoordination, spasticity, muscle weakness
| 2. impaired control of loudness, harshness, hoarseness, hypernasality, impaired pitch, reduced rate, scanning speech
87
what are common congenital pediatric voice disorders
1. VF paralysis
2. laryngeal stenosis
3. laryngomalacia: flaccid epiglottis obstructing airway. Omega shaped epiglottis
4. laryngocele: air filled dilation of the laryngeal vestibule
5. webbing
88
what are the direct therapy approaches for voice
1. vocal function exercises
2. flow phonation
3. Lessac-Madsen REsonant Voice Therapy
4. LSVT
5. Inspiratory and expiratory muscle strength training
