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SLHS 408 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q
  • Inflammatory condition below the epithelium
  • Bilateral
A

Laryngitis

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2
Q

Where does laryngitis occur on the TVF?

A

Entire length

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3
Q

Etiology of laryngitis

A

Infection, phonotrauma, cigarette smoking, autoimmune disease, GERD

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4
Q
  • Mass/growth of the epithelium
  • Bilateral
A

Vocal Fold Nodules

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5
Q

Where do vocal fold nodules occur on the TVF?

A

Junction of the anterior 1/3 and posterior 2/3 membranous portion

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6
Q

Etiology of Vocal Fold Nodules

A

Usually results from phono traumatic behaviors

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7
Q
  • Mass/growth of the epithelium
  • Unilateral
A

Vocal Fold Polyps

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8
Q

Where do vocal fold polyps occur on the TVF?

A

Middle 1/3 of the membranous TVF

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9
Q

What are the two forms that the fluid-filled vocal fold polyp can take?

A

Sessile (blister-like) or Pedunculated (polyp is attached to the TVF by a stalk-like appendage)

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10
Q

Etiology of Vocal Fold Polyps

A

Acute vocal trauma, chronic phono traumatic behaviors

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11
Q
  • Mass/growth below the epithelium
  • Unilateral
A

Vocal Fold Cysts

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12
Q

Where do vocal fold cysts occur on the TVF?

A

Middle 1/3 of the membranous TVF

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13
Q

Etiology of Vocal Fold Cysts

A

Occasionally congenital, sometimes due to poor lymphatic drainage, most often due to phono traumatic behaviors

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14
Q

-Inflammatory condition below the epithelium
- Bilateral

A

Reinke’s Edema

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15
Q

Where does Reinke’s Edema occur on the TVF?

A

Entire membranous length of the TVF

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16
Q

Etiology of Reinke’s Edema

A

Long-standing trauma or chronic exposure to irritants (such as cigarette smoke or stomach acids)

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17
Q
  • Mass/growth of the epithelium
    -Unilateral or Bilateral
  • White plaque-like formation on the vocal fold surface
A

Leukoplakia

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18
Q

Where does leukoplakia occur on the TVF?

A

Usually found in the anterior 2/3 of the TVF

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19
Q

Etiology of Leukoplakia

A

Trauma to the vocal folds caused by inhalation of dust, noxious fumes, cigarette smoke, inhaled drugs such as marijuana, chronic bacterial or fungal infections, chronic laryngitis; also associated with excessive alcohol intake

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20
Q
  • Mass/growth of the epithelium
    -Unilateral or Bilateral
  • Presents as wart-like lesions
A

RRP (Recurrent Respiratory Papillomatosis)

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21
Q

Where does RRP occur on the TVF?

A

Anywhere along the TVF, but most often at the anterior commissure

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22
Q

Etiology of RRP

A

Human Papilloma Virus (HPV)

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23
Q
  • Unitlateral or Bilateral
  • Benign growths
A

Granulomas

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24
Q

Where do granulomas occur on the TVF?

A

On the vocal processes; usually in posterior glottis on the arytenoids

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25
Q

Etiology of Granulomas

A

Phono trauma, LPR (laryngopharyngeal reflux); intubation trauma

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26
Q
  • Small piece of connective tissue connecting the vocal folds that can affect phonation and breathing
  • Bilateral
A

Laryngeal Web

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27
Q

Where does Laryngeal Web occur on the TVF?

A

Anterior commissure of TVF

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28
Q

Etiology of Laryngeal Web

A

Can form as a consequence of trauma or infection, but most are congenital

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29
Q
  • Omega-shaped epiglottis
  • Excessive flaccidity of the supra glottic larynx
  • Causes collapse of laryngeal cartilages during inspiration
  • Bilateral
A

Laryngomalacia

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30
Q

Etiology of Laryngomalacia

A

Congenital abnormality without a clear cause (maybe due to insufficient calcium deposition, or related to CNS problems in children)

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31
Q

Which disorders results in problems with complete glottic closure?

A
  • Laryngitis
  • Nodules
  • Polyps
  • Cysts
  • RRP
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32
Q

Which disorders result in lowered pitch?

A
  • Laryngitis
  • Nodules
  • Cysts
  • Reinke’s Edema
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33
Q

Which disorders can result in hoarseness?

A
  • Laryngitis
  • Nodules
  • Polyps
  • Cysts
  • Leukoplakia
  • RRP
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34
Q

Which disorders can result in breathiness?

A
  • Nodules
  • Polyps
  • Cysts
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35
Q

Primary complaint of granulomas

A

PAIN

36
Q

Primary complaint of laryngeal web

A

SOB, Stridor

37
Q

Primary complaint of laryngomalacia

A

SOB, Stridor

38
Q

What is a functional upper airway disorder?

A

Disorder where there is no organic abnormality of the larynx

39
Q

What does paradoxical vocal fold movement entail?

A

Vocal folds doing the opposite of what they should be

40
Q

True or False: Inducible laryngeal obstruction (ILO) is a transient problem.

A

True

41
Q

True or False: ILO is a problem related to breathing.

A

False

42
Q

The majority of people diagnosed with ILO are _____.

A

adults

43
Q

Which noise is most associated with ILO?

A

Stridor

44
Q

True or False: ILO is most likely to occur on inspiration.

A

True

45
Q

True or False: Asthma inhalers are effective with symptoms of EILO.

A

False

46
Q

What are the proposed etiologies of ILO?

A
  1. Laxity of muscles, ligaments, or cartilages of the larynx, making it prone to movement during high intensity breathing that narrows the airway
  2. Hyperactive laryngeal adductor reflex
  3. Co-morbidities (asthma, gastro-esophageal or laryngeal reflux)
  4. Psychological contribution
47
Q

Besides the true vocal folds, what other structures can narrow the airway in an episode of ILO?

A

False vocal folds, epiglottis, arytenoids

48
Q

What is one difference in symptom presentation between EILO and asthma?

A

ILO usually has one or few triggers; asthma usually has multiple or many triggers

49
Q

True or False: At rest, the larynx looks normal at rest before a trigger brings on an episode of ILO.

A

True

50
Q

What are symptoms associated with ILO besides dyspnea?

A
  • Tightening in the throat or chest
  • Feeling of suffocation
  • Dizziness
51
Q

Similarities between laryngitis and vocal fold nodules

A
  • Occur bilaterally
  • Causes hoarse/rough voice
  • Causes low pitch
  • Incomplete glottic closure
  • Decreased vibration
  • Can be caused by phono trauma
52
Q

Differences between laryngitis and vocal fold nodules

A
  • Nodules result in specifically an hourglass incomplete closure pattern
  • Laryngitis is an inflammatory condition of the epithelium, whereas nodules are masses/growths of the epithelium
  • Laryngitis can be caused by infectious agents
53
Q

Similarities between vocal fold polyps and vocal fold cysts

A
  • Occur unilaterally
  • Occur in the middle 1/3
  • Can be caused by phono trauma
  • Cause rough, breathy voice
  • Hourglass closure pattern
  • Asymmetrical vibration
54
Q

Differences between vocal fold polyps and vocal fold cysts

A
  • Cysts are masses below the epithelium, polyps are masses of the epithelium
  • Cysts can be congenital or caused by lymphatic drainage issues
  • Polyps can be pedunculated or sessile
  • Cysts cause a lowered pitch
  • Polyps can cause SOB
55
Q

Similarities between leukoplakia and RRP

A
  • Masses/growths of the epithelium
  • Can be unilateral or bilateral
  • Can cause hoarseness
  • Decreased vibration
56
Q

Differences between leukoplakia and RRP

A
  • RRP can occur anywhere whereas leukoplakia usually is found at the anterior 1/3
  • RRP can cause total loss of voice
  • Leukoplakia can be caused by trauma to the vocal folds or infection while RRP is caused by HPV
57
Q

Similarities between Reinke’s Edema and laryngitis

A
  • Inflammatory condition
  • Involves entire length of TVF
  • Both can be caused by phono trauma or irritant exposure
  • Lowered pitch
  • Hoarseness
58
Q

Differences between Reinke’s Edema and laryngitis

A
  • Laryngitis is an inflammatory condition of the epithelium while Reinke’s is an inflammatory condition below the epithelium
  • Laryngitis can cause incomplete glottic closure while closure is usually complete with Reinke’s
  • Reinke’s can cause SOB
59
Q

Similarities between granulomas and vocal fold cysts

A
  • Can be caused by phono trauma
  • Occur unilaterally
  • Globus sensation
60
Q

Differences between granulomas and vocal fold cysts

A
  • Granulomas can be found bilaterally
  • Granulomas are pound in the posterior glottis and do not usually interfere with glottic closure or vibration
  • Primary compliant with granulomas is pain
61
Q

Similarities between laryngeal webs and laryngomalacia

A
  • Occur bilaterally
  • Often congenital
  • Primary complaint is SOB, stridor
62
Q

Differences between laryngeal webs and laryngomalacia

A
  • Web occurs at the anterior glottis, whereas laryngomalacia occurs mostly outside the TVF and involves the supraglottis
  • Symptoms are most present upon inhalation with laryngomalacia but are present upon inhalation and exhalation with web
  • Laryngomalacia can be characterized by an omega-shaped epiglottis
  • Web can cause a high-pitched voice
63
Q

Similarities between vocal fold nodules and vocal fold polyps

A
  • Caused by phono trauma
  • Mass/growth of the epithelium
  • Rough, hoarse, breathy voice
  • Hourglass closure pattern
  • Decreased vibration
64
Q

Differences between vocal fold nodules and vocal fold polyps

A
  • Polyps are unilateral, nodules are bilateral
  • Nodules lowers pitch
  • Polyps can cause difficulty breathing
  • Polyps can be sessile or pedunculated
65
Q

Similarities between unilateral vocal fold paralysis and bilateral vocal fold paralysis

A
  • Damage to the RLN
  • TVF may appear bowed
  • May have pooling of secretions if paralyzed in the intermediate or lateral position
  • Incomplete glottic closure if paralyzed in the intermediate or lateral position
  • Breathy, hoarse voice if paralyzed in intermediate or lateral position
  • Possible dysphagia
66
Q

Differences between unilateral vocal fold paralysis and bilateral vocal fold paralysis

A
  • Critical breathing difficulties if bilateral paralysis is in the median position
  • May have no voice symptoms at all if bilateral paralysis in the median position
67
Q

Similarities between adductor spasmodic dysphonia and abductor spasmodic dysphonia

A
  • Focal dystonia
  • Onset in middle age
  • Most prevalent in females
  • Unknown etiology
  • Voice symptoms do not occur at rest or during non-phonatory tasks
  • Occur less during laughter or signing
  • Tension throughout the larynx can be seen
68
Q

Differences between adductor spasmodic dysphonia and abductor spasmodic dysphonia

A
  • Abductor SD causes a weak/breathy voice
  • Adductor SD causes a strained/strangled quality
  • Adductor SD most often involves spasming of the TA muscle or other muscles of adduction
  • Abductor SD involves spasming of the CTA
69
Q

Similarities between essential voice tremor and spasmodic dysphonia

A
  • Involuntary movement
  • Voice breaks
  • Can cause slower speaking rate
70
Q

Differences between essential voice tremor and spasmodic dysphonia

A
  • Essential tremor can involve multiple sites of extraneous movement such as the soft palate and pharyngeal walls in addition to the larynx
  • Voice is described as shaky or quivery with essential tremor
71
Q

Similarities between Parkinson’s hypophonia and unilateral vocal fold paralysis

A
  • TVF bowing
  • Incomplete glottic closure
  • Breathy voice quality
  • Decreased loudness
  • Asymmetrical vibration
72
Q

Differences between Parkinson’s hypophonia and unilateral vocal fold paralysis

A
  • PD hypophonia is related to hypokinetic dysarthria and paralysis is due to damage to the RLN
  • TVF are fully mobile with PD hypophonia
  • Speech rate is affected in PD hypophonia
73
Q

Similarities between primary muscle tension dysphonia and secondary muscle tension dysphonia

A
  • Excessive muscle effort
  • Vocal strain
  • Compression can be seen laterally and anteroposterior
  • Strained, harsh voice
  • Vocal fatigue
  • Globus sensation
74
Q

Differences between primary muscle tension dysphonia and secondary muscle tension dysphonia

A
  • Primary MTD is due to maladaptive behaviors with no underlying laryngeal abnormality
  • Secondary MTD is due to maladaptive behaviors due to an underlying laryngeal pathology
  • Stress is a primary MTD
75
Q

Similarities between mutational falsetto and muscle tension dysphonia

A
  • Psychological distress can cause both
  • Can have incomplete glottic closure
  • Pitch is high
76
Q

Differences between mutational falsetto and muscle tension dysphonia

A
  • MTD mostly affects females ages 40-50, mutational falsetto mostly affects males age 11-15
  • Voice can be very weak in mutational falsetto
77
Q

Similarities between muscle tension dysphonia and conversion aphonia

A
  • Can be caused by stress
  • Larynx may look normal at rest
  • Significant compression can be seen during phonation
  • Voice can be strained
  • Voice can be high-pitched
  • Pain reported
78
Q

Differences between muscle tension dysphonia and conversion aphonia

A
  • In conversion aphonia, the TVF may not fully adduct
  • Patient may only be able to whisper in conversion aphonia
  • Vegetative phonation is often normal in conversion aphonia
79
Q

Similarities between conversion aphonia and mutational falsetto

A
  • Can be caused by psychological distress
  • Pitch is high
  • Larynx looks normal at rest
  • May have incomplete glottic closure
80
Q

Differences between conversion aphonia and mutational falsetto

A
  • Mutational falsetto typically occurs in adolescent males, conversion aphonia can occur in anyone
  • Vegetation phonation is often normal in conversion aphonia
81
Q

What is an unproductive cough?

A

A cough that does not produce any phlegm or mucus

82
Q

A chronic cough is one that lasts for more than _____ weeks.

A

8

83
Q

Peak incidence of chronic cough is in the age range of:

A

5th and 6th decades of life (50s and 60s)

84
Q

What is hypersensitivity?

A

Reaction to lower dose stimulus; incidental and non-harmful stimuli

85
Q

What is learned hypersensitivity?

A

An initial irritant “primes” the system which then becomes a generalized physiologic response

86
Q

What is allotussia?

A

Cough is triggered by incidental and mostly non-harmful stimuli

87
Q
A

SLHS 408 (3 decks)

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