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Nature of Disorders of Speech, Voice, Fluency and Swallowing > L11 Voice > Flashcards

L11 Voice Flashcards

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1
Q

dysphonia

A

abnormal voice quality

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2
Q

aphonia

A

lack of voice

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3
Q

difference between voice disorder and problem

A
  • Disorder implies that there is some type of mental/physiological impairment
  • Problem is more related to when a person’s voice isn’t congruent to how the person wants it to perform - trans/non binary clients
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4
Q

vocal abuse

A
  • outdated term to describe when people engage in voice misuse leading to a voice disorder
  • judegemental
  • we now use vocal misuse
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5
Q

risk factors for developing a voice problem

A
  • age
  • sex
  • family
  • smoking
  • hearing
  • occupation
  • mental health issues
  • locking voice
  • acid reflux
  • poor posture
  • dehydration
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6
Q

voice characteristics

A
  • stamina
  • pitch
  • loudness
  • tremor
  • flexibility
  • quality
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7
Q

stamina abnormalities

A
  • Run out of breath when I talk
  • Phone calls hard
  • Group talk hard
  • Presentations hard
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8
Q

pitch abnormalities

A
  • Abnormally high/low
  • Monopitch
  • Pitch breaks
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9
Q

loudness abnormalities

A
  • Abnormally high/low
  • Monoloudness
  • Excess loudness variation
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10
Q

tremor

A

Jerky voice quality

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11
Q

flexibility abnormalities

A
  • Lack of dynamic range
  • Voice & pitch breaks
  • Can’t rapidly access voice
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12
Q

what does VTD stand for

A

vocal tract discomfort

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13
Q

signs/symptoms of VTD

A
  • Fatigue
  • Burning
  • Tickling
  • Dryness
  • Iriritability
  • Lump in throat (globus sensation)
  • Aching
  • Pain
  • Mucous
  • Difficulty catching breath
  • Tightness
  • Pushing to get voice out
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14
Q

four classifications of voice problems

A
  1. A lesion on the vocal fold membrane
  2. A neurological voice disorder
  3. A lack of glottic closure
  4. Reflux-related
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15
Q

organic voice disorders

A

aphonia or dysphonia as a result of organic changes to the larynx

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16
Q

characteristics of organic voice disorders

A
  • Mass lesions on the vocal folds
  • Tissue changes in the larynx
  • Alterations to cartilaginous structures
  • Nerve innervation problems
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17
Q

causes of organic voice disorders

A
  • Congenital or acquired
  • Infection
  • Trauma
  • Reflux
  • Other irritants
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18
Q

examples of organic voice disorders

A
  • vocal polyps
  • vocal cysts
  • reike’s oedema
  • laryngopharyngeal reflux
  • post-nasal drip
  • layngeal web
  • sulcus vocals
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19
Q

identify the voice disorder

A

vocal polyps

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20
Q

identify the vocal disorder

A

vocal cyst

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21
Q

identify the vocal disorder

A

reike’s oedema

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22
Q

identify the vocal disorder

A

laryngopharyngeal reflux

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23
Q

identify the vocal disorder

A

post nasal drip

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24
Q

identify the vocal disorder

A

laryngeal web

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25
identify vocal disorder
sulcus vocalis
26
cause of vocal polyps
Trauma or environmental (e.g. irritants)
27
treatment for vocal polyps
SLT may help, but may not cure. If incurable, then needs surgery to remove
28
voice in vocal polyps
Rough, probably strained
29
cause of vocal cysts
May be trauma, or spontaneously develop. Could be a fluid-filled sac or plugged mucous-secreting gland
30
treatment for vocal cysts
Usually needs surgery and then SLT
31
voice with a vocal cyst
Rough
32
cuase of reike's oedema
smoking
33
treatment for reike's oedema
smoking cessation
34
voice quality with reike's oedema
Rough, may have stridor
35
cause of laryngopharyngeal reflux
Dietary – pepsin (enzyme) adheres to larynx, activates in the presence of acid
36
treatment for laryngopharyngeal reflux
Gaviscon Advance / PPIs BD
37
voice quality for laryngopharyngeal reflux
cuts in and out, may be rough
38
cause of post-nasal drip
Nasal irritation. May be environmental (e.g. pollen), idiopathic or secondary to LPR
39
treatment for post-nasal drip
Sinus rinsing +/- steroidal sprays
40
voice quality with post-nasal drips
May cut in and out, variable quality. Strained or rough if coughing a lot
41
cause of laryngeal web
Congenital. Generally only seen in paeds.
42
treatment of laryngeal web
Surgical. Note – causes airway patency issues
43
cause of sulcus vocalis
Unknown, but possible congenital or through repeated inflammatory processes
44
treatment of sulcus vocalis
Surgical
45
voice quality with sulcus vocalis
Breathy and possibly rough with likely higher-than-normal habitual pitch
46
characteristics of neurogenic voice disorders
- Depends on nerve lesion - Central lesions tend to involve other symptoms - Peripheral lesions tend to involve just the voice
47
causes of neurogenic voice disorders
- Acquired neurological diseases (e.g. MND, IPD, MS) - Trauma to the head/neck/throat - Post-infective (usually respiratory tract infection) - Latrogenic (i.e. caused by the doctor: heart/lung/throat surgery)
48
examples of neurogenic voice disorders
- dysarthrias - vocal paresis/paralysis - presbyphonia - spasmodic dysphonia
49
identify the vocal disorder
Vocal Paresis/Paralysis
50
identify the vocal disorder
Presbyphonia
51
typical diseases causing flaccid dysarthria
- Myasthenia Gravis - Motor Neuron Disease/Amyotrophic Lateral Sclerosis - Guillain-Barré syndrome
52
voice quality with flaccid dysarthria
- Incomplete glottal closure – sometimes none (aphonic) - Weak/slowed vocal fold movement - Monoloudness
53
typical diseases that cause spastic dysarthria
- Motor Neuron Disease/Amyotrophic Lateral Sclerosis - Cerebral palsy - Multiple sclerosis
54
voice quality with spastic dysarthria
- Monopitch, monoloudness - Low pitch, pitch breaks - Harsh vocal quality, breathy voice
55
typical diseases causing ataxic dysarthria
- Friedrich’s Ataxia - Multiple Sclerosis
56
voice quality with ataxic dysarthria
- Harsh vocal quality - Monopitch, monoloudness - Excess loudness variation - Vocal tremor
57
typical diseases causing hypokinetic dysarthria
- Parkinson’s Disease - Lewy Body Disease - Multiple System Atrophy (MSA)
58
voice quality with hypokinetic dysarthria
- Monopitch, monoloudness - Breathy voice (vocal bowing) - Low pitch
59
typical dieases causing hyperkinetic dysarthria
- Isolated causes - Essential tremor
60
voice quality with hyperkinetic dysarthria
- Monopitch, monoloudness - Strained-strangled voice quality - Voice breaks - Transient breathiness
61
cause of vocal paresis/paralysis
Usually acute nerve injury/severing, but may be stroke-related
62
treatment for vocal paresis/paralysis
Surgical medialization, voice strengthening
63
voice quality with vocal paresis/paralysis
Breathy, low volume, reduced pitch range, increased vocal fatigue. Aphonia if bilateral.
64
cause of presbyphonia
Normal, age-related changes
65
treatment for presbyphonia
Voice strengthening.
66
voice quality with presbyphonia
Breathy, low volume, reduced pitch range, increased vocal fatigue.
67
cause of spasmodic dysphonia
Neurogenic, but may be exacerbated by stress. Vocal folds don’t adduct and abduct smoothly, they jerk randomly together
68
treatment for spasmic dysphonia
Botox injections. Minimal benefit from SLT.
69
voice quality with spasmodic dysphonia
Unstable, jerky quality. - Adductor type – harsh quality (90% of cases) - Abductor type – breathy, aesthenic
70
functional voice disorders - muscle tension dysphonia
dysphonia that occurs as a result of disturbed psychological processes that lead to chronic patterns of misuse/dysfunction of the laryngeal musculature
71
characteristics of functional voice disorders
- Inefficient phonatory pattern - Habituated voice misuse - Psycho-social factors - Tension in intrinsic and extrinsic laryngeal muscles
72
causes of functional voice disorders
- Upper Respiratory Tract Infection (URTI) - Associated with organic voice disorder (by compensation) - Psychosocial stressors
73
examples of functional voice disorders
- vocal nodules - muscle tension dysphonia
74
identify the vocal disorder
vocal nodules
75
identify the vocal disorder
muscle tension dysphonia
76
cause of vocal nodules
Usually phonotrauma (i.e. vocal abuse)
77
treatment for vocal nodules
SLT input usually resolves, but entrenched/fibrotic nodules may need surgery
78
voice quality with vocal nodules
Rough, probably strained quality
79
cause of muscle tension dysphonia
May be triggered by URTI, trauma or stress
80
treatment for muscle tension dysphonia
SLT. (Almost) no role for ENT
81
voice quality with muscle tension dysponia
rough, strain
82
psychogenic disorder
a dysphonia (impaired or disordered voice) or aphonia (absent voice) where the causative or perpetuating factors are largely of psychological or emotional conflict
83
classification of psychogenic disorders
- classical conversion - cognitive behavioural conversion - habituated conversion
84
classical conversion | psychogenic
Lack of conscious acceptance of psychological problems
85
cognitive behavioural conversion | psychogenic
Conscious acceptance of issues, but avoidance of same due to desire to avoid conflict (internal or external)
86
habituated conversion | psychogenic
As with type 2, but the source of anxiety is gone, while the musculoskeletal tension remains
87
signs of psychogenic voice disorders
- Low mood - Family/interpersonal difficulties - Mild-moderate depression - Difficulty expressing views/emotions - Stressful life events - Suppressing anger/frustration - Anxiety Burden of responsibility - Common to females - Over-commitment and helplessness - Near normal psychological adjustment
88
Mutational Falsetto/Puberphonia
- Males maintain a high-pitched falsetto voice after puberty - Often associated with maternal/parental attachment issues
89
do SLTs diagnose voice problems
nope that's an ENT job

Nature of Disorders of Speech, Voice, Fluency and Swallowing (12 decks)

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