Lecture 1 Foundation

Question 1

What is the primary function of the larynx?

Answer 1

Airway protection

Question 2

How does the larynx protect the airway during swallow?

Answer 2

Epiglottis covers the trachea

Question 3

How does the larynx protect the airway during voicing?

Answer 3

Vocal fold adduction

Question 4

What are the secondary functions of the vocal folds?

Answer 4

Voicing, swallowing

Question 5

What are 5 broad categories that can cause voicing difficulties? (Give example of each)

Answer 5

Anatomical deviation, (ex: polpys), disease (ex: laryngitis, laryngeal cancer), emotion (voice “tells on you”), misuse(screaming), overuse (profession)

Question 6

What is the primary function of the airway?

Answer 6

Bringing air in and out (duh)

Question 7

What are the ways in which the vocal folds can be altered?

Answer 7

Shape, tension, length

Question 8

What are the “valves” of the entire oral mechanism and laryngeal vestibule?

Answer 8

[Vocal folds (true), false vocal folds, arytenoids, aryepiglottic folds, epiglottis, velopharyngeal port,] main 5 tongue, lips

Question 9

What are the “valves” of the laryngeal vestibule?

Answer 9

True vocal folds, false vocal folds, arytenoids, epiglottis, velopharyngeal port

Question 10

Explain the concept of “valves

in relation to the vocal mechanism

Answer 10

Closing the different

“valves” prevents the air from escaping. Opening them allows air to escape

Question 11

What is the position of the vocal folds during inspiration?

Answer 11

Abducted

Question 12

What is the position of the vocal folds during expiration?

Answer 12

Abducted, more closed than during inspiration

Question 13

If you can hear audible sound during expiration, what does this tell you?

Answer 13

The vocal folds are not fully opening

Question 14

What are the cavities involved in resonance of the voice?

Answer 14

Vocal folds(vibrating), pharynx, oral cavity, nasal cavity

Question 15

How are voices different?

Answer 15

The difference in size of the pharynx, oral ccavity, nasal cavity, vocal folds

Question 16

When do the aryepiglottic folds valve (adduct)?

Answer 16

Vigorous valving conditions (ex: severe coughing)

Question 17

When do the false (ventricular folds) valve (adduct)?

Answer 17

Vigorous valving conditions (ex: severe coughing)

Question 18

When do the true vocal cords (thyroarytenoid muscle) valve (adduct)?

Answer 18

Always during swallowing

Question 19

What factors in the larynx can change based on our emotional state?

Answer 19

Vertical positioning of the larynx, relative relaxation of the vocal folds, posturing and relaxation of the muscles of the pharynx and tongue

Question 20

What should we keep in mind with regards to emotion when treating a patient?

Answer 20

Treat the whole person, recognize voice changes with mood state and assess voice in various settings

Question 21

How is meaning picked up in the voice?

Answer 21

Both the sound of the voice itself, and use of paralinguistic factors like stress.

Question 22

What is the linguistic function of the voice?

Answer 22

To express linguistic meanings in addition to the words said, and to express emotion (tone of voice, prosody, pitch, stress)

Question 23

Why is it difficult to establish normative incidence and prevalence data about voice disorders?

Answer 23

Practically everyone has had a temporary change in voice due to a cold

Question 24

What is the range of prevalence numbers around children?

Answer 24

Some say as low as 4%, others as high as 20-30% (but data is lacking

Question 25

What is the range of prevalence numbers around voice disorders in the elderly?

Answer 25

29% current 47% lifespan

Question 26

What is the range of prevalence numbers around voice disorders in teachers?

Answer 26

Prevalence rates range from 4% to 57.7% (huge disparity) POINT: teachers and other professional voice users have much higher risk

Question 27

What is the range of prevalence numbers around voice disorders in student SLPs?

Answer 27

12% in one study. Higher than average student population

Question 28

What are the two types of functional voice disorders?

Answer 28

Muscle tension dysphonia and Psychogenic voice disorders

Question 29

What is the most common voice disorder?

Answer 29

Muscle tension dysphonia

Question 30

What is muscle tension dysphonia?

Answer 30

A functional voice disorder where the muscles of the vocal systems are overused (too much muscular effort to phonate. It can lead to issues over time such as polyps, nodules, etc.

Question 31

What is psychogenic dysphonia?

Answer 31

Dysphonia resulting from some kind of psychological trauma. Not the person willfully not speaking normally. Typically needs some sort of counseling with it to see improvement

Question 32

What is conversion aphonia?

Answer 32

Complete loss of voice after a trauma (psychogenic)

Question 33

What are organic voice disorders?

Answer 33

Voice disorder resulting from a structural deviation of the vocal tract (ex: cleft palate, laryngeal cancer). Need surgical intervention, potential SLP intervention afterward

Question 34

What is a neurogenic voice disorder?

Answer 34

A voice disorder with neurological origins (originating in the brain, nerves, etc.) Ex: paralyzed vocal cord after lesion effecting CN. Not typically fully treatable by SLP, but can maximize function

Question 35

What are the typical elements of a voice assessment?

Answer 35

Case history, Viewing the structure, measuring of respiratory volume/performance, Acoustic measures of the voice, survey about patients perception of their voice/ its impact on life/profession, diagnostic probing (testing stimulability by introducing a voice technique)

Question 36

How does emotion effect the larynx/voice?

Answer 36

Controlling respiration (shortness of breath), relaxation of the VF, posturing, relaxation of the muscles of the pharynx and tongue, raised height results in tight, tense position

Question 37

How big of a gap should there typically be between the hyoid bone and the larynx?

Answer 37

1 finger

Question 38

When do babies stop sounding "alike"?

Answer 38

After 6 months (sound like primary language, prosody colors vocalizations). Sound influenced by mood.

Question 39

What is suprasegmental phonation?

Answer 39

vocal patterns throughout speech (ex: where pitch is applied, where stress is applied)

Question 40

What is suprasegmental voicing?

Answer 40

jargon with suprasegmental aspects (pitch, stress, etc)

Question 41

What percentage of adults have a voice disorder at a given time? Lifetime?

Answer 41

3-9%. 30%

Question 42

What are the 7 causal classifications of voice disorders?

Answer 42

laryngeal problems-structural, inflammatory conditions, trauma or injury, systemic conditions, non-laryngeal aerodigestive disorders, psychiatric/psychological disorders, neurological disorders

Question 43

What is the SLP's role when treating organic voice disorders?

Answer 43

Improve physiological function after structural problem is stabilized

Question 44

What is the SLP's role when working with neurogenic voice disorders?

Answer 44

maximize function to near normal levels (can't cure) Assess respiratory volumes, expiratory control, visualize paralyzed VF

Question 45

What are symptoms of muscle tension dysphonia?

Answer 45

Gradual onset, eventual pain, discomfort in throat, fatigue, effort increase with voice use

Question 46

What does an SLP refer to an ENT for?

Answer 46

ID of the problem, medical treatment

Question 47

What does an ENT refer to an SLP for?

Answer 47

To evaluate and diagnose voice problem, respiration, phonation, and resonance components

Question 48

What are other specialists SLPS may work with on an organic voice disorder?

Answer 48

Physical medicine, respiratory therapist, surgeon, nursing, ENT

Question 49

How long does it typically take to treat puberphonia?

Answer 49

one to two visits