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CD 661 Voice > Lecture 13 Child and Adult Voice > Flashcards

Lecture 13 Child and Adult Voice Flashcards

1
Q

What makes an infant vocal tract different from an adult?

A

shorter VT

Velum & epiglottis are in closer proximity

VFs (one big body, no ligament nor distinguishing layers)

Arytenoids are large

Laryngeal position is high (C2-C4)

Hyoid and Thyroid Cartilage are contiguous

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2
Q

When does the VT lengthen?

A

4-6 months

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3
Q

Velum and epiglottis reach their adult distance by?

A

4-6 months

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4
Q

When do the arytenoids reach their adult size?

A

4-6 months

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5
Q

By what age does the larynx descend to C6-C7?

A

15 years

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6
Q

When does the lamina propria develps into three distinguished layers ?

A

puberty - complete by 16-17

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7
Q

When does the vocal ligament first appear?

A

appears at age 4, but continues to develop

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8
Q

What is the main disadvantage of having a thick VF cover and increased vascularity for a child?

A

Makes the VF cover more susceptible to inflammatory and post-traumatic edema

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9
Q

By not having a differentiated layer (LP), what does this do to a child’s voice?

A

affects child’s ability to make fine adjustments for register control and create mucosal wave

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10
Q

Young children have more of this type of muscle fibers

A

type II (more fast acting, but fast fatiguing)

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11
Q

Adolescents or around the age of puberty, Laryngeal muscles are made up of this type of muscle fiber

A

type I : slow contracting, fatigue resistant

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12
Q

The thyroarytenoid muscle continues to develop until around:

A

age 3

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13
Q

The Superior Laryngeal and Recurrent Laryngeal Nerve fibers increase in number, myelination and axonal & dendritic endings until

A

age 3

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14
Q

True or False:

Children have a high fundamental frequency at infancy, but slowly lowers as child gets older

A

True

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15
Q

True or False:

Subglottic pressure (Ps) is is lower for children than for adults

A

False

*higher

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16
Q

True or False:

Children have lower mean airflow rates

A

True

17
Q

True or False:

Max phonation times are lower until puberty

A

True

18
Q

How would you describe a child’s lung volume and use of breathing?

A

A child has less lung volume, rib use is greater than abdominal when compared to adults

19
Q

Fill in the Acoustic Norms for children:

Jitter - norm=_____ s.d=______

RAP - norm=_____ s.d.=______

Shimmer - norm=_____ s.d.=______

NHR - norm=_____ s.d.=______

A

Jitter : n - 1.4 /s.d. - 0.07

RAP : n - 0.75 / s.d. - 0.04

Shimmer : n - 3.35 / s.d. - 0.12

NHR : n - 0.11 / s.d. - 0.002

20
Q

Match the max phonation time to their appropriate age groups:

  1. ) 6-10 seconds A.) 10-12 yrs
  2. ) 14-17 seconds B.) 6-10 yrs
  3. ) 15-22 seconds C.) 3-5 yrs
A

6-10 seconds : 3-5 yrs

14-17 seconds: 6-10yrs

15-22 seconds: 10-12 yrs

21
Q

What is laryngomalacia?

A

laryngeal cartilages are soft / may collapse into airway upon inhalation / usually resolves with maturation

*common cause of infant stridor

*Signs: collapse of laryngeal cartilages / enlarged or floppy AC / excessive AC mucosa

22
Q

Congenital Disorder that may be related to autosomal dominant pattern of inheritance

A

Laryngeal Cleft

23
Q

Having a laryngeal cleft on this portion of the cricoid cartilage will cause the airway to narrow

A

posterior

24
Q

What are the symptoms and problems associated with laryngeal cleft?

A

Inspiratory and expiratory stridor

Dyspnea

Aspiration

Feeding difficulties

25
Q

Congenital Disorder which narrows the tissue below the level of the glottis

A

Subglottic Stenosis

26
Q

What are the symptoms of subglottic stenosis?

A

Inspiratory and expiratory stridor

Dyspnea

Low pitch cough

Nostril flaring

excessive chest wall movement

27
Q

What are some congenital anomalies that are seen amongst children?

A

Laryngeal Paralysis - birth trauma or CNS damage (Arnold Chiari Malformation)

Laryngeal Web - chormosomal abnormality

Congenital Cyst - rare

VF Papilloma

28
Q

This is the most common acquired voice disorder in children

A

Nodules

*accounts for 50% of pediatric voice disorders

29
Q

What are some examples of an acquired disorder that you can see with children?

A

VF nodules

VF paralysis

Laryngopharyngeal reflux

30
Q

What is the method of treatment for children who have nodules?

A

*conservative approach is always best (no surgery)

*have the family and teacher involved

*identify and modify casual behaviors

*Resonant Voice Therapy and Flow Phonations

*Breathing & Muscle Relaxation Exercises

31
Q

True or False:

Adults who have nodules as children seem to have a higher incidence of voice problems

A

True

32
Q

What are some of the VF characteristics of an adult over 65 years old?

A

*laryngeal cartilages calcify

*lamin propria thickens

*less elastin and collagen, more fibrotic tissue

*atrophy of sub mucous gland

*atrophy muscles

*decreased neural firing rates for TA and CT

33
Q

What are some perceptual changes for the geriatric voice?

A

*habitual pitch higher in males / lower in females

*hoarseness

*breathiness

*decreased frequency & intensity ranges

34
Q

What are the acoustical characteristics of a geriatric voice?

A

Greater F0 variability

increased jitter

decreased intensity variability

slower speaking rate

35
Q

What are the aerodynamic qualities of a geriatric voice?

A

smaller lung capacity

decreased lung pressure

greater peak airflow and greater air leakage

greater open quotient

decreased MFDR (maximum declination rate)

36
Q

What are the laryngoscopic findings of a geriatric voice?

A

bowing, incomplete closure, posterior gap

vocal process prominence

atrophy & thinning of VFs

edema

decr. mucosal wave & amplitude of vibration
incr. VF stiffness

increased aperiodicity

37
Q

What are the most disorders for the geriatric population?

A

Laryngeal Cancer (men)

VF paralysis

Edema

Nodules/Polyps (women)

CD 661 Voice (13 decks)

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