Lesions of VC Flashcards

Question

Congenital Laryngocele

Answer 1

1. Congenitally large laryngeal ventricle 2. Enlarged by activities that increase intralaryngeal air pressure 3. Air filled or fluid filled 4. Herniation of laryngeal ventricle (space between false and true cords) - born with a weakness (large space between true and false VF)

Answer 2

1. Straining 2. Coughing 3. Vocal abuse 4. Playing wind instruments 5. Glassblowing 6. Hoarseness 7. Inspiratory stridor 8. Dysphagia 9. Medical --> incision --> drainage

Answer 3

1. Sessile fluid filled cysts 2. Arise from laryngeal ventricle (deep in the larynx) 3. a. Displace true and false folds b. Glottic and supraglottic obstruction c. Swallowing problems d. Voice impaired to aphonic e. May obstruct airway --> causes stridor

Answer 4

I. Internal Type - within the thyroid cartilage II. External Type - each protrudes above thyroid cartilage through thyrohyoid membrane III. Combination Type - Internal occurs right above the VF - External is above the thyroid cartilage, can be filled with air or fluid- need to get air or fluid out and then it will go away - Lump in the throat- globus symptom – usually due to tension

Answer 5

- Uncommon vocal cord lesions and if small they may not cause hoarseness or bleeding (if it is not on the edge) - larger ones can be treated with a laser

Answer 6

1. Edema 2. Hematoma- blood clot 3. Fractures of larynx and tracheal stenosis 4. Dislocation of arytenoids 5. Inter-arytenoid fixation 6. Lacerations 7. Vocal Fold Paralysis 8. Laryngeal Web 9. Perforation of the pyriform sinus or esophagus 10. Ulcer and Granuloma of the vocal process 11. Hemorrhage - If a child is hoarse, ask why (sick, what's their baseline, screaming or yelling often, could it be congenital?)

Answer 7

- Most likely be on the superior surface, it will cause swelling, could be due to getting hit in the neck ( a car accident)

Answer 8

1. GERD a. Gastroesophogeal Reflux Disease b. Chronic digestive disease c. Stomach acid backflows in to esophagus 2. LPR a. Laryngopharyngeal Reflux Disease b. Extension of GERD c. Stomach acid backflows in to esophagus, larynx and pharynx - GERD will affect voice - LPR may cause scalloping on the posterior edge of the larynx

Answer 9

1. Lots of secretions 2. Scalloping 3. Mucus banding- shows pt. of traumatic impact * *** May help to elevate the head of the bed- need to use bricks, not pillows (use wedges)

Answer 10

1. Automobile accidents- hitting the steering wheel 2. Gunshot wounds 3. Laryngeal Intubation 4. Nasogastric intubation

Answer 11

1. a. Endotracheal tube is too large for the patient’s airway b. Mucosa ulceration leads to granuloma c. Dislocation of arytenoid cartilage 2. a. Damage to posterior cricoarytenoid- abduction of the VF (can’t open) b. Mimic recurrent laryngeal nerve palsy muscle has been traumatized *** Posterior issues

Answer 12

1. Low pitch 2. Soft intensity 3. Sluggish movement 4. Vocal quality (diplophonia)

Answer 13

1. a. Vocal process b. bilateral or unilateral 2. Damage resulting from prolonged or faulty intubation to maintain airway ***When you hear granuloma, think posterior (posterior issues are painful, not anterior) - Can have an immature granuloma (voice will be okay, but it will be painful)

Answer 14

1. Strenuous speaking 2. Singing 3. Yelling/screaming 4. Coughing (always ask why someone may be hoarse, is it coughing) 5. Throat clearing 6. Velopharyngeal insufficiency - Crosses all boundaries (children for screaming and yelling, for an adult singer it could be abuse or misuse)

Answer 15

1. Incorrect use of pitch or loudness (leads to these things) a. Elevated loudness levels, high background noise, heavy machinery, speaking over loud music, hearing loss (someone with a hearing loss may be speaking too loudly) b. Elevated pitch levels, increased loudness leads to increased pitch, emotional stress, excessive muscular tension - Straining with no lesion (low pitch) - Straining with a lesion (high pitch)

Answer 16

1. Hyperadduction of the vocal folds a. Inflammation b. Vocal nodules (front) c. Contact ulcers (back of the VF- pain is associated with anything posterior due to the arytenoids rubbing together) - Glottal fry causes the arytenoids to bang together. Lowest note we can produce is glottal fry (sing up a scale from lowest to highest)

Answer 17

1. Client comments- pretty good in the morning, but deteriorates over the course of the day 2. Vocal fatigue 3. Vocal change 4. Chronic throat clearing 5. Intermittent loss of voice 6. Poor pitch control- may have pitch breaks 7. Deterioration of voice during day 8. Tender strap muscles- does your neck feel sore

Answer 18

1. Bilateral (unilateral is rare) - juncture of anterior and middle third of VF - unilateral lesion (most likely not a nodule) 2. a. young- soft, normal epithelium, pink b. mature- very hard to cure a mature nodule, need to do surgery prior to voice treatment) - firm, organized epithelium, whitish to yellow

Answer 19

- mucus banding can indicate the start of a nodule

Answer 20

1. Cords are drawn wide apart in forceful inspiration (need to teach pts. to use a quieter voice) - need to whisper for at least 3 days post surgery 2. folds slightly separated along the anterior two- thirds and a triangular aperture remains posteriorly. (no stress, but can’t project their voice) 3. (just as abusive as talking)- folds are adducted firmly along the anterior two thirds and air is forced through the posterior triangle with considerable friction. *** If pts. speak right away you can have a web form between the VF

Answer 21

1. Ulceration of the folds in the arytenoid (posterior) region. 2. This causes ulceration of the covering of the arytenoid region. 3. Visual appearance is a raised granuloma on one side and a crater on the other side. - Pachydermia or an abnormal thickening of the mucous membrane forms. 4. Contact ulcers develop in individuals having deep throaty voices. (VERY IMPORTANT, (fry)) - In therapy teach them to use a softer production and lighter pitch

Answer 22

1. Hyperactivity 2. Emotional reactivity 3. Family problems 4. Aggressive/less mature 5. Difficulty managing stressful situations

Answer 23

1. Extreme tension of the speech musculature coupled with generalized bodily tension 2. Forcing the pitch below the optimum 3. Glottal plosive attack 4. Explosive speech patterns a. predominate speech patterns b. rigid melody or confined pitch c. considerable breath pressure d. hoarse quality - Need to treat the whole person - We need to determine what their optimal pitch is compared to their habitual pitch (the pitch they speak at)

Answer 24

Altering the fundamental frequency alters the length, thickness, and tilt of the vocal folds so that on adduction shifting parts of stress occur and the glottal impact does not always fall in the same region. (easy onset to avoid hard contact (more frontal focus)

Answer 25

1. Occurs in any vascular organ - can occur on nasal or laryngeal mucosa * *** Primarily UNILATERAL and ANTERIOR 2. Varies from small (6mm) to bigger and obstructive 3. Air born irritants, (smoking, inhalation of toxic fumes) or - Idiopathic ( we don’t know what causes them) 4. Soft globular mass exhibiting mucoid degeneration a. Pedunculated- with a pedicle or foot (stem hanging down) b. Sessile- having no peduncle, but attached directly by a broad base. 5. a. Diplophonia (occurs often with pedunculated polyps) b. Breathiness c. Low pitch d. Intermittent aphonia e. Hoarseness (cords don’t close, so harshness with breathiness, no breathiness- just harsh, and if no breathiness it may be a functional problem ) 6. a. Pretreatment recording and counseling b. Pretreatment photography c. Surgical management- Usually say that polyps need surgery d. Post-op voice rest e. Post-op voice therapy Therapy- eliminating the compensatory behaviors that the patient developed due to the polyp

Answer 26

1. May exhibit diplophonia

Answer 27

*** Two distinct pitches during phonation 1. Unilateral paralysis of true vocal fold 2. Vibration of the ventricular folds (typical) 3. Hyperfunctioning of the vocal mechanism 4. Vocal Folds vibrate at different frequencies (one side lags), you can have edema in one cord and not the order 5. Vocal Fold Pathology (possibly VC masses)

Answer 28

1. Produced by vibration of the false vocal folds. 2. May develop as purely functional or as a substitute voice for true vocal fold pathology. - We use the false VF when we cough, may use false after surgery

Answer 29

1. Ventricular phonation 2. Musculoskeletal tension disorder 3. Low v.s. high pitch- if person uses True and false VF= low pitch because of extra mass a. Just false VF= high pitch 4. Hoarse 5. Diplophonia - Behavior modification- eliminate coughing - If just using the false cords, what is going on with the true cords - could be due to prominent hypertrophy of the false VF

Answer 30

1. the most frequent and represents the extreme and end stage of hyperkinetic dysphonia due to constant vocal abuse. 2. occurs during times of stress or a crucial period of a psychoneurotic person, an emotional crisis may precipitate a psychogenic dysphonia by over adduction of the ventricular folds. 3. due to paralysis of the true cords, the ventricular folds take over the function of phonic glottal closure. (in this case you want them to use the false cords to phonate) 4. may be a sign of dysarthria resulting from brain disease. As a sign of spasticity the voice may change to choked, rough, low, and a squeezed sound. 5. Lesions of the cerebellum may have ataxic, irregular, labored phonation with spasmodic over contraction of the ventricular folds. 6. a desirable compensatory adjustment when the ventricular folds are substituting for defective vocal folds. (was it compensatory)

Answer 31

1. A larynx that exhibits significant signs of aging such as: a. Reduced control over phonation b. Changes in speaking and fundamental frequency c. Reduced pitch range and deterioration of vocal quality d. Loudness, resonance, and timing are also affected - Old age and VFs - You need to think about age when you are treating someone - Do you work on pitch stability? - Strengthening?- don’t do it on VFs with a pathology, it will make it worse - Always make sure it is not neuro related

Answer 32

1. Presbyphonia: acoustic properties associated with ageing in the absence of any other pathology a. Altered pitch b. Roughness c. Breathiness d. Weakness e. Hoarseness f. Tremulousness/instability -Work on reducing breathiness and hoarseness Presbylaryngis is a condition that is caused by thinning of the vocal fold muscle and tissues with aging. The vocal folds have less bulk than a normal larynx and therefore do not meet in the midline. As a result, the patient has a hoarse, weak, or breathy voice. This condition can be corrected by injection of fat or other material into both vocal folds to achieve better closure.”...

Lesions of VC Flashcards

(56 cards)