SPHP 123 Final Flashcards
(125 cards)
1
Q
Voice carries info about what 3 things?
A
- Emotional State
- Physical Status
- Meaning behind the words we speak
2
Q
What do you include in a psychosocial interview?
A
- Psychosocial history
- Current Status
- How Client uses their voice to maintain relationships in day to day life?
- What life event/emotional difficulty may be related or precipitated voice issues?
- Profiles exist
- What professions do they have?
- Whats happening in their lives
3
Q
Aronson suggests for nonorganic voice problems we should what?
A
- Educate client
- Explain relationship between stress and laryngeal muscle contraction
- Discuss problem is not in their head
- Address questions (onset & stress?)
4
Q
Intervention issues may include?
A
- Family life/stage
- Patients aspirations (what they want out of TX?)
- Communication issues with fam, employment, coworkers, other professionals
- How voice is affecting their daily lives?
5
Q
A treatment plan must take into account what?
A
- Personal and life style characteristics
- Underlying vocal image of the client
- Client’s preferred voice goals
6
Q
Examples of cultural aspects of voice?
A
- Low pitch (male): Strength, Authority, Relaxation
- Low pitch (female): Gracious, Charm, Softness
- Males (Report Talk): Vying for knowledge & skill
- Females (Rapport Talk): Making connections & negotiating relationships
7
Q
Self Concept and Voice?
A
**Others can tell how you are feeling by your voice (paralinguistic aspects) -Eye Contact -Anxiety -Confidence
8
Q
Fear/Anxiety?
A
- *Internalized desire to escape relationship/conflict
- *Laryngeal sphincter opens widely to allow maximal respiratory flow for running (voice becomes weak)
- Weak
- Breathy
9
Q
Conversely individual who decides to stand his ground or “fight” may do what?
A
Lock laryngeal sphincter for combat (creating over adduction) (constriction of acoustic tube)
- Effort
- Pain
10
Q
Body tension or specific intrinsic/extrinsic laryngeal musculature may result in what?
A
Difficulties with vocal mechanism functioning
11
Q
Compensations used?
A
- Loud voice: Shore up their feelings of inadequacy
2. Loud bullying voice: Mask a fragile self esteem
12
Q
Pitch variability or lack of may do what?
A
- Monotone
- Slow rate
- Adopt inappropriate low pitch (stressful to voice)
- Abnormal high pitch
13
Q
T/F: Severe emotional problems treatment plan involves a team approach and referral with a mental health professional counseling the patient?
A
TRUE
14
Q
T/F: The needs and the best interests of the client are always paramount?
A
TRUE
15
Q
What do Speech Pathologists do?
A
- Build effective relationships with client
- Enhance self esteem
- Help gain insight
- Help social communicative interactions
- Help produce appropriate vocal behaviors
16
Q
Clinical therapeutic considerations are as follows?
A
- Be encouraging
- Personal distance issues
- Utilize coping strategies (role play)
- Stress reduction (exercise)
- Loss and grief (employment issues, altered life)
- Anger/Denial/Fear/Anxiety (loss of control, costly medical care)
17
Q
Intervention may include what?
A
- Problem clarification: discussing psychosocial changes with fam.
- Feelings clarification: Allowing feelings to surface without judgement.
- Concept correction: Problems/implications discussed realistically
- Skills inventory: Problem solving/ role playing
- Mobilizing support/services: Outside referrals, resources
18
Q
Psychodynamic aspects of voice disorders?
A
**Disorders following traumatic stress.
**Team approach with mental health professionals
Goals: 1. Regain voice
2. Attend to whole person
3. Aware of aspects of social communication
4. Relaxation exercises
5. Reduce muscular tension
19
Q
Emotional outbursts and effects on voice?
A
- Crying/shouting= Result in phonotrauma
- High lung volumes= Possible phonotrauma
- Increase in subglottic pressure= Possible phonotrauma
- Vocal fold hemorrhage= Changes in voice quality and vocal fatigue
20
Q
What dysphonias are most common in females?
A
- Functional
- Spasmatic
- Vocal nodules
21
Q
What disorders are most common in males?
A
- Cancer
- Papilloma
- Granuloma
22
Q
Counseling/Treatment for children?
A
- *Group therapy
- Role playing (Signal=waving)
- Use other behaviors rather than yelling
23
Q
Counseling/Treatment for transgendered/gender identity issues?
A
- Use pronouns
- Promote Ed. among peers, colleagues, students
- Value of diversity
- *Refer to other professionals as needed
24
Q
Counseling/Treatment for older clients?
A
- Discover legacy
- Loss of control in their lives (failing health, peers dying)
- Loss of their identity/role (financial independence)
- Be genuine
- Offer choices
- *READ CLIENT
- *Its okay to deviate from original plan as long as there is a good reason to.
25
Phonotrauma/Misuse?
* *Dysphonia related to tension, habit and trauma
- Inappropriate pitch and loudness
- Vocal abuse
- Inappropriate vocal practice
- Inappropriate laryngeal muscle activity
26
What are some causes of vocal fold irritation/injury?
1. Excessive musculoskeletal tension
2. Inappropriate pitch level
3. Singing with poor technique
4. Excessive coughing/throat clearing
5. Alcohol,drugs, smoking
6. Gastroesophageal reflux
27
Treatment approaches for phonotrauma/misuse?
1. Vocal hygiene
2. Reduce tension
3. Chewing therapy
4. Yawn Sigh
5. Biofeedback
28
Disorders related to hyperfunction? (8 of them)
1. Muscle tension dysphonia (MTD)
2. Benign lesions of lamina propria
3. Contact ulcers
4. Reflux issues
5. Laryngeal hyperkeratosis
6. Laryngeal Leukoplakia
7. Prolonged ulcerative laryngitis
8. Laryngoceles
29
Muscle Tension Dysphonia (MTD)
**Mild, moderate, or severe
1. Primary muscle tension dysphonia
-Hyperfunctional vocal production
-Weak voice
-Hoarse/thin quality
-Dysphagia
Onset= Mid-adult yrs
-Vocal fry (after they had a URI)
-Painful voicing (after they had a URI)
2. Secondary muscle tension dysphonia
-Hyperfunctional behaviors in response to glottal incompetence (documented by nasoendoscopy
Factors that contribute to MTD?
- High stress levels
- Poor breathe support
- Cervical neck tension
30
Benign lesions of the lamina propria?
**videostroboscopy to diagnose nodules, cycsts, lesions and fibrous masses
1. Vocal fold nodules: Entire folds
FACTORS: -High subglottal pressure
-Hyperadduction of folds
-Vocal lengthening
-Dehydration
-Allergies
-Reflux
ASSESSMENT RESULTS: -Hoarseness
-Voice breaks
2. Vocal fold cycsts: Unilateral
3. Reactive lesions: Occur opposite another lesion
4. Fibrous masses of the lamina propria: Entire folds
31
Factors of benign lesions?
1. Physiological: -Muscular tension
- Faulty posture
2. Medical: -Allergies
- Dehydrated folds
- Chronic cough
- Laryngopharyngeal reflux
3. Psychological: -Attitude
- Coping skills
- Lifestyle
TREATMENT?
- Vocal hygiene
- Vocal reduction
- Improve respiration
32
Contact Ulcers?
- Intubation/Nonintubation
- Ulcers/granulomas
CAUSES?
- Laryngopharyngeal reflux
- Gastroesophageal reflux
- Coughing/throat clearning
- Excessive gargling of mouthwash
- Post nasal drip
TREATMENT?
- Vocal hygiene
- Shape vocal behaviors
- Raise habitual pitch
- Modify low pitch
- Eliminate hard glottal attack
33
Reflux?
1. Gastroesophageal reflux disease (GERD)
Stomach acid passes through LOWER esophageal and stays in esophagus (heartburn, indigestion)
2. Laryngopharyngeal reflux disease (LRPD)
Stomach acid passes through UPPER esophageal and spills onto delicate laryngeal tissue.
RESULTS?
- Hoarse/rough
- Bad taste/odor in oral cavity
ONSET?
25 to 44 & 45 to 64 YRS OLD
TREATMENT?
- Changes in Diet/sleeping habits
- Medications (for stomach acid)
* *Serious cases= surgery
34
Laryngeal Hyperkeratosis?
**Plaque thickening caused by abnormal growth of epithelium
Malignant (Needs biopsy & avoidance of irritants)
CAUSES?
- Laryngopharyngeal reflux
- Smoking
- Post nasal drip
- Throat clearing
ONSET?
40-60 YRS OLD
35
What are keratin deposits?
Thick covering of vocal fold on one or both sides
| anywhere on folds
36
Laryngeal Leukoplakia?
* *White patches on mucosa
- Hoarseness
- Precursor to carcinoma
- Chronic irritation of tissues
TREATMENT?
- Eliminate smoking cigs
- Surgery
- Voice therapy
37
Prolonged Ulcerative Laryngitis?
**Prolonged inflammation and ulceration of vocal folds
CAUSES?
- Did not smoke or alcohol in history
- Respiratory infection
- Asthma
- Allergies
- Cold sores
- Lesions (white/pink)
TREATMENT?
- Voice rest
- Steroids
- Antibiotics
- Vocal hygiene
38
Laryngoceles?
* *Air sacs that connect larynx and cause a ballooning in the neck tissue during coughing.
* *Seen in brass instrument players
Laryngeal chondromas: Rare cartilaginous tumors
TREATMENT?
Surgery
39
Disorders due to trauma to larynx from external agents?
1. Direct injury
2. Burning of laryngeal tissue
3. Heliobacter pylori (HP)
4. Surgical procedure complications
TREATMENT?
- Depends on type of trauma
- voice rest
40
Disorders due to trauma to larynx from external agents?
1. Direct injury: Resulting from impact, blows to larynx; results in dysphonia
2. Burning of laryngeal tissue: inhalation of smoke, gases from a fire
TREATMENT?
-Antibiotics and Steriods
3. Heliobacter pylori: Bacteria that can cause chronic persistent gastritis, Ulcers, GERD issues
4. Surgical procedure complications: Tracheostomy; endotracheal intubation; and long term presence of nasogastric tubes may result in injury to voice structures.
TREATMENT?
-Voice rest
*Depends on type of trauma
**Any injury to larynx will affect the voice
41
Aphonia and Dysphonia as conversion reaction?
```
**Emotional reaction to avoidance of dealing with a distressing situation or interpersonal conflict
(tense or loss of voice)
MANAGEMENT?
-Laryngological evaluation
-Symptomatic voice therapy
-Expression of emotional problems
-Referral to psychiatrist/psychologist
CHARACTERISTICS?
-Coughing
-Throat clearing
-Laughing
-Crying
ONSET?
-Sudden
-Upper respiratory infection
SYMPTOMS?
-Hoarseness
-Breathiness
**Substance abuse need to be ruled out
TREATMENT?
-Interview
-Build relationship
-Review Otolaryngologists Report
-Rule out stress and muscle tension
VOICE ELICITATION?
-Head rolls
-Shoulder Shrugs
-Chewing
-Yawn Sigh
**Keep voice moving (counting, days of the week, reading)
```
42
Treatment of dysphonia related to occupational demands?
```
**Teachers, singers, stock traders, actors, politicians, salesperson, aerobic instructors
FACTORS?
-Allergies that affect URI
TREATMENT?
-Antihistamines/decongestants
-Humidification
-Liquid intake
LIFESTYLE FACTORS?
-Stop smoking, drinking
-Avoid medications (too much aspirin creates hemorrhage)
-Good nutrition
-Rest
-Exercise
```
43
Treatment of dysphonia related to teachers?
```
FACTORS?
-Poor acoustic environments
-Number of yrs teaching
-Type of teaching
-Vocal loading (biggest factor)
TREATMENT?
-Amplification
-Vocal hygiene
-Vocal function exercises
-Respiration training
```
44
Vocal athletes (Singers/Actors)?
FACTORS?
- Outdoor performance space
- Onstage smoke
- Lack of appropriate amplification
* *Country singing is less stressful because it is closer to the speaking voice.
45
Treatment of dysphonia (professionals)
- Teach about anatomy, physiology
- Teach acoustics of voice
- Relaxed chewing
- Relaxation activities
- Forward tone focus
46
Syndromes of laryngeal dysfunction?
CHARACTERISTICS?
- Abnormal and reactive movements
- Cluster of upper respiratory movements
- Involuntary hyperadduction of VF's on inspiration
47
Irritable Larynx Syndrome?
- Muscle tension dysphonia
- Chronic cough
- Throat clearing
- Globus
* *When you inhale folds go into spasm
* *Increase tension; gets worse & worse
48
Working with singing/acting voice teacher?
Client rehabilitation
**SLP needs to team with them for treatment
TREATMENT ISSUES?
-Endurance
-Efficiency
-Stress full voice
-Teach to rely on tactile, proprioceptive & visual feedback
49
Coordinating voice therapy with the medical-surgical management?
**Otolaryngologist is responsible
Vocal rest: Recommended post injury
(burn,trauma, tearing of VF mucosa, surgery)
Vocal use reduction program:
-Behavior mod. program
-Goal of severe reduction then moves through 3 stages.
STAGE 1 (SEVERE):
-Reduction steps
-Determine number of voice units to use and monitor the changes in vocal folds and voice
STAGE 2 (MODERATE):
-Reduction steps
-Adding prescribed situations to the list
-Determine an increased number of voice units and monitor improvement
STAGE 3 (LOW):
-Reduction steps
-Adding additional situation to the list
-Determining an increased number of units available and monitor.
50
Warming up the voice?
- Vocal exercises
- Marking (Signing at soft levels in normal voice range)
- Cool down (humming & speaking gently)
51
Nodules?
After heavy use, soft swellings may appear on VF's
52
Vocal Fold Cysts?
- Decreases mucosal wave
- Removed surgically
- Severity is related to the size
- Submucosal cysts may cause contact swelling
53
Granulomas and Ulcers?
```
**May be related to prior intubation or gastroesophageal reflux
TREATMENT?
-Medication
-Raising head when laying down
-Not eating at night
```
54
Reinke's Edema?
* *Fluid is built up in submucosal lining of Reinke's space making the vocal fold less stiff and increasing mass
* *Smoking and phonotrauma
55
Revision Surgery?
May be needed by patients to correct complications of prior procedures on the vocal folds of professionals
56
Psychodynamic Voice Disorders?
**Higher in women
**Emotional stress can cause hypercontraction
TREATMENT?
-Active client involvement in care
-New daily regimes
-Attention to musculature issues
57
Multidisciplinary Approach?
* *Depends on client, setting & resources
| * *Composition of the team
58
Medically Oriented Team?
- Family physician
- Otolaryngologist
- Respiratory therapist
- Social worker
59
Educationally Oriented Team?
- Teacher
- School psychologist
- School nurse
- Counselor
- Audiologist
60
Professional Voice Users Team?
- Drama coach
- Voice scientists
- Psychologist
- Singing teacher
61
Role of SLP?
- Case coordinator
- Requests findings and reports
- Communicates directly with physician
- Responds to specific requests
- Provides written reports
- Suggest treatment options
- Provides education
- Makes referrals
62
ASHA Voice Assessment to identify & describe
- Underlying strengths and deficits related to a voice disorder or laryngeal disorder affecting respiration and communication
- Effects of voice disorder on person
- Participation restrictions for individuals with the disorder
63
ASHA Preferred Practice Patterns
-Relevant case history (med,vocal, ed., family history)
STANDARDIZED & NONSTANDARDIZED ASSESSMENTS:
-Auditory/Visual
-Perceptual aspects of vocal production
-Emotional/psychological status
-Functional consequences of voice disorder
64
Possible interview questions?
1. Biological data (Bday, Birth history)?
2. Family history of speech, hearing, voice, lang., med problems?
3. Describe voice problems (onset, how long has it persisted, who noticed it)?
4. Vocal use (misuse, overuse, situations when more difficult to use the voice)?
5. Why are you seeking assistance?
6. Medical (surgeries, breathing problems, fatigue, tremor, twitching)
65
Voice Assessment (SLP)
DETERMINES?
- Presence
- Absence
- Nature
- Severity
66
Typical Voice Quality Descriptors?
1. Normal
2. Breathy
3. Strained
4. Rough
67
Multisystem Assessment?
1. Respiratory
2. Phonatory
3. Neurologic
4. Cognitive
5. Affective
6. Digestive systems
68
Behavioral Analysis of the Production?
1. Positioning of torso, neck and head
2. Oral-Peripheral exam
3. Resonance patterns
4. Respiration
5. Articulation
6. Prolonged vowels, reading, spontaneous speech
7. Hearing screening
69
Acoustic measures of voice?
Routine aspect of clinical voice examinations and are described as objective, noninvasive, inexpensive ways to categorize vocal function
70
Three primary classes of acoustic measures?
1. Amplitude
2. Freq
3. Glottal Noise Measures
71
Electromyography?
* *Instrumental analysis/assessment
| * *Differentiate between vocal fold fixation & paralysis
72
Aerodynamic assessment of respiratory & phonatory system?
* *Instrumental analysis/assessment
* *Airflow pressure readings
* *Measures supraglottal & subglottal pressure, glottal impedance
73
Direct and Indirect still photography?
* *Instrumental analysis/assessment
| * *Confirm presence of laryngeal lesions
74
Flexible Videoendoscopy?
* *Instrumental analysis/assessment
| * *Respiratory tract to identify airway obstruction
75
Laryngeal Mirror Exam?
* *Instrumental analysis/assessment
| * *Show actual size, color and relationship of laryngeal and hypopharyngeal structures
76
Transnasal, flexible, fiberoptic videoendoscopy?
* *Instrumental analysis/assessment
| * *Document laryngeal movement patterns during speech & singing
77
Stroboscopic Laryngopscopy?
* *Instrumental analysis/assessment
* *Video recording to document regularity of VF vibration and closure patterns during isolated vowels
* *KeyPENTAX Digital Video Stroboscopy
78
Videokymopgraphy?
* *Instrumental analysis/assessment
| * *Detects presence of mucus, phase differences between the fold, short term freq and amp variation
79
Videoflouroscopy?
* *Instrumental analysis of velopharyngeal function
| * *Assesses velopharyngeal closure during speech & phonation
80
Videonasopharyngosocopy?
* *Instrumental analysis of velopharyngeal function
* *Visualize the velopharyngeal mechanism and its function by viewing the nasal surface of the velum and the velopharyngeal port during connected speech
81
Measurement of nasal resonance?
* *Instrumental analysis of velopharyngeal function
* *Nasometer
* *Analyzes the acoustic energy emitted through the oral cavity & nasal cavity during speech
82
Perceptual evaluation for resonance disorders?
* *Instrumental analysis of velopharyngeal function
* *Hypernasality
* *Hyponasality
83
Electroglottography (EGG)
* *Indirect methods of measuring vocal fold vibratory behavior
* *Measures changes in the impedance to flow of current during vocal fold vibration.
84
Photoglottography (PGG)
* *Indirect methods of measuring vocal fold vibratory behavior
* *Measures changes in light intensity occurring as a function of vocal fold vibration
85
Transllumination
* *Indirect methods of measuring vocal folds vibratory behavior
* *Similar to photoglottography, correlated to the change in glottal area during phonation.
86
Acoustic Measures
* *Indirect methods of measuring vocal folds vibratory behavior.
* *Provide perspective on vocal activity through instrumental analysis of characteristics of the acoustic patterns from which laryngeal activity my inferred.
87
Vocal fold movement?
1. Measures of Freq: Avg. Fundamental Freq, variability range, freq range, freq stimulability from cycle to cycle.
(Jitter=Freq & Shimmer=Amp)
2. Measures of Amp: Avg sound pressure level, variabillity, amp range, amp stability from cycle to cycle
3. Measures of aperiodicity: Noise may be generated by leakage of air or by irregularities in laryngeal structure.
(Turbulent Noise)
4. Measures of coordination & timing: max phonation time, Rise or fall time (onset), Number of interruptions (breaks) (tremors).
88
Analysis of producer?
1. Med history/status
| 2. Psychosocial history/status (emotions, community culture)
89
Analysis of processor?
Characteristics of person listening to voice affect the way the voice is perceived, clients perception of own voice
90
Self perception scales?
**Quality of life in persons with voice disorders
Voice Handicap Instrument (VHI) & Voice-Related Quality Of Life (V-RQOL) (Instruments used)
Others perception: Trained observations of clinician (informal convos/formal testing)
(Dysphonia Severity Index (DSI) )
91
Ask leading questions
* *Appraisal
1. Tell me about it
2. How does that make you feel
3. Can you explain more
92
Use reflecting statements
**Appraisal
1. No judgements-paraphrase
(you seem to resent that)
93
other nonverbal behaviors
* *Appraisal
1. Inappropriate eye contact
2. Masklike face
3. Tremors
94
Listen to audible characteristics
* *Appraisal
1. Emotional in voice
2. Tremors
3. Breaks
95
Consistency of Symptoms
```
INCONSISTENT SYMPTOMS
-Vocal Misuse
-Psychogenic Dysphonia
CONSISTENT SYMPTOMS FOLLOWING ONSET
-Laryngeal nerve paralysis
-Hemorrhagic polyp
**Symtoms worsen when system fatigues
```
96
Selection of Diagnostic Strategy
1. Determine how voice is currently being used/what factors are present
2. See how stimulable the client is
97
CLIENT: 8 yrs old, severely hoarse and periods of aphonia. He is loud, aggressive, enjoys sports.
MEDICAL REPORT: Allergic rhinitis, Vocal Fold Edema
FAMILIAL: Has 4 siblings, Father cigar smoker with bilateral hearing loss
```
ETIOLOGICAL ASPECTS
-Increased effort/swollen folds
-Excessive loudness
-Psychosocial factors
RISK FACTORS
-Allergies to father smoking
-Fathers hearing loss
-Noise level at home
-Fam history
-Allergic rhinitis
HYPOTHESIS
-Vocal misuse
-Excessive tension
-Mouth breathing
SIGNS DURING EVAL
-Hard onsets
-Visible neck tension
-Throat clearing
MANIPULATION OF VARIABLES
-Observe loudness
(chart with numbers read aloud; gradual change in loudness)
CONTRASTIVE LOUDNESS LEVELS
-Attempts to maintain airflow & evenness of vibration on prolongation of /s/ & /z/
```
98
Maximum Phonation Time (MPT) (CLIENT)
Measures phonation during one exhalation phase of speech breathing; /a/ in one breath
(15-20 secs=adults & 10 secs=CH)
(Look for voice breaks, tremors on tape recordings)
99
The S To Z Ratio (CLIENT)
Used to measure respiratory and phonology efficiency.
100
Hearing Evaluation (CLIENT)
-Due to clients fathers hearing loss
| normal hearing
101
Evaluation of Pitch (CLIENT)
Vocal abuse issues are primary issue
| Not applicable
102
Referral (CLIENT)
Otolaryngologist, Physician
103
Acoustic Analysis (CLIENT)
Software to assess loudness levels
104
Steps in Diagnosis
1. Develop diagnostic hypothesis
2. Test hypothesis
3. Evaluate voice function
4. Explore modifications by shaping key behaviors
5. Select instrumental analyses to confirm perceptual judgments
6. Schedule additional consultations and evaluations
105
Voice Quality Assessment
- Related to phonation
- Difficult to describe
- Rating scales used sometimes
106
CAPE V
| Conference on Auditory-Perception Evaluation of Voice
-Rating scale
-Rate 6 aspects of voice
OVERALL SEVERITY
-Roughness
-Breathiness
-Strain
-Pitch
-Loudness
107
Breathiness
-Excessive leakage of air during phonation
-Mild to severe
(Can denote aphonia)
108
Hoarseness
-Leakage of air as well as noise present in the signal.
-Most common voice symptom
(Nodules, Polyps, Leukoplakia, Cysts,etc)
109
Harshness
-Tension & Constriction in Vocal Tract
(Hard onsets, Visible tension, Overadduction of the folds)
ETIOLOGY: Neurologic
PSYCHOGENIC: Musculoskeletal Tension
110
Vocal Fry and Pulse Register
- Lowest note on musical pitch range
- Popcorn popping
- Door creaking
111
Falsetto
-Increases pitch & simplifies the way the VF's vibrate
| Ch like tone
112
Hypernasality
-Inappropriate/incomplete velopharyngeal closure
| Cleft palate, Submucous cleft
113
Velopharyngeal Incompetency
Partial or total paralysis of the muscles of the velum.
114
Velopharyngeal Insufficiency
Deficits caused by inadequate development of postsurgical tightness
(Cancer surgery, Trauma/Injury)
115
Inadequate Velopharyngeal Function
- Hypernasal
- Articulation affected
- Vowels hypernasal
116
Borderline Velopharyngeal Inadequacy
Difficulty with high pressure consonants during connected speech
117
Hyponasality
- Stuffy nose
| - Denasal voice quality (/m/ & /n/)
118
Mixed Resonance Pattern
-Hypernasal
-Hyponasal
(Swallow adenoids, Unmasked Submucous Cleft)
119
Cul-de-Sac-Resonace
-Muffled/Hollow oral resonance
-Echo in back of mouth
(Caused by excessive tension in tongue)
120
Asthenic Voice
- Weak/Thin resonance pattern
- Elevated habitual pitch
- Forward carriage of tongue
121
Inconsistent Voice Quality
- Correlated with fatigue
| - May be initial stages of neurogenic issues
122
Limited Voice Endurance
-Detrioration in laryngeal quality as a result of fatigue
123
Rigid Fiberoptic Oral Endoscopy
Rigid tube inserted into the oral cavity
124
Flexible Fiberoptic Nasoendoscopy
Tube inserted into the nasal passage
125
Stroboscopy
- Provides info concerning neuromuscular and physiological aspects
- Use of strobe light=neuromuscular
- Allows for visual inspection of laryngeal structures and function
