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Adult Comps* > Voice > Flashcards

Flashcards in Voice Deck (38):
1

LPR symptoms

-hoarseness
-globus sensation
-pain
-irritation & inflammation
-increased mucous production

2

LPR treatment

suppress acid through a PPI

-dont eat 3 hours after meals
-elevate head of bead
-diet changes

3

principles of voice therapy (7)

education
behavioral modifications
relaxation work
postural work
breath work
voice production shaping
counseling

4

Relaxation approaches

-progressive relaxation (Jacobson)

-direct massage (McClosky) ---- massage face, stretch tongue, passive movements of jaw, massage neck, etc.

-stretch/flex and release exercises

5

Postural tx

-assess "plumb line"
-assess balance of head on atlas
-look at their work-station, etc.

--tx:
-"here i am sitting"
-sit as you would stand
-refer to OT or chiropractor

6

why work on breathing & problems

"voice disorders disrupt normal speech breaking behaviors (Hillman)

-shallow inhalations
-running out of air
-exhalation prior to speech
-breath holding
-paradoxical respiratory movements

7

tx for breathing

target abdominal breathing

-stablalize shoulders
-force exhalation, feel for recoil
-candle blowing
-slow rate of inhalation
-breath through nose

8

PVFM

-when the larynx closes off not allowing the person to breath
-difficulty getting breath in
-tightness in throat
-inhalatory stridor
-02 stats stay above 90
-stops soon after excersise

9

tx for PVFM

rescue breathing technique

-breathe in through nose slowly with wide throat posture
-breath out through puckered lips
-feel throat widen as you breathe in

10

decreased glottal competence tx techniques

-pushing
-hard glottal attacks
-coughing, troat clearning
-pitch manipulation
-laryngeal manipulation

11

approaches to shape phonation

1. onset manipulation
-aspirate onset to reduce hard glottal attacks
-light glottal attacks to reduce breathiness
-easy/gentle onset

2.reinforce active/continuous breath flow
-kazoo buzzes
-lip/tongue trills

12

in voice don't treat the _______, treat the _____

don't treat the symptoms, treat the cause

13

non-adducted hyperfunction

-aphonia or dysphonia
-crisp, vegetative cough or throat clear

-dx confirmed via endoscopy

severe hoarseness--->aphonia-->conscious transfer into a whisper--->URI resolves --->pt remains locked in a whisper

14

tx for non-adducted hyperfunction

-describe the problem -- "laryngeal muscle tension"
-lay the ground rules
-explain bad vs good voice
-you have control over your voice

---**Clinician's toolbox of tricks

15

what CN involved most in voice??

CN x -Vagus

16

3 branches of the vagus

1. palato-pharyngeal branch - palate and pharynx
2. superior laryngeal branch - interior branch (laryngeal interior) and external branch (cricothyroid)
3.recurrent laryngeal branch - intrinsic laryngeal muscles except cricotyroid

17

tx of adducted hyperfunction

1. vocal hygiene
2. vocal rest
3. vocal entrainment exercises
4. resonant voice therapy (verdoloni)
5. voice therapy

18

resonant voice therapy

** Verdoloni

-the goal is to achieve the strongest "cleanest" voice possible with the least effort and impact between the VF to minimize trauma

-"forward focus voice"
-work on the "basic resonant voice training gesture"

19

Vocal function exercises

**Stemple

exercises are practiced 2x day
-works to improve the strength and endurance of the VF muscles & the coordination of respiratory and laryngeal muscles

-includes maximal prolongations, pitch glides, sustained vowels to words and phrases

20

Clinician toolbox tricks

**Bunting

-cough
-throat clear
-cry
-sing
-laryngeal manipulation
-gargling

21

LMN damage

flaccid dysarthria

22

UMN system

spastic dysarthria

23

Cerebrllum system

ataxic dysarthria

24

Extraparymadal system

1. hypokinetic
2.hyperkinetic (quick or slow)
3. tremor (organic voice tremor)

25

6 types of non-neurologic organic voice disorders

1. infalmmatory reactions (acute or chronic laryngitis, LPR, irritable larynx syndrome)
2. benign lesions (nodules, polyps)
3. endocrine disorders (hypo/hyperthyroidism)
4. trauma (mechanical or burns)
5. congenital disorders (laryngeal web)
6. maligent tumors

26

ALS is

spastic and flaccid dysarthria

27

WD is

ataxic and hypokinetic dysarthria

28

MS is

ataxic and spastic dysarthria

29

flaccid dysarthria voice symptoms

-hypernasality
-nasal emission
-breathiness
-short phrases
-inhalatory stridor

30

spastic dysarthria voice symptoms

-harshness
-low pitch
-slow rate
-strained/strangles voice quality
-pitch breaks
-slow and regular AMRs

31

hypokinetic dysarthria voice

-monopitch
-monoloud
-variable rate
-rapid/blurred AMRs
-short rushes of speech
-reduced stress

32

hyperkinetic dysarthria voice (huntingtons - quick)

-slow/irregular AMRs
-distorted vowels
-prolonged intervals
-voice tremor
-voice stoppages
-transiet breathiness

33

ataxic dysarthria voice

-irregular articulatory breakdowns
-prodosdic excess
-prolongation of phonemes
-irregular AMRs
-Excessive loundness variation

34

spasmodic dysphonia

-inappropriate adduction and abduction of the VFs

-abnormal involuntary contraction of the thyroarytenoid (adductor) and PCA (abductor)

tx = botox

35

how to treat abdominal breathing

stabilize shoulders (lie on floor, stand against wall)
force exhalation, feel recoil
candle blowing
panting
slow rate of inhalation

36

how to treat glottal incompetence

pushing/hard glottal attacks
couging/throat cler
pitch manipulation
LSVT

37

how to decrase rate of speech

taping
metronome
DAF
listen tapes

38

how to use resoance to shape phonation

forward placement/focus (hum)
use forward vowels (/i/ /u/)
Lessac Madesen resonant voice