Voice and Resonance Flashcards
includes disorders, voice diagnostics, and voice characteristics
1
Q
dysphonia
A
a voice disorder characterized by auditory perceptual symptoms
2
Q
organic voice disorders
A
- structural
- neurogenic
3
Q
organic voice disorders: structural
A
- physical changes of vocal mechanism
- cysts, growths, trauma to larynx, contact ulcers, nodules, edema, lesions, laryngitis, hemorrhage, glottal stenosis, sarcopenia
4
Q
organic voice disorders: neurogenic
A
- innervation to structures is impaired/damaged
- spasmodic dysphonia, Parkinson’s disease, Myasthenia gravis, ALS, essential/vocal tremor, paralysis/paresis of vocal folds
5
Q
functional voice disorders
A
- misuse
- psychogenic
6
Q
functional voice disorders: misuse
A
- normal structure, improper use/misuse
- muscle tension dysphonia, vocal fatigue, diplophonia, hypofunctional (incomplete vf closure), hyperfunctional (overuse)
7
Q
functional voice disorders: psychogenic
A
- normal structure, psychological cause
- conversion dysphonia, conversion aphonia, puberphonia (i.e., mutational falsetto), depression, anxiety, stress disorders
8
Q
assessment
A
- case history
- auditory evaluation
- perceptual evaluation
- oral motor exam
- respiration
- articulation
- resonance
- instrumental imaging
9
Q
types of voice and resonance treatment
A
- physiological
- symptomatic
10
Q
physiological treatment of voice and resonance
A
aim to modify the physiology of the voice
11
Q
symptomatic treatment of voice and resonance
A
aim to modify disordered vocal symptoms
12
Q
Lee Silverman Voice Treatment (LSVT)
A
- developed for Parkinson’s disease, may be used with others
- intensive high-frequency treatment program designed to improve vocal fold adduction and overall speech production
- focused on “think loud, speak loud”
- SLP certification program required to implement LSVT
13
Q
Phonation Resistance (PhoRTE)
A
- adapted from LSVT
- /a/ loud maximum sustained phonation, /a/ loud ascending and descending pitch glides, functional phrases with loud volume and high pitch voice, functional phrases with loud volume and low pitch voice
14
Q
treatment: vocal function
A
vocal function exercises:
- strengthening muscles to improve voice production
15
Q
treatment: relaxation
A
- hyper functional voice, relaxation techniques to reduce laryngeal tension
- yawn-sigh: minimize vocal hyperfunction tension, relax voice + improved pitch
16
Q
treatment: resonance
A
surgery, prosthesis, medical management, speech therapy
17
Q
voice diagnostics: case history
A
- date of onset
- chief complaint
- medical history
- vocal use/misuse
- referral source
- signs and symptoms
- prior voice therapy
- impact on everyday
18
Q
informal assessment categories
A
- vocal characteristics
- resonance
- respiration
- intelligibility
19
Q
informal assessment of vocal characteristics: acoustic/perceptual
A
- loudness
- quality
- pitch
20
Q
informal assessment: resonance
A
- hypernasal
- hyponasal
- cul-de-sac
- mixed
- vp dysfunction
- vp insufficiency
- vp incompetence
- vp mislearning
21
Q
hypernasal
A
- excess air through nasal cavity, during production of all sounds besides nasals /m, n, ŋ/
- structural abnormalities (e.g., clefts)
- genetic syndromes (e.g., 22q11.2 deletion)
22
Q
hyponasal
A
- not enough air through nasal cavity during production of nasal consonants
- blocked air
- nasal cavity obstruction (e.g., sinusitis)
- inflammation (e.g., cold)
- severe hearing loss
23
Q
cul-de-sac
A
- sound is trapped in oral, nasal, or pharyngeal cavity
- muffled/low voice
- nasal blockage (e.g. polyps, deviated septum)
- pharyngeal blockage (e.g., large tonsils and/or enlarged adenoids)
24
Q
mixed resonance
A
- cooccurrence of hypernasality, hyponasality, and/or cul-de-sac resonance
- apraxia: inconsistent abnormal vp opening
- causes of hyper/hypo nasality and cul-de-sac
25
vp dysfunction
vp valve does not close completely during production of oral sounds
26
vp insufficiency
velopharyngeal dysfunction due to anatomical/structural defect (e.g., cleft palate)
27
vp incompentence
poor movement of structures (e.g., CN damage, dysarthria)
28
vp mislearning
poor closure due to mislearning (e.g., misarticulation)
29
respiration: types of breathing
1. abdominal
2. clavicular
3. thoracic
30
informal assessment: respiration
- evaluate respiration during speech tasks
- assess coordination, length of words per breath, and maximum phonation time
31
intelligibility
impact on overall communication
- articulation
- prosody
- oral motor
32
intelligibility: articulation
vowel and consonant precision, duration, and fluency
33
intelligibility: prosody
rate, rhythm, and stress of speech
34
intelligibility: oral motor
movement, function, and symmetry of structures
35
acoustic evaluation: pitch
- pitch determination
- fundamental frequency
36
perceptual evaluation: pitch
- perceived high/low tone
- pitch level, pitch variations, pitch breaks, tremor
37
acoustic evaluation: loudness
measure intensity level
- sound level meter
- computer programs (PRAAT)
38
perceptual evaluation: loudness
- perceived loudness of sound
- loudness level: too soft (paralyzed vocal folds, Parkinson's disease), too loud (variable innervation of vocal folds, spastic dysarthria)
- variations in loudness: mono loudness (dysarthria, affective disorder)
39
acoustic evaluation: quality
- jitter: frequency perturbation
- shimmer: amplitude perturbation
- s/z ratio: minimal pairs
40
perceptual evaluation: quality
- perceived pleasantness
- breathy: air escaping between vocal folds
- harsh: hard, glottal attacks, low pitch, hypo/hyper loudness
- hoarse: combination of breathy and harsh qualities
- rough, strained and strangled, gurgly and wet, phonation breaks, glottal fry, etc.
41
instrumental assessment: imaging
- laryngeal imaging may assess structure, function, and vocal fold vibration during phonation
- videolaryngoendoscopy and videolaryngostroboscopy
