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voice assessment Flashcards

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1
Q

describe the ax process (4)

A
  1. diagnostic interview
  2. auditory-perceptual ax
  3. laryngeal imaging
  4. acoustic/instrumental ax
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2
Q

elements of pediatric voice ax? (6)

A
  1. voice history (symptoms, onset, previous tx etc.)
  2. med history
  3. voice usage
  4. fam history
  5. dev info (hearing, motor, SL, cog)
  6. child’s personal profile
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3
Q

elements of adult voice ax? (5)

A
  1. voice history (symptoms, onset, previous tx etc.)
  2. med history
  3. current health practices (drugs, alcohol)
  4. fam/work history
  5. psychological considerations
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4
Q

what are the 4 levels of voice usage?

A
  1. elite vocal performers (singers, actors)
  2. professional voice user (public speakers)
  3. non-vocal professional (teachers, lawyers)
  4. non-vocal nonprofessional (laborers, clerks)
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5
Q

what are the specific signs of muscular tension disorder (MTD) according to Morrison, Rammage et al. (1983)? (5)

A
  1. jaw jut
  2. head retraction
  3. raised larynx
  4. suprahyoidal tension
  5. posterior tension gap bw VFs (seen in endoscopy)
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5
Q

what are the auditory signs of dyspnea (3)?

A

a) stertor: noise above VFs
b) laryngeal stridor: noise at larynx level
c) wheezing: noise in lower airway

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6
Q

possible signs of temporomandibular joint dysfunction? (2)

A
  • crepitus (cracking when mouth opens)
  • palpable TMJ click at temple
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7
Q

what kind of tactile evaluation may an SLP engage in during a voice ax? (4)

A
  • abdomen (during breathing)
  • TMJ
  • muscles in suprahyoid region
  • muscles in laryngeal region
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8
Q

what does pain or discomfort in the thyrohyoid space suggest?

A

musculoskeletal tension

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9
Q

oral secretions are usually a good indicator of the _____.

A

laryngeal secretions

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10
Q

what is sialorrhea? what can it lead to?

A
  • hypersalivation
  • hydrophonia (gurgly voice)
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11
Q

what is another term for hyposalivation?

A

xerostomia (dry mouth)

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12
Q

what is halitosis (1)? what is it caused by (3)?

A
  • halitosis = bad breath
  • reflux, poor hygiene, infections
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13
Q

what are the 4 vocal registers?

A
  1. whistle (aka flageolet)
  2. falsetto (aka loft/head)
  3. modal (aka chest)
  4. fry (aka strohbass, pulse, creak)
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14
Q

describe what is going on with the VFs/muscles at each vocal register (+ whispering)?

A
  1. fry = slow vibrations
  2. modal = some muscle tension
  3. falsetto = muscles more tense
  4. whistle = muscles so tight that vibrations stop (except at anterior)
  5. whisper = posterior abduction
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15
Q

dx voice tasks 1: what non-speech vocalizations are we looking at? (2)

A
  1. sustained phonation of /a/, /i/, /u/
  2. vocal range (pitch, loudness, transitions)
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15
Q

dx voice tasks 2: what kind of speech are we assessing? (3)

A
  1. text passages
  2. semi-standardized speech samples (interview, pic description)
  3. spontaneous speech
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16
Q

what is the GRBAS scale?

A
  • Grade 0-3
  • Roughness (deepness) 0-3
  • Breathiness 0-3
  • Asthenia (projection) 0-3
  • Strain (effort) 0-3
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17
Q

prothetic continua are ___. what kind of scales should be used? example?

A
  • additive
  • continuous scales
  • e.g., loudness
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18
Q

metathetic continua are ___. what kind of scales should be used? example?

A
  • substitutive
  • interval scales
  • e.g., pitch
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19
Q

when dysphonic voice samples were associated with Black speakers, experienced White SLPs ranked overall severity numerically slightly ___. was the effect statistically significant?

A
  • lower
  • no
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20
Q

pulmonary function measures? (3)

A
  1. lung volumes (TV, IRV, ERV)
  2. forced spirometry
  3. respiratory movements
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21
Q

T or F: TLC increases throughout the lifespan

Study These Flashcards
A

false – decreases after age 20-25

22
Q

what might electromyography (EMG) of the laryngeal or cervical muscles be used for?

Study These Flashcards
A

confirming muscle paralysis

23
static images for laryngeal imaging? (2)
- MRI (better for soft tissue) - CT (better for bone)
24
what is direct laryngoscopy?
metal tube down throat to image larynx
25
what is mirror laryngoscopy?
pull tongue forward and stick mirror at back of throat
26
what are the 3 videostroboscopy speed settings?
1. running (slow-motion view of VFs) 2. walking (even slower motion) 3. stop (flashes are locked to F0)
27
why is the stop setting of videostroboscopy important?
- determines if motion is regular - if movement is observed during stop setting, means that movements are irregular
28
describe complete glottis closure. describe vibrations
- VFs are closed fully from anterior to posterior commissures - optimal vibrations
29
describe posterior gap. is this more common in males or females?
- posterior end of VFs (by arytenoids) is not completely adducted - more common in females
30
describe anterior gap. is this more common in males or females?
- anterior end of VFs is not completely adducted - more common in males
31
describe anterior and posterior gap (hourglass) (2). what kind of voice quality does this result in?
- gaps at anterior and posterior commissures - lesions in middle bc that's the area of max collision - results in roughness from lesions + breathiness from gaps = hoarseness
32
describe incomplete glottic closure. why might this occur?
- big gap (think A) - bottom of A is at arytenoids - may occur when one VF is paralyzed
33
describe bowed/spindle glottic closure. what kind of vocal quality would be heard?
- adducted at arytenoids but VFs have lost muscle tone and get blown apart by air (think oval) - breathy quality
34
describe irregular glottic closure. what kind of vibrations occur as a result?
- VFs out of sync due to something obstructing the edges - irregular vibrations
35
what is diplophonia?
diff vibration of the 2 VFs, resulting in 2 diff pitches
36
what are the directions of the mucosal wave (3)
- superior-inferior - medial-lateral - anterior-posterior
37
what is vertical level difference?
when the VFs are different heights
38
describe the interaction between F0 and the mucosal wave
as F0 increases, mucosal wave decreases
39
describe the interaction between loudness and the mucosal wave
as loudness increases, mucosal wave also increases
40
what does digital videokymography do?
summarize periodicity over time
41
diff bw electroglottography (EGG) and photoglottography (PGG)?
- EGG: current on 2 sides of larynx; current crosses easily as VFs close - PGG: light thru nose and trachea below neck; open = more light
42
what does a pneumotachograph do?
measures differential pressure on both sides of a known flow resistance (wire mesh)
43
what does a warm wire anemometer do?
the cooling effect of the airflow changes the electrical resistance of a heated wire
44
- flow = ? - flow rate = ?
- flow = diff pressure / resistance - flow rate = flow volume / time
45
estimation of subglottal pressure can be achieved by measuring the intraoral pressure during production of /pipipi/ with a catheter based on the assumption that ____.
the airway between the larynx and the lips is unconstrained during the unvoiced plosive production
46
the measurement of intraoral pressure at a minimal loudness level indicates the _____.
minimum pressure for glottal excitation
47
to make a good speech recording, use at least __-bit signal resolution with ____ kHz or ___ kHz sampling frequency
- 16 - 22.05 - 44.1
48
how can you avoid p-pops and excessive nasality when recording? (2)
- keep mic 10-15cm away - use 45 degree angle
49
describe the appearance of the following voice qualities on a waveform: a) breathy b) rough
a) breathy = lower amp b) rough = higher amp
50
describe the appearance of breathy/rough voice qualities on a spectrogram
more random stuff, less clear striations
51
what are phonetograms useful for?
tracking voice therapy outcomes
52
briefly define jitter vs shimmer
- jitter: frequency variation (horizontal) - shimmer: amplitude variation (vertical)
53
the dysphonia severity index (DSI) is calculated as a weighted combo of? (4)
1. max phonation time 2. highest freq in Hz 3. lowest intensity in dB 4. jitter in %
54
DSI: results tend to fall between +5 (normal voice) and –5 (severely dysphonic). trained vocalists can ____.
exceed the +5 value

voice (6 decks)

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