Voice Disorders

Question 1

This is one of the classifications for a voice disorder in which results from misuse or abuse of the vocal mechanism

Answer 1

Phonotrauma

Question 2

Another classification for a voice disorder in which is a result from a disease process or may be congenital

Answer 2

Organic

Question 3

This classification refers to the muscular tensions that can be found in the vocal mechanism

Answer 3

Functional

Question 4

A classification for a voice disorder in which results from an underlying psychological issue and there is no identifiable vocal pathology

Answer 4

Psychogenic

Question 5

The last of the classifications for voice disorders in which is a result from either damage to the RLN or SLN, disease that affects these nerves, brain injury, and or lesion

Answer 5

Neurological

Question 6

True or False: Vocal Fold Nodules are caused due to chronic or continuous misuse of the vocal folds.

Answer 6

True

Question 7

True or False: Vocal Fold Nodules are always unilateral

Answer 7

False - always Bilateral

Question 8

The following are descriptions about Vocal Fold Nodules except for:

A.) occurs bilaterally

B.) soft, gelatinous at first and then hardens due to more collagen and fibronectin

C.) Interferse with mucosal wave

D.) Occurs at juncture of anterior 2/3 and posterior 1/3 of vocal fold

Answer 8

D - Actually, occurs at anterior 1/3 and posterior 2/3 of vocal fold juncture

*Adds both mass and stiffness to vocal fold

*‘Hour glass glottic closure’

*Results in aperiodic vibration

Question 9

What is this?

Answer 9

Soft Nodule

Question 10

Vocal Fold Nodules:

Perceptual Characteristics: ________, _______, _____ _____, and ______/______

Answer 10

roughness, breathiness, decreased loudness, and vocal strain/effort

Question 11

Vocal Fold Nodules:

Acoustic: decreased _______ and ________ ranges, increased _______/_______ perturbations, and increased ________ levels.

Answer 11

pitch and loudness ranges, increased frequency/intensity, noise

Question 12

Vocal Fold Nodules:

Aerodynamics: _________ air flow rates, ________ subglottal pressure (Ps)

Answer 12

increased, increased

Question 13

Stroboscopic Characteristic:

• Hour glass glottic closure
• Bilateral lesions at juncture of anterior 1/3 and posterior 2/3 of membranous VFs
• Decreased or absent mucosal wave in region
• Decreased amplitude of vibration

Answer 13

vocal fold nodule

Question 14

True or False: Vocal Fold Nodules chronic or continuous misuse/abuse

Answer 14

True

*Excessive yelling, talking, screaming

*hard glottal attacks

*coughing or throat clearing

*laryngeal muscle tension

*incorrect singing

Question 15

True or False: The possibility of a Vocal Fold Polyp to form increases if the Vocal Folds are already irritated

Answer 15

True

Question 16

What is this?

Answer 16

Polyp

Question 17

True or False: Vocal Fold Polyps are usually bilateral

Answer 17

False

*usually unilateral

Question 18

All of the following are characteristics of Vocal Fold Polyps:

A.) Soft fluid filled growth of tissue in SLP

B.) Can be sessile or pedunculated

C.) Occur anywhere along membranous vocal fold, but are typically in same region as nodules

D.) Hour glass or irregular closure

E.) All of the above

Answer 18

E - All of the above

Question 19

True or False: If the polyp is fluid-filled, the mass of the VF will increase and therfore decrease stiffness

Answer 19

True

Question 20

Perceptual Characteristic:

______, _______, sometimes _________, and _______

Answer 20

rough, breathy, diplophonic, strained

Vocal Fold Polyp

Question 21

Acoustic:

_______ pitch and ________ range, ______ frequency/intensity perturbations, _______ noise levels

Answer 21

decreased, loudness, increased, increased

Vocal Fold Polyp

Question 22

Aerodynamic:

_______ air flow due to hourglass or irregular closure and _____ subglottal pressure

Answer 22

increased, increased

Vocal Fold Polyp

Question 23

Videostroboscopic Characteristics

• increased mass, unilateral
• incomplete closure
• aperiodicity
• mucosal wave increased or decreased

Answer 23

Vocal Fold Polyp

Question 24

Almost always related to smoking, build up of fluid in SLP, bilateral or unilateral,

Answer 24

Vocal Fold Edema or Reinke’s Edema

*increases mass of vocal folds (may increase or decrease stiffness)

Question 25

What is this?

Answer 25

*Reinke's Edema*

Question 26

**Perceptual:** \_\_\_\_\_\_\_ fundamental frequency, \_\_\_\_\_\_\_, ______ effort

Answer 26

*low, roughness, vocal* Reinke's Edema

Question 27

**Acoustic:** loss of _______ \_\_\_\_\_\_\_, _______ pitch range

Answer 27

high pitches, decreased \*Reinke's Edema

Question 28

**Aerodynamics:** \_\_\_\_\_\_ air flow, normal Ps

Answer 28

* increased* * \**Reinke's Edema

Question 29

**Videostroboscopic** ## Footnote - bilateral swelling along entire membranous length of VFs - complete glottic closure - if unilateral, affected VF may interfere with vibratio of unaffected VF - Phase asymmetry - Decreased amplitude of vibration - Mucosal wave: depends on degree of stiffness

Answer 29

*Reinke's Edema*

Question 30

Caused by *trauma* to vocal fold tissue, vocal folds are erythematous and swollen, voice is hoarse and low pitched, resolves within two days

Answer 30

*Traumatic Laryngitis*

Question 31

What is this?

Answer 31

*Acute Laryngitis*

Question 32

What is this?

Answer 32

*Vocal Fold Hemorrhage*

Question 33

All of the following are causes for Vocal Fold Hemorrhage except for: ## Footnote A.) Ruptured blood vessel in submucosal layer B.) Usually by phonotrauma or trauma to VFs during surgery or medical procedure C.) Use of anticoagulant medication decreases the risk D.) Damaged by the blood E.) All of the above exept for C

Answer 33

E - All of the above except for C \*rupture blood vessel, phonotrauma/trauma to VFs, use of anticoagulant medication **increases** the risk, and damaged by the blood

Question 34

**Perceptual:** \_\_\_\_\_\_ to ______ ; \_\_\_\_\_\_\_ness

Answer 34

* dysphonia, aphonia; hoarse* * \** Vocal Fold Hemorrhage

Question 35

**Acoustic:** \_\_\_\_\_ pitch and ______ range, _____ pitch and intensity perturbations

Answer 35

* decreased, intensity, increased* * \** Vocal Fold Hemorrhage

Question 36

**Videostroboscopic:** - patchy red area on VF surface - decreased mucosal wave - decreased amplitude of vibration \*due to increased stiffness and mass

Answer 36

*Vocal Fold Hemorrhage*

Question 37

Vascular lesion, originate at the SLP at mid membranous portion, related to phonotrauma, more prevalent in women

Answer 37

*Vocal Fold Varices / Ectasia*

Question 38

Decreased mucosal wave due to **increased VF** stiffness, may or may not be perceptual symptoms, may cause decreased pitch range and some hoarseness

Answer 38

* Vocal Fold Varices/Ectasia* * \** Vocal Fold Varices: superficial, enlarged and dilated veins \*Vocal Fold Ectasia: lesioned blood vessel, coelescent hemangiomatmous appearance

Question 39

What is this?

Answer 39

*Vocal Fold Varices*

Question 40

Due to blockage of glandular duct with subsequent retention of mucus, may occur after vocal abuse or can be congenital, usually unilateral and **occurs** more often in women

Answer 40

*Vocal Fold Cysts*

Question 41

What is this?

Answer 41

*Vocal Fold Cyst*

Question 42

**Perceptual:** rough, breathy, might be low \_\_\_\_\_\_, ______ loudness

Answer 42

*pitched, decreased* \*Vocal Fold Cyst

Question 43

**Acoustic:** \_\_\_\_\_\_\_ pitch range, \_\_\_\_\_\_\_, _______ noise levels

Answer 43

*decreased, aperiodicity, increased* \*Vocal Fold Cyst

Question 44

**Aerodynamic:** \_\_\_\_\_\_ airflow

Answer 44

*increased* \* Vocal Fold Cyst

Question 45

**Videostroboscopic:** \_\_\_\_\_ or _____ mucosal wave \_\_\_\_\_\_ amplitude of vibration \_\_\_\_\_\_\_ VF mass/stiffness of VF cover \_\_\_\_\_\_ or hourglass closure

Answer 45

*absent/ decreased, decreased, increased, irregular* \*Vocal Fold Cyst

Question 46

Muscle Tension Dysphonia is caused by the following: ## Footnote A.) excessive extrinsic laryngeal muscle tension (supra and infrahyoid muscles and neck muscle) B.) excessive internal/supraglottic laryngeal muscle tension C.) by itself or secondary to a primary vocal pathology as a negative compensatory strategy D.) All of the above

Answer 46

D - All of the above

Question 47

Clinical signs of extrinsic laryngeal MTD on laryngeal palpation: ## Footnote A.) elevated laryngeal height B.) narrow, tense thyroid space C.) tension in suprahyoid muscle D.) Tense tight floor of mouth E.) All of the above

Answer 47

E - all of the above \*tense, tight thyrohyoid muscles, inability to lateralize larynx (left to right), base of tongue tension

Question 48

**Videostroboscopic:** \_\_\_\_\_\_ and ______ compression \_\_\_\_\_\_ compression VF _______ and \_\_\_\_\_\_ \_\_\_\_\_\_\_ squeezing \_\_\_\_\_\_\_ glottic closure, ______ gap or bowing

Answer 48

*anterior, posterior, mediolateral, hyperadduction, foreshortening, supraglottic, incomplete, anterior* \*Muscular Tension Dysphonia

Question 49

What is this?

Answer 49

*Muscular Tension Dysphonia with Supraglottic squeezing*

Question 50

**Perceptual:** harsh, rough, breathy, tense, phonation breaks, normal pitch or elevated pitch, whispher, aphonia

Answer 50

*MTD*

Question 51

The phenomena where the adduction of the false vocal folds are used for phonation

Answer 51

*Ventricular Phonation* *\**It can be both primary or secondary disorder \*FVF vibration may cause diplophonia

Question 52

**Perceptual:** voice is rough and harsh, low pitched due to the mass of FVF or combined mass of true and false folds, breathy, monotone, decreased pitch range

Answer 52

*Ventricular Phonation*

Question 53

Persistence of child-like voice quality after puberty

Answer 53

*Puberphonia*

Question 54

**Perceptual:** voice is high pitched, hoarse and breathy, decreased loudness, pitch lowers during heavy lifting or shouting

Answer 54

*Puberphonia*

Question 55

**Videostroboscopic:** Incomplete glottic glosure, stiff VFs, decreased amplitude

Answer 55

*Puberphonia*

Question 56

Complete loss of voice (aphonia) with no underlying physical cause

Answer 56

*Conversion Aphonia*

Question 57

The following are characteristics of Conversion Aphonia except for: ## Footnote A.) nonphonatory VF movements are normal B.) on phonation, VF movement is irregular and adduction inadequate to produce vibration C.) Onset of aphonia is associated with fear, stress, or traumatic event D.) Non-speech functions such as throat clearing, coughing, laughing, show normal VF movement E.) All of the above

Answer 57

E - All of the above

Question 58

Characterized by Vocal Fold adduction during quiet breathing

Answer 58

*Paradoxical Vocal Cord Movement*

Question 59

Vocal fold adduction during inhalation

Answer 59

*Paradoxical Vocal Fold Movement*

Question 60

Complain of throat tightness, neck tightness, chronic cough, stridor, wheezing, voice may be (hoarse, weak, breathy, strangled)

Answer 60

*Paradoxical Vocal Cord Movement*