Voice/Swallowing Disorders

Question 1

Patients with voice disturbance, were later diagnosed with ___.

Answer 1

ALS

Question 2

Dysarthria, dysphagia, tongue fasculations, and incomplete VF closure were common ___ findings.

Answer 2

ALS findings

Question 3

_____ dysphonia is associated with improvement in voice quality w/sedatives or sensory tricks such as yelling, singing, whispering or laughing while speaking.

Answer 3

Spasmodic dysphonia

Question 4

_____ spasmodic dysphonia is characterized by a tight, strained, and strangled voice.

Answer 4

Adductor spasmodic dysphonia

Question 5

___ is the gold standard of treatment for Adductor Dysphonia, and is injected into the thyroarytenoid muscle.

Answer 5

Botulinum toxin

Question 6

Botulinum toxin is the gold standard of treatment for Adductor Dysphonia, and is injected into the _____ muscle.

Answer 6

Thyroarytenoid muscle

Question 7

Botulinum toxin is the gold standard of treatment for_____ Dysphonia, and is injected into the _____ muscle.

Answer 7

Adductor dysphonia

Question 8

Patients with _____ spasmodic dysphonia will break when counting from 80-89.

Answer 8

ADductor spasmodic dysphonia

Question 9

Patients with _____ spasmodic dysphonia will break when counting from 60-69.

Answer 9

ABductor spasmodic dysphonia

Question 10

Patients with _____ spasmodic dysphonia will break when pronouncing vowels.

Answer 10

ADductor spasmodic dysphonia

Question 11

___ is often a useful adjunctive therapy for patients w/spasmodic dysphonia.

Answer 11

Voice therapy

Question 12

Injection of the ___ muscle is performed for ABductor spasmodic dysphonia.

Answer 12

Posterior cricoarytenoid muscle

Question 13

_____ - grade VC injury appears as fibrillation potentials, abscene of motor unit potentials and recruitment on laryngeal EMG.

Answer 13

High grade - VC injury

Question 14

___ manifests as b/l dystonic facial spasms including excessive blinking, jaw thrusting, and vocal dystonias.

Answer 14

Meige’s syndrome

Question 15

A Dystonia is an abnormal _____ resulting in muscular spasm and abnormal posture, typically due to neuro disease or a side effect of drug therapy.

Answer 15

Abnormal muscle tone

Question 16

Spasmodic dysphonia, abnormal tongue movements, and Kayser-Fleischer rings are associated with ___.

Answer 16

Wilson’s disease.
(excess copper deposition)

Question 17

_____ lesions cause spasticity and hyperreflexia

Answer 17

UMN

Question 18

____ CNS lesions cause flaccidity, weakness, atrophy, fasiculations and hyporeflexia

Answer 18

LMN

Question 19

___functional VC disorders fall in the category of muscle tension dysphonia, tremor, and spasmodic dysphonia

Answer 19

Hyperfunctional

Question 20

___functional VC disorders MS, Parkinson’s, VC paralysis

Answer 20

Hypofunctional

Question 21

Treatment for functional dysphonia consists of ___ and ___.

Answer 21

voice therapy and biofeedback.

Question 22

Hoarseness out of proportion to the FFL, think…

Answer 22

1. Muscle tension dysphonia
2. Lesion not visible

Question 23

Dystonia is a ___functioning VC disorder

Answer 23

Hyperfunctioning

Question 24

A focal dystonia is referred to as a ___ or ___ dysphonia

Answer 24

spasmodic or bulbar

Question 25

___ is the treatment of choice for spasmodic dysphonia and essential voice tremor.

Answer 25

Botox injections

Question 26

Botox injection is the treatment of choice for ___ dysphonia and ___.

Answer 26

Spasmodic dysphonia and essential voice tremor.

Question 27

If the voice “normalizes” with speech (eg, some days voice is normal, some days it sounds hoarse), this is indicative of ___ dysphonia.

Answer 27

muscle tension dysphonia

Question 28

If the voice does not “normalize” with speech (eg, some days voice is normal, some days it sounds hoarse), this is indicative of ___ dysphonia.

Answer 28

spasmodic dysphonia (autonomic, brain always in control)

Question 29

Struggling with “Ps” in speech, is an example of __ductor dysphonia.

Answer 29

ABductor dysphonia
(P is “soundless,” notice the air w/speech)

Question 30

____ dysphonia makes the VFs open inappropriately w/voicing

Answer 30

ABductory dysphonia (eg, in the middle of speech, almost “losing” their breath)

Question 31

___ dysphonia causes the VFs to meet and stay together inappropriately w/voicing

Answer 31

ADductor dysphonia

Question 32

1.

___ involves rhythmnic contraction and often adjacent pharyngeal/cervical voice use at rest.

Answer 32

Essential tremor

Question 33

The most common complication of a Zenker’s diverticulum is _____.

Answer 33

Aspiration

Question 34

Sarcoidosis affects the ___.

Answer 34

“SAW”
“S”arcoidosis - supraglottis
“A”myloidosis - glottis
“W”egner’s - subglottis

Question 35

Amyloidosis affects the _____.

Answer 35

“SAW”
“S”arcoidosis - supraglottis
“A”myloidosis - glottis
“W”egner’s - subglottis

Question 36

Wegner’s (Granulomatosis w/polyangitis) affects the _____.

Answer 36

“SAW”
“S”arcoidosis - supraglottis
“A”myloidosis - glottis
“W”egner’s - subglottis

Question 37

___ diverticulum can be treated with endoscopic diverticulostomy but a ___ diverticulum should be treated w/open diverticulectomy b/c of close relationship to RLN.

Answer 37

Zenker diverticulum can be treated with endoscopic diverticulostomy but a Killian-Jamieson diverticulum should be treated w/open diverticulectomy b/c of close relationship to RLN.

Question 38

Zenker diverticulum can be treated with ___ diverticulostomy but a Killian-Jamieson diverticulum should be treated w/___ diverticulectomy b/c of close relationship to RLN.

Answer 38

Zenker diverticulum can be treated with endoscopic diverticulostomy but a Killian-Jamieson diverticulum should be treated w/open diverticulectomy b/c of close relationship to RLN.

Question 39

Patients affected w/____ motion develop intermittent *stridor** and **respiratory distress **due to inappropriate adduction during inspiration.

Answer 39

Paradoxical VC motion

Question 40

paradoxical VC motion (PVCM) is associated with __ (disorders).

Answer 40

psychosocial distress, exercise, stress, and exposure to inhalation irritants.

Question 41

Acute treatment of paradoxical adduction of VCs during inspiration is ___.

Answer 41

Reassurance and supportive measures (panting, “sniff-hiss” breath) until the episode passes.

Question 42

Cricotracheal resection ___ VHI in the immediate post-op period (1mo), and ___by 2 years f/u

Answer 42

Increases (worse pitch)

Returns to baseline

Question 43

The risk of _____ is higher for Killian-Jamieson diverticulum than for Zenker’s diverticulum b/c of the anatomical relationships

Answer 43

RLN injury

Question 44

___ excision rather than endoscopic resection is a safer management of a Killian-Jamieson diverticulum.

Answer 44

Open transcervical excision