Anatomy
This joint allows arytenoids to rock and slide, rocking moves vocal processes medially for adduction and laterally for abduction.
What is the cricoarytenoid joint?
This theory states that vocal fold vibration is driven by aerodynamic forces acting on elastic tissue — NOT by repeated muscle contraction and relaxation.
What is the myoelastic-aerodynamic theory of phonation?
This is the critical distinction between a compensatory technique and a rehabilitative exercise in voice therapy.
- compensatory techniques change behavior in the moment without altering underlying physiology
- rehabilitative exercises target specific muscles with overload, specificity, and intensity principles to improve physiologic function over time
This is the current gold standard perceptual voice rating tool, uses a visual analog scale format, and rates six specific parameters, define each.
What is the CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice):
Overall Severity, Roughness, Breathiness, Strain, Pitch, and Loudness.
This is the specific anatomical location on the vocal fold where nodules almost always appear — and the one feature that should make you ask why if this rule is broken.
Anterior one-third junction (halfway along the membranous portion) — and if a nodule appears to be unilateral, you should investigate further because true nodules are almost always bilateral.
This projection on the arytenoid cartilage is where ALL adductor and abductor muscles insert.
What is the muscular process?
This effect creates negative pressure perpendicular to transglottal airflow that assists in drawing the vocal fold edges back together, similar to a shower curtain being drawn toward running water.
What is the Bernoulli effect?
Pushing and pulling isometric exercises are indicated for hypofunctional voice disorders but absolutely contraindicated in patients with these two conditions.
What are cardiac disease and aneurysms — because isometric effort increases intrathoracic pressure similar to a Valsalva maneuver.
GRBAS stands for these five terms and was developed by this organization in this year.
Grade, Roughness, Breathiness, Asthenia, Strain — developed by the Japan Society of Logopedics and Phoniatrics in 1981.
This voice disorder is characterized by pain with phonation (odynophonia), ulcerations at the vocal processes of the arytenoid cartilages, and is most commonly seen in young adult males who habitually use an excessively low pitch to sound more authoritative.
What is contact ulcer (which can progress to granuloma).
The anterior commissure of the vocal folds attaches to this cartilage, and its forward rocking motion raises pitch.
What is the thyroid cartilage?
Articulation changes the shape of this component in source-filter theory, explaining why different vowels and consonants have different acoustic properties despite the same glottal source.
What is the filter (the supraglottal vocal tract)?
Before initiating any voice treatment program regardless of setting, ASHA's standard of care requires this step.
What is obtaining a recent ENT evaluation to rule out life-threatening conditions including laryngeal cancer and ALS that can present with hoarseness alone.
PROMs like the VHI exist because acoustic and aerodynamic measures alone cannot capture this important dimension of the patient's experience with their voice disorder.
What is the patient's subjective perception of how the voice disorder impacts their daily activities, communication participation, emotional state, and quality of life — the functional handicap rather than just the physiologic impairment.
A patient's vocal fold bowing is visible on stroboscopy, their pitch has risen measurably over several years, their voice is breathy and fatigued by the afternoon, but their morning voice is nearly normal. Their age is 72.
What is presbyphonia — and the key message is that it is NOT an inevitable consequence of aging but a treatable condition that responds to voice therapy and should not be dismissed as "just getting older."
This ligament connects the hyoid bone to the mid-epiglottis and mechanically inverts the epiglottis during swallowing when the hyoid elevates.
What is the hyoepiglottic ligament?
A male patient's habitual speaking F0 measures 220 Hz. Using normative values, this finding is most consistent with.
What is an elevated pitch for an adult male (normative range is 85–155 Hz) — possible mutational falsetto, puberphonia, or intentional high pitch use
LSVT and Speak-Out! are pre-programmed intensive voice therapy programs with the strongest evidence base specifically for this patient population and core principles behind it.
What is Parkinson's disease — emphasizing loudness, effort, and high-intensity practice.
A clinician rates a patient's voice as Overall Severity 67/100, Roughness 72/100, Breathiness 40/100, Strain 55/100, Pitch appropriate, Loudness mildly reduced. Based on these values, this is the severity level that best describes this patient's dysphonia overall.
What is severe — an OS of 60+ on CAPE-V is consistent with severe dysphonia, with roughness and strain as the dominant features.
A polyp differs from a nodule in this important etiologic way.
What is that nodules require chronic/repeated phonotrauma, while a polyp can result from a single acute traumatic event.
These two paired cartilages have no known phonatory function and are considered vestigial — one sits atop the arytenoid apices and one is embedded in the aryepiglottic folds.
What are the corniculate and cuneiform cartilages?
On stroboscopy, a patient shows an hourglass-shaped glottal closure pattern — a narrow gap at the midmembranous portion of the folds while anterior and posterior portions appear to contact. This pattern is most consistent with this diagnosis.
What is vocal nodules — bilateral midmembranous lesions that prevent full medial approximation at that location.
The easy onset technique for hard glottal attack treatment instructs the patient to do this specifically before vowel-initial words to prevent the explosive adduction-before-airflow pattern.
What is adding an /h/ before the vowel or initiating airflow slightly before adduction begins — so air is already moving through the glottis when the folds approximate, preventing the explosive burst of abrupt glottal opening.
CAPE-V is administered using these three specific speaking tasks.
What are sustained /a/ and /i/ vowels (3–5 seconds each), the CAPE-V standardized sentences, and spontaneous speech.
A patient presents with a breathy voice of sudden onset immediately following thyroid surgery. The most likely diagnosis and the specific nerve involved.
What is unilateral vocal fold paralysis due to RLN (recurrent laryngeal nerve) injury — the most vulnerable nerve in thyroid surgery due to its proximity to the posterior thyroid capsule.