Anatomy and Physiology
What is the main muscle of inspiration?
The diaphragm
What are the distinguishing deficits of hypokinetic dysarthria?
Reduced loudness (hypophonia)
Monopitch and monoloudness
Imprecise articulation
Short rushes of speech
PICTURE
Reinke’s edema
When doing vocal function exercises, what does it mean to unload the vocal folds?
To reduce effort while allowing efficient, full vocal fold vibration
What is chronic refractory cough?
Persistent cough lasting over 8 weeks, unresponsive to standard medical treatments
The smallest branches stemming from the secondary bronchi are called ______.
Bronchioles
Mention 1 component to ensure emotional care and cognitive care.
Emotional care: Warmth, genuineness, mutual trust, empathy, respect.
Cognitive care: managing expectations, gathering information, education.
Granulomas from intubation trauma can resolve quickly: TRUE/FALSE
TRUE
Mention one of the PhoRTE (Phonation Resistance Training Exercises) exercises
BONUS QUESTION!!
A preferred method to restore voice after a laryngectomy is ______.
Distraction techniques are ineffective in managing chronic cough because they do not target the physiological mechanism: TRUE/FALSE
False
Active expiratory pressure is generated by which two muscle groups?
Internal intercostals and abdominal muscles
Mention one possible aerodynamic change due to muscle tension dysphonia.
Increased subglottal air pressure, decreased airflow rate, increased phonation threshold pressure, increased laryngeal resistance.
Mention a probable cause for developing vf nodules.
Phonotraumatic behaviors
Mention 3 examples of semi-occluded vocal tract exercises (SOVTEs)
Mention one trigger of chronic cough
Environmental irritants, reflux, post-nasal drip, and stress.
PICTURE
Ventricular folds
Essential voice tremor is easier to identify during ______ vs ______.
During sustained phonation versus connected speech
Vocal tremor is an ________tremor.
action-induced
Mention 3 tenets of CTT
1. Clear speech
2. Lots of negative practice
3. Auditory kinesthetic awareness
4. Prosody and pauses
5. Projecting your voice
6. Embedded basic training gestures
7. Rapport: therapeutic alliance!
Name one cough suppression technique used in BCST (Behavioral Cough Suppression Therapy)
Silent cough (huff) + swallow
Repeated huffs + swallow
Humming + swallow
Yawning + swallow
Relaxed throat breathing
In presbylarynx, increased glottal gaps are primarily due to hypertrophy of the vocal folds.
False: atrophy of the vocal folds
What normative CPPS values are expected for sustained phonation versus connected speech in females and males, according to Buckley et al. (2023)?
Sustained phonation:
Males: 17.52 (SD = 2.90 dB)
Females: 16.17 (SD= dB 2.56 dB)
Connected speech:
Males: 8.92 (SD =1.26 dB)
Females: 9.17 (SD =1.34 dB)
Name 2–3 perceptual voice characteristics commonly associated with laryngeal dysplasia or laryngeal cancer.
•Hoarseness
•Change in pitch (typically lower due to the mass effect)
•Vocal strain
•Sore throat or globus sensation
•Persistent cough
•Stridor
Mention a possible hierarchy for water resistance training exercises
Sustained phonation → pitch glides → pulsing → functional phrases
Name two key clinical differences between ILO and asthma.
Exhibit breathlessness primarily during inhalation (whereas asthma is during exhalation).
Point to their larynx as the source of the tightness (ie stridor), whereas patients with asthma describe tightness in the upper chest region (ie wheezing).
Experience abnormal voice quality change (ie, hoarseness or loss of voice) during dyspneic episodes, whereas patients with asthma do not.
Exhibit symptoms of laryngeal hypersensitivity (eg, abnormal sensations in the throat including itch, ache, pain, or globus/foreign body sensation), whereas patients with asthma do not.
Gain little or no relief of ILO symptoms when using short acting beta-agonists (ie, rescue inhalers/bronchodilators) used for asthma, whereas asthma attacks generally respond 15 to 20 minutes after using a rescue inhaler.