Structural Disorders
Inflammation of the arytenoid cartilages, typically due to intubation.
What is the most common neurological voice disorder?
Vocal fold paralysis
What are the hallmark signs of Muscle Tension Dysphonia? (2)
Excessive laryngeal/supraglottic tension
Decreased vibratory amplitude
What is the most comprehensive therapy approach?
Eclectic (hygienic, psychogenic, symptomatic, physiologic)
DAILY DOUBLE
What gender and race is most impacted?
Men
African Americans
What is the cause of stenosis?
Acquired - Intubation
Congenital - malformation of the Cricoid
Name the three positions vocal folds may rest when paralyzed.
Paramedian
Intermediate
Lateral position
What is the functional disorder associated with sudden onset, normal vegetative functions, stress/tension, avoidance of true problem?
Conversion aphonia/dysphonia
DAILY DOUBLE
Name the 4 parts of Vocal Function Exercises
Warm up
Stretch
Contract
Power Exercise (Adductory strength)
Describe Laryngeal Cancer.
Change in normal tissue that grows uncontrollably.
Squamous cell that originates in the Epithelium.
Typically on the true vocal folds.
Describe Recurrent Respiratory Papilloma.
What is it?, Location, Cause, 2 symptoms, 1 treatment method
Wartlike growths (benign)
Epithelium, invade deeper
Human Papilloma Virus
Increase mass/stiffness, breathy, rough, stridor
Multiple surgeries, Post op Voice Therapy
Name the location of neural injury for:
Vocal fold paralysis
Spasmodic Dysphonia
Myasthenia Gravis
Recurrent Laryngeal Nerve - Left
Basal Ganglia
Lower motor neuron
Describe 3 signs/symptoms of Puberphonia.
high pitch (hyperfunction Cricothyroid)
Breathiness
High tongue posture/elevated larynx
What is Semi-Occluded Vocal Tract?
Name 1 non-speech and 1 speech excercise
Improves vocal function through efficiency.
Humming
Resonance Voice Therapy
What is a laryngectomy?
Removal of the larynx, including cartilages, epiglottis, muscles, hyoid bone, and first 2-3 tracheal rings
Describe common signs/symptoms of growths on the vocal folds
Increased mass
Increased stiffness
Decreased mucosal wave
Rough and/or Breathy
Decreased pitch/loudness and range
Fatigue
When is Spasmodic Dysphonia better or worse? Name at least 3 situations for each.
Better: In the morning, after a beverage, laughing/whispering
Worse: under stress, when tired, on the phone
What are 3 causes of Ventricular Phonation?
Severe muscle tension
vocal fold paralysis
scarring
Name the four steps in developing a vocal hygiene program.
Identify the behavior
Specific occurence
Effect of laryngeal mechanism
Modify/eliminate behavior
List at least 5 common symptoms.
Lump in throat
Decrease pitch
Strain/increased effort
Fatigue
Cough/sore throat
Stridor
Compare (3) and Contrast (3)
Cysts
Polyps
Nodules
All are benign growths, can be on the superficial layer, similar signs/symptoms
Different causes
Cysts do not respond to voice therapy
Polyps have active blood supply
Nodules bilateral
Provide at least three compensatory strategies for Myasthenia Gravis.
Vocal breaks/rest
Schedule in the morning
Quiet room/smaller group/closer proximity to reduce projection
Name four therapy techniques that can be employed for functional voice disorders.
Vocal hygiene
Education
Counseling
Relaxation/Massage/Stretching
Describe the Physiological Voice Therapy approach.
Address underlying physiology of voice production rather than specific symptoms
Improve the relationship or balance amongst:
Respiration, Phonation, Resonance
Treat the voice holistically
Evaluate condition of voice production and develop direct physical exercises or manipulations to improve that condition
What are the three options for speech following a laryngectomy?
Artificial Larynx (electro, oral, intraoral)
Esophageal Speech (Glossopharyngeal press, consonant injection, swallow method)
Surgical Prosthesis (TEP)