structures
Typically bilateral, develop at junction of anterior and middle 2/3 of the vocal fold, hourglass glottic closure pattern
Vocal Fold Nodules
Unilateral lateral paralysis. SPEECH, SWALLOW, AIRWAY
Speech: breathy, aphonic
Swallow: dysphagia for liquids
Airway: no problem
Lesions caused by HPV, interference with glottic closure and vocal fold vibration depends on location and size of the lesion(s), managed procedurally/surgically
Laryngeal Papilloma
Intrinsic laryngeal muscles
Cricothyroid
Posterior cricoarytenoid
Interarytenoids
Lateral cricoarytenoid
Thyroidarytenoid
Mucus or fluid-filled lesion on the mid-membranous vocal fold
Vocal Fold Cyst
Can be caused by LPR, intubation, or phonotrauma, lesion typically noted on the anterior complex or on lateral wall of the posterior glottis
Contact Ulcer/Granuloma
Unilateral medial paralysis. SPEECH SWALLOW AIRWAY
Speech: reduced pitch range, hoarse
Swallow: No problem
Airway: Slightly reduced
Pathologic tissue change identified with biopsy, hoarseness and strain are predominant voice quality characteristics, management depends on degree of spread
Dysplasia, laryngeal cancer
Function of the PCA
Abducting vocal folds
Fungal infection that results in leukoplakia on the vocal folds and/or surrounding structures; incomplete glottic closure 2/2 edema and irregular vocal edges, managed medically
Candida/Candida Laryngitis
Dysphonia related to inflammation of vocal fold mucosa, generalized bilateral edema of the vocal folds,
Laryngitis
Bilateral adductor paralysis. SPEECH SWALLOW AIRWAY
Speech: aphonic, unable to phonate
Swallow: dysphagia for liquids
Airway: no problem
Majority occur at birth, often occurring at the anterior commissure; can cause dyspnea if obstructing glottal airway, managed surgically
Laryngeal Web
What muscles are the most responsible for changing pitch
1. Cricothyroid
2. Thyroidarytenoid
3 ways to stop voicing
VF adduction OR abduction (make sure to list both)
Occlusion of the vocal tract (lip closure)
Disrupting airflow (cessation of exhalation/stop breathing out)
Fluid accumulation in Reinke's space, edema is noted across the entire membranous vocal fold, often complete glottic closure
Reinke's Edema
bilateral abductor paralysis SPEECH SWALLOW AIRWAY
Speech: not able to inhale, no phonation
Swallow: no problem
Airway: stridor. need trach
Furrowing of the SLP to varying degrees, common voice-related complaints include vocal fatigue and increased effort, requires surgical management however it is difficult to manage
Sulcus Vocalis
name the laryngeal structures (all 7)
1. hyoid bone
2. epiglottis
3. thyroid
4. cricoid
5. arytenoid
6. cuneiform
7. corniculate
Layers of the vocal fold (body and cover)
Body:
Vocalis muscle
Deep lamina propria
Intermediate lamina propria
Cover:
Epithelium
Superficial lamina propria
Originates in the SLP, usually in the middle 1/3 of the membranous vocal fold, oftentimes hourglass closure pattern
Vocal Fold Polyps
What would you do to differentiate between vocal tremor, adsd, absd
Vocal tremor: prolonged vowel sound
ABSD: count 60-70, voiceless sounds
ADSD: count 80-90, voiced sounds
White plaque formation on the vocal fold(s) related to chronic irritation, rough/hoarse vocal quality, requires tissue testing to determine course of management
Leukoplakia
What muscles are responsible for adduction
Interarytenoid- adducts posterior glottis
lateral cricoarytenoid- adducts vocal processes
thyroarytenoid- adducts the membranous vocal folds
what cartilage makes up the epiglottis and what cartilage makes up the thyroid, cricoid, arytenoids. What is the difference?
Epiglottis: elastic cartilage, does not ossify
Thyroid, cricoid, arytenoids: hyaline cartilage, ossifies with age