Category 1
What does the Vagus nerve supply?
The larynx
Range of Motion for deep breathing
6-7 cm
Noise to Harmonic Ratio
Measure of the proportion of harmonic sound(periodic tone) to noise (aperiodic tone) in the voice measured in decibels.
Norm: < .14
Voice Therapy Techniques:Conversation Training
○Results after as few as 2 therapy sessions
○Subject material is interesting to the patient, making it more meaningful to them
○Generalization to conversational level begins DAY 1! This is typically the hardest part of voice therapy
○Not everyone is stimulable – so must be a good candidate
○Can use as a technique to transition to conversational level after traditional voice therapy
○Does not necessarily address vocal fold pitch range or work as a comprehensive vocal warm up
Infrahyoid muscle group
Attach from the hyoid to the structures below the larynx. They pull the larynx down as they contract
Sternothyroid
Sternohyoid
Omohyoid
What parameters observed during stroboscopy
Anatomy,
symmetry of arytenoid movement,
glottal closure,
subglottic component
What are the components of GRBAS
Rate each of the below parameters between 0 (normal) – 3 (severe)
Roughness
Breathiness
Asthenia (weakness)
Strain
0 = normal
1 = a trained ear would notice
2 = you could convince an untrained ear to notice
3 = an untrained ear would notice
No standardized instructions in English or scoring form
What is an efficient voice?
-Steady stream of airflow
-Acoustically optimal vocal tract
Voice Therapy Techniques:Laryngeal Massage
○Addressing tension in the thyrohyoid space
○Can perform with and without voicing
○Thyrohyoid space tends to squeeze shut in patients with muscle tension (primary or secondary)
○Can use monitoring the TH space for openness as biofeedback
○Would not recommend doing on a patient without appropriate supervision or practice
○Instructions:
■Finding the thyroid space
■From your adam’s apple, walk your fingers up from your hyoid bone walk fingers down
■Apply pressure downward onto the thyroid cartilage in a circular motion
■Move the larynx side to side
■Stretch the thyroid cartilage down and hold for 10 seconds
Thyrohyoid Muscle
This attaches from the hyoid bone to the thyroid and its contraction DEPRESSES the hyoid and RAISES the larynx
What are the muscles of INSPIRATION
Diaphragm,
External intercostals
What are the components of the CAPE-V?
1) Place a dash mark on the line for each attribute
2) Measure how far the line is in millimeters
3) X mm = the score for that attribute
4)Mark I or C (inconsistent or consistent)
5) Circle additional features
Voice Therapy Techniques: Resonant Voice
-Voice production involving oral vibratory sensations on the anterior alveolar ridge or lips or higher in the face
○It uses a continuum of oral sensations and easy phonation, building from basic speech gestures through conversational speech.
○The goal is to achieve the strongest, "cleanest" possible voice with the least effort and impact between the vocal folds to minimize the likelihood of injury and maximize the likelihood of vocal health
○The program incorporates humming and both voiced and voiceless productions that are shaped into phrase and conversational productions
Voice Therapy Techniques:Tongue Tension Reduction
○Addresses base of tongue tension
○Can target with or without voicing
○Can use mixed in with other techniques
○Tongue stretches include;
■Using gauze or paper towel
■Grabbing sides and far back of tongue (without stretching or touching frenulum)
Intrinsic Laryngeal Muscles
Interarytenoid
Lateral cricoarytenoid
Posterior cricoarytenoid
Cricothyroid
Thyroarytenoid
What are the muscles of EXPIRATION
Internal intercostals
Abdominal muscles
Shimmer
Measure of the cycle-to-cycle variations of amplitude
Norm: < .05 dB
Voice Therapy Techniques:Flow Phonation
○Focused on improving airflow
○When done correctly, resonance should be forward focused
○“whooooooo” and fricatives
Voice Therapy Techniques:Tongue Out Trills
Speaking with tongue out or humming
Range of Motion for quiet breathing
1.5cm
Jitter
Measure of the cycle-to-cycle variations of fundamental frequency
Norm: < 1.0%
Voice Therapy Techniques:Semi-Occluded Voice Therapy (SOVT)
○Narrowing at any supraglottic point along the vocal tract in order to maximize interaction between vocal fold vibration (sound production) and the vocal tract (the sound filter) and to produce resonant voice using the phonemes /z/, /v/, / ð/
Suprahypoid Muscle Group
*Don't Miss Goats So Go Hide*
They form a sling to support the hyoid and the larynx
Sometimes known as the elevators as they contract and pull the larynx up
Digastric
Mylohyoid
Geniohyoid
Stylohyoid
Genioglossus
Hyoglossus