Random
Which is better diaphragmatic breathing or clavicular breathing?
Diaphragmatic because it is the most efficient.
Clavicular is not and is associated with hypertension and the strain in using the neck muscles is counterproductive in relaxing the upper thoracic area.
What is normal pitch changes during puberty called?
Stormy mutation period
What are the 3 classifications of voice disorders?
Organic
Neurogenic
Functional
Describe the difference between phonation and pitch breaks
Phonation breaks: Spontaneous abduction of the vf's during connected speech
Pitch breaks: Sudden shift in pitch caused by transient dysphonia or vocal fatigue and overuse
What are the 3 classifications of perceptual problems of the voice
Pitch
Intensity
Quality
What is the standardized tool used to assess voice?
CAPE-V
If the vf's are stretched, and there is high tension, thin, and less mass the pitch will be ___.
If the vf's have more mass, have low tension, the pitch will be___.
higher
lower
What is the difference between Primary MTD and Secondary MTD?
Primary: Have normal laryngeal structures, patients report some discomfort phonating, vocal fatigue and some hoarseness, if not voice changes are noticed they will not see an SLP
Secondary: Continued hyperfunction with continued misuse that now results in dysphonia and changes in the structures. VF swelling, nodules, change in vocal ligament ect.
Which organic voice disorder results from atypical vf posture and an ability to only whisper?
List question to ask in a case history
How long has the prob lasted?
Sudden or gradual onset?
What are their feeling/attitudes towards it?
When is the prob the best or worst?
Drink enough water?
Too much caffeine? Smoke?
Medications?
What is the only ABductor intrinsic laryngeal muscle?
Posterior Cricoarytenoid
Fundamental frequency at birth
500Hz
Describe Reinke's Edema
Build up of fluid and swelling in the superficial lamina propria (Reinke's Space) from misuse/over valving
Results in lower fundamental frequency
From smoking, GERD, LPR
Which neurological voice disorder consists of involuntary movement of the vocal mechanism and can be either adductor type or abductor type or a combination of both?
Spasmodic Dysphonia
Voice spasms=spasmodic dysphonia
Air pressure is associated with__
Air flow is associated with___
Loudness
Quality
What is the primary intrinsic laryngeal muscle for pitch adjustment and is also known for raising pitch?
Cricothyroid
If voice is a secondary function of the larynx, what is the primary function of the larynx?
Protect the airway.
Others: push/pull and build up pressure
Describe Contact Ulcers (granuloma)
occurs on posterior portion of vf's
functional or organic cause
from misuse/overvalving or GERD
unilateral, gets bigger then develops granuloma tissue then falls off
(do not get surgery to remove this as it will come back)
Which rare voice disorder consists of blood filled sacs on the vf's from an organic or functional cause?
Hemangioma
What is s/z ratio?
measures how long patients can sustain /s/ and /z/
s measures expiratory control
z measures phonatory control
used to test quality
want a 1:1 ration, if 1.2 or above that means probably vf pathology
Describe features of presbephonia
muscular atrophy
thinning and dehydration of the mucosa
calcification of the cartilages
edema
Males fund freq goes up
Sarcopenia (loss of muscle and tissue as you age)
flaccidity= reduced tone
bowing the the vf's
What muscle forms the bulk of the muscular process of the vf's?
Thyroarytenoid
Describe the difference between Vocal Nodules and Polyps
Nodules: There are 2 (bilateral), cause from misuse/overvalve, ant 1/3, post 1/3, white bulges, go from gelatinous to hard and callus-like
Polyps: Unilateral, ant 1/3, post 1/3, caused from single event (concert, yell), gelatinous
Which organic voice disorder is caused by HPV that develops wart-like growths?
Papilloma
What is shimmer and jimmer?
They both measure cycle to cycle variability, they test irregularity of vf vibrations
shimmer=loudness (amplitude)
jimmer=pitch (frequency)