Voice Disorders Final Exam
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97 questions
| 🇬🇧 | 🇬🇧 |
| Median, paramedian, lateral | What are the VF paralysis positions? |
| Close to midline or in the closed position | Definition of Median |
| Slightly open position | Define paramedian |
| Farthest from midline and in the open position | Define lateral |
| Problem.. 1VF cannot adduct (close) Position... 1VF remains open | Unilateral Adductor Palsy. What is the problem and what position is it in? |
| Problem... 1VF cannot abduct (open) Position... 1VF remains closed | Unilateral Abductor Palsy. What is the problem and what position is it in? |
| Breathy and reduced loudness | What does a patient with unilateral adductor palsy sound like? |
| Hoarse, harsh and diplophonia | What does someone with unilateral abductor palsy sound like? |
| Problem... VFs cannot adduct (close) Position.. VFs are open | Bilateral Adductor Palsy. What is the problem and position? |
| Problem... VFs cannot abduct (open) Position... VFs are closed | Bilateral Abductor Palsy. What is the problem and position? |
| Aphonic | How does a patient with bilateral adductor palsy sound? |
| Dyspnea, stridor and respiratory distress | How does a patient with bilateral abductor palsy sound? |
| Action induced or a task specific disorder the muscles and structures are normal at rest but move inappropriately with actions | What is spastic dysarthria? how do the muscles and structures look/move? |
| Psychogenic | What is the old therapy of spastic dysarthria? |
| Neurogenic, abnormal basal ganglia | What is the new theory of spastic dysarthria? |
| Problem... involuntary VF abduction Vocal quality... reduced loudness, pitch breaks, breathy, occasional aphonia | Abductor Spasmodic Dysphonia. Problem and how do they present? |
| Problem... tight and prolonged over adduction of the vocal folds Vocal quality... strain/struggle, choked | Adductor Spasmodic Dysphonia. Problem and how do they present? |
| Adductor spasmodic dysphonia (ADSD) | What disorder is most commonly known to be treated with botox injections? |
| 1. hysterical (conversation) aphonia 2. muscle tension dysphonia (MTD) 3. mutational falsetto | What are three psychogenic voice disorders (functional vice disorders)? |
| Abnormal voice but normal laryngeal structures... relies on psychologists and behavioral therapy | What is a psychogenic voice disorders (functional voice disorders)? |
| Loss is sudden or gradual after a traumatic/emotional event. significantly affects the person's quality of life | What is hysterical aphonia? |
| Similar to puberphonia BUT the larynx grows correctly | What is mutational falsetto? |
| Affect pitch | Damage to the SLN would do what? |
| Affects how the VFs move. May affect loudness, vibrations, hoarseness, breathiness | Damage to the RLN would do what? |
| Disruption of the integration/regulation of force, rate, speed and direction of movement, Harsh, hoarse and breathy vocal quality... reduced control of loudness | What are the main voice symptoms of ataxic dysarthria? |
| Neuritis/infections trauma neoplasm (tumor) vascular degenerative diseases | What are the different causes of neurogenic voice disorders? |
| Involuntary movements of the body and abrupt pitch and loudness changes and voice stoppages due to jerky VF movements | What are key findings of huntington's disease? |
| Reduced loudness, ROM or articulators and bradykinesia | What are key findings of parkinson's disease? |
| Myasthenia gravis | What disorders has vocal fatigue that improves from rest? |
| When the tumor is malignant | When is surgery needed? |
| T - tumor size (1-4) N- number of nodes that are invaded M- presence or absence of metathesis | The TNM --> tumor nodule status refers to what? |
| Injection and inhalation method | What are two methods of esophageal speech? |
| Patient takes air in their mouth and pushes it down into the esophagus with their tongue, then expelled for esophageal speech | What is the injection method of esophageal speech? |
| Patient inhales rapidly while keeping their UES open/relaxed and creates negative pressure in their esophagus to draw in air, which is then expelled for esophageal speech | What is the inhalation method of esophageal speech? (through the stoma) |
| - Larynx is removed - Breathes through stoma (permanent) - May wear larytube, a tracheostomy tube, or no tube - Cannot use a one-way valve - May use voice prosthesis | A laryngectomy results in... |
| Heats, humidifies and filters air. | The main functions of a heat and moisture exchanging device are.. |
| Stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease. | What is ankylosis? |
| Arthritis, trauma, joint disease | What can cause ankylosis? |
| Hoarseness , Breathiness , Low pitch | What would be the main perceptual vocal signs of an adult with papilomas? |
| Respiratory distress Chronic cough Weak cry Dysphagia Stridor | Infants with papilomas will have: |
| Laryngeal webs | Which organic disease could be acquired or congenital? |
| Incomplete maturation/ development of the larynx in utero | Laryngeal webs can be congenital due to ... |
| Surgery, trauma, severe laryngeal infection, forceful intubation | Laryngeal webs can be acquired due to.. |
| TEP because... Ease of use - vibratory source (PE segment) Most natural sounding Increases social interaction | Which Alaryngeal speech option is the best “gold standard” and why? |
| More susceptible to bacteria / needs to be changed often A lot of keep up and maintenance High cost (one-way valve) New way of breathing and talking | What are the disadvantages of TEP? |
| TEP, artificial larynx (electrolarynx), and esophageal speech | What are the three alaryngeal speech options? |
| The articulators and neck | An artificial larynx (electrolarynx) involves the use of.. |
| Easy to use Battery operated or USB vibratory source (external apparatus) Readily available | What are the advantages of an artificial larynx? |
| Unnatural sounding due to radiation or swelling External power source Need their hands | What are the disadvantages of an artificial larynx? |
| Stoma | When a laryngectomy patient coughs it goes through the ... |
| Stomas are too low A lot of upkeep and maintenance needed Health status - respiratory difficulties Co-morbidities: dementia | Why are some patients after a laryngectomy not good candidates for a TEP? |
| Most cost effective Use their own air and muscles → pharyngoesophageal (PE) segment No external apparatus | What are the advantages of esophageal speech? |
| Hard to learn least intelligible | What are the disadvantages of esophageal speech? |
| Increases VF closure, respiration and awareness that effort is needed Think Loud... PD | What is the purpose of the Lee Silverman Voice Therapy (LSVT)? |
| LSVT | What is the only vocal treatment method that requires the SLP to be certified |
| LSVT, VF adduction exercises | What vocal treatments target hypofunctioning of the VFs? |
| LSVT | What voice treatment is very intensive and targets the recalibration of the patients perception on how loud or soft they sound to other? |
| Botox | Which vocal treatment treats the hyperfunctioning of the VFs to help improve breathing? |
| Improve medial glottal closure aka VF closure increase intrinsic muscle strength and agility | What is the purpose of VF adduction exercises? |
| Muscle lesions or VF inflammation | VF adduction exercises should not be use with patients who have ... |
| Shaker | What vocal treatment method increases the strength and endurance of the suprahyoid muscles ? |
| Shaker | Which vocal treatment targets vocal pathologies with the following features Monopitch, reduced frequency range, age related vocal changes, swallowing patients |
| Isometric and isokinetic | What are the two procedures of the shaker treatment? |
| The primary muscles of phonation (vocal folds) | The shaker method does not target what muscles? |
| Raise the head for 60 seconds, keep it there and then rest (sustained) | The procedure of isometric for the shaker method is... |
| Raise your head and drop it 30x (repetitive) | The procedure of isokinetic for the shaker method is... |
| Reduce force of VF contact (hard attack) Reduce medial compression Increase coordination of airflow and phonation | What is the purpose of easy onset and yawn sigh ? |
| Easy onset | CASE STUDY : Andrew, 19 years old, is being treated for bilateral vocal nodules due to an abundance of vocally abusive behaviors. In addition to counseling about good vocal hygiene, which other voice therapy technique would be best for him? |
| Lessac- Madson Resonant Voice Therapy | CASE STUDY: Mr. Mack is a 5th grade school teacher and has developed polyps due to ongoing vocally abusive behaviors. Asking him not to use his voice would be inappropriate due to his occupation. Which treatment technique would be best for him to learn. |
| Eliminate effects of vocal fold injury by configuring the larynx and surrounding structures to reduce the level of respiratory effort and impact of stress on the vocal folds | The purpose of Lessac- Madson Resonant Voice Therapy is to ... |
| Those who are teachers and singers.... those who have benign vocal lesions, bowing, paralysis, nodules, polyps, or dysphonia | Lessac- Madson Resonant Voice Therapy is commonly used amongst .. |
| Pitch | The most prevalent vocal features for sex identification for transgender voice therapy is |
| Modify the individuals pitch, resonance and prosody to match their gender expression not typically due to a voice disorder | The purpose of Transgender Voice Therapy is.. |
| To manage airflow for those who tend to have breath-holding tendencies | Stretch and flow exercises target... |
| Stretch and flow exercises (uses a tissue) | What treatment provides bio feedback? |
| Functional dysphonia, aphonia, muscle tension dysphonia | Common populations associated with stretch and flow exercises are.. |
| - COPD, Parkinson’s Disease, MS, Spinal cord injury - Reduced respiratory muscle strength | Common populations associated with expiratory muscle strength training |
| Reduce force of VF contact Reduce medial compression Reduce laryngeal tension | The purpose of confidential voice is to... |
| FASLE!! it will cause more tension.. just work on soft/breathy voicing through relaxation | TRUE/FALSE.. you want your client to whisper for confidential voice? |
| Gives steps to combine auditory-perceptual cues with knowledge of anatomy/physiology to be able to novel vocal qualities. | The purpose of Integrated Implicit-Explicit Approach |
| The motor learning theory | The Integrated Implicit-Explicit Approach is prompted by .. |
| Naturally humidify the vocal folds to reduce ventricular phonation | The purpose of inhalation phonation/singhale is to... |
| Lombard Effect | CASE STUDY: Mrs. Miller, 58 years old, presents with functional aphonia characterized by normal laryngeal anatomy, but atypical voice quality (speaks only in a whisper). She is not always compliant in therapy, but continues to show up because her social life is being negatively affected. When asked to increase her volume when speaking she is unable to. Which treatment technique would be best to increase her volume? |
| When the patient's voice becomes louder in the presence of background noise (masking) | What is the purpose of the lombard effect? |
| Identify and modify or eliminate behaviors and environmental factors that caused (or may cause) a voice disorder | What is the goal of vocal hygiene? |
| NO | Is it adequate to use vocal hygiene techniques alone? |
| Lack of progress Improved vocal quality acceptable to the patient Elimination / reduction in pathology Elimination of physical symptoms | Why would we terminate voice therapy? |
| Goals for therapy Commitment to attending sessions Keeping family engaged at therapy sessions & home Challenges with pediatric patients Fatigue & Frustration levels | 5 Factors to Consider when starting Voice therapy: |
| Provide education to the family and caretakers Encourage increased self awareness Encourage frequent practice | Three General guidelines for Voice Therapy: |
| Awareness of problem Willingness to participate in treatment and practice Willingness to eliminate harmful behaviors Voice problem General Health | What are the factors determining prognosis? |