Comps - Vb 1

Front 1

characteristics of nodules

Back 1

- most common benign lesions of VF, particularly young boys and adult women
- caused by chronic abuse of larynx and misuse of voice
- usually bilaterally located at anterior-middle third aspect of VF
- begin soft and pliable, gradually become fibrotic
- voice may sound fine in morning, deteriorate throughout the day
- cause breathiness due to incomplete VF closure
- lower pitch/hoarseness due to increased mass of nodules
- s/z ratio >1.4

Front 2

behavioral voice therapy for nodules

Back 2

- trial period recommended before surgery, as nodules commonly grow back
- therapy should address psychological support
found that children with voice disorders are likely to experience social and emotional handicap

Front 3

four point program for nodules

Back 3

- by Boone
- identify abuse-misuse
- reduce occurrence of it
- search for facilitating approaches for easy voice
- use best facilitating approach as practice method

Front 4

treatment approaches for nodules

Back 4

- confidential voice
- improve respiration, head-neck posture
- increase greater mouth opening
- increase hydration
- eliminate throat-clearing

Front 5

confidential voice

Back 5

- soft, non-whispering voice
- reduces vocal hyper-function, loudness, speaking rate
- improves breath control

Front 6

characteristics of polyps

Back 6

- benign unilateral lesion located anterior-middle third aspect of VF
- precipitated by one event of vocal misuse
- usually small and sessile, but may be red or white/large or small/sessile or pedunculated
- causes diplophonia (voice produced with two frequencies simultaneously due to irregular VF vibrations), lower pitch, rough, breathy quality

Front 7

treatment of polyps

Back 7

- surgery required
- may return without voice therapy to eliminate behaviors
- preferably patient receives therapy, then surgery, then continuation of therapy if necessary

Front 8

treatment approaches for polyps

Back 8

- glottal fry
- yawn-sigh
- nasal-glide stimulation

Front 9

types of vocal abuses

Back 9

- yelling/screaming
- coughing/throat clearing
- smoking
- excessive talking/singing/crying/laughing

Front 10

types of vocal misuse

Back 10

- using hard glottal attack
- singing too high or low pitched
- speaking too loud/cheerleading
- speaking or singing for excessive periods of time

Front 11

procedure for eliminating vocal abuse

Back 11

- identify abuse and baseline of occurrence, may require observation outside of clinic
- children may use Vocal Abuse Reduction Program
- discuss vocal abuse types and have client and family tally daily abuses
- have patient plot daily abuse on graph to encourage awareness

Front 12

Vocal Abuse Reduction Programs

Back 12

- developed by Boone
- explanation of lesions
- systematic reduction of child's abuses
- tally card, counting chart, hot-air balloon race

Front 13

types of functional disorders

Back 13

- psychogenic (falsetto, functional aphonia, functional dysphonia)
- excessive muscle tension disorders (MT dysphonia, nodules, polyps)

Front 14

muscle tension dysphonia

Back 14

- result of excessive laryngeal tension (through poor posture, misuse of neck/shoulder mucsles, high stress, loud or excessive voice use, LPR)
- associated with hyperfunction of true/false vocal fold vibratory patterns
- can be difficult to differentiate from other dysphonia (more consistent laryngeal postures, voiced/voiceless, speech/sustained vowels)

Front 15

types of MTD

Back 15

- primary MTD: occurs in the absence of organic/psychogenic/neurologic pathology
- secondary MTD: occurs in the presence of organic/psychogenic/neurologic pathology