Hcom 472 Management And Therapy For Special Problems

Front 1

there is a vast difference between the voices of younger aged persons__to____yrs and older aged persons (over 80 years)

Back 1

65 to 80 years

Front 2

the voices of “fit aged” do not differ significantly from those of

Back 2

younger subjects

Front 3

voice changes in the aged are more likely to be influenced by

Back 3

disease rather than by physiologic aging.

Front 4

The elderly are a ________ group group and represent the fastest growing segment of the U.S. population

Back 4

hereterogeneous (, with the over-85 group showing the largest percentage increase of any population segment. )

Front 5

TRUE OR FALSE
that there are some generalized characteristics of the voices of aged people that lead to their identification as older subjects.

Back 5

TRUE

Front 6

The female voice continues to _______ in FUNDAMENTAL FREQUENCY ) throughout the life span;

Back 6

LOWER

Front 7

the male Fundamental frequency begins to ______ slightly in the sixties and in each decade after that.

Back 7

RISE in the 60's

Front 8

TRUE OR FALSE
There is LESS (FO)Fundamental frequency variability among both aged females and male speakers.

Back 8

FALSE
GREATER
There is greater FO variability among both aged females and male speakers.

Front 9

TRUE OR FALSE
voice is among the distinguishing factors displayed between younger and older people

Back 9

FALSE
voice is NOT among the distinguishing factors displayed between younger and older people

Front 10

Direct work on improving respiratory efficiency can help the older people develop better ?

Back 10

EXPIRATORY control, perhaps saying more words per breath.

Front 11

TRUE OR FALSE
If hearing loss is severe enough in both children and adults, it will NOT affect voice

Back 11

FALSE
If hearing loss is severe enough in both children and adults, it WILL affect voice

Front 12

If hearing loss is severe enough in both children and adults, it will affect voice as well as have obvious effects on ?

Back 12

on speech (prosodic and phonologic changes)

Front 13

Severe hearing loss will impact?

Back 13

LANGUAGE acquisition and usage in younger children

Front 14

Congenital hearing loss takes the greatest toll on ?

Back 14

VOICE

Front 15

TRUE OR FALSE
Having never heard spoken language like their normal hearing peers, is severely hard of hearing will show severe voice-speech symptoms.

Back 15

TRUE

Front 16

, the severely hard-of-hearing person will often speak at a what rate of speech ?

Back 16

at a SLOWER rate of speech
show some VARIATION in the MELODIC PROSODY of spoken language

Front 17

TRUE OR FALSE

There is a growing number of children and adults who, after a lifetime of severe hearing loss, have their hearing partially or wholly restored by successful cochlear implants.

Back 17

TRUE

Front 18

NAME the two voice abnormalities that can be modified by direct voice therapy.

Back 18

elevated pitch and excessive variability

Front 19

The higher voice pitches found in the speaking voices of both prepubertal and postpubertal hard of hearing children suggest that not hearing the voices of others in their environment leads to using what type of voice pitches than their age peers?

Back 19

HIGHER voice pitches than their age peers

Front 20

TRUE OR FALSE
The anatomical and physiological characteristics of the larynx and vocal folds are the same in both hearing and hard of hearing children.

Back 20

TRUE THE SAME

Front 21

The professional user of voice, exerts unusual demands on what aspects of voice?

Back 21

respiration-phonation resonance

Front 22

TRUE OR FALSE
We use the term professional voice for people whose primary occupation competence (and probable success) is shaped by their voices.

Back 22

TRUE

Front 23

One of the obstacles we experience in working with the professional voice user is the relative “performance innocence” of ?

Back 23

the teacher or clinician.
(The professional uses his or her voice often beyond the normal limits we generally associate with heavy voice use. The teacher or voice clinician who has never performed beyond these supposed limitations may experience difficulty convincing the performer about what to do to correct a voice problem. )

Front 24

Another obstacle to working successfully with the professional voice user is the lack of meaningful ________between the performer and the clinician.

Back 24

LANGUAGE

Front 25

The diplophonic voice is

Back 25

usually produced by TWO DISTINCT VOICING sources, each phonating SIMULTANEOUSLY with the other.

Front 26

Occasionally, diplophonia is produced by the true folds-if?

Back 26

ONE of the folds has a different MASS and TENSION from the other one.

Front 27

in persistent paralytic dysphonia, the patients voice may sound diplophonic as the paralyzed folds vibrates at what rate and why?

Back 27

FASTER
paralyzed folds vibrates faster because of its thinner mass (as a result of lower motor neuron atrophy

Front 28

WHAT is The first step in treating a diplophonia?

Back 28

to IDENTIFY the DOUBLE-VOICE source
(Video nasoendoscopy has been an excellent tool for examining the vocal tract, attempting to identify an extra phonation source.

Front 29

WHAT is The first consideration in the treatment of diplophonia?

Back 29

whether or not the second sound source can be reduced or eliminated. Surgical eradiction of a unilateral additive lesion, for example might bring the two vocal folds into size compatibility.

Front 30

TRUE OR FALSE
During the last months of puberty, some girls experience a one-octave pitch break (the voice breaks upward) as they are using conversational voice.

Back 30

FALSE-BOYS not GIRLS
During the last months of puberty, some BOYS experience a one-octave pitch break (the voice breaks upward) as they are using conversational voice.

Front 31

TRUE OR FALSE
IF boys experience a one-octave pitch break (the voice breaks upward) as they are using conversational voice. There is no need for voice therapy, because this kind of pitch break is temporary.

Back 31

TRUE

Front 32

The second kind of pitch break is related to continuous vocal ?

Back 32

HYPERfunction, particularly prolonged speaking at an inappropriate pitch level.

Front 33

WITH PITCH BREAKS Elevating pitch one or two notes usually?

Back 33

Eliminates the problem.

Front 34

With PITCH BREAKS what usually eliminates the problem?

Back 34

Elevating pitch one or two notes

With the new pitch level, the patient might profit from developing a voice legato with chant talk, using a relaxed voice with chewing, practicing yawn-sigh, eliminating hard glottal attack, and attempting the open-mouth approach.

Front 35

In asthma, the patient experiences what with their airway tubes, particularly in the bronchi and bronchioles,

Back 35

NARROWING
which limits the free passage of air.

Front 36

Spasms of the airway can be caused by ?

Back 36

external smooth muscles going into spasm, causing a narrowing of the opening.

Front 37

TRUE OR FALSE
The speech-language pathologist does not usually encounter the patient during severe respiratory obstruction.

Back 37

TRUE

Front 38

Most people with asthma are free of symptoms most of the time, experiencing occasional bouts of wheezing and shortness of breath. Depending on the frequency and severity of respiratory struggle, some patients experience what with their voice?

Back 38

some hoarseness and breakdown in normal voicing prosody

Front 39

When respiratory symptoms are under some control, the voice clinician may help the patient develop and use what type of voice?

Back 39

FUNCTIONAL VOICE

Front 40

for asthma patients Phonation can often be helped by reducing the number of ?

Back 40

syllables the patient says on one breath.

Front 41

TRUE OR FALSE
Among various chronic pulmonary diseases experienced by the adult population, emphysema is NOT the most common.

Back 41

FALSE-IS THE MOST COMMON
Among various chronic pulmonary diseases experienced by the adult population, emphysema is the most common.

Front 42

The primary cause of emphysema is?

Back 42

smoking or from continuous exposure to smoke-laden dust.

Front 43

with Emphysema The continuous smoke exposure in the lungs causes the alveolar walls to?

Back 43

to LOSE their ELASTICITY, COLLAPSING on pulmonary EXPIRATION

Front 44

TRUE OR FALSE
with Emphysema Voice management can only begin BEFORE the patient stops smoking.

Back 44

FALSE AFTER
Voice management can only begin after the patient stops smoking.

Front 45

WITH EMPHYSEMA Formal respiratory therapy for these patients is better left in the hands of ?

Back 45

the respiratory therapist or other pulmonary specialists.

Front 46

WITH EMPHYSEMA Some directed practice with what type of breathing in the sitting or standing position may be useful?

Back 46

practice in diaphragmatic-abdominal breathing
(as well as practice in counting syllables per utterance in an attempt to become more aware of when to renew breath. )

Front 47

Some children and adults appear in the clinic with faulty breath control, either caused by what type of disease?/ or from functional causes, or both

Back 47

ORGANIC
by some organic disease or from functional causes, or both.

Front 48

TRUE OR FALSE
WITH FAULTY Breath Control , there may be a functional overlay to an organic respiratory disorder that can be directly treated, improving overall respiratory function as well as better breath support for voice.

Back 48

TRUE

Front 49

TRUE OR FALSE

What we do with voice problems or with respiratory problems DOES NOT have to be consistent with the limitation imposed by various respiratory diseases and treatments that patient may be receiving from other professionals.

Back 49

FALSE

What we do with voice problems with respiratory problems MUST BE consistent with the limitation imposed by various respiratory diseases and treatments that patient may be receiving from other professionals.

Front 50

WITH FAULTY BREATH CONTROL The clinician should be not preoccupied with the presenting disease problem, but face the patient more generically, as a person with a?

Back 50

VOICE DISORDER that shows itself in various pitch-loudness-quality dimensions.

Front 51

A tracheostomy is and may be necessary when?

Back 51

external opening into the trachea, may be necessary when an individual experiences respiratory difficulties due to an obstruction of the upper airway, has problems with pulmonary toilet (managing secretions), or requires mechanical ventilation to maintain adequate respiration.

Front 52

Cysts in the larynx are usually which direction, occuring where and representing an abnormality of?

Back 52

UNILATERAL
, occuring on the vocal folds (inner margin, superior, or inferior surface) or anywhere on the venticular folds, representing an abnormality of the ductal system of laryngeal mucous glands.

Front 53

CYSTS in the larynx represent an abnormality of?

Back 53

DUCTAL SYSTEM of LARYNGEAL MUCOUS GLANDS

Front 54

vocal nodules appear/look like/feel?

Back 54

the hard, fibrotic structure

Front 55

CYSTS APPEAR/look like/feel?

Back 55

appears soft and pliable

Front 56

with cysts The speech-language pathologist who identifies any kind of laryngeal lesion should refer the patient to ?

Back 56

an otolaryngologist
This is especially true for cysts because their management requires surgical excision rather than voice therapy

Front 57

TRUE OR FALSE
CYSTS require surgical excision rather than VOICE THERAPY

Back 57

TRUE

Front 58

Laryngeal granuloma may or may not contribute to ______ , depending on the site and type of granuloma

Back 58

VOICE SYMPTOMS

Front 59

Vocal fold granuloma is composed of ?

Back 59

rough, granulated tissue that develops reactively to some kind of mucosa trauma, usually situated more toward the POSTERIOR Glottis.

Front 60

Vocal fold granuloma is usually situated more toward which direction of the GLOTTIS?

Back 60

POSTERIOR GLOTTIS

Front 61

Tracheal intubation often leads to what type of granuloma?

Back 61

to postintubation granuloma

Front 62

TRUE OR FALSE
postintubation granuloma is more prevalent in females than males

Back 62

TRUE
(believed to be the result of smaller airway openings in females during surgical intubation

Front 63

Occasional patients develop vocal fold granuloma from severe voice?

Back 63

ABUSE
They may or may not also be experiencing some LPR, which aggravates the problem.

Front 64

The site of granuloma is usually on what part of the tissue covering the vocal process end of the arytenoids.

Back 64

granuloma found usually on MEMBRANEOUS tissue covering the vocal process end of the arytenoids.

Front 65

TRUE OR FALSE
Many children and adults with dysphonia experience laryngopharyngeal reflux which contributes to their voice problems.

Back 65

TRUE

Front 66

The most severe reflux is often experienced at what time of day or night?

Back 66

NIGHT
, causing heartburn, or occassional choking in which the patient experiences acid in the pharynx, sometimes aspirating acid into the larynx.

Front 67

Among the physical findings on laryngeal examination of reflux certain physical attributes are discovered name a few.

Back 67

posterior glottal redness, contact ulcers, pharyngeal irritation and arytenoid hyperplasia with possible granuloma.

Front 68

TRUE OR FALSE
WITH REFLUX The patient on questioning may be unaware of any symptoms related to LPR/EER; this is especially true among children.

Back 68

TRUE

Front 69

REFLUX: The SLP usually encounters the dysphonic patient with LPR/EER initially at the time of the ?

Back 69

VOICE EVALUATION

Front 70

NAME A FEW facilitating approaches that help a reflux patient maintain a functional voice.

Back 70

Helping the patient reduce throat clearing and nonproductive coughing (more often habit than mucous producing), developing easy glottal attack, changing throat focus to facial mask focus, and sometimes elevating voice pitch one or two half-notes

Front 71

Sulcus Vocalis: Sulcus is a generic term that means?

Back 71

furrow or identation

Front 72

. In sulcus vocalis, on endoscopy or stroboscopy we see a furrowed medial edge of the ?

Back 72

VOCAL FOLD
usually bilaterally symmetrical, with the entire length of the vibrating folds in a spindle configuration.

Front 73

TRUE OR FALSE
The SLP today sees more patients with sulcus vocalis than in former years.

Back 73

TRUE

Front 74

IN EXAMINING FOR SULCUS VOCALIS using what type of examination were many of these abnormalities missed?

Back 74

MIRROR EXAMINATION

Front 75

videostroboscopy permits close examination of vocal fold cover adnormalities; with sulcus vocalis, when the folds are

Back 75

ABDUCTED

Front 76

WITH SULCUS VOCALIS we can often idetify the mucosa wave on ADDUCTION OR ABDUCTION on phonation?

Back 76

Adduction
we can see the compromised muscosal wave produced by the stiff, compromised lamina propria.