How Voice Works

Front 1

Bernoulli Effect

Back 1

air pushes through the vocal folds, adducts them

Front 2

myoelastic aerodynamic theory

Back 2

I don't know

Front 3

Tidal Breathing

Back 3

the amnt of air movement during quiet breathing to sustain life (1/2 liter of air is inhaled.)

Front 4

Speech Breathing

Back 4

during speech breathing, a person may inhale as much as 2 liters of air

Front 5

vital capacity

Back 5

total amnt of controllable air in the lungs

Front 6

residual volume

Back 6

air remaining after exhalation

Front 7

the primary role of respiratory system

Back 7

during speech, its goal is to control vocal intensity (loudness)

Front 8

Resonance

Back 8

the acoustic phenomenon by which a sound source excites air in an air filled chamber to vibrate.

Front 9

Quality and loudness aspects of the voice

Back 9

can be attributed to the unique arrangement of the supraglottic resonators

Front 10

Anatomic structures of resonance

Back 10

-oral cavity
-nasal cavity
-soft palate
-Pharynx (nasopharnyx, oropharynx, Laryngopharynx)
-the role of velopharyngeal closure

Front 11

How do you get someone to decrease perceived hypernasality?

Back 11

have them open their mouth wider, you're using more oral resonance that way.

To identify hypernasality, get them to say "puppy", then close nairs and say it again, if it sound's different, they need some work

Front 12

stridor

Back 12

inhalation, exhalation, straining noise at vfs

Front 13

Thyroid cartilage

Back 13

idk

Front 14

thyroid cartilage

Back 14

largest cartilage of larynx (the largest prominence is the adam's apple)

Front 15

cricoid cartilage

Back 15

signet shaped

Front 16

Larynx parts

Back 16

-thyroid cartilage
- cricoid cartilage
- epiglottis
- arytenoid cartilage
-hyoid bone

Front 17

epiglottis

Back 17

large leaf shaped (no function for speech)

Front 18

Arytenoid cartilages

Back 18

pair-pyramid shaped

Front 19

hyoid bone

Back 19

point of attachment for laryngeal and tongue musculature.

Front 20

muscles of the larynx

Back 20

-vfs
-supplemental muscles
-extrinsic laryngeal muscles
-intrinsic laryngeal muscles

Front 21

Vocal Folds

Back 21

pair of thyroarytenoid muscles attached to thyroid and arytenoids

Front 22

Functions of Vfs:

Back 22

-adduction
-abduction
-glottis
-phonation
-aerodynamic-myoelastic theory
bernoulli effect

Front 23

adduction

Back 23

come together

Front 24

abduction

Back 24

pull apart- sole muscle is posterior crycoarytenoid

Front 25

glottis

Back 25

opening between vfs

Front 26

phonation

Back 26

vf vibration

Front 27

aerodynamic theory

Back 27

interplay of aerodynamics and muscle force

Front 28

bernoulli effect

Back 28

subglottic air pressure causes out and upward movement and vf are blown apart. air rushing through causes it.

Front 29

physiology of voice

Back 29

-fundamental freq.
-pitch
-habitual pitch
-optimal pitch
-loudness is measured in dB

Front 30

fundamental freq.

Back 30

speed of vf vibration

Front 31

pitch

Back 31

the perceptual counterpart to fundamental freq. (fo) measured in Hz or the number of complete vibrations per second

Front 32

habitual pitch

Back 32

average fo (the actual pitch one uses for speech)

Front 33

optimal pitch

Back 33

suitable pitch level. adult male ave: 125 Hz, adult female ave: 200 Hz. (not disordered)

Front 34

loudness

Back 34

measured in dB

Front 35

Respiratory system

Back 35

can be divided into 2 parts:
-upper resp. tract
-lower resp tract

Front 36

upper respiratory tract

Back 36

trachea, 2 bronchi, and the lungs???/

Front 37

lower respiratory tract

Back 37

trachea, 2 bronchi, and the lungs???//

Front 38

pulmonary system

Back 38

consists of trachea and lungs

Front 39

muscles for breathing are divided functionally for inhalation and exhalation

Back 39

?

Front 40

diaphragm

Back 40

most important single muscle, thin, dome shaped muscle and tendon that seperates.

Front 41

CREM

Back 41

-Credentials
-Respect (you respect your client, they respect you)
-Education (continually educate yourself and your client too)
-Motivator (you motivate them, both of you-therapist and client must be motivated)

Front 42

Inhalation

Back 42

intercostal muscles

Front 43

dysphonia

Back 43

voicing is inconsistent, voice is in and out

Front 44

aphonia

Back 44

complete loss of voicing

Front 45

harshness

Back 45

energy and attack that one uses

Front 46

aphonic break

Back 46

loss of voicing during speech

Front 47

pitch break

Back 47

spikes in pitch

Front 48

tremor

Back 48

old people trembly voice, neurological problem

Front 49

diplophonia

Back 49

2 pitches, can hear both high and low at same time

Front 50

glottal attack

Back 50

abrupt tension to all sounds

Front 51

strained/ strangled

Back 51

often neurological, spasmodic disphonias

Front 52

glottal fry

Back 52

?

Front 53

vocal tension

Back 53

you can even see it, like with a whisper

Front 54

deterioration

Back 54

start strong, voice deteriorates

Front 55

rating scales

Back 55

- GRBAS scale
- consensus auditory
- voice handicap index

Front 56

GRBAS scale

Back 56

evaluates:
grade,
rough,
ashenic (weak),
breathy,
strained

Front 57

consensus auditory

Back 57

perceptual evaluation of voice (CAPE-V) (Asha 2003)

Front 58

functional voice assessment

Back 58

-acoustic and aerodynamic assessment
-examination of oral structures
-visualization of laryngeal structures

Front 59

Acoustic Analysis

Back 59

-uses instrumentation to analyze properties of a sound wave
-data compared with normative data
-visi-pitch and CSL

Front 60

Acoustic analysis provides measures of:

Back 60

-freq (pitch)
-amplitude/intensity (volume)
-disturbance (perturbation)

Front 61

frequency (pitch)

Back 61

-measures of vibration (Hz)
-fundamental frequency (lowest freq of the voice)

Front 62

Amplitude/ intensity (volume)

Back 62

males: 77.8 dB
females: 74.0 dB

Front 63

Disturbance (perturbation)

Back 63

-refers to disturbance in the regularity of the waveform
-disturbances reflect changes in mass, tension, or vibratory characteristics of the folds from one cycle to the next.
-correlates to perceived roughness or harshness

Front 64

Jitter

Back 64

short term analysis of cycle to cycle variation in fundamental freq.

Front 65

shimmer

Back 65

short term evaluation of cycle to cycle variation in amplitude. Reflects changes in intensity

Front 66

Harmonics to Noise Ratio (HNR)

Back 66

other recommended tasks: record a conversational and reading sample- rainbow passage, my grandfather- mic held approximately one inch from mouth.

Front 67

aerodynamic assessment

Back 67

airflow measurement (spirometry)

Front 68

glottal airflow

Back 68

to measure vocal efficiency

Front 69

measures of vibratory cycle

Back 69

glottal waveform analysis

Front 70

non- instumental assessment

Back 70

-pitch range
-maximum phonation time (MPT)
-s/z ratio
-speaking rate

Front 71

pitch range

Back 71

using a pitch pipe or keyboard. low-to-high. the norm is 2 to 3 octaves

Front 72

maximum phonation time (MPT)

Back 72

sustain a vowel. 3 trials, norm is 15-20 secs (mine is 13-19)

Front 73

s/z ratio

Back 73

should be 1:1 ratio

Front 74

speaking rate

Back 74

words per minute, norm for reading 210-265 WPM, speaking 115-165 WPM

Front 75

Vocal tract visualization

Back 75

-indirect (laryngeal mirror)
-direct visualization (fiberoptic laryngoscopy, rigid laryngoscopy, videolarygealstroboscopy (VLS)

Front 76

Clinical report writing

Back 76

-only a physician can render a medical dianosis
- SLPs provide assessment of vocal quality and vf functioning
-describe structural findings as "suggestive of" or "consistent with"

Front 77

recommendations

Back 77

-independent of ENT include: re-evaluation by ENT, review of examination w/ ENT for medical managements
-voice therapy include dx, specific number of sessions, and duration for approval/authorization of insurance.

Front 78

vibration theories

Back 78

- myoelastic aerodynamic theories
- bernoulli effect
- mucosal wave

Front 79

mucosal wave

Back 79

-not only do the vfs vibrate, but there is additional movement of the surface of the cords
-vf are comprised of muscle and mucosa
-the mucosa is divided into the lamina propria and the epithelium,
-there are 3 layers of the lamina propria, all three are diff density, elasticity, and strength
-during vibration, they move in a wave-like manner

Front 80

descriptions of voice disorders

Back 80

-functional
- organic
-neurological

Front 81

functional vds

Back 81

result from behaviors or reactions to traumatic events. functional describes the etiology of the voice problem that exists in the absence of pathology.
- pathology is a structural or functional change that occurs from a disease process
-the voice problem is related to misuse of the mechanism
-hyperfunction: over use
-hypofunction: weak, reduced voice

Front 82

organic vds

Back 82

caused by some physical condition that has impacted the structure of the larynx.
-related to changes in the anatomy of histology of the larnygeal tissue. changes result in a change in the voice
-organic pathology can result from a functional disorder
-nodules is an example.

Front 83

neurological vds

Back 83

result from damage to the central (brain and spinal cord) nervous system or the peripheral (cranial nerves) nervous system.
-results from an interruption in neuromuscular control. there can be a complete absence of movement or a loss of coordination of movement.

Front 84

characteristics of a voice disorder

Back 84

-difficulty initiating or controlling the voice
- pitch: controlled by tension which effects how the vfs vibrate (too high or low)
-loudness- too weak or too loud
-quality:deviations in hoarsness or nasality, problems can exist by themselves or in any combo. (in tandem)

Front 85

prevalence

Back 85

voice disorders are heard frequently in the adult population 6-10%.

Front 86

voice subsystems

Back 86

-breathing-asthma, cancer, emphysema
-oral cavity- deviant structures
-nasal cavity- deviant structures (deviated septums)
-articulation- manner

Front 87

what constitutes a voice disorder

Back 87

-indentified by the person who uses it.
- does it effect daily life
- define what is normal
-medical diagnosis is required

Front 88

pitch

Back 88

-mono-pitch
-inappropriate pitch
-pitch breaks
- reduced ranged

Front 89

mono-pitch

Back 89

lacks vibration, inability to, involuntary control pitch

Front 90

inappropriate pitch

Back 90

either too high or too low for age, sex, size

Front 91

pitch breaks

Back 91

unexpected sudden shifts in pitch either upward or downward

Front 92

reduced range

Back 92

loss of ability to produce high or low pitch

Front 93

loudness

Back 93

-mono loudness
- reduced variation
-reduced loudness range

Front 94

mono-loudness

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lacks vibration in volume

Front 95

reduced variation

Back 95

voice may be too soft or too loud (could indicate a psychological problem, auditory dysfunction or habit)

Front 96

reduced loudness range

Back 96

usually the inability to produce a loud voice

Front 97

quality difficulties

Back 97

-horse and rough
-breathy
-tension
-tremor
-strain/struggle
-diplophonia
-stridor
-excessive throat clearing
-aphonia

Front 98

horse and rough voice quality

Back 98

lack of clarity, increased noisiness and discordance

Front 99

breathy

Back 99

audible air escape

Front 100

tension

Back 100

"hard-edge" hard glottal attack, observable muscle tension, in most cases related to hyperfunction.

Front 101

tremor

Back 101

rhythmic variations in pitch and loudness that are not under voluntary control.

Front 102

strain/struggle

Back 102

difficulty initiating phonation or difficulty maintaining voicing, voice may fade in or out. complete stoppages may occur (Aphonia), may indicate some type of neurological etiology

Front 103

diplophonia

Back 103

"double voice" when 2 distinct voices occur at once

Front 104

stridor

Back 104

noisy breathing. Involuntary

Front 105

aphonia

Back 105

episodic or inconsistent breaks in voicing

Front 106

nodules

Back 106

vocal abuse, vocal load cause these callouses- behavioral therapy is usually best- the best voice is the one that takes the least amnt of effort to produce. occurs on anterior 1/3rd of vfs

Front 107

polyps

Back 107

occur because of viruses. sometimes have to be surgically removed, kind of like blisters. speech is often breathy.
therapy- typically medical removal.
cause: can be caused by trauma to the vfs (one event usually).
-sessle polyps can also be peunculated.

Front 108

vf hemorrhage

Back 108

caused by misuse, some times related hormonally- female singers sometimes

Front 109

renike's edema

Back 109

strictly from smoking cigaretts voice sounds deeper in pitch, raspy, breathing pitch is called by length and mass of vfs (might even have stridor- noisy breathing- like Nadine)

Front 110

laryngitis

Back 110

need to stop talking during horse voicing. sometimes these start- all the disorders w/ laryngitis they thicken.

Front 111

granuloma

Back 111

contact granulomas.
-causes- intibated during surgery, will go away, make you horse, it's just irritation and rubbing on vfsm usually happens posteriorly, breathing voice because of ill closure, deeper pitch from more mass

Front 112

cancer

Back 112

often occurs w/ hemmorhaging

Front 113

vf bowing or presbylaryngis

Back 113

assymetry in upper part of larynx

Front 114

spasmotic dysphonial

Back 114

doesn't respond to voice therapy.