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61 Cards in this Set

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  • Back
Voice
tone generated by the vibration of the vocal folds
protective functions of the laraynx
Closing airway to protect the lungs
Impounding the breath for increasing internal abdominal pressure
Opening the airway to allow easy inhalation and exhalation
Cartilages of the larynx
Thyroid cartilage
Arytenoid cart
Carcoid cart
Trachea
Myo-elastic-Areo-dynamic theory
Sub glottal air pressure builds up till the air comes out
Bernoulli effect- when air russhes past the folds and causes a partial vacum in which they slap together
European theory
Neuro-chronaxic therory
More scientific
Says that nerves intervate the vocal cords and cause them to vibrate
americans
nature of voice
Pitch
Loudness
quality
Pitch vs frequency
FREQUENCY
Measured in hz
Men = 120Hz
Woman= 200 Hz
pitch stats
9-20 semitones to convey emotional meaning in speech
Some singers have up to 36
Vocal folds move constantly to
Speakers emotional intent
Speakers end of a sentence
Stressing words for emphasis
Asking a question
What is a voice disorder?
Disturnbed laryngeal quality
Horsness, harsness, or
Hypernasality/denasality (hyponasality)
Too soft or too loud
Too high or low for age, size, cultural background or gender
Inappropriate stress and intonation patterns
No voice - aphonia
Pain or fatigue in laryngeal area
Laryngoscopic exam
Pic of doc looking into mouth with mirror
endoscope exam
A computer system in which the doc shoves a thing down the throat and they spray the back of ur throat
Takes a video of vocal cords..special video b.c vocal cords move so fast
Vocal nodules
More common in boys
But in adolecenst more common in girls
Calousus happen in anterior 1/3, and are bilateral
vocal polyps
Fluid filled
Unilateral
White
Caused by vocal abuse
Pic of pedunculated one (stalk/mushroom looking)
Sesile polyps are like the length of cord
Contact ulcers
Mostly in the back
Bilateral
Painful!
usually in men over 40
After surgery they return
Functional voice disorders of the larynx
Attributed to
Excessive + abuse
Uris
Allergies
Asthma
Tobacco and alcohol
Infections laryngitis
when upper respitory track become infected, either viral or bacterial. Red and swollen vocal folds. Heals with rest unlike chronic
Vocal fold paralysis
head neck chest injuries or viral infections. Unilarteral - horse weak or raspy voiceor bilateral-constant weezing. Diplothonia - produce 2 vibrations at the same time.
Dysarthria
incoordiation, involuntary movement etc result of stroke or head trama. Hypernasel, slow speech, strained voice.
Papilomas - juvinival
wart like growths that cover interior of larynx and grow along the vocal cords. Voice goes down in pitch. Usually kids around 6. Caused by papova virus. 80% goes away. Danger is could block off airway.
Slidor
producing voice on inhalation.
Laryngeal cancer
persistant horsness. Should be seen by ENT. Complain of lump in throat.
Psycogenic disorder
A conversion disorder b.c the patient convers an emotinal conflict into a physical symptom
Dead give away is that they say they have no voice but they can cough. Ususally caused by stress. Pitch is either too high or too low
Resonance disorders
Cleft palate
Functional hyper nasality
Intervention process
ENT exam
SLP evaluation
Treatment for functional voice disorders - identify vocal abuse, reduce its occurance, find best voice for paitent
“ for organic” - dissus paiteients voice needs, institue a vocal hygiene program
“ for psychongenic “ - convice paitent that mechinisum is ok. May need referal to psychologists.
“ for resonance disorders - behavioral therephy, bio feedback, medical intervention
laryngectomy
The most severe voice problem is aphonia
The most dramatic cause of aphonia is totally laryngectomy
Total laryngectomy
due to laryngal cancer
purpose of the surgery is to
Save the patients life
Prevent the spreeding of the cancerous cells
Common site and more common in men
Although generally successful the operation is life altering
Who gets cancer of the larynx
men over 50 who are heavy smokers and drinkers
Recent reports of laryngeal cancer b.w ages of 5 and 34
In 1980 there were 10000 new casess, 12500 in 1990
50-70% of all oral and laryngeal cancer deaths are associated with somking aor a combination of drinking and smoking
Treatment options for cancer of the larynx
Xray irradation - 85-96% vocal cord cancer only cured
Cordectomy
Hemi laryngectomy - if caught early and only in one vocal cord
What they take when they do surgery
Hypoid bone
Epiglotis
Thryoid cartlage
Vocal folds both real an false
Carcoid cartaliage
And someimes 1-3 rings of trachea
Also maybe lymphnoids
stoma
hole where they breath instead of the nose
Life without a larynx
No breathing through mouth or nose
No smelling
Taste decreases
No air warming or cleaning - so more uris, upper respitory infections
Sneeze and cough are through the stoma
No swimming or bathing
Cant use mouth to mouth as rescue
Weaker than before surgery
Cant “fix” the chest - cant lift heavy things, or give birth
swallowing
Normal voice needs
Air stream
Vibrating element
Resonance chamber
Psychological aspects of life (post op.)
Patients often depressed (high suicide rate)
Loss of independence
Financial setbacks are common
Discomfort and soreness in healing
Embarrassment
Lack of physical strength
Family problems
Worry of recurrence of cancer
Anger/frustration
Types of speech after a laryengectomy
Esophageal - best
Pharyngeal
Buccal - worst - air into mouth and use tounge against cheeck - like donald duck
types of Artifical larynx
Electro larynx - what he showed us in class
Reed type - robot sounding
Role of SLP for laryngecotmy
Pre op - councling. Member of ILA
Post op - councling, positive reenforcment, care of devise
Outpatient - therephy, instruction on how to use devise
Ppl who cant have a larnegectomy done
Alcholoics
Diabetics
Arthritis
Mild dementia
Psyciatric problems
Chronic lung disease
Low motavation to talk
Therepy for a laryngectomee
Read medical charts
Study history
Establish rapport
Evaluate structures and status of patient
Show success quickly
Choose therapy materials that are relevant to the patient
Role of the family after larengetomy
Realisitc expectations
Don’t baby the patient
Spouses need to meet with other spouses in the same situation
Swallowing problems
Questions about reoccurance of cancer
Coughing and choking..what to do
Excersises they can do to help
humidifiers
fluency
Smooth and rapid flow of one sound into another
fluency
Smooth and rapid flow of one sound into another
Types of fluency disorders
Repetitions
interjections
Revisions/incomplete phrases
disrythmic phonation
Prolongations
Broken words
Tesnse pauses - blocks
Stuttering
The involuntary repetitions and prolongations of sounds and syllables that occur with varying frequency during speech and to which the individual reacts in a negative way
Accessory (secondary) behavior or tricks
Nodding head
Toe tapping
Eye blinking
Circumlocution - go around the word, say another word
Finger tapping
Eye movements
Slapping leg
Stomping feet
Lift eyebrows
Development of fluency disorders
Speech hesitancy
Parenthetical remark
Revision 3 to kindergarten
Revisions and interjections decrease by high school
Onset of stuttering
2-5 years old
Gradual
Idiopathic stuttering - with known cause, most frequent neurological injury
Stuttering stats
Prevalence - percentage of population expierecncing stuttering at any one time divided by population
Incidence - % who have ever expierenced stuttered = 4.9%
Recovery - 78% of childern who stutter will recover by age 16
More males stutter than females..ratio is 3.1adults is 4.1
Johnson’s (diagnosogenic theory) of stuttering
a learned behavior
Externaly driven

Suttering is caused by the listener not speaker; learned
Criticism of behavioral theories of stuttering
Nomal developing children stutter
Parents of stutteres must have a higher standard of expectations
Stuttering cant be unlearned
psychoanalytic theory of stuttering
Suttering seen as manifestation of inner conflict or repressed needs (freud)
Id and super ego in conflict

Stuttering resulted because stutterers were not given good care (travis)
Reasearch shows
neither stutterer or parent have more nuerotic behavior than nonstutterers
psychotherapy makes the stutterer feel better about their problem but they still stutter.
Organic theories of stuttering
Neuromotor disorder - due to distuption in neuromotor system. Only effects muslces related to speech.
Neuro linguisitic disorders
Genetic factors - males have 9% chance of having a daughter who stutters, 22% of a son
Women will have 17% chance of daughter who stutters and 36% chance of son who stutters
77% that identical twins will stutter
32% that not identical ??
18% non tiwns, just siblings
Enviornmental -
treatment of stuttering
Spontaneous recovery
If parents are concerened do therapy
Audiometric evaluation
Language evaluation
Psychological evaluation
Family (parental) actions of stutterers
Role model
Don’t reprimand
Slow down everything
Include family in thereaoy
Reduce pressure
Check moms rate
one on one time
Pay attention to child
Refrain from asking for full accounting
Keep child healthy
SLP role of stuttering
Direct therapy 2 times a week
Model speech
Start with words then phrases then sentences then connected speech
Spontaneous fluency
Stuttertig modification theraphy
they struggle to be fluent so goals are to decrease speakers fears of speaking. To help stutterer to stop avoid stuttering, to just do it. Confront speakers fears and anxieties about stuttering. Learn how to stutter on comand as to desensitize. Bouncing - using easy repatistions.
Psycotheraphy stuttering theraphy
refer to psycologist if stuttering is emotional in nature
Fluency shaping theraphy
stuttering is learned therefore can be unlearned. Fluent can be systamaticlly introduced. Never addresses 2ndary problems like face ticks etc.
definitions of theraphy for stutterers
Cancelation
Prepratory sense
controled speech
Acceptable stuttering
repeating an unacceptable disfluency in a less intrusive way
teach them to prepare mentally to ease into speaking.
fluent sounding speech but stutter must change his speech pattern
when not severe stuttering and they feel comfortable with their disfluencys
stuttering stats
Average stutter stutters on 14 % of his syllables.
After 18-24 months should have 1-2%
Consequenses of stuttering
No difference b.w stutters and non stutters in most aspects of life.
Generally stutters wont have as challenging of a carrer.