Voice

Front 1

larynx

Back 1

-biological valve at top of trachea
- closes off trachea to protect lungs
-builds air pressure below it to assist in lifting, coughing, child bearing
-houses vocal folds

Front 2

adduct

Back 2

-move toward middle
-close

Front 3

abduct

Back 3

-move away
-open

Front 4

glottis

Back 4

-area between v.folds

Front 5

vocal folds

Back 5

-layered structure
-epithelium
-thyroarytenoid
-lamina propria

Front 6

false v.folds

Back 6

-aka ventricular
- above true vf's
-used only for lifting/coughing

Front 7

areyepiglotic folds

Back 7

-above false vf's
-seperate pharynx nd laryngeal vestibule

Front 8

laryngeal innervation

Back 8

- vagus nerve x, primary nerve involved
- superior laryngeal nerve & recurrent laryngeal nerve branches of vagus

Front 9

SLN

Back 9

-internal branch gives sensory info to larynx
-external gives motor infor to cricothyroid muscle

Front 10

RLN

Back 10

- gives all motor innervation to interarytenoids, posterior cricoarytenoids, thyroids, and lateral cricoarytenoid muscles
-supplies all sensory infor below v.folds

Front 11

hyoid bone

Back 11

-larynx is suspended from it
-many extrinsic laryngeal muscles attached to it

Front 12

epiglotis

Back 12

-attached to hyoid
-protects trachea by closing inferiorly and posteriorly over laryngeal area
-directs liquids and food into esophagus

Front 13

thyroid cartilidge

Back 13

- largest cartilidge
-Adam's apple
- shields other laryngeal structures from damage

Front 14

cricoid cartilidge

Back 14

- 2nde largest
-uppermost tracheal ring
- completely surround trachea
-linked with arytenoids and thyroid

Front 15

arytenoid cartilidges

Back 15

- shaped like pyramids
-on cricoid cartilidge on either side of midline

Front 16

corniculate cartilidges

Back 16

- sit on apex of arytenoids
-small and cone shaped
-play a minor role in vocalization

Front 17

cuneiform cartilidges

Back 17

- tiny cone shaped
-under mucous membrane that covers aryepiglotic folds
-minor role of phonatary funtions of larynx

Front 18

intrinsic laryngeal muscles

Back 18

-control vocalization
-thyroarytenoids, cricothyroids, posterior cricoarytenoids (only abductors), lateral crico arytenoids, transverse arytenoids, oblique arytenoids

Front 19

extrinsic laryngeal muscles

Back 19

- all have 1 attachment to hyoid bone, and 1 out of larynx
-elevate or lower position of larynx in neck
-infrahyoids and suprahyoids

Front 20

infrahyoids

Back 20

-ex laryngeal muscles
- below hyoid, depress the larynx
-effect pitch
-TOSS, thyrohyoids, omohyoids, sternothyroids, sternohyoids

Front 21

suprahyoid laryngeal muscles

Back 21

-ex laryngeal muscles
- above hyoid
-elevate larynx
- digastrics, geniohyoids, mylohyoids, stylohyoids, genioglossus, hyoglossus

Front 22

presbyphonia

Back 22

-age related vocie disorder

Front 23

fundamental frequency

Back 23

-an idividuals typical pitch
-determined by mass, length, elasticity of vf's

Front 24

jitter

Back 24

-variations in vocal frequency
-seen in dysphonic patients
-measured by sustaining vowel
-people w/tremor or harseness may have a high jitter

Front 25

shimmer

Back 25

-cycle to cycle variation of itensity
-measured w/sustaine dvowel
-people w/roughness may have large amount of shimmer

Front 26

voice quality

Back 26

-hoarse (breathy & harsh, low)
-harsh (rough, unpleasant, vf's close too tightly)
-strain-strangled (effotful phonation, squeezing out sound)
-breathy (vf's open)
-Glottal Fry ( vf's vibrate slowly, low pitch, crackly)
-diplophonia (double voice)
-stridency (shrill, unpleasant, high pitched)

Front 27

when can tx begin

Back 27

-must have a medical evaluation of voice mechanism
- may need to refer to a neurologist

Front 28

Indirect laryngoscopy

Back 28

-mirror used to view laryngeal structures during phonation

Front 29

direct laryngoscopy

Back 29

-performed by a surgeon while patient is under
-goes through mouth into pharynx
-vocal function can't be observed, but will get direct view of larynx
-valuable when biopsy is required

Front 30

flexible fiber-optic laryngoscopy

Back 30

--thin flexible tube
-goes through nose, over the velum, and into position of above larynx
-patient can speak

Front 31

endoscopy

Back 31

-flexible(nose) or rigid (oral)
- can be attached to video camera (videoendoscopy)
-used to study laryngeal anatomy and physioloogy in detail including mucosal wave

Front 32

sound spectography

Back 32

- a graphic representation of a sound wave's intensity and frequency as a funtion of time
-quantitative analysis of speech
-used to measure improvements in voice

Front 33

videostroboscopy

Back 33

-helpful indifferentiating between functional and organic disorders
-strobe light, opticcal illusion of slow motion movementof vf's

Front 34

electorglottography (EGG)

Back 34

-measures vf closure patterns
-noninvasive
-surface electrodes placed on both sides of thyroid carilidge

Front 35

electromyography (EMG)

Back 35

-invasive
-measures laryngeal function, needle elctodes are inserted into laryngeal muscles
- useful when trying to dtermine vf pathology

Front 36

aerodynamic measurements

Back 36

-airflows, air volume, air pressures
-used to evaluate dysphonia, monitor voice changes and tx
-tidal volume(air inhaled/exhaled normal breath), vital capacity (air volume is exhaled after deep breath), total lung capacity (total air volume in lungs)

Front 37

pitch measurements

Back 37

-visipitch

Front 38

perceptual voice eval

Back 38

-subjective
-pitch, volume, resonance, repsiration, sustain phonation
-rating scales often used

Front 39

hyponasality vs hypernasiality

Back 39

-nasal resonance absent on nasal sounds

-too much nasal resonance on non-nasal sounds

Front 40

phonation assessment

Back 40

-MPT, sustain phonation
-s/z ratio

Front 41

resonance disorders

Back 41

-hypo/hypernasality
-assimilative nasiality
-cul-de-sac resonance

Front 42

hypernasility

Back 42

-most common resonance problem
-too much nasal sound
-caused by functional (Deaf) or organic (cleft palate) , velopharyngeal insufficiency

Front 43

velopharyngeal insufficiency

Back 43

- velopharyngeal mech is inadaquate to achieve closure
- nasal cavities are not sealed off for non nasal sounds
caused by decreased muscle mass of velum, adenoidectomy or tonsilectomy, paresis or paralysis of velum (CP, stroke, tbi, debiliatating diseases)

Front 44

hyponasality

Back 44

-lack of nasal resonance on nasal sounds
substitute b/m, d/n, g/ng
-temporary (colds), enlarged adenoids, mouth breathers

Front 45

assimilative nasality

Back 45

-when sound from a nasal consonant carries over to adjacent vowels

-functional or organic

Front 46

cul-de-sac resonance

Back 46

- tongue is carried too far back in oral cavity
-common in deaf, large adenoids/tonsils

Front 47

functional vs organic resonace disorders

Back 47

-O, must be treated medically b4 therapy (surgery, protheses)

Front 48

tx of hypernsality

Back 48

-biofeedback
-nasometer(visual feedback)
- mirror under nose, ear training, increase mouth opening, increase loudness, improve artic, change rate, decrease pitch

Front 49

tx of hyponasality

Back 49

- nasometer, biofeedback
-focusing, teaches to feel vibrations in mask
-nasal-glide stim
-visual aids, tissue, mirror

Front 50

tumors

Back 50

-supraglottic (above vf)
-glottic (at vf's)
-subglottic (below vf's)
-dr's classify tumors by T(site), N (involvement of lymph nodes), M (spread of cancer)

Front 51

3 tx's for laryngeal cancer

Back 51

- Laryngectomy ((partial or full)
- chemotherapy (alone or combined, used when tumor is large and spread is a risk)
-radiation therapy (alone or combined, used b4 surgery to trya nd elliminate cancer)

Front 52

rehabilitation of larynbgectome

Back 52

-team approach
-slp pre & post counsel

Front 53

effects of laryngectome

Back 53

- normal voicing impossible
-must breath through stoma
- sound can be produced with external devices, esophageal speech, & surgical modifications

Front 54

esophageal speech

Back 54

-taught to speak using esophagus using burps
-2 methods: injection method, inhalation method

Front 55

injection method of esophageal speech

Back 55

- patient impounds air in mouth, then pushes it back into esophagus, makes soft tissues of esophagus vibrate

Front 56

inhalation method of esophageal speech

Back 56

- patient inhales rapidly while keeping esophagus open and relaxed, ait moves through esophagus and sets tissues into vibration

Front 57

surgical modifications for laryngectome

Back 57

- Bloom-singer prostechtic device (TEP), small tube inserted to stop food from entering trachea
-patitnet bblocks stoma w?finger to build up air for speech

Front 58

granuloma

Back 58

-inflamed vascular lesion
-develop on vocal processes of arytenoids
-uni or bi
-caused by vocal abuse, intubation, injury, reflux
-breathy and hoarse, throat clearing,
-tx w/ surgery, voice therapy, or both

Front 59

hemangioma

Back 59

-similar to granulomas, but soft and filled w/blood
-intubation, reflux
- surgery and follow up voice therapy

Front 60

leukoplakia

Back 60

-benign thick whitish plaques
-caused: smoking, alcohol, vocal abuse
-prescancerous but should be monitored
-hoarse, low-pitch, breathy, soft
-tx: voice therapy, surgery

Front 61

hyperkeratosis

Back 61

-rough pink lesion, benign but may be precursors to malignancy
- smoking, reflux, vocal abuse
- hoarse/harsh, reduced volume, low pitch
-tx: elliminat irritants, surgery, voice therapy

Front 62

papiloma

Back 62

- primarily in children
- wart like growths, pink or white, found in airway
-horase, breathy, low pitch
-ariway obstriction life threatening concvern
- may need multiple surgeries, surgery can cause increased voice issues

Front 63

laryngeal web

Back 63

- membrane that grows across anterior portion of glottis
- can be congenital or acquired due to trauma
- infants have immediate surgery and tracheostomy
-tx adults surgery to remove web

Front 64

paralysis of vf's

Back 64

- occurs when nerve supply is cut off
-caused by surgery, neurological diseases, malignant diseases, intubation trauma, laryngeal trauma, stroke, vagus nerve deficits
-uni or bi

Front 65

ankylosis

Back 65

- sitffening of joints (arytenoids), caused by arthritis or cancer
-vf's dont close fully

Front 66

spasmonic dysphonia

Back 66

-psychologically based with neurogenic causes, brainstem dysfunction, occurs in adults
-abductor SD, breathy speech, tx botox, medication, speech therapy
-adductor SD, most common, strangled vocie, tx laser surgery, RLN resection, botox, voice therapy

Front 67

nodules

Back 67

- small nodes on vf's, red /pink then turn gray/white
- typically bilateral, junction of anterior and middle 1/3 portion of vf's
-develop over time dure to vocal abuse
-create low pitch, breathy or hoarseness
- tx: vocal rest, voice therapy, surgery

Front 68

polyps

Back 68

-softer than nodules, may be filled w/fluid
-typically unilateral
- sessile (broad based) or penduculated (stalk)
- can grow over time or suddenly
- breathjy and haorse, diplophonia
- tx: voice rest, voice therapy

Front 69

tx for abuse based disorders

Back 69

- voice therapy, meds, surgery, or combo