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57 Cards in this Set

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Intrinsic Laryngeal Muscles:
Intrinsic Laryngeal Muscles: Have both of their attachments to structures within the larynx. With one exception, all are adductors. Primarily responsible for controlling vocalization.
Extrinsic Laryngeal Muscles:
Extrinsic Laryngeal Muscles: Have one attachment to a structure outside the larynx and on within the larynx. All are attached to the hyoid bone. They give the larynx fixed support.
Mean Fundamental Frequency:
"Mean Fundamental Frequency: There is a gradual and discernable decline in MFF from birth on. As people grow older, their voices become lower in pitch with some gender differences in old age. Boys and girls voices are similar before adolescence. Children 7-8: 281-297 Hz. Children 10-11: 238-270 Hz. 19 yr Girls: 217. 19yr Boys: 117 Hz. Girls voices may drop 3-4 semitones, boys as much as an octave. Adult Men: 100-150. Women: 180-250.
Pitch: Frequency with which the vocal folds vibrate, the fundamental frequency (habitual or typical pitch.) Determined by the mass, tension and elasticity of the vocal folds. High pitch: thinner, more tense. Lower pitch: thicker, more relaxed.
•Jitter: Variations in vocal frequency that are often heard in dysphonic patients.
Volume: Determined by the intensity (loudness) of the sound signal. The greater the sound signal, the greater the loudness. The greater the amplitude, the louder the voice.
Shimmer: Cycle-to-cycle variation of vocal intensity (loudness).
Hoarseness: Combination of breathiness and harshness. Results from irregular vocal fold vibrations.
Harshness: Rough, unpleasant, gravely. Associated with excessive muscular tension and effort. The vocal folds are adducted to tightly and then the air is released to abruptly.
Strain-Struggle: Phonation is effortful. Initiating and sustaining phonation is difficult and there is much strain.
Breathiness: Results from the vocal folds being slightly open during phonation. Air escapes through the glottis and adds noise to the sound produced by the vocal folds. May be organic (physical) or nonorganic (functional).
Glottal Fry:
Glottal Fry: The vocal fold vibrate very slowly. The sound occurs in slow but discrete bursts and is extremely low in pitch.
Diplophonia: “Double Voice.” Occurs when one can simultaneously perceive two distinct pitches during phonation. The vocal folds vibrate at different frequencies due to differing degrees of mass and tension.
Stridency: Shrill, unpleasant, high pitched and “tinny.” Caused by hypertonicity of the pharyngeal constrictors and elevation of the larynx.
1. Indirect Laryngoscopy
1. Indirect Laryngoscopy: Light source and mirror to view laryngeal structures.
1. Direct Laryngoscopy:
1. Direct Laryngoscopy: Done by a surgeon and under anesthesia. A laryngoscope is put through the nose. Patient can not phonate.
1. Flexible Fiber-Optic Laryngoscopy:
1. Flexible Fiber-Optic Laryngoscopy: A thin flexible tube put through the nose to view vocal mechanism and photograph rapid vocal movement.
1. Endoscopy:
1. Endoscopy: Flexible (nasally) and rigid (orally) scope.
1. Spectrograph:
1. Spectrograph: Sound or speech spectrograph is useful for quantitative analysis of speech.
1. Videostroboscopy:
1. Videostroboscopy: Flexible or rigid scope is used for slow motion viewing along with a microphone on the patient’s neck to record voice signals.
1. Electroglottography: Surface electrodes are placed on the sides of the thyroid cartilage and a high frequency electric current is passed between electrodes what the patients phonate.
1. Electroglottography: Surface electrodes are placed on the sides of the thyroid cartilage and a high frequency electric current is passed between electrodes what the patients phonate.
1. Electromyography:
1. Electromyography: Inserts needle electrodes into the patient’s peripheral laryngeal muscles; the resulting electrical signals are judged as either normal or indicative or pathology.
1. Aerodynamic Measurements:
1. Aerodynamic Measurements: Tidal volume (normal breathing), vital capacity (exhale after maximal inhalation), total lung capacity (total volume of air in the lungs).
1. Pitch Measurements:
1. Pitch Measurements: Visi-Pitch.
"Hypernasality: Excessive nasality. Cleft palate is a major cause. Decreased muscle mass of the velum. Adenoidectomy or tonsillectomy. Paresis (weakness) or paralysis of the vellum . A nasometer allows the patient to receive visual feedback. Visual aids (mirror/tissue), ear training, increased mouth opening and loudness, improving articulation, changing speaking rate, decreasing pitch.
"Hyponasality: Lack of appropriate nasal resonance on nasal sound. Temp. due to colds or allergies. Obstructions in the nasal cavity enlarged adenoids or tonsils or a deviated septum. Can be mouth breathers. A nasometer allows the patient to receive visual feedback.Focusing or directing tone into the “facial mask”, nasal-glide stimulation, visual aids.
Assimilative Nasality:
Assimilative Nasality: Occurs when the sound from a nasal consonant carries over to adjacent vowels. Such as: Banana. Velar opening occur too soon and last too long. Functional or organic.
Cul-de-Sac Resonance:
Cul-de-Sac Resonance: Produced by backward retraction of the tongue; the tongue is carried too far posteriorly in the oral cavity. The tongue blocks some sound waves from reaching the oral cavity, resulting in a distorted voice and resonance.
Medical Intervention:
Medical Intervention: Always imperative, as a first step. Determines whether disorders are functional or organic. Can be surgery, prostheses or both.
Laryngectomy: Surgery to remove the larynx.
Hemilaryngectomy: Only the diseased part of the larynx is removed.
"Laryngectomee: A person who’s had their larynx removed. Early warning signs of laryngeal cancer include hoarseness, difficulty swallowing, and pain I the laryngeal area. Pre and Post-operation counseling is imperative.
Alaryngeal Speech:
Alaryngeal Speech: Laryngectomees produce vocalizations in three ways: external devices, esophageal speech, and surgical modifications or implanted devices in the laryngeal area. Artificial larynx: Hand-held external device pressed against the neck where the sound generated by a vibrator is transferred to the mouth.
Esophageal Speech:
"Esophageal Speech: Speaking on burps and belches. Injection Method: Impounded air is pushed back into the esophagus and then expelled, producing vibration of the soft tissues of the esophagus. Inhalation Method: Inhale rapidly with an open and relaxed esophagus. Sets the esophageal tissues into motion.
Blom-Singer Tracheoesophageal Puncture (TEP):
Blom-Singer Tracheoesophageal Puncture (TEP): The tracheoesophageal wall is punctured and a shut is inserted. The patient exhales and occludes the stoma with a finger, forcing the air from the trachea to the esophagus, setting it into vibration, resulting in sound production.
Granuloma: A localized, inflammatory, vascular lesion, that is usually composed of granular tissue, in a firm, rounded sac. Caused by vocal abuse, intubation, injury to larynx, or GER.
Hemangioma: Similar to granulomas but are soft, pliable, and filled with blood. Caused by intubation or GER.
Leukoplakia: Benign growths of thick, whitish patches on the surface membrane of the mucosa. Caused by tissue irritation due to smoking, alcohol, or vocal abuse.
Hyperkeratosis: A rough, pinkish lesion. Benign but are precursors to malignancy. Caused by tissue irritation due to smoking, GER, and vocal abuse.
Laryngomalacia: Congenital condition, soft, floppy laryngeal cartilages, especially the epiglottis.
Papilloma: Occur primarily in children. Wart-like growths caused by the human papilloma virus.
Laryngeal Web:
Laryngeal Web: Membrane that grows across the anterior portion of the glottis. Can be congenital or acquired. Treatment is surgery to remove the web.
Paradoxical Vocal Fold Motion (PVFM):
Paradoxical Vocal Fold Motion (PVFM): Inappropriate closure or adduction of the true vocal folds during inhalation, exhalation, or both. Psychological and physiological causes.
Gastroesophageal Reflux Disease (GERD):
Gastroesophageal Reflux Disease (GERD): When gastric contents spontaneously empty into the esophagus when the person has not vomited or belched. Heartburn, acid indigestion, sore throat, hoarseness, and contact ulcers.
Spastic Dysphonia: Focal laryngeal dystonia.
"Spastic Dysphonia: Focal laryngeal dystonia. Abductor: Intermittent, involuntary, fleeting vocal fold abduction during phonation. Adductor: Overpressure due to prolonged over-adduction or tight closure of the vocal folds.
Multiple Sclorosis
"Multiple Sclerosis: (MS) Patients experience progressive and diffuse demylination of white matter, with corresponding preservation of axons at the brainstem, cerebellum, and spinal cord.
Myasthenia Gravis
"Myasthenia Gravis: A neuromuscular autoimmune disease that produces fatigue and muscle weakness. There is a decreased amount of acetylcholine at the myoneoronal juncture. Hypernasal, breathy, hoarse, and soft in volume. May have dysphagia and distorted articulation.
Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease
"Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease: A progressive, fatal disease involving degeneration of the upper and lower motor neurons. Breathy, low pitched, and monotone with poor respiratory control.
Parkinson’s Disease:
"Parkinson’s Disease: Cased by a lack of dopamine in the substancia nigra of the basal ganglia. It can be idiopathic (occurring in isolation) or secondary to other conditions such as dementia.Breathy, low pitched, and monotone.
Treatment Techniques for Neurological Disorders:
"Many tend to manifest dysarthria so treatment techniques are based upon treatment for dysarthria. Improve articulation with exaggerated consonants & slow rate of speech. Improve resonance with open mouth, decreasing posterior tongue tension, and improving velopharyngeal closure. Increase prosody to decrease monotone. Improve respiration through relaxation, efficiency of breathing.Improve vocal fold approximation through activities already mentioned.
Vocally Abusive Practices:
Vocally Abusive Practices: Excessive shouting; screaming; cheering; excessive talking; coughing; hard glottal attacks; throat clearing; strained and explosive vocalizations; excessive laughing or crying; speaking with inappropriate pitch, loudness, or both; and speaking in noisy environments.
Vocal nodules
Vocal Nodules: Small nodes that develop on the vocal folds caused by prolonged vocally abusive behaviors. Typically bilateral.
Polyps: Like nodules, are masses that grow and bulge out from surrounding tissue. Softer and may be filled with fluid or have vascular tissue. Typically unilateral.
Contact Ulsers
Contact Ulcers: Sores or craterlike areas of ulcerated, granulated tissue. Typically bilateral. Causes by slamming together of the arytenoid cartilages, GER, or intubation.
Vocal fold thickening
Vocal Fold Thickening: Caused by prolonged vocally abusive behaviors.
Tramatic Laryngitis
Traumatic Laryngitis: Created when a patient engages in vocally abusive behaviors. The folds get swollen.
Specific Treatment Techniques:
"Specific Treatment Techniques:1. Speak with appropriate pitch and volume 2. Reduce the frequency of coughing 3. Relax the body 4. Chant-talk method (word are spoken in a connected manner) 5. Digital manipulation of the larynx: Clinician pushes it down. 6. Respiration training: Teach thoracic and diaphragmatic breathing 7. Encourage voice rest 8. Easy onset 9. Appropriate focus on the facial mask