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70 Cards in this Set

  • Front
  • Back
Degenerative disorders
Parkinsonism, Progressive supranuclear palsy, Shy drager syndrome, amyotrophic lateral sclerosis, hunington's disease
Cerebellar disorders
balance, range, rate, force of movement, all ataxic, ataxic dysphonia, arnold chiari malformation
Disorder of muscle and myoneural junction
Myasthemia, myotonic dystrophy
Misc CNS Damage
Tourette's, Spasmodic Dysphonia, Laryngeal Aphonia
Peripheral/Cranial Nerve Damaage
Palatopharyngeal damage, superior laryngeal, recurrent laryngeal nerve
Symptoms neurologic disorder
not in isolation swallowing, muscle control, respiratory control, sort out most important and treatable. May need alt. comm.
Parkinsonism bio reason
Degenerative-90% have larynx probs basal nuclei stop produce dopamine which stops motor funct.
Possible cause parkinson
head trauma, long term use of major tranquilizer, toxin in environ., genetic/viral.
Physical effects parkinson
Tremor, bradykinesia-loss of dynamic movement (rigid), mask like expression which is big comm. barrier, diff. initiating move.
Voice parkinson
red. in voluce because respiratory move, low picth, monotone, breathy, hoarse. Slow to begin speech then burst. Dyspahgia (difficulty swallow), dysarthria
Other probs w/ parkinson
Not have cog. impair, depression part of disease/reaction, larynx maybe assymetric and bowed vf due to atrophy.
Treatment parkinson
Lee Silverman Voice Treatment-must be certified must be done 4-5x's/week for 4 wks. Therapy is hard and exhuasting.
Lee Silverman Voice Treatment focus
improve loudness, resp. control, rate does not deal directly w/ artic/swallowing, but does become improved.
Progressive supranuclear palsy bio reasons
degenerative-cortex extrapyramidal/pyramidal system typicall pyramidal. cortical bulbar. Later in life in CNS.
Physical effects of progressive supranuclear palsy
hypertonicty results in spacticity, hyperactive relfex affects oral reflex.
Voice progressive supranuclear palsy
Limited range,force of movement,primary symp speech,motor move. not effect. other motor move., pitch breaks, intonation wacky, hoarseness, harsheness, short pharses, imprecise artic. hypernasal.
Other stuff progressive supranuclear palsy
Emotional labial-emotions not match situations, not psycologic it's neruologic. short life 3-5 yrs.
Shy drager syndrome bio reasons
degenerative lesions in CNS affects motor/automomic control(resp., heart,digestions) late middle age-early old age. more in M than F short span muscle weakness all over/rigid
Voice Shy drager syndrome
reduced range, rate, force of motion, hoarse, monoloud, monopitch, red. stress-poor intonation, red. max phonation, red. resp. support, breathiness, imprecise artic. hypernasl, vf paralysis, alt. comm.
Amyotrophic Lateral Sclerosis bio reasons
degenerative Involves UMN and LMNw/ UMN spasticity/LMN weakness, starts in corticospinal/corticobulbar if in CS longer life if in CB 1-3 yrs. m and f =
Physical probs Amyotrophic Lateral Sclerosis
overall motor impair, paralysis
Voice Amyotrophic Lateral Sclerosis
hoarse hard, slow rate, monopitch, breathy, tromor, hypernasal, prolonged phonemes, swallowing prob. SLP find way to comm.
Hunington disease bio reason
degenerative genetic found gene and can screen for it. Autosonomal dominant 50% of all children w/ one parent w/ gene will have.
Hunington disease emotional effects
cog. impair and emotional lability, emotional instability, keep unkempt, abusive.
Hunington disease physical
motor patterns that cause wrything.
Voice Hunington disease
hoarse breathy, strain + struggle, pitch shifts, dec. MPT, inappro. inton.
Ataxic dysphonia bio
cerbellar disorder-not seen in isolation effects of cerebellar ataxia-cerebellum weakness from trauma, tumor, viral inf, degenerative
Ataxic dysphonia if trauma
should stay consisent
Ataxic dysphonia if degenerative
will progressively get worse
Ataxic dysphonia voice
range, rate, force of move., monoloudness/pitch, low picth, extreme variation pitch, no control inton, stress, hoarse, breathy, strain and strug. artic impair
Arnold Chiari Malformation bio
congenital cerebellar-cause of ataxia, connective tissue holds brain to skull is defective, so squeezing through foramen magnum.
Arnold Chiari Malformation symptoms voice
vocal/artic because of cranial nerve nuclei onset grad. sgurically starts as ataxia
Essential/central tremor bio
progressive not life threat. cann start anywhere, does effect head/neck/resp. limbs/trunk.
Essential tremor what happens
Oscillators send out signals something goes wrong w/ control of signals. rhythmic pulses sent to muscles. In people w/ other neuro disorders
Essential tremor voice
Late adolescents-older adult-tremor 5-6hz, hoarse, shaky, breathy, strain+strug, changes in loud/pitch inapp. stress.
Tourette's syndrome bio
Mapped gene, extreme OCD, shos up early childhood 3-12yrs becomes worse, not life threat, affects motor behave.
Tourett's syndrome voice
strange noises, facial ticks, unusual utter., outburst, diagnosis by neuro. if can focus can be successful. can't change motor behave, vocal abusers
Tourette's syndrom treat
good diagnosis, explain situation, enough vocal hygine as you can.
Multiple Sclerosis bio
scarring of nerves, myelin sheath around nerve gets scarred, imparis ability to transmit signal. early adult more common near equator. remitt and relapse
Multiple Sclerosis voice
weak: speech, swallowing, phonation. red.: louness cont., pitch, pitch cont. short utter, hypernasal, slow sppech, impair resp control. range from normal-unitell.
Multiple Sclerosis treat
alt. comm. w/ aphonia, work w/ whatever you can change, medical treat symptoms.
Spasmodic Dysphonia bio
part of dystonia, focal dystonia abrupt onset years to get diagnosis spasms of muscles in larynx, cause unknown. onset early adult can be 8-9yrs.
Spasmodic Dysphonia adductor
most common only during phonation-spasm closed sound like strangle, probs initating/sustaining, tesnion inc. pitch break dec, intensity, hoarsenes, harshness, strain + struggle, mild-unintell, impact work/social
Spasmodic Dysphonia abductor
voicing stops PCA spasms vf open, periodic aphonia, trouble w/ voicing and voiceless.
Spasmodic Dysphonia treat
botox used to paralize muscle-through outside of neck into larynx must be careful about eating/drinking voice therapy w/ botox vocal funct. exercise
Myasthenia bio
muscus lik substance in nerve synaspe(myoneural junt) autoimmune, prevent acetylcholine-neurotransmitter to cross synapse for muscle contract. early adulthood women 50's men
Myasthenia Physical
Muscle function restored after rest progressively worse through day, muscles attached to CN are more succeptable than muscle to spinal nerve.
Myasthenia voice
muscles get tired after 30-40 sec late in disease treated w/ tensilon/prostigmine. myasthenia laryngis only voluntary muscles.
Myotonic Dystrophy bio
many diff. dystorphy, weakness+paralysis of facial+laryngeal muslces, progressive early adulthood. genetic autosomal
Myotonic Dystrophy voice
breathiness+fatigue slurred aphonia, dec. pitch+intensity, swallowing
Laryngeal apraxia bio
damage to premotor area of the frontal lob broca's area plans which muscles to activate in which order. Maybe w/ oral or whole body from stroke/trauma
Laryngeal apraxia voice
normal-aphonic, trial and error effors for phonation, trouble start phonate, silent groping, slow, labored, inconsistency in quality.
Peripheral/Cranial Nerve Damage
CN X Vagus-strke, trauma, heart surger, cervical spin fusions, viral, idiopathic. lesions can be intramedullary and extramedullary CNX nuclei location
Palatopharyngeal unilateral damage
weakness of velum + pharynx effecte mild-severe hypernasal/food out nose, mild nasal emission of air on pressure consonants-worse for bilateral
Superior laryngeal damage unilateral
cricothyroid in larynx-red. in change in pitch, mild breathiness/hoarseness, dec. med. compression, dec. intensity, cause epig. to shift to one side.
SLN damage bilateral
mod-severe: ability change pitch, impaired intensisy, monotone, dec. intonation, hoarse/breathy, personal amp. device, teach to use extrinsic.
Recurrent laryngeal nerve unilateral
abductor-1 vf stuck open cataveric position, mild to mod swallow, breathy, low pitch range, vocal fatigue, use working vf, ENT can push paralyzed vf toward midline dec all probs, but hoarseness
RLN bilateral
vf stuck open, abductor paralysis cricothyroid can produce enough tension to move toward midline, but no PCA to move away.
RLN bilateral voice
sounds good, can't take deep breath, worst airway during physical activity, nothing can be done, breathing phrasing, glottal closure gone, comp. w/ vent. folds.
Treatment basis
what caused, will it get worse, how bad is damage?
Treatment nerve lesions
best chance of treat. low/unilateral, teach abusive habits because won't be abusive because not enough force. teach GCR, inc. tension so can id sensation, throat clearing and coughing because inc. vf closure inc. intensity, and inc. ability change int.
Teach nerve lesions
teach GCR, inc. tension so can id sensation, throat clearing and coughing because inc. vf closure inc. intensity, and inc. ability change int.
Respiration help nerve lesions
help w/ good resp. support, deep inhale, controlled exhale, work, also teach stress/intonation patterns, work on range and variability w/ extrinsics. biofeedback on CSL
Basics about nasal cavity
always same resonant freq, mouth changes resonants moving structures, all lang. have balance bt oral and nasal sounds. mnng and adjacent vowels
Causes of excessive nasal resonants
soft palate and pharynx paralysis, anatomic anomolies, and cleft palate.
semivowels and vowels cannot measure it's qualitative, effects more speech tahn hypo. mild-severe. not voice doesn't originate in larynx.
dec. nasality on mnng and adjacent vowel caused by adenoids, tonsils, polyps, deviated septum, preferred by listeners
Hypernasality and Hyponasality treatment
cannot fix probs due to velopharyngeal closure-surgery and prostethis.
learned lest likely to most are vocal abusers-metallic sounding voice-tightened muscle of pharynx. middle aged men-aggressive, hard glottal, tension.
Stridency voice treatment
shift down melodic resonants, dec. percep of hypernasal w/ very percise artic. open mouth and rate give palate a chance to work the best. check velopharyngeal competence.