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33 Cards in this Set

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Talbot's Law
Images greater than 5/sec appear to be moving.
Most practical clinical techniques is?
to observe movement of the vocal folds
Observing movement of vocal folds provides info. about:
Nature of vf vibration
immediate image of presence/absence of pathologic condition
Permanate record
Observable characteristics of the vf vibratory pattern include
Glottic Closure
Phase closure
Vertical level of vf
amplitude
mucosal wave
vibratory behavior
phase symmetry
periodicity
Glottal closure is rated as:
Complete or incomplete or sometimes inconsistent
Periodicity
the regularity of successive cycles
Periodicity interpretation
Asymmetry
Marked asymmetry in mechanical properties of vocal folds, unilateral paralysis, unilateral lesion
Periodicity interpretation
Interference with homogeneity
Interference with homogeneity of vocal folds by cyst or carcinoma
Periodicity interpretation
Unsteady tone
Incapability of maintaining a steady tonus of laryngeal muscles, spastic dysphonia or other neruomuscular disease
Periodicity interpretation
Inconsistent force
Incapability of exhaling air from lungs with consistent force; neuromuscular disease or pulmonary disease
In normal conditions are the supraglottic structures involved in vibratory movements?
NO
Phonosurgery
Designed to...
Distinguish form conservation laryngeal surgery
Improve or restore voice
Need to remove diseased tissue, but also improve voice!

In conservation laryngeal surgery primary aim is eradication of the cancer, voice restoration is impt but 2ndary.
Dysphonia
Pathologic condt. may include...
May result from..
Is a comprehensive voice eval necessary?
Presenting symptom of the phonosurgical patient
Condition may include various benign vf lesions
May result from normal aging process, exc use, vocal abuse.
Yes it is necessary to perform a comph. voice eval, identify pathologic condition, select approp. surgical candidate.
VF nodule
Occur where?
Looks like?
Symmetrical/asymmetrical
Layers affected?
Mass and stiffness of what are increased?
-Occur along edge at the anteroposterior midpoint of the membranous vf
-Whitish, small, and usually bilateral
-Usually symmetrical and interferes with complete closure
-Confined to sup lam propria
-Mass and stiffness of the cover are increased slightly
VF polyp
Develop where?
Look like?
Layers affected?
Mass increase? where?
Does it interfere with opposite vf?
-Dev around edge of vf at mid of membranous vf
-Looks reddish/whitish, small/large, sessile/or pedunculated, unilateral/bilateral
-Affects Sup lam. prop layer
-Mass of cover increase
-Yes interfere with contralateral vf
Reinke's Edema
Occurs where?
Looks like?
Layers affected?
Symmetrical/asymmetrical?
bilateral?
Complete Closure?
Mass increase?
Does it interfere with opposite vf?
-occures on Membraneous vf
-looks like swollen along entire length
-In the sup lam prop layer
-lesion usually bilateral but can be asymmetrical
-VF usually close completely
-Mass of cover increase, but stiffness decreases
-Yes it interferes with opposite fold
Sulcul Vocalis
Occurs where?
Looks like
Bilateral/unilateral?
Complete closure?
Symmetrical?
Layer affected?
Mass increase?
-A furrow along edge of membranous vf
-Edge is bowed to some extent
-Usually lesion is bilateral
-Glottis does not close completly, forms spindle shaped chink
-Roughly symmetrical
-Affects sup lam. propria
-Cover's mass decreases, stiffness increases
Vocal Fold Scar
Occur in what layer?
Produced by?
Consists of what type of fiber and what kind of tissue?
Complete closure?
-Can occur in any layer
-Produced by trauma, surgery, burn or inflammation
-Scar tissue consists of dense collagenous fiber and is stiffer than normal tissue
-Scar tissue often impeded glottis closure during phonation.
Hyperplasia
Increased growth and thickening
Precancerous
Carcinoma of VF
Layers?
symmetrical?
Complete closure?
Profound effect of voice
Enters deeper structures, muscle
asymmetrical
Impeaded glottic closure
My get so stiff it wont vibrate
Papilloma
Symmetrical
closure?
Opposite fold affected?
Life threatening virus
-asymmetrical
-disturbed glottic closure
-mass interferes with opposite vf
VF Cyst
Layer?
Cause of?
Layers?
Occurs where?
unilateral? or bilateral?
Mass/stiffness increase or decrease?
-Arise in superficial layer
-Result of blocked mucosal gland
-Occasional extension into intermediate and deep layers
-Anywhere on membranous portion of vf
-Usually unilateral
-Mass and stiffness will be increased.
Vocal Hemorrhage and Varix
Caused from?
Stiffness can cause?
Cause voice to do?
rest recommended?
-Varicose vein on sup. surface of vf will rupture causing bleeding into reinke's space
-Mucosal disruption of stiffness can scar vf cover
-Voice-Can cause acute dysphonia at time of bleed, cont. hoarseness for some time.
-STRICT VOCAL REST!!
Vocal Fold Nodule
-Midpoint of membraneous vf
-whitish small sessile usually bilateral
-symmetrical
-mass and stiffness of cover are increased slightly but transition and body are not affected
Polyp
-Dev around edge at middle of membranous vf
-reddish/whitish, sessile/pedunculated, unilateral/bilateral
-On superficial layer of lam. prop
-Interferes with opp. vf
Reinke's Edema
Membranous vf is edematous and swollen along entire length
-usually bilateral, can be asymmetrical
-Mass of cover increases, but stiffness decreases
Sulcus Vocalis
-Furrow along edge of memb. vf
-Edge is bowed
-Usually lesion is bilateral
-Roughly symmetrical
-Cover's mass decreases, stiffness increases
VF Scar
-Can occur in any layer
-Produced by trauma, surgery, burn/inflammation
-Scar tissue consists of dense collagenous fiber and is stiffer than normal tissue
-Scar tissue usually impedes glottic closure
Epithelial Hyperplasia
-Pathology in which thickening of the epithelium is primary lesion
-Regarded as precancerous
-Originates from cover, may enter sup lam prop
-Vocal ligament not involved unless lesion becomes malignent
Carcinoma of VF
Most are squamous cell carcinoma
-Originate from cover and go deeper
-Originally unilateral
-tissue is asymmetrical
-Glottic Closure impeded
-Lesion inteferes w/ vibratory movements of opp vf
Papilloma
-Lesion is asymmetrical
-Proliferated newplastic epithelial cells growing in a appillary fashion
-Glottic closure disturbed
-Mass interferes with opp vf
VF Cyst
-Arise in Sup layer
-Result of blocked mucosal gland duct, with occasional extension into intermediate and deep layers of vf
-Can occur anywhere on membranous portion of vf
-Usually unilateral
-Mass and stiffness increase
Vocal Hemorrhage and Varix
Varicose vein on sup surface of vf wil rupture causing bleeding into reinke's space
-Mucosal distruption of stiffness can scar vf
-Can cause acute dysphonia
-Strict voice rest!!!