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119 Cards in this Set

  • Front
  • Back
Trauma related dysphasia
make up most disordered voice pop. 10% of population has voice disorders. Vocal misuse and vocal abuse.
Vocal misuse
less severe and chronic than abuse-increased tension and strain. Not using larynx psyilogically efficient manner.
Types of vocal misuse
Hard glottal, high laryngeal position, ant and post learyngeal squeezing, inappropriate pitch level, glottal fry, lack of pitch variablity.
Hard glottal attack
chronic pattern becomes a problem sound like there's a lot of tension. treatment teach to be breathy
High laryngeal position
excessive tension in suprahyoid extrinsic-hoid may be under mandible causes strain in both extrinsic and intrinsic. raises formant freq alters vibratory pattern tight vf closure
Anterior and posterior laryngeal sqeezing
increase tension arytenoids and epiglottis move toward one another. vf hard to see epiglottis in way. difficulty raising pitch reduced range
Inappropriate pitch variability
too high(talking to kids)/too low(more authoritative)
Glottal fry
lowest possible pitch phonation is not periodic-talk on residual air-respiratory support is forced. look at respiratory support
lack of pitch variability
holding vf in one position becomes strained, poor pitch and variability, tend to go to glottal fry at end of utter.
Ventricular phonation
so much tension in larynx cause the ventricular folds toward midline and can vibrate. Habitual or the vf don't work can develop to compensate for vf. low pitch, very hoarse, rattling, rumbling, crachking reduced intensity
Vocal abuse
being bad to larynx worse than misues-chronic misuse-women have more vascular laryngies. harsh usage of larynx may result in vocal lesions
Vocal abuse types
Excessive prolonged loudness (coaches,ministers), excessive use during inflammation, and excessive coughing/throat clearing (slams vf together, screaming.
acute laryngitis
busted blood vessels very hoarse vocal fatigue, lower pitch
Chronic non specific laryngitis
dues to long term smoking, dusty air (external agents), very hoarse vocal fatigue, lower pitch
Chronic atrophic laryngitis
dred up due to radiation-cough a lot, very little moisture.
ENT diagnosis, acute laryngitis, chronic non specific, chronic hypertonic laryngitis, and chronic atrophic.
Chronic hypertrophic laryngitis
enlargement of epithelium, not regular/smooth phonation due to external environment. sausage in appearance. not across whole vf.
Long time antihistamine and decongestant
dry out the vf because they dry out mucous.
Coordination and proprioception
coordinating and position of vocal folds
Effect Coordiantion and proprioception
CNS depressors (alcohol) Stimulants,numbing agents,inhalers
may dry secretions in upper airway 80%
Agents cause changes in vf structure
anabolic steroids, aspirin, nicotine, acid reflux, milk
CNS depressor
affect coordination and proprioception of vf and may cause aspiration, and do not allow vf to get coated
caffeine etc. cause jitter in vf
numbing agents
cause vf to feel better, but cause more damage because feel better
causes bow and tremors in vf bc they are bronchial dilaters. will affect the move of air through larynx
anabolic steroids
steroides decrease size of vf androgens may increase size of vf in women and estrogen may decrease size in men.
cause hemoraging in vf
anything inhaled causes chemical damage to vf
acid reflux
can destroy vf GERD and LRD
builds up mucous and water needed to flush mucous.
Vocal pathologies
vocal nodules, polyps, edmea, contact ulcers all grow on tissues.
Vocal nodules occurance
People who talk too much pre puberty and adult females anterior 1/3 and posterior 2/3 of vf. Most common vocal pathology.
vocal nodules description
start soft->hard and white may be unilateral/bi most common bi may be 6mm. Breathy, lowered pitch, hoarsemess and increased shimmer and jitter
vocal nodules treatment
Early detection voice therapy later may need surgery. relaxation, respiratory support voice journal behave mod.
Polyps description
Second most common vocal pathology, may occur quickly with one screaming episode. soft, fluid filled, sessile, pedunculated bi/unilateral.
Polyps sessile
broad based
pedunculated polyps
off a stem causes less change in vf.
Polyps treatment/charact.
Don't go away without rest and voice therapy. Long term will not go away. Hoarse breathy, limited pitch range.
Vocal pathology, swelling infection or trauma do not talk while edema in vf. Allergies block off airway. build up of fluid in vf tissue
Contact ulcer characteristics
mostly adult, high stressed men, hard glottal attacks, stident, throat clearing, uni/bilateral.
contact ulcer indications
airway blockage, breathy, hoars, soreness, vocal fatigue.
Contact ulcer cause/treatment
can result from chronic coughing, correlated w/ reflux, always treated w/ vocal therapy, and eliminating bad habits
Pre cancerous keratosis of larynx
abnormal growth of epithelium-prolonged severe abuse assoc. w/ inhalation varying degree of pre malignancy. Irritants must be removed.
overgrowth of epithelium plaque like layer not medially restricted. Keratin piles (wart like lesions) related to chronicupper respiratory inf.
Hyperkeratosis treatment
removal of irritants vocie treatment last resort-laser treatment
Hyperkeratosis voice
low intensity, low pitch, hoarse, breathy, increased tension, must be closely monitored ENT.
cause airway obstruction step closer to cancer than hyperkeratosis.
leukoplakia treatment
remove irritants and surgery may be necessary
leukoplakia voice
low intensity, low pitch, hoarse, breathy, increased tension, must be closely monitored ENT.
histologic hoarse breathy need to remove irritants and abuse if not cancer is eminent.
% of pop. w/ heavy occupational misuse
Gerd-heartburn stays in esophagus. LRD-usually not felt 1st symptom w/o voice acid in larynx.
reduce edema dries out vf. long term use-loss of blood flow to mucosa, increased tremor
Types of laryngitis
acute, chronic non-specific, chronic hypertrophic, chronic atrophic.
Coughing/throat clearing
slam vocal folds together w/ a high degree of force to clear airway. Common allergies/reflux. only abuse when habitual
Excessive voice during inflammation
cont. talking w/ laryngittis/sore throat/cold, tend to strain/exert more effort to produce voice->trauma epithelium is swollen slamming can cause ulcers.
Excessive prolonged loudness
habituated patterns of loudness teachers/preachers. laryngeal mucosa may be irritated, inflamed, swollen, may cause altered mass, and affect stiffness, breathy.
excessive talking
may result in vocal fatigue, voice quality, slightly rough/hoarse weak.
Big cont. alcohol & nicotene related to GERD/reflux treatment-radiation.
Relaxation voice therapy
needs to be done overall most of the time. progressive relax-tense then release so feel diff. don't clench teeth. side to side neck rolls should be able to move larynx don't roll head back
can get polyp from one event young kids more boys than girls
Clinicians role
coach, prognostic indicator, voice model change way goal presented
prognostic indicator
clinician role-ability to provide approprate instructions that they can comply with also ability of client to change base on instructions
voice model
clinician role-good respiratory support-do not be abusive to own voice
prognostic consideration
medical state, motivation, health (general), age, misuse vs. trauma, clinician
intermittent aphonia
can not keep phonation going caused by swelling in mucus.
laryngeal sicca
really thick mucus-not enough water, eliminate dairy, something in throat coughing and throat clearing
progression of therapy
start where they are move toward logical goal-goals must be evidence based-may include referral to dr./psych-show pictures of vf/tape record
therapy stress
can't be treated as just mechanical problems
therapy cognitive impair
new problems may not be able to treat-allow 6 wks
Treat non cancer
change behave, best possible voice, prevent more damage, med clearance have all info, assess potential, soc/emoti strategies, fam/friend involve, estab. motivation, possible outcome non partic., goals
Phonation time
max 20, reduces over time 10 sec for elderly a problem not enought intake/no controlled exhale
decreased phonation time prob
not enough air can't talk for long, performance anxiety
treatment resp prob
work on diaphragmatic breathing warm up-algon w/ relax best way to get resp support-count in for 5 out for 5 build up to 8-don't allow for fix of breathing.
gen voice therapy approches
auditory training, respiratory control, relatxation, optimum pitch, voice rest
Auditory training
gen voice therapy-people need to know what doing wrong. discriminate b/w what's correct-have client listen to someone else and themselves figure out diff.
Respiratory control
gen voice therapy-may work w/ auditory training-discriminate b/w deep and shallow breathing. limiting facts of resp control is age, disease, stroke. unless physical limits can teach.
intubation granuloma
causes by intubation-metal rubbing against vf-feels like lumps of grainy sand, occurs immed, something in throat, surgery
VF hemorrhage
severe bruising/ruptured blood vess in vf-prevents vf from meeting @ midline can be one screaming event/chronic abuse
VF hemorrhage symptoms
sharp pain feeling of something in throat vf stiff low pitch, hoarse, limited pitch range,unilatearl
VF hemorrhage treat
eliminate abuse, modified vocal rest wait for it to heal, no aspirin
Voice rest
gen voice therapy-controversial, ent say complete vocal rest-SLP-no humming singing, screaming, silent throat clearing, couguing, no more than 15min 5 min @ one time no whiserping never say don't talk
Specific therapy tech
opening larynx prevent hard glottal, decrease trauma-breathy phon, easy onset of phon, froeschl tech, chant-talk, whispering, laryngeal massage
dismissal criteria
best possible voice acheived, self monitoring well, unmotivated, won't stop abuse, not trying, 6 weeks if no progress move on
vocal fold trauma web
caused by surgery, inhalation of toxins/ superheated air scar tissue
treatment of vocal fold trauma web
cut them put in keal to hold vf apart, help acheive best voice poss.
consider when planning therapy
age, what's possible, motivation level, any other disorders, severity of prob, cognition, psychological state, ability to comply w/ instr.
sulcus vocalis
long groove in super layer lp and epithelial covering runing length-congenital, elderly-people w/ atrophy, chidren and adult vocal abusers
sulcus vocalis treat
nothing if congenital, eliminate abuse
sulcus vocalis symptoms
limited pitch range shimmer/jitter, low pitch, limited tension, hoarse, breathy, not usually bad enough for therapy
airway management
number one priority before vocal quality
misc agents
milk-increase mucus, aspirin, can cause hemoraging, nicotene, hot and toxi, anything you inhale/or is a toxin can cause a prob.
keratosis of larynx
abnormal growth of epithelium-from prolonged severe abuse assoc w/ toxin inhale varying degree of malignancy hyperkeratosis, leukoplakia, dyskeratosis
optimum pitch
gen voice therapy controversial some say everyone has opt. pitch, if everything is done correct, opt pitch, can be consider therapy goal, tech. for reaching goal
chant talk
not a lot of inton. choral-done in group, constant phon., very rhythmic, cross b/w talk and sing.
Therapist chant talk
causes client to relax, move from counting o short pharse then add variation, move back to conversation
prevent medial comp, basic breathy phonation, increase tens in vf, only use briefly in therapy
SLP job best voice
work on appro. voice for age and gender, cause motivation-pract new behaviors, change behave, set up monitoring system
laryngeal massage
mech reduces tension in larynx-more tense person smaller space will be. Goal create space
How to laryngeal massage
1-find hyoid, 2-come down about 1/4" 3-make small circles, massage until create space then move forward until front center, push down on thryoid hear pitch lower as phonate 10-15min
varicose vein on vf calves in blood vess. no longer work, swollen blood bess, assoc w/ misues, won't rupture, limit pitch, vocal fatigue, dec. fund freq, hoarse teach to use larynx effect.
cancer symptoms
foul breath, lump in neck, pain, lost of strain, struggle, trouble swallow, something in throat, inhale stridor, shortness of breath
chewing froeschl tech
if chewing no laryngeal tense-vegitative acts prevent laryngeal tense, start w/ chew, add phon, then eliminate chewing, people won't do it outside of therapy because strange
breathy phonation
vf don't come together w/ force confidential voice, most people do all time, therapy tech, start w/ vowels
endotracheal tube
tube in mouth thru vf to assist w/ airway main. cause intubation granulmoa on post 1/3 of vf can obstruct airway, must be biopsied.
dislocate aryntenoids
cause by endotracheal tube ENT must relocate cause swelling and torn ligaments
inhalation of steam/hot air
scar tissue, trach is necessary, inhalation destroys mucosa, scar tissue is rigid/ vibration won't occur on vf, something in throat, never have good voice, need to know state of larynx for therapy
blunt trauma
car accident, strangle, sports, fight, 1st-airway manage, recon of larynx postponed until airway stable
blunt trauma symptoms
low fund freq, limited pitch from scarring, breathy hoarse swallowing probs
blunt trauma treat
best poss voice, give strategies for explaining voice quality, never will sound same
nasogastric tube
feeding tube thru nose into esophagus can cause irriation arytenoids can compress nerves
cricothyroid dislocation
knocked from the side out of align. pain when trying to phonate, take several days to realize, still phonate but can't change pitch too much/not enough tense. may or may not have norm voices
Mass lesion
If you have a mass lesion on vocal fold you'll never get normal voice back
hyperfunction of larynx
used to tense addressed by mechanically relaxing larynx, address underlying stress issue, and reducing inappropriate behaviors
an innate proces which means it is a natural phenomena that you can use in therapy movver from a cough to phonation
prob. w/ easy onset phonation
needs more respiratory support, dries out larynx, make sure water available
easy onset phonation
release air before start phonate, breathy attack, sigh therapy/aspirate phonation, sighing automatically realxes muscles.
aspirate phonation tech
start w/ sigh move to phonation, then w/ diff vowels, single words, start w/ h, don't use tension, then m should be no constr. except lips, short phrases mine is hot wean off sigh