Voice Midterm 4

Front 1

Primary objectives of voice diagnostics

Back 1

1. ID cause

2. Describe the present vocal components

3. Develop the management plan

Front 2

Secondary objectives of voice diagnostics

Back 2

1. Patient education

2. Judge patient motivation

3. Establish credibility of voice pathologist

Front 3

Voice Medical Examination, what can it involve?

Back 3

1. Indirect laryngoscopy

2. Fiberoptic laryngoscopy

3. Direct laryngoscopy

4. Laryngeal videostroboscopy

Front 4

Components of Voice Pathology Exam

Back 4

1. Patient Interview

2. Perceptual Voice Assessment

3. Instrumental Assessment of Vocal Function

4. Patient Self-Rating

Front 5

11 Parts of patient interview

Back 5

1. Problem

2. Effects

3. Development

4. Variability

5. Associated signs/symptoms

6. Voice use

7. Health

8. Vocational

9. Social

10. Recreational

11. Psychological

Front 6

What is perception?

Back 6

The psychological representation of a physical stimulus

Front 7

Why is perception difficult to define?

Back 7

it is often formed based on their world

Front 8

Influential factors of perception

Back 8

1. Age

2. Sex

3. Language

4. Culture

5. Intrinsic and extrinsic bias

Front 9

Perception of vocal quality is highly...

Back 9

complex

Front 10

Systematic scaling techniques

Back 10

specific strategies forcompleting perceptual analysis of voice

Front 11

Ordinal scale

Back 11

wherenumbers are assigned to attributes

Front 12

Visual Analog scale

Back 12

atool where a line is used with two defined end points and ratings can be placedon the line to define the magnitude of a sensation

Front 13

Auditory Perceptual Evaluation Parts (8)

Back 13

1. General Quality

2. Respiration

3. Phonation

4. Resonance

5. Loudness

6. Pitch

7. Vocal Effort

8. Severity

Front 14

GRBAS

Back 14

0-3 rating scale

G= Grade is how rough the voice sounds

R= Roughness is a judgment of how irregular and noisy the voice sounds

B= Breathiness is a judgment of how much additional airflow is perceived

A= Asthenia is a judgment of how weak the voice sounds

S = Strain is a judgment of how compressed or hyperfunctional the voice sounds

Front 15

CAPE-V

Back 15

Consensus of Auditory Perceptual Evaluation of Voice

Front 16

Clinical Utility - Detection, Severity, Diagnosis

Back 16

Detection - identify the existence of a voice problem

Severity - assess the severity or stage of progression of the voice problem

Diagnosis - identify the differential source of the voice problem

Front 17

Instrumental measures (6)

Back 17

1. Laryngeal videostroboscopy

2. High Speed Digital Imaging (HSDI)

3. Aerodynamic Assessment

4. Acoustic Recording and Analysis

5. Electroglottography

6. Electromyography

Front 18

2 types of Laryngeal Videostroboscopy

Back 18

1. Rigid endoscopy (70 degree angle)

2. Flexible Endoscopy

Front 19

Talbot's Law

Back 19

When sequential images are produced at intervals shorter than 0.2 seconds, they persist on the retina with successive images to produce the optical illusion of movement

Front 20

High Speed Digital Imaging is in...

Back 20

real time

Front 21

Acoustic Analyses assess physical correlates of perceptual evaluation (4)

Back 21

1. Pitch/Frequency

2. Loudness/Intensity

3. Perturbation (disturbance between cycles)

4. Noise

Front 22

Routine Voice Acoustics Measures (12)

Back 22

1. Fundamental Frequency

2. Frequency Variability

3. Phonation Range

4. Frequency Perturbation

5. Intensity

6. Overall SPL

7. Amplitude Variability

8. Dynamic Range

9. Amplitude Perturbation

10. Harmonics to Noise Ratio

11. Voice Range Profile

12. Spectral Analysis

Front 23

Fundamental Frequency Normative Data

Back 23

Males = 100-150 Hz

Females = 180-230 Hz

Front 24

Frequency Variability Normative Data

Back 24

(Pitch sigma)

20-30 Hz range

Front 25

Phonation Range Normative data

Back 25

Young adults have a 3 octave range

Front 26

Frequency Perturbation (jitter) normative data

Back 26

<1.00%

Front 27

Overall SPL Normative data

Back 27

75-80 dB conversation

Front 28

Amplitude variability normative data

Back 28

~10 dB

Front 29

Dynamic Range normative data

Back 29

50-115 dB SPL

Front 30

Amplitude Perturbation (shimmer) normative data

Back 30

<0.35 dB

Front 31

Harmonics to Noise Ratio: What reflects better voice quality?

Back 31

Greater signal or harmonic energy in the voice. Large noise energy represents more abnormal function

Front 32

Voice Range profile is also called a...

Back 32

phonetogram

Front 33

What does a phonetogram plot?

Back 33

maximum and minimum intensities for entire frequency range

Front 34

What is spectral analysis?

Back 34

A sound spectrogram displays the glottal sound source and filtering characteristics across time

Front 35

What are the parts of a spectrogram?

Back 35

Horizontal Axis = time

Vertical Axis = frequency

Lowest band = Fundamental frequency

Gray scale represents intensity changes

Front 36

Aerodynamic measurement of voice production helps interpret what about valving activity of larynx?

Back 36

1. VF structure

2. VF configuration

3. VF movement

Front 37

Aerodynamic assessment ideally measures...

Back 37

1. Volume of air/vital capacity

2. Airflow rate

3. Subglottal pressure

Front 38

What is needed to measure all 3 aspects of aerodynamic assessment at once (but not necessary)?

Back 38

pneumotachograph

Front 39

What are the aerodynamic assessment tasks?

Back 39

1. Maximum Phonation Time

2. S/Z ratio

3. Hand-held spirometer

4. Subglottal pressure screening (5 for 5)

Front 40

Instruments for measuring pressure and flow (5)

Back 40

1. U tube manometer

2. Wet spirometer

3. Hot wire anemometer

4. Pneumotachograph

5. Magnetometers

Front 41

Common Aerodynamic Measures (6)

Back 41

1. Airflow volume

2. Maximum Phonation time

3. Airflow Rate

4. Subglottal air pressure

5. Phonation threshold pressure

6. Laryngeal airway resistance

Front 42

Electroglottography (EGG) - what is it?

Back 42

Using an electrical current passing through the neck, EGG measures VF contact across time

Front 43

Electromyography (EMG) is the only...

Back 43

direct measure of laryngeal function

Front 44

What is EMG?

Back 44

Needle electrodes are inserted into the laryngeal muscles and the pattern of electrical activity is measured (used to determine paralysis vs. arytenoid fixation)

Front 45

Patient Self assessment is...

Back 45

Atool that defines these impacts on a patient and/or their family needs to help the clinician to understand the broader influence of the disorder/disease beyond the immediate impairment

Front 46

Patient self assessment is important for identifying...

Back 46

1. Functional tx goals

2. Patient awareness of deficit

3. Impact on QoL

Front 47

Self assessment tools

Back 47

1. Voice Handicap Index

2. Voice Related Quality of Life

3. Glottal Function Index

4. Reflux Symptom Index

Front 48

What is dynamic range

Back 48

range of vocal intensities that a person can produce

Front 49

What is airflow volume

Back 49

volume of air in the lungs available to drive the VF for voice production

Front 50

What is airflow rate?

Back 50

Rate at which air passes between the VF during phonation

Front 51

What is PTP?

Back 51

measure of the effort needed for initiate phonation

Front 52

Tidal Volume

Back 52

Amount of air inhaled and exhaled during a respiratory cycle

Front 53

Inspiratory reserve volume

Back 53

Amount of air that can be inhaled above TV

Front 54

Expiratory Reserve Volume

Back 54

Amount of air that can be exhaled below TV

Front 55

Residual Volume

Back 55

Air remaining in lungs after max exhalation

Front 56

Dead Air

Back 56

Air present in upper respiratory passage and bronchial tree; not involved in gas exchange

Front 57

Vital Capacity

Back 57

Max amount of air exhaled after having inhaled as deeply as possible MP

Front 58

Functional Residual Capacity

Back 58

Amount of air remaining in the lungs and airways at REL

Front 59

Inspiratory Capacity

Back 59

Amount of air that can be inhaled from REL

Front 60

Total Lung Capacity

Back 60

Total amount of air that the lungs can hold