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114 Cards in this Set
- Front
- Back
Bernoulli Effect
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air pushes through the vocal folds, adducts them
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myoelastic aerodynamic theory
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I don't know
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Tidal Breathing
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the amnt of air movement during quiet breathing to sustain life (1/2 liter of air is inhaled.)
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Speech Breathing
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during speech breathing, a person may inhale as much as 2 liters of air
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vital capacity
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total amnt of controllable air in the lungs
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residual volume
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air remaining after exhalation
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the primary role of respiratory system
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during speech, its goal is to control vocal intensity (loudness)
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Resonance
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the acoustic phenomenon by which a sound source excites air in an air filled chamber to vibrate.
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Quality and loudness aspects of the voice
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can be attributed to the unique arrangement of the supraglottic resonators
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Anatomic structures of resonance
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-oral cavity
-nasal cavity -soft palate -Pharynx (nasopharnyx, oropharynx, Laryngopharynx) -the role of velopharyngeal closure |
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How do you get someone to decrease perceived hypernasality?
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have them open their mouth wider, you're using more oral resonance that way.
To identify hypernasality, get them to say "puppy", then close nairs and say it again, if it sound's different, they need some work |
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stridor
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inhalation, exhalation, straining noise at vfs
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Thyroid cartilage
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idk
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thyroid cartilage
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largest cartilage of larynx (the largest prominence is the adam's apple)
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cricoid cartilage
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signet shaped
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Larynx parts
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-thyroid cartilage
- cricoid cartilage - epiglottis - arytenoid cartilage -hyoid bone |
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epiglottis
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large leaf shaped (no function for speech)
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Arytenoid cartilages
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pair-pyramid shaped
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hyoid bone
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point of attachment for laryngeal and tongue musculature.
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muscles of the larynx
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-vfs
-supplemental muscles -extrinsic laryngeal muscles -intrinsic laryngeal muscles |
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Vocal Folds
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pair of thyroarytenoid muscles attached to thyroid and arytenoids
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Functions of Vfs:
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-adduction
-abduction -glottis -phonation -aerodynamic-myoelastic theory bernoulli effect |
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adduction
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come together
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abduction
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pull apart- sole muscle is posterior crycoarytenoid
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glottis
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opening between vfs
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phonation
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vf vibration
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aerodynamic theory
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interplay of aerodynamics and muscle force
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bernoulli effect
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subglottic air pressure causes out and upward movement and vf are blown apart. air rushing through causes it.
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physiology of voice
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-fundamental freq.
-pitch -habitual pitch -optimal pitch -loudness is measured in dB |
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fundamental freq.
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speed of vf vibration
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pitch
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the perceptual counterpart to fundamental freq. (fo) measured in Hz or the number of complete vibrations per second
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habitual pitch
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average fo (the actual pitch one uses for speech)
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optimal pitch
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suitable pitch level. adult male ave: 125 Hz, adult female ave: 200 Hz. (not disordered)
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loudness
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measured in dB
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Respiratory system
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can be divided into 2 parts:
-upper resp. tract -lower resp tract |
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upper respiratory tract
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trachea, 2 bronchi, and the lungs???/
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lower respiratory tract
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trachea, 2 bronchi, and the lungs???//
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pulmonary system
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consists of trachea and lungs
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muscles for breathing are divided functionally for inhalation and exhalation
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?
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diaphragm
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most important single muscle, thin, dome shaped muscle and tendon that seperates.
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CREM
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-Credentials
-Respect (you respect your client, they respect you) -Education (continually educate yourself and your client too) -Motivator (you motivate them, both of you-therapist and client must be motivated) |
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Inhalation
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intercostal muscles
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dysphonia
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voicing is inconsistent, voice is in and out
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aphonia
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complete loss of voicing
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harshness
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energy and attack that one uses
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aphonic break
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loss of voicing during speech
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pitch break
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spikes in pitch
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tremor
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old people trembly voice, neurological problem
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diplophonia
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2 pitches, can hear both high and low at same time
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glottal attack
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abrupt tension to all sounds
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strained/ strangled
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often neurological, spasmodic disphonias
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glottal fry
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?
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vocal tension
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you can even see it, like with a whisper
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deterioration
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start strong, voice deteriorates
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rating scales
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- GRBAS scale
- consensus auditory - voice handicap index |
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GRBAS scale
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evaluates:
grade, rough, ashenic (weak), breathy, strained |
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consensus auditory
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perceptual evaluation of voice (CAPE-V) (Asha 2003)
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functional voice assessment
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-acoustic and aerodynamic assessment
-examination of oral structures -visualization of laryngeal structures |
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Acoustic Analysis
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-uses instrumentation to analyze properties of a sound wave
-data compared with normative data -visi-pitch and CSL |
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Acoustic analysis provides measures of:
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-freq (pitch)
-amplitude/intensity (volume) -disturbance (perturbation) |
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frequency (pitch)
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-measures of vibration (Hz)
-fundamental frequency (lowest freq of the voice) |
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Amplitude/ intensity (volume)
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males: 77.8 dB
females: 74.0 dB |
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Disturbance (perturbation)
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-refers to disturbance in the regularity of the waveform
-disturbances reflect changes in mass, tension, or vibratory characteristics of the folds from one cycle to the next. -correlates to perceived roughness or harshness |
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Jitter
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short term analysis of cycle to cycle variation in fundamental freq.
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shimmer
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short term evaluation of cycle to cycle variation in amplitude. Reflects changes in intensity
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Harmonics to Noise Ratio (HNR)
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other recommended tasks: record a conversational and reading sample- rainbow passage, my grandfather- mic held approximately one inch from mouth.
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aerodynamic assessment
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airflow measurement (spirometry)
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glottal airflow
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to measure vocal efficiency
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measures of vibratory cycle
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glottal waveform analysis
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non- instumental assessment
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-pitch range
-maximum phonation time (MPT) -s/z ratio -speaking rate |
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pitch range
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using a pitch pipe or keyboard. low-to-high. the norm is 2 to 3 octaves
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maximum phonation time (MPT)
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sustain a vowel. 3 trials, norm is 15-20 secs (mine is 13-19)
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s/z ratio
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should be 1:1 ratio
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speaking rate
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words per minute, norm for reading 210-265 WPM, speaking 115-165 WPM
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Vocal tract visualization
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-indirect (laryngeal mirror)
-direct visualization (fiberoptic laryngoscopy, rigid laryngoscopy, videolarygealstroboscopy (VLS) |
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Clinical report writing
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-only a physician can render a medical dianosis
- SLPs provide assessment of vocal quality and vf functioning -describe structural findings as "suggestive of" or "consistent with" |
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recommendations
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-independent of ENT include: re-evaluation by ENT, review of examination w/ ENT for medical managements
-voice therapy include dx, specific number of sessions, and duration for approval/authorization of insurance. |
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vibration theories
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- myoelastic aerodynamic theories
- bernoulli effect - mucosal wave |
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mucosal wave
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-not only do the vfs vibrate, but there is additional movement of the surface of the cords
-vf are comprised of muscle and mucosa -the mucosa is divided into the lamina propria and the epithelium, -there are 3 layers of the lamina propria, all three are diff density, elasticity, and strength -during vibration, they move in a wave-like manner |
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descriptions of voice disorders
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-functional
- organic -neurological |
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functional vds
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result from behaviors or reactions to traumatic events. functional describes the etiology of the voice problem that exists in the absence of pathology.
- pathology is a structural or functional change that occurs from a disease process -the voice problem is related to misuse of the mechanism -hyperfunction: over use -hypofunction: weak, reduced voice |
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organic vds
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caused by some physical condition that has impacted the structure of the larynx.
-related to changes in the anatomy of histology of the larnygeal tissue. changes result in a change in the voice -organic pathology can result from a functional disorder -nodules is an example. |
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neurological vds
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result from damage to the central (brain and spinal cord) nervous system or the peripheral (cranial nerves) nervous system.
-results from an interruption in neuromuscular control. there can be a complete absence of movement or a loss of coordination of movement. |
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characteristics of a voice disorder
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-difficulty initiating or controlling the voice
- pitch: controlled by tension which effects how the vfs vibrate (too high or low) -loudness- too weak or too loud -quality:deviations in hoarsness or nasality, problems can exist by themselves or in any combo. (in tandem) |
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prevalence
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voice disorders are heard frequently in the adult population 6-10%.
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voice subsystems
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-breathing-asthma, cancer, emphysema
-oral cavity- deviant structures -nasal cavity- deviant structures (deviated septums) -articulation- manner |
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what constitutes a voice disorder
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-indentified by the person who uses it.
- does it effect daily life - define what is normal -medical diagnosis is required |
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pitch
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-mono-pitch
-inappropriate pitch -pitch breaks - reduced ranged |
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mono-pitch
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lacks vibration, inability to, involuntary control pitch
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inappropriate pitch
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either too high or too low for age, sex, size
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pitch breaks
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unexpected sudden shifts in pitch either upward or downward
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reduced range
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loss of ability to produce high or low pitch
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loudness
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-mono loudness
- reduced variation -reduced loudness range |
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mono-loudness
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lacks vibration in volume
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reduced variation
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voice may be too soft or too loud (could indicate a psychological problem, auditory dysfunction or habit)
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reduced loudness range
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usually the inability to produce a loud voice
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quality difficulties
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-horse and rough
-breathy -tension -tremor -strain/struggle -diplophonia -stridor -excessive throat clearing -aphonia |
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horse and rough voice quality
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lack of clarity, increased noisiness and discordance
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breathy
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audible air escape
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tension
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"hard-edge" hard glottal attack, observable muscle tension, in most cases related to hyperfunction.
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tremor
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rhythmic variations in pitch and loudness that are not under voluntary control.
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strain/struggle
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difficulty initiating phonation or difficulty maintaining voicing, voice may fade in or out. complete stoppages may occur (Aphonia), may indicate some type of neurological etiology
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diplophonia
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"double voice" when 2 distinct voices occur at once
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stridor
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noisy breathing. Involuntary
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aphonia
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episodic or inconsistent breaks in voicing
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nodules
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vocal abuse, vocal load cause these callouses- behavioral therapy is usually best- the best voice is the one that takes the least amnt of effort to produce. occurs on anterior 1/3rd of vfs
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polyps
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occur because of viruses. sometimes have to be surgically removed, kind of like blisters. speech is often breathy.
therapy- typically medical removal. cause: can be caused by trauma to the vfs (one event usually). -sessle polyps can also be peunculated. |
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vf hemorrhage
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caused by misuse, some times related hormonally- female singers sometimes
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renike's edema
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strictly from smoking cigaretts voice sounds deeper in pitch, raspy, breathing pitch is called by length and mass of vfs (might even have stridor- noisy breathing- like Nadine)
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laryngitis
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need to stop talking during horse voicing. sometimes these start- all the disorders w/ laryngitis they thicken.
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granuloma
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contact granulomas.
-causes- intibated during surgery, will go away, make you horse, it's just irritation and rubbing on vfsm usually happens posteriorly, breathing voice because of ill closure, deeper pitch from more mass |
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cancer
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often occurs w/ hemmorhaging
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vf bowing or presbylaryngis
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assymetry in upper part of larynx
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spasmotic dysphonial
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doesn't respond to voice therapy.
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