Voice Disorders and Laryngectomy Overview

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Questions and Answers

What is the primary relationship between frequency and pitch in voice disorders?

Frequency is equivalent to pitch. (correct)

High frequency results from thicker vocal folds.

Frequency and pitch are completely unrelated.

Frequency determines the quality of vocal resonance.

How does the mass of the vocal folds affect the fundamental frequency (F0)?

Thicker vocal folds contribute to a lower F0. (correct)

Thinner vocal folds contribute to a lower F0.

Thicker vocal folds contribute to a higher F0.

Mass has no effect on F0.

What is the main factor influencing the intensity of voice production?

The resonance of the vocal tract.

The pitch of the voice.

The length of the vocal folds.

The amount of airflow from the lungs. (correct)

What is the typical fundamental frequency range for adult females?

180-220 Hz Signup and view all the answers

Which vocal fold characteristic contributes to a higher fundamental frequency (F0)?

Increased tension. Signup and view all the answers

When does fundamental frequency (F0) typically begin to decrease in women?

Around menopause. Signup and view all the answers

What condition is characterized by differences in pitch, loudness, or phonatory quality when compared to peers?

Dysphonia. Signup and view all the answers

Which of the following factors does NOT contribute to the intensity of vocal fold production?

Vocal fold tension. Signup and view all the answers

What is the hallmark characteristic of spasmodic dysphonia?

Intermittent voice stoppages Signup and view all the answers

What type of spasmodic dysphonia is the most common?

Adductor type Signup and view all the answers

Which symptom is NOT typically associated with iatrogenic etiology?

Progressive muscular weakness Signup and view all the answers

What is a common vocal characteristic in individuals with ALS?

Soft and breathy voice Signup and view all the answers

Which of the following is not a symptom of spasmodic dysphonia?

Rigid muscular tone Signup and view all the answers

What treatment is effective in improving voice function in individuals with Parkinson's disease?

Lee Silverman Voice Treatment (LSVT) Signup and view all the answers

What is the life expectancy of an individual diagnosed with ALS?

Less than 10 years Signup and view all the answers

Which characteristics describe the adductor type of spasmodic dysphonia?

Strangled and squeezed voice Signup and view all the answers

Which of the following best describes vocal tic disorder?

It involves sudden, rapid, recurrent vocalizations occurring many times per day for 1 year. Signup and view all the answers

What distinguishes Tourette syndrome from vocal tic disorder?

Only Tourette syndrome includes motor tics alongside vocal tics. Signup and view all the answers

What is a common psychological attribution for paradoxical vocal fold movement (PVFM)?

It was previously thought to be solely due to anxiety or stress. Signup and view all the answers

In which population is paradoxical vocal fold movement (PVFM) most commonly observed?

Females and individuals aged 10-40 years Signup and view all the answers

What characterizes psychogenic voice disorders?

They arise from emotional and psychological events. Signup and view all the answers

What is often reported by individuals suffering from PVFM?

Feeling of choking or tightness in the throat. Signup and view all the answers

What contributes to the treatment approach for paradoxical vocal fold movement (PVFM)?

Understanding co-occurring conditions is essential for treatment. Signup and view all the answers

What is a key difference between organic and non-organic voice disorders?

Non-organic disorders do not have identifiable physical causes. Signup and view all the answers

What is a common psychological factor that can worsen vocal problems?

Chronic worry Signup and view all the answers

Which of the following is a psychopathic condition that may affect voice quality?

Generalized Anxiety Disorder Signup and view all the answers

What does mutational falsetto refer to?

Inappropriately high voice in males Signup and view all the answers

What is a characteristic feature of juvenile voice disorder?

Pitch does not drop after puberty Signup and view all the answers

What surgical procedure involves inserting a tube to facilitate breathing and bypass the vocal folds?

Tracheostomy Signup and view all the answers

What is the role of the Passy-Muir Valve in communication?

Allows speech during exhalation Signup and view all the answers

Which of the following best describes 'la belle indifference'?

A lack of concern regarding serious symptoms Signup and view all the answers

What is one potential cause of mutational falsetto in males?

Undergrowth of the larynx Signup and view all the answers

What is the primary goal of a laryngectomy?

Remove malignancy Signup and view all the answers

Which group has the highest mortality rate from laryngeal cancer?

African American males Signup and view all the answers

What causes hypernasality?

Velopharyngeal port remains open Signup and view all the answers

Which of the following is NOT a defining characteristic of voice disorders?

Volume Signup and view all the answers

What condition can lead to underloudness in vocal quality?

Neurological injury Signup and view all the answers

Which term describes a pitch that is unusually low and sounds like a poorly tuned engine?

Glottal fry Signup and view all the answers

What is a common cause of hyponasality?

Blocked nasal cavity Signup and view all the answers

What vocal quality indicates a person is producing their voice too softly?

Underloudness Signup and view all the answers

Which phonatory quality is characterized by a tense and abrupt onset of voice?

Hard Glottal Attack Signup and view all the answers

What is the first referral a person should make if experiencing voice disorder symptoms lasting more than two weeks?

Otolaryngologist Signup and view all the answers

Which assessment protocol is involved in determining a child's likelihood of developing stuttering?

Case History and Interview Signup and view all the answers

What is NOT a typical warning sign of voice disorders in adults?

Frequent yelling Signup and view all the answers

Which professional is likely to collaborate in a voice care team for a comprehensive understanding of a voice disorder?

Psychiatrist Signup and view all the answers

What aspect does the Voice Handicap Index (VHI) primarily evaluate?

Functional, physical, and emotional impacts Signup and view all the answers

Which of the following is a characteristic of glottal fry?

Low, creaky voice quality Signup and view all the answers

In which scenario would it be necessary to collect voice use information from a parent or caregiver?

When a child exhibits possible voice disorder symptoms Signup and view all the answers

Study Notes

Voice Disorders

Voice disorders are characterized by differences in pitch, loudness, or phonatory quality from a person of a similar gender, age, cultural background, and racial or ethnic group.
This difference is noticeable and detracts from everyday performance.
Definitions include voice, phonation, resonance, articulation, frequency, adduction, abduction, pitch, and phonatory quality.
Intensity is measured in decibels (dB) and is related to loudness.
Two vocal fold production features relate to intensity:
- Amount of airflow from lungs
- Amount of resistance by vocal folds to airflow.
Vocal fold functioning includes hypofunction and hyperfunction, spasticity (voice starts/stops intermittently), and diplophonia (double pitch production).

Voice Without a Larynx

Laryngectomy is a procedure that removes the larynx, frequently due to cancer.
Laryngectomy can be combined with surgery and radiation therapy.
Speech production is altered through alaryngeal communication techniques.

Voice Disorders in Children

Approximately 4-6% of children experience voice disorders.
Vocal nodules are a common cause of voice disorders in children.
Voice disorders in children may result from physiological factors (e.g., gastroesophageal reflux, low blood circulation, dehydration, and laryngeal tension) or psychological factors (e.g., anger, anxiety, distractibility, frustration, interpersonal problems, hyperactivity, and loud talking).
Voice disorders in children are more common in males.

Reasons Why Voice Disorders May Not Be Treated

Access to treatment
Knowledge of treatment related to voice disorders
Social perceptions

How Voice Disorders Are Classified

Vocal abuse
Neurogenic disorders
Psychogenic disorders

Vocal Nodules

Vocal nodules appear on the inner edges of the vocal folds as calloused growths.
Vocal nodules are frequently seen in children and adults and can result from chronic vocal misuse.
Vocal nodules can be acute or chronic in nature.

Contact Ulcers and Granuloma

Develop on the arytenoid cartilages in the posterior larynx.
Develop from repetitive forceful contact of the vocal folds.
Typically associated with breathiness, low voice quality.

Neurogenic Voice Disorders

Voice disorders caused by lesions on the vagus nerve.
Voice disorders linked to diseases such as spasmodic dysphonia, ALS, and Parkinson's Disease.
Diseases include: vagus nerve lesion, spasmodic dysphonia, ALS, Parkinson's Disease, etc.

Spasmodic Dysphonia

Disordered motor control of the larynx, resulting in intermittent voice interruptions.
Voice characteristics that follow spasmodic movements: jerky, grunting, squeezed, groaning, and stuttering.
Types include adductor and abductor.

Parkinson's Disease

Progressive neurological disorder causing reduced dopamine levels.
Speech and communication skills can be affected, including reduced pitch variation and breathiness.

Iatrogenic Etiology

Voice disorders resulting from medical or surgical treatments, such as intubation or surgery.
Resulting voice disorder may be a symptom or disorder of impaired laryngeal function.

Vocal Tics and Tourette Syndrome

Unusual vocalizations/tics, including clicks, yelps, snorts, etc.
Often associated with motor tics affecting other parts of the body.

Paradoxical Vocal Fold Movement (PVFM)

Abnormal closure of the vocal folds during breathing.
Rare and can be linked with underlying psychological factors.

Psychogenic Voice Disorders

Voice disorders linked to psychological or emotional experiences, and conditions like anxiety.
Symptoms include vocal quality alterations, such as breathiness, hoarseness and stress due to emotions.

Mutational Falsetto and Juvenile Voice Disorders

Voice problems related to changes in the larynx (e.g., inappropriate pitch, difficulty with voice change).
This can be related to conditions such as puberty, or endocrine or psychological issues.

Alaryngeal Communication

Speech production without the larynx (e.g., using tracheostomy or laryngectomy).
Methods include using artificial larynx, voice-output devices, esophageal speech, and tracheoesophageal speech.

Assessment Protocol

Procedures and methods for assessing voice disorders, including case histories, interviews, clinical observation, and instrument-based analyses.
Acoustic, aerodynamic, electroglottography, and videostroboscopy are examples of instrumental assessments.

Treatment

Multifaceted interventions targeting the specific causes of the voice problem using evidence-based practices, surgery or therapy, or both.
Voice disorders treatment options include: vocal hygiene programs, relaxation exercises, breathing exercises, and counseling.

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Description

This quiz explores the characteristics and definitions of voice disorders, including details on vocal fold production and measurements of intensity. It also covers the implications of laryngectomy on speech production and the alterations that follow this surgical procedure. Understand the medical background and terminology related to voice health.