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?

<p>180-220 Hz (B)</p> Signup and view all the answers

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

<p>Increased tension. (D)</p> Signup and view all the answers

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

<p>Around menopause. (D)</p> Signup and view all the answers

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

<p>Dysphonia. (D)</p> Signup and view all the answers

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

<p>Vocal fold tension. (B)</p> Signup and view all the answers

What is the hallmark characteristic of spasmodic dysphonia?

<p>Intermittent voice stoppages (A)</p> Signup and view all the answers

What type of spasmodic dysphonia is the most common?

<p>Adductor type (A)</p> Signup and view all the answers

Which symptom is NOT typically associated with iatrogenic etiology?

<p>Progressive muscular weakness (D)</p> Signup and view all the answers

What is a common vocal characteristic in individuals with ALS?

<p>Soft and breathy voice (C)</p> Signup and view all the answers

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

<p>Rigid muscular tone (C)</p> Signup and view all the answers

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

<p>Lee Silverman Voice Treatment (LSVT) (D)</p> Signup and view all the answers

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

<p>Less than 10 years (C)</p> Signup and view all the answers

Which characteristics describe the adductor type of spasmodic dysphonia?

<p>Strangled and squeezed voice (B)</p> Signup and view all the answers

Which of the following best describes vocal tic disorder?

<p>It involves sudden, rapid, recurrent vocalizations occurring many times per day for 1 year. (A)</p> Signup and view all the answers

What distinguishes Tourette syndrome from vocal tic disorder?

<p>Only Tourette syndrome includes motor tics alongside vocal tics. (D)</p> Signup and view all the answers

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

<p>It was previously thought to be solely due to anxiety or stress. (D)</p> Signup and view all the answers

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

<p>Females and individuals aged 10-40 years (C)</p> Signup and view all the answers

What characterizes psychogenic voice disorders?

<p>They arise from emotional and psychological events. (B)</p> Signup and view all the answers

What is often reported by individuals suffering from PVFM?

<p>Feeling of choking or tightness in the throat. (A)</p> Signup and view all the answers

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

<p>Understanding co-occurring conditions is essential for treatment. (C)</p> Signup and view all the answers

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

<p>Non-organic disorders do not have identifiable physical causes. (C)</p> Signup and view all the answers

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

<p>Chronic worry (C)</p> Signup and view all the answers

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

<p>Generalized Anxiety Disorder (B)</p> Signup and view all the answers

What does mutational falsetto refer to?

<p>Inappropriately high voice in males (B)</p> Signup and view all the answers

What is a characteristic feature of juvenile voice disorder?

<p>Pitch does not drop after puberty (D)</p> Signup and view all the answers

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

<p>Tracheostomy (B)</p> Signup and view all the answers

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

<p>Allows speech during exhalation (B)</p> Signup and view all the answers

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

<p>A lack of concern regarding serious symptoms (A)</p> Signup and view all the answers

What is one potential cause of mutational falsetto in males?

<p>Undergrowth of the larynx (C)</p> Signup and view all the answers

What is the primary goal of a laryngectomy?

<p>Remove malignancy (B)</p> Signup and view all the answers

Which group has the highest mortality rate from laryngeal cancer?

<p>African American males (B)</p> Signup and view all the answers

What causes hypernasality?

<p>Velopharyngeal port remains open (B)</p> Signup and view all the answers

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

<p>Volume (B)</p> Signup and view all the answers

What condition can lead to underloudness in vocal quality?

<p>Neurological injury (A)</p> Signup and view all the answers

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

<p>Glottal fry (B)</p> Signup and view all the answers

What is a common cause of hyponasality?

<p>Blocked nasal cavity (B)</p> Signup and view all the answers

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

<p>Underloudness (C)</p> Signup and view all the answers

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

<p>Hard Glottal Attack (B)</p> 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?

<p>Otolaryngologist (B)</p> Signup and view all the answers

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

<p>Case History and Interview (B)</p> Signup and view all the answers

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

<p>Frequent yelling (D)</p> 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?

<p>Psychiatrist (D)</p> Signup and view all the answers

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

<p>Functional, physical, and emotional impacts (C)</p> Signup and view all the answers

Which of the following is a characteristic of glottal fry?

<p>Low, creaky voice quality (C)</p> Signup and view all the answers

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

<p>When a child exhibits possible voice disorder symptoms (A)</p> Signup and view all the answers

Flashcards

Voice Disorder

A difference in vocal pitch, loudness, or quality compared to people of similar age, gender, and background that noticeably impacts daily life.

Fundamental Frequency (F0)

The average rate of vibration of the vocal folds, perceived as pitch.

Vocal Fold Length

Longer vocal folds vibrate more slowly, leading to lower pitch.

Vocal Fold Mass

Thicker vocal folds vibrate more slowly, resulting in lower pitch.

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Vocal Fold Tension

More tension in vocal folds leads to faster vibrations, and higher pitch.

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Intensity (Voice)

The physical measure of sound pressure, perceived as loudness. Measured in decibels (dB).

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Phonation

The act of producing vocal sound.

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Resonance

The quality of a voice determined by the shape of the vocal tract and nasal cavity which modifies its fundamental frequency.

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What is Vocal Tic Disorder?

A disorder characterized by sudden, repeated vocalizations like clicks, yelps, or snorts, happening many times daily for a year, significantly impacting daily life.

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What is Tourette Syndrome?

A disorder involving both vocal and motor tics, affecting the head, torso, and limbs.

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What is Paradoxical Vocal Fold Movement (PVFM)?

A condition where vocal folds close during breathing, causing a sensation of choking or difficulty breathing.

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What is the most common demographic for PVFM?

Females between 10 and 40 years of age.

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Why is PVFM complex?

It can be caused by physical factors like GERD or psychological factors like anxiety.

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What is Psychogenic Voice Disorder?

A voice disorder linked to emotional or psychological events.

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What is Psychogenic Dysphonia?

A specific type of Psychogenic Voice Disorder characterized by a disordered voice quality caused by emotional or psychological factors.

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How does the voice reflect mental states?

The voice conveys emotions like fear, excitement, or anxiety.

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Psychogenic Voice Disorders

Voice problems caused by psychological or emotional factors, often linked to trauma or stress. These disorders don't involve physical damage to the vocal cords.

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Mutational Falsetto

A male child or adolescent who speaks in an inappropriately high voice, usually due to an underdevelopment of the larynx.

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Juvenile Voice Disorder

A woman who maintains a high pitched and childlike voice into adulthood, despite going through puberty.

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Conversion Disorder

A mental health condition where psychological distress manifests as physical symptoms, including voice problems.

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Tracheostomy

A surgical procedure to insert a tube into the trachea to help a person breathe, bypassing the vocal cords.

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Passy-Muir Valve

A device used with tracheostomies that allows air to flow over the vocal folds for speaking, while also enabling proper breathing.

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Alaryngeal Communication

Communicating without a larynx, typically as a result of a tracheostomy or laryngectomy.

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Emotional Impact on Voice

Stress, anxiety, and depression can directly affect voice quality, leading to changes in pitch, volume, and tone.

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Spasmodic Dysphonia

A voice disorder caused by spasms in the larynx, resulting in intermittent voice stoppages. It's now considered laryngeal dystonia, an abnormal movement of the larynx.

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Adductor Spasmodic Dysphonia

The most common type of spasmodic dysphonia, where the vocal cords (vocal folds) tighten too much, leading to a strained, squeezed voice.

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Abductor Spasmodic Dysphonia

A less common type of spasmodic dysphonia, where the vocal cords don't come together properly, leading to a breathy, weak voice.

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ALS (Amyotrophic Lateral Sclerosis)

A progressive neurodegenerative disease causing muscle weakness, fatigue, atrophy, spasms, tremors, and cramping. It leads to severe loss of voice and speech function over time.

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Parkinson's Disease

A progressive neurological disease impairing communication abilities and voice due to dopamine depletion. It affects the respiratory and laryngeal systems, leading to a weak, breathy voice.

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Lee Silverman Voice Treatment (LSVT)

A program specifically designed to improve vocal loudness and vocal fold adduction for people with Parkinson's disease.

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Iatrogenic Etiology

A symptom or disorder caused by medical treatment or clinical procedures.

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Vocal Fold Movement Impairment (VPMI)

A disorder where one or both vocal folds don't function properly, often caused by medical treatments or procedures.

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Laryngectomy

Surgical removal of the larynx, often due to cancer or trauma. The person who undergoes this procedure is called a laryngectomee.

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Laryngeal Cancer

Cancer of the larynx, often linked to tobacco use and alcohol consumption. Early identification is crucial.

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Velopharyngeal Port

The space between the soft palate and the back of the throat. It opens for nasal sounds and closes for other sounds.

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Hypernasality

A voice disorder where the velopharyngeal port remains open, causing excessive nasal resonance.

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Hyponasality

A voice disorder where the nasal cavity is blocked, resulting in a stuffy and congested voice.

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Glottal Fry

A voice disorder characterized by a low, raspy, and creaky voice, produced by tightly approximated vocal folds.

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Monotonic Voice

A voice lacking in vocal variation, either too soft or too loud, which can be a sign of vocal abuse.

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Overloudness

Speaking excessively loudly, often due to hearing loss, and can lead to vocal strain.

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Vocal Strain

Muscles working harder due to inefficient airflow, leading to fatigue and discomfort in your voice.

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Hard Glottal Attack

A harsh, abrupt vocal start caused by forcefully squeezing the vocal folds together.

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Breathy Phonation

A soft, whispery voice due to incomplete vocal fold closure, allowing air to escape during phonation.

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Voice Disorder Warning Signs (Children)

Frequent yelling, screaming, and crying, especially in the absence of illness or allergies, can indicate a potential voice disorder in children.

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Voice Disorder Warning Signs (Adults)

Sustained changes in voice quality, pitch, loudness, or resonance lasting over two weeks warrant evaluation.

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Voice Care Team

Collaboration of medical professionals specializing in voice disorders, including otolaryngologists, SLPs, and psychologists, for a holistic diagnosis and treatment plan.

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Voice Handicap Index (VHI)

A tool used to assess the impact of voice disorders on daily life, evaluating functional, physical, and emotional aspects.

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Assessment Protocol for Voice Disorders

A comprehensive assessment includes medical history, oral-motor examination, clinical observation, and instrumentation to determine the nature and cause of the disorder.

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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.

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