Questions and Answers
Which voice injury requires complete vocal rest?
Vascularization of the tissue of the vocal folds (or surrounding structures) is a condition that requires complete vocal rest.
True
What therapy technique reduces vocal fold tension?
Which of the following symptomatic voice therapy techniques are appropriate for hyperfunctional voice disorders?
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Negative practice is counterproductive in voice therapy and should not be used.
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How to teach patients to hum properly?
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What disorder is injection augmentation used to treat?
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A surgically created opening in the neck to allow for breathing is called a __________.
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Select from the list below any symptoms that patients with supraglottic cancers can present with.
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Aspiration is a big concern after a total laryngectomy.
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Match the procedure to its description
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There is a risk of airway fire in laser (CO2) surgery.
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The removal of small nodules or lesions via microsurgery can be done in a quickly as 10-20 minutes.
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The SLPs role in the surgery process is pre- and post-operative care and helping the patient unlearn bad compensatory habits.
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The goal of phonosurgery is (select all that apply)
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What way(s) is the airway protected during laryngeal surgery?
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Which two conditions are usually treated by microflap surgery?
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What are the advantages of awake procedures?
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Postoperative counseling is not important.
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A laryngologist can remove a nodule during an awake procedure.
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Why would a surgeon choose to use Juvaderm or Restylane instead of a lipoinjection for vocal fold augmentation?
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Besides a distal chip, what other equipment do flexible scopes have that enables doctors to perform surgery with them?
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The procedure that involves removal of one vertical half of the larynx including one false vocal fold, ventricle, true vocal fold, and portion of the thyroid cartilage on the involved side is called:
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Concomitant treatment involves
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The TEP using a duckbill style prosthesis requires ___________ air pressure for speech than other prostheses.
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A supraglottic tumor staged T4b invades through the thyroid cartilage, and/or invades tissues beyond the larynx.
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Head and neck cancer accounts for _____% of new cases of cancer
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Cancer is the uncontrolled growth of _________________ cells.
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The ratio of male-to-female head and neck cancers is ___________.
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What technique involves using intraoral air pressure to inject air into the esophagus?
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Which method creates a vacuum effect in the esophagus due to an increase in negative pressure in the thoracic cavity?
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What is the primary benefit of the indwelling prosthesis compared to other prostheses?
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What occurs during the consonant press injection method?
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In which technique does the patient take a deep breath through the stoma?
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Communication following total laryngetcomy is dependent on alaryngeal speech modes
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Gastric upset is a problem side-effect of medication because it may lead to laryngopharyngeal reflux.
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Two ways obesity can affect the voice include increased likelihood of reflux and ______________
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The most common cause of chronic cough in adults are upper respiratory infection, asthma, and ________________.
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It's important for those working with CCM artists to know what __________________________________ are.
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Contemporary commercial musical and classical music are synonymous.
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Which two medications reduce mucus?
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Match the term with its description
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High-speed videoendoscopy captures vocal fold vibration in real time because the rate of frames per second is so quick.
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Which allows assessment of vocal fold function during more complex vocal tasks>
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SLPs can diagnose voice disorders
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Spasmodic dysphonia can affect either the ____________ or _______________ muscles.
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Match the pathology to its description.
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Vocal fold nodules typically form unilaterally.
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_____ has its own blood supply
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Which of the following is not a cause of laryngitis?
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Match the perceptual rating form to the individual that will fill it out.
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Which of the following perceptual tools is the most scientifically valid and is completed by the patient?
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It's important to ask patients if they're taking ____________, ___________, and/or _________________ because they can have interactions or side-effects that may impact the voice. Allergic reactions are also possible.
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If you have a patient taking several herbal supplements and you are worried about potential side effects or interactions, who should you consult?
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What elevates the hyoid bone?
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What depresses the hyoid?
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What elevates the ribcage?
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_______ when one lung ruptures.
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Inspiration is always active, while expiration can be passive or active
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Match the term to its description
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Elastic recoil is an active force in respiration
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Even with training, screaming is never healthy.
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Match the type of treatment to its description
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Match the disorder with its appropriate surgical treatment.
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Match the disorder with the appropriate surgical treatment.
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Which of the following is not a medication used to treat laryngopharyngeal reflux?
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The upper esophageal sphincter is impacted in gastroesophageal reflux.
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What is the difference between spasmodic dysphonia and essential tremor
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Adolescent males who have seemingly maladjusted growth of the larynx – Maintenance of a high--pitched voice
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What is the purpose of an SLP using vocal function exercises in evaluation?
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Who are vocal fucntion exercises suitable for?
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How can weak, breathy phonation be treated?
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Match the type of spasmodic dysphonia to its description.
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Match the type of perceptual rating form to its description
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Match the perceptual measure to its description.
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LSVT is used for hypofunctional voice disorders.
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Lassac Madison voice therapy (LMRVT) is used for hypofunctional voice disorders
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Tasks like coughing and sneezing as well as certain speaking events can cause the abdominal wall to __________. This ________ the intra-abdominal pressure.
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A behavioral therapy technique important for many patients includes changing a hard glottal attack for an easier, more relaxed start to phonation.
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All types of acid-preventing gastrointestinal drugs are free of any harmful side effects.
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One advantage of digital laryngostroboscopy is __________
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A perceptual voice rating scale (GRBAS or CAPE-V) can be used alone for the determining of the type of voice disorder that is present?
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High-speed videoendoscopy captures vocal fold vibration in real time because the rate of frames per second is so quick.
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In the case of many neurogenic voice disorders, surgery is the best treatment option available.
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In ________________ the vocal folds are moving abnormally at rest, and in _______________ the vocal folds are not moving at rest. This is one of the ways we're able to tell them apart.
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Why does a singer's assessment use both the rigid and flexible scope for imaging?
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Which of the following symptomatic voice therapy techniques are appropriate for hyperfunctional voice disorders?
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Which of the following is more likely to cause a globus sensation?
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These vocal qualities are the most common associated with vocal nodules. Check all that apply
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Vocal fold nodules occur in the _________ layer of the vocal folds.
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What is the most common of the vocal pathologies?
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How long are surgical interventions postponed in the case of suspected trauma to the RLN?
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The removal of the _____________ helps symptoms for more than 70% of patients with myasthenia gravis.
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What condition is ADSD often confused with?
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The removal of the arytenoid cartilage is called a:
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Surgeons are focused on which priorities during excision of things causing dysphonia?
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It was OK that patient A (polyp) did not attend post-operative therapy (not the one visit post-op) with an SLP because the pathology is not likely to recur.
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Case study: Female, age 24, first grade teacher, reports a breathy voice, loss of vocal range and reduced endurance. She reports her voice is "horrible" by Thursday afternoon. She is single, lives alones, and typically limits her social life except on weekends. What is the most likely diagnosis?
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When the diaphragm relaxes during inspiration it moves downward and flattens, enlarging the chest cavity.
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Case study: A boy, 15 years, complains of high pitch, breathy vocal quality, and reduced vocal loudness. What disorder does he present with?
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The diaphragm is a major muscle of inspiration
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Which of the following are infrahyoid muscles?
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The act of inspiration is always active
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For vocal nodules, phonosurgery is often necessary.
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Vocal cysts have their own blood supply.
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Typical symptoms for individuals that present with vocal polyp:
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Gastroesophageal reflux is associated with intubation trauma and granuloma formation.
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Laryngopharyngeal reflux (LPR) is often referred to as silent reflux.
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Match the type of reflux to its description
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Which of the following is a treatment approach for GERD?
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How does LPR differ from GERD?
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Study Notes
Esophageal Speech
- Produced by transporting approximately 45 mL of air from the oral and pharyngeal cavities into the esophagus.
- Air is redirected past the pharyngoesophageal (PE) segment to vibrate tissue and create sound.
- Rapid air transport can lead to the production of intelligible speech, which is articulated with the tongue, lips, teeth, and palate.
Primary Techniques for Esophageal Speech
-
Injection Technique:
- Involves forcing air back into the pharynx and esophagus using two methods:
- Consonant Press Injection: Utilizes natural air pressure from plosive and fricative sounds to inject air.
- Glossopharyngeal Press: Seals lips and tongue to create increased intraoral pressure directing air to the PE segment.
- Involves forcing air back into the pharynx and esophagus using two methods:
-
Inhalation Technique:
- Engages rapid thoracic cavity expansion to draw air into the esophagus.
- Patient breathes deeply through a stoma, creating a vacuum effect as the diaphragm moves downward.
Tracheoesophageal Puncture (TEP)
- A surgical procedure creating a small puncture through the posterior tracheal wall into the esophagus.
- Can be performed during laryngectomy surgery (primary TEP) or later (secondary TEP) after adequate healing.
- Involves inserting a one-way valve into the puncture to prevent closure and aspiration of contents into the trachea.
Procedure Details
- The puncture allows pulmonary air to flow into the esophagus, driving the vibration needed for TE speech.
- Involves careful surgical creation of the puncture and valve placement.
TEP Prosthetic Devices
-
Non-Indwelling Devices:
- Duckbill Style: Original prosthesis with a slit-type valve.
- Low Pressure/Low Resistance: A hinged valve that requires less respiratory effort for sound production compared to duckbill style.
-
Indwelling Prosthesis:
- Refers to long-term wear prosthesis inserted by a clinician, reducing maintenance needs.
Key Points
- Esophageal speech relies on airflow manipulation from the lungs or oral cavity into the esophagus.
- Mastery of sound production techniques is critical for intelligible speech post-laryngectomy.
- TEP is an effective surgical option enhancing voice restoration, supported by specialized prosthetic devices.
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Description
Test your knowledge about voice injuries and the importance of vocal rest. This quiz will help you identify which vocal conditions require complete rest for recovery. Understand the implications of different injuries on vocal health.