question

Which FTs coordinate airflow?

answer

vocal function, power adduction, accent method,

question

vocal function exercises

answer

sustained /i/ as long as you can at top of head; lips in position for "null," starting at low note and sweeping up to high note then opposite-do in quiet voice

question

power adduction

answer

do this if did well on vocal function exercises; /ol/ for singers; /i/ for nonsingers; do these at five different notes as long as can (start at note where you talk)-- focus should be high front so as to take away tension

question

goal of vocal function exercises is to do it right....

answer

now to sound right

question

where are nodules found

answer

1/2 way point of membranous glottis; or 1/3 back from anterior of whole glottis

question

why are nodules bilateral

answer

the hard mass (nodule) on one vocal fold hits the other; one that shows up first is bigger

question

why are polyps not bilateral

answer

they are a squishy bag, not hard

question

causes of polyps

answer

burns, bad cough, screaming, over singing...

question

what all sounds the same

answer

polyps, nodules, and cancer

question

where do polyps happening from one time trauma happen on vf?

answer

same place as nodules (1/2 m.g.) bc that's where vocal folds come together the hardest

question

why do polyps and nodules not go away very quickly

answer

there is no lymph at the level of the vocal folds; very important to catch cancer soon for this reason!!!

question

granuloma

answer

inlammation that usually occurs in the cartilaginous glottis from intubation; happens after contact ulcer

question

who are granuloma most common in

answer

women and children

question

what are precipitating factors of granuloma

answer

reflux and infection

question

is granuloma bi or uni lateral

answer

bilateral

question

what can cause granuloma

answer

lifting heavy weights, having babies, etc. also intubation

question

why can contact ulcers cause pain in ear

answer

the vagus nerve is close to the vestibulocochlear nerve

question

ex. of long term goal

answer

Client will demonstrate appropriate vocal hygiene and vocal quality in all speaking situations.

question

Whydon't you want to try to fix pitch

answer

if you increase pitch, you increase the bernoulli effect, causing vocal folds to slam together

question

What is a way to check for mouth opening

answer

compare a i m

question

why do you work on vocal focus

answer

to change resonance and get clear voice

question

what sounds can you use to get focus away from vocal folds

answer

/p/ /s/; any high front focused sound (nasals are good)

question

what sounds are glottal focus

answer

/h/ and vowels

question

what are ways to get the focus in the middle of mouth

answer

make sure mouth is open; do chewing technique; gargle blowing air

question

chewing technique

answer

helps with focus; chew multiple syllable words to get mandible moving and not tense up vocal folds (good for kids and singers)

question

gargle technique

answer

helps get tongue relaxed; helps to see if they can blow air

question

what three things must be in objective

answer

behavior, stimulus, crtiterion

question

who most often has contact ulcers

answer

drill sergeants, professors (basically low loud voices)

question

who most often has vocal nodules

answer

children, cheerleaders, females, young boys (basically high pitched voices)

question

what perpetuates polyps

answer

hyperfunction is enough, not need for abusive behaviors

question

perpetuating factors for nodules

answer

phonotrauma, throat clearing, tension etc..

question

what "P" is smoking?

answer

predispose more often

question

Which P(s) do we have to focus on the most as slps

answer

precipitating and perpetuating

question

How can you reduce vocal fatigue

answer

reduce abuse (ex. throat clearing, hydration) aka vocal hygiene; compensate in healthy ways; get appropriate focus; appropriate breath support

question

vocal unloading: how it works and what for

answer

coord of breathing and muscles; releases tension in muscles Straw between lips: blow and hum--> blow and do siren sounds--> sing national anthem (don't have to do all on one breath)

question

easy onset exercises

answer

talk on sigh, yawn-sigh, /h/ initial words (isolated, words, sentences, whisper then gradually add voice, make air (not voice) hit back of room, /m/ initial words

question

If doing /m/ for easy onset, what should the progression of sentences be

answer

single sound--> my momma,--> my boy is good--> Mary said please make cake--> reading-->asking questions to e/o--> 2 min monologue

question

which is intermittent, polyps or nodules

answer

polyps

question

primary cause of paralyzed vocal fold

answer

surgery

question

why is it good to have damage in the recurrent laryngeal nerve

answer

it can grow back; you usually wait 6 months before doing any kind of intervention

question

Which is not a dysarthria: spasmodic dysphonia, vocal spasmodic tremor, or muscle tension dysphonia

answer

muscle tension dysphonia

question

What is the best test for tremor

answer

sustained vowels

question

how will the sustained vowel sound in Spasmodic Dysphonia

answer

either strained (abductor??) or breathy and losing intensity (adductor??)

question

Who does singing sound better for?

answer

muscle tension dysphonia

question

Who do sentences sound bad for?

answer

tremor bc it is hard to keep voice on

question

What will SD have trouble with

answer

voice-voicless sentences bc they have trouble turning voice on

question

what voice disorder sounds bad on all tasks

answer

muscle tension dysphonia

question

which voice disorder sounds better when singing

answer

muscle tension dysphonia???

question

what is a big difference betweed SD and MTD

answer

SD is intermittent (they both have strain/strangled quality to voice); also MTD has fewer instances of tremor

question

dysathria

answer

neurologically based disorder of voice

question

flaccid

answer

soft, hanging loose or limp

question

voice symptoms of flaccid dysarthria

answer

breathy, weak

question

disorders of flaccid dysarthria

answer

vocal fold pareses, vocal fold paralysis, myasthyenia gravis

question

spastic

answer

tightness, stiffness

question

ataxic

answer

discoordinated

question

hypokinetic

answer

decreased muscle movement but not because weakness of muscle

question

hyperkinetic

answer

increased muscle movement, resulting in abnormal movements

question

disorders of spastic dysarthria

answer

multiple strokes, tbi, multiple scerlosis, amyotrphoic lateral scerlosis

question

site of brain damage for flaccid dysarthria

answer

LMN

question

site of brain damage for spastic dysarthria

answer

bilateral dammage to corticobulbar tracts of the upper motor neuron

question

bilateral

answer

both sides

question

contralateral

answer

opposite sides

question

ipsilateral

answer

same side

question

vocal symptoms for spastic dysathria

answer

low pitch, strain-strangled; have trouble initiating movement, hypernasality if bilateral

question

vocal symptoms for ataxic dysarthria

answer

prosidic abornamility, scanning speech

question

vocal symptoms for hypokinetic dysarthria

answer

weak, monotone

question

vocal symptoms for hyperkinetic dysarthria

answer

chorea- prosodic abnormality dystonia-effortful, strain-strangled

question

dystonia

answer

slow, sustained muscle contractions

question

site of brain damage for ataxic dysarthria

answer

damage to the cerebellum and/or its sensory or motor nerve pathways

question

disorders of ataxic dysarthria

answer

stroke, tumors, CP, infection, multiple scerlosis, , and some genetic disoders (ex. Fragile X) note: Ataxic dysponia can also have hypotonia bc cerebellum is involved in muscle tone

question

site of brain damage for hypokinetic dysarthria

answer

basal ganglia

question

site of brain damage for hyperkinetic dysarthria

answer

basal ganglia

question

disorders resulting in hypokinetic dysarthria

answer

Parkinsons is biggy

question

disorders resulting in hyperkinetic dysarthria

answer

choreic (Huntingtons) or dystonic (Spasmodic Dysphonia) results from degenerative diseases, stroke, trauma,inflammation, and metabolic diseases

question

choreic

answer

quick, jerky muscle contractions

question

indication of damage to cerebellum

answer

equal stressed syllables may not be able to coordinate breathing with phonation may not be able to raise velum when needed (hypernasal)

question

what is true of all dysarthrias

answer

they lose accuracy in articulation first

question

what do you want to treat first in dysarthrias

answer

breathing

question

what disorders can cause a strained sound in voice

answer

muscle tension dysphonia, spastic dysarthria, spasmodic dysphonia, essential tremor

question

what disorders might have tremor

answer

essential tremor, parkinson's, and cerebellar disease

question

adductor spasmodic dysphonia voice quality

answer

the adductor muscles (IA and LCA) are contracting, causing the voice to sound strain-strangled, effortful and jerky, sudden voice arrests causing speech to sound stuttered

question

abductor spasmodic dysphonia voice quality

answer

the abductor muslce (PCA) is contracting causing the glottis to be open inappropriately at times. This causes the voice to sound aphonic at times; it also sounds jerky and breathy and often like a whisper

question

what happens to voice if there is damage to the superior laryngeal nerve

answer

the vocal fold sags; you lose pitch; aspiration and drooling due to sensory problems

question

aspiration

answer

audible breath

question

what is often confused with damage to the SLN by ENT

answer

vf paralysis bc they both sag

question

why would you not do same strategies for damage to SLN as for hypokinesia (vf paralysis)

answer

it could cause hypertension

question

hypernasality

answer

sound in nasal cavity due to open velopharyngeal port

question

what causes hypernasality

answer

syndromes, some dysarthrias (bilateral spastic dys), cleft palate

question

nasal emission

answer

air comes through nose

question

significance phoneme specific emission

answer

kids should be able to do these sounds structurally and developmentally but don't; esp in high pressure sounds like plosives, fricatives, and affricates

question

manner, place or voicing first?

answer

manner!! it has the greatest effect on intelligibilty

question

submucous cleft

answer

bone did fuse, so air goes through, might have bifid uvula

question

what is an indication of subumcous cleft possibly

answer

history of heart problems

question

velopharyngeal incompetence

answer

the velum and superior laryngeal constrictor are both structurally fine, but it does not lift for some reason

question

velopharyngeal insufficiency

answer

there is not enough tissue in pharynx, velum is not long enough

question

how would velum get paralyzed (where in brain)

answer

pharyngeal branch of vagus nerve

question

what would you do for hypernasality

answer

reduce oral resistance by 1. getting mouth open 2. light articulatory context (using voiceless fricatives first) if you can't do anything else, have them whisper bc you can't whisper through your nose

question

what voice therapy would you do for SLN

answer

vocal function, pitch range stuff (easy to treat!)

question

paradoxical vocal cord motion

answer

the same as vocal cord dysfunction and many other names

question

PVCM def

answer

vocal folds don't work appropriately for respiration, not necessarily phonation; could be vf hyper or hyposensitivity

question

which dysarthria has normal reflexive function but abnormal phonation

answer

spasmodic dysphonia

question

how does pvcm often start out

answer

chronic throat clearing or irritable larynx syndrome

question

How to get rid of throat clearing step by step

answer

drink water, swallow hard, sniff-swallow, yawn-sigh, start over (do for one hour!!)

question

techniques you can use when symptoms of PVCM occur

answer

abdominal breathing relaxed throat breathing: inhale through nose slowly, exhale through mouth doing /s/ while focusing making air hit alveolar ridge so tongue won't move to pharyngeal wall; if they can't inhale through nose, put small coffee straw between lips and focus on inhaling through it and exhaling /s/ (do 5 5x/day) if they know trigger, have them practice in that situation if trigger is smell, have them inhale through mouth and exhale through pursed lips if their vf shut down before they can use them, have them sniff then go into breathing technique

question

what stimulates PVCM

answer

airway irritants

question

what do you do for atheletes who have PVCM

answer

have them drop their body to push air out, then have them go into breathing exercise

question

desensitation

answer

start small then go rightin the middle of the stimulus

question

what techniques can be taught for exercise induced PVCM

answer

work on rhythmic breathing: can uses pursed lips or /s/, inhale 3 steps, exhale 4 with all air out by last step. next, have them pick up the pace

question

Reflux and PVCM

answer

reflux might trigger it, often accompanies it

question

Besides refulx, what else is often associated with PVCM

answer

muscle tension dysphonia and nodules bc of the increase in muscle tension

question

when do you do a laryngeal massage

answer

for muscle tension dysphonia primarily

question

how long does program last for PVCM

answer

4 weeks but they have to be motivated and do work or it won't work and they will turn into chronic coughers, which we can't help

question

what are you most concerned with in earlier stages of cleft palate

answer

feeding and swallowing

question

What speech tasks do you work on first with kids with cleft palates

answer

vowels, getting mouth open then do consonants, following developmental sequence (so start with bilabials and alveolars) do voicless before voiced!

question

What can you use to see what sounds kids are stimulable to?

answer

normal articulation test

question

Resonant voice therapy

answer

uses resonance to fix voice quality by changing vocal focus

question

What do we do with hyponasality

answer

refer to ENT

question

what three things should be done for hypernasality

answer

open mouth, direct airflow, light contacts

question

when hole is cut below the larynx

answer

tracheostomy

question

when hole is cut where the larynx was

answer

laryngectomy

question

what is effected when one gets a tracheostomy

answer

swallowing, speech, taste, smell; can usually eat orally

question

cuff up

answer

the cuff is inflated, so stuff can't get in lungs; makes i hard to talk

question

cuff down

answer

the cuff is deflated, you can talk

question

passy muir

answer

redirects air breathed in from the stoma up to through the vocal folds to talk; this is for trach patients; uncuffed; can help ween off ventilator, can help with swallowing and sense of taste

question

options for speaking with trach

answer

cuffed up (talking trach-uses extenral source of air, electrolarynx, and fenestrated) cuffed down and uncuffed (passy muir, exhaled air alone is used, block tube so air goes up and not down into trach)

question

what perceptual characteristics indicate hyperfunction

answer

hard glottal attacks, strain, increased breath units, pain, hoarseness, wrong ptich, increased intensity, tension

question

what perceptual characteristics indicate hypofunction

answer

breathiness, decreased intensity, decreased pitch range, short breath units, usually a lower pitch, phonation breaks, delayed onset, hypersnasality (bc lack of muscle movement)

question

how do you know what to target

answer

target what they sound better on

question

What are hyperfunction techniques

answer

resonant voice therapy, vocal function exercise, vocal unloading, yawn-sigh, chant therapy, stretch and flow, easy onset, chewing

question

what do hyperfucntion techniques focus on

answer

focus or airflow

question

resonant voice therapy

answer

goal is to change focus to provide clearest voice with the least effort by moving through good resonance

question

ways to talk with laryngectomy

answer

espohgeal speech, tracheoesophageal puncture, electrolarynx, tonaire

question

electrolarynx

answer

source of sound is buzzer placed against neck; shapes and resonates sound in mouth; uses air already in mout, stoma blast; can have transcervical or intraoral

question

Tracheal esophageal puncture prosthetic

answer

uses pulmonary air to talk; source of sound is pharyngeal-esophageal segement; most like natural speech, no stoma blast

question

esophageal speech

answer

uses air to talk; pharyngeal esophageal segemtn is source; stoma blasts

question

why get a talking trach

answer

if you have respiratory problems and need an external source of air

question

vocal function exercises

answer

first, null and /i/ at high front focus, then coordinating airflow and muscle functin is goal

question

vocal unloading

answer

airflow technique to get air moving; helps people realize they are tense

question

yawn-sigh

answer

airflow technique

question

strech-flow

answer

get air out in steady stream and see how long you can talk on it

question

chewing

answer

focus methods, helps you bring focus to center of mouth

question

hypofunctional techniques

answer

many people who ae hypofunctioning are those with weak or parlyzed vocal folds, so exercises might be hard, may have to modify; lee silverman and lumbard effect are both good exercises

question

lee silverman

answer

good for parkinons, intensive program used to get louder

question

lumbard effect

answer

putting noise in someones ear so they make natural adjustments to try to talk over it

question

chant therapy

answer

helps with continuoys flow of air and moves up focus, helps with easy onset since you never shut air up

question

rheumatoid arthrtitus

answer

in actue stage it causes inflammation, redness, and swelling with a feeling of a lump in throat; this can lead to breathiness, stridor, hoarseness in chronic stage it causes there to be joint fixation; the symptoms depend on where the joint is fixated and if it's unilateral or bilateral; sometimes gets mistaken for paralysis causes loss in pitch range bc of CT joint fixation

question

treatment for rheumatoid athritis

answer

depends on stage, but vocal rest is advised as well as heat to inflammation

question

what often gets confused with a paralyzed vocal fold by ENTs

answer

superior laryngeal damage... don't do the same technique as you would for a paralyzed vocal cord bc it can cause hyperfunction

question

chronic laryngitus

answer

the vocal folds are swollen and red from front to back.... can eventually lead to scarring... low pitched, breathy, weak in volume, and hoarse.. often leads to tension, so there is strain too

question

difference between nodules, granulomas, and polyps

answer

nodules: bilateral, midpoint of membranous glottis, for from gradual misuse polyps: unilateral, can be from one time trauma or from gradual misuse, granuloma: uni or bilateral, usually in cartilagenous glottis, some shooting pain in ear bc of swelling, can lead to airway obstruction and vf fixation; happens after ulcer; can be from intubation

question

vascular lesion causes and symptoms

answer

usually in singers...basically vocal hemoraging that leads to scarring and stiffness, which leads to vocal fatigue, loss of pitch range, strain,

question

what causes vocal fatigue

answer

excessive voice use, poor vocal technique, emotional and/ or physical stress

question

symptoms of vocal fatigue

answer

weakness, decrease in dynamic and pitch range, tightness in throat, strain, reduced respiratory support

question

flaccid dysarthria often leads to...

answer

hyperfunciton

Voice Facilitation Techniques; dysarthria, nasality, etc. – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards