Final Advanced Speech Lang disorders

Phonation

vibrating vocal folds produce an acoustic pressure wave that is the source of speech sound for speech

Pitch

the number of vocal fold vibrations per second (Hz)

Loudness

(intensity) volume of sound pressure level (dB)

Quality

mix of tonal (period) and atonal (noise) in the acoustic pressure wave produced by the vf + sound pressure levels of the tonal and noise components 

Hypofunction

associated with a breathy voice; vocal fold cycles have a too slow closing phase and a shouted (or no) closure phase

Hyperfunction

associated with rough tense voice; vocal fold cycles have a too fast closing phase and a too long and tight closed phase

Vocal Nodules

are benign masses growths) that result from chronic overuse of the voice; they begin as a soft mass and eventually develop a callous-like texture.

Vocal fold polyps

 softer than nodules and often unilateral (one-fold); result from phonotrauma and sometimes from a single screaming episode

Laryngitis

disturbs the free motion of the outer layers of vocal fold tissues, which results in dysphonia.

Chronic reflux

often due to lifestyle (frequent and excessive use of tobacco and alcohol), damages vocal fold tissues when it spills out from the top of the esophagus onto laryngeal structures.

Vocal fold cysts

(fluid-filled sacs) may result from phonotrauma and interfere with the free motion of the outer layer of the folds.

Muscular tension dysphonia (MTD)

 is a functional voice disorder in which phonation is disturbed by excessive tension in the head and neck muscles.

Unilateral vocal fold paralysis (UVFP)

Injury to the nerve on one side of the larynx due to trauma

Spasmodic dysphonia (SD)

 Rare (prevalence around 1/100,000) voice disorder regarded by many voice scientists and clinicians as a neurological disorder.

Laryngeal cancer

 can develop anywhere in the larynx. About 50%  of tumors affecting the VF (more frequent in men 60 and up, symptoms being voice change like hoarseness, roughness, and irregularity

Dysphagia

is a medical term that refers to difficulty swallowing. It can affect the ability to move food or liquid from the mouth to the stomach

dysphagia symptoms 

Coughing during or after swallowing, Gurgly voice quality, Food sticking in the throat, Recurrent pneumonia, Weight loss and dehydration

CN V Trigeminal

Sensory: Jaws, teeth, lips, cheeks, tongue, hard palate. Motor: chewing

CN VII Facial

Sensory: soft palate, taste anterior 2/3. Motor: superficial muscles of the face, stylohyoid

CN IX Glossopharyngeal 

Sensory: tonsils, pharynx, soft palate, taste, and tactile posterior ⅓ tongue. Motor: pharyngeal elevators. Important to: salivation, gag reflex

CN X Vagus

Sensory: larynx, pharynx, trachea, esophagus. Motor: larynx (intrinsic), Palatal muscles, pharynx. Key to swallowing

CN XI accessory 

Motor: pharynx, extrinsic larynx, uvula. Key to swallowing

CN XII hypoglossal  ( tongue)

Motor: strap muscle of the neck, some extrinsic, and all intrinsic tongue muscles. Key to tongue movement

Neurogenic causes of dysphagia

Stroke, Brain tumors, Degenerative diseases, Trauma and brainstem injuries

structural causes of dysphagia

Head and neck cancer, Cricopharyngeal hypertrophy, Zenjet diverticulum, Post-surgical effects, Congenital anomalies

Suckling

Rhythmic, with negative and positive pressure, mainly in early infancy.

sucking

More organized, with a 1:1:1 suck-swallow-breathe ratio.

Nutritional management

 Ensuring adequate hydration and caloric intake.

Compensatory strategies

Postural adjustments (e.g., chin tuck). Bolus modification (texture, viscosity). Altered feeding environment.

Therapeutic exercises

Oral motor strengthening. Sensory stimulation. Swallowing maneuvers (e.g., supraglottic swallow)

Encephalopathy

brain disease

Ischemic

decrease in blood supply

Bilirubin

Jaundice

Aminoacidopathies

any disease/disorder that impacts amino acid transport in and out of cells

Carbohydrate metabolism

problems with carbohydrate breakdown

Poliomyelitis

inflammation of the gray matter of the brain viral 

Botulism

bacterial infection, flaccid paralysis

Meningitis

serious inflammation of the meninges, the thin membrane covering the brain and the spinal cord

Encephalitis

inflammation of the brain

Cognitive communication disorder

a problem resulting from impairment in one or more cognitive processes

Cognitive components 

Perception, attention, memory, and learning, organization, reasoning, functional integrative performance, executive functioning

Acquired CCD

Right hemisphere brain damage. TBI. Lack of oxygen to the brain (anoxia). Brain tumor

Symptoms of cognitive disorders

Inconsistency, Poor judgment, Attention deficits, Impaired memory, Disorientation, Denial of disability, Poor organization, Reduced self-care, Anomia

Attention

arousal alertness, sustaining focus, shifiting focus

Memory and learning

encoding storage retrieval, longterm (retrofrade, anterograde, episodic)

Organization

categorization and sequencing

executive functioning

awareness of strengths, goal setting, planning, initating

Deductive 

general —> specific. Formal inference 

Inductive

speciifc —> general. inference from pervious experince

Analogical

relationships/comparisons

Evaluative

value judgments

Convergent

main idea

Divergent

generating possibilities

acquisition (phase of learning)

teach the strategy and explain purpose

Application (phase of learning)

practice strategy, role play, use in structured task

Adaption (phase of learning)

use in real world situaiton

stimulabiltiy

abiltiy to produce a sound with cues

intelligibility

how well speech is understood

Dosage 

the frequency, intensity, and duration of service

Format

whether a person is seen for treatment one-on-one or as part  of a group

provider

the person administering the treatment

setting

the location of treatment 

timing

when the intervention occurs relative to the diagnosis

Delirium

a mental state marked by confusion, disorientation, and reduced awareness of one's surroundings, often accompanied by symptoms like fluctuating mood, inattention, and disorganized thinking

Dementia

development of multiple cognitive deficits and Memory impairments

cortical dementia

damage to the brain's cerebral cortex, affects cognitive functions like memory, language, and reasoning

Subcortical dementia

early symptoms including personality changes, slower thinking, apathy, and depression, with severe language and cognition problems