dr. k exam 2

vocal register

This is a range of "tones" or pitches and vibratory patterns produced by the human voice.

incidence

Epidemiology term for the number of cases of a condition in a given amount of time.

voiceless

Speech or a speech sound produced without vocal fold vibration.

whisper

A voice quality produced without vocal fold vibration. Its low-volume, yet noisy quality, is due to increased airflow through a slightly narrowed glottis.

dysphonia

A voice impairment and/or change in pitch, loudness, or quality.

harsh voice/ventricular phonation

The constriction recruits the ventricular (AKA false) vocal folds to vibrate either in addition to or instead of the true vocal folds.

diplophonia

This type of phonation is produced when two portions of the vocal fold(s) vibrate at different frequencies simultaneously, resulting in a rough voice quality and/or the perception of two distinct pitches to the voice.

pitch instability

This is the difficulty controlling or maintaining a steady pitch during a sustained vowel.

tremor

Tremor is a form of hyperkinesia. It is an involuntary, rhythmic, and quick movement.

essential voice tremor

This is a voice tremor in an individual diagnosed with essential tremor.(This type of tremor is diagnosed if the person has an action-induced tremor of unknown etiology.)

mixed spasmodic dysphonia

A mix of both adductor and abductor types of spasmodic dysphonia.

acid reflux disease

This disease involves the return of stomach contents and/or acids into the esophagus or possibly the larynx

functional dysphonia

This is a disordered voice quality (dysphonia) that has no known cause (no associated organic or neurogenic disorder).

vocal fold polyp

This is a type of mass lesion that usually occurs after isolated, recent phonotrauma; they are fluid-filled and come in two types: sessile (flat) or pedunculated (with a “stalk”).

rigid laryngoscopy

This type of endoscopy is performed with a rigid scope inserted orally into the pharynx and positioned above the larynx. High-intensity light is used to illuminate the structures to be observed and video recorded.

acoustic analysis

This is the use of speech science / acoustics to analyse the voice. Different speech samples are elicited, then analyzed using a program like Praat.

vital capacity

This is the total volume of air that is expired after maximal inhalation; VC is affected by height, weight, sex, and age.

average sub glottal air pressure

The average amount of subglottal air pressure in a fixed period during phonation.

chant talk

This is a voice intervention for vocal hyperfunction that mimics "legato" singing, which is smooth and connected voice with no break between tones. The client is coached to produce a chant that is elevated in pitch, with prolonged vowels, lack of syllable stress, and softening of glottal attack.

fundamental frequency

The lowest periodic waveform or frequency of vocal fold vibration; it is also the rate of vocal fold vibration during phonation.

counseling (voice therapy)

This is not counseling in the sense of psychotherapy (which is outside our scope of practice), but counseling / collaborating with a client to find functional solutions to challenges in activities of daily living due to the client's voice disorder.

shimmer

Also known as amplitude perturbation; a measure of the cycle-to-cycle variability of waveform amplitude.

electrolarynx

This is a medical device used to produce speech post-laryngectomy.

laryngectomy

This is the removal of the larynx (laryngeal cartilages, hyoid bone, muscles, and upper rings of trachea) due to cancer.

tracheoesophageal puncture

the puncture between the trachea and esophagus (a tracheoesophageal puncture).

chest register

A term taken from singing / musical terminology; it refers to singing in one's most comfortable singing range.

modal voice

As a voice quality, modal is used interchangeably with a normal or unremarkable voice quality.

falsetto

In the speaking voice, falsetto is an unnatural or artificially high pitched voice or register, especially for a male. In singing, falsetto is the uppermost register and is sometimes called "head" voice.

creek/vocal fry/glottal fry

A term that refer to a low pitch voice and/or a voice produced with irregular vocal fold vibration, with only part of the length of the vocal folds vibrating.

breathy voice

Voice with an audible escape of air; this voice quality is often associated with a weak vocal quality and indicates glottal insufficiency.

voice tremor

Voice produced while the laryngeal structure(s) and/or articulatory structures are experiencing an action-induced tremor (a regular back-and-forth movement).

monopitch

Little variation in pitch during connected speech.

inappropriate pitch

Somewhat subjective assessment that depends on societal norms for age, gender, etc. A too-high or too-pitch that can be associated with disorders like puberphonia, Reinke’s edema, etc.

positional tremor

This type of tremor occurs during specific positioning of the involved body part, i.e. holding the body part in position against gravity.

adductor spasmodic dysphonia

Also known as laryngeal dystonia, SD is a neurogenic voice disorder in which the laryngeal muscles experience involuntary and unpredictable spasms (stuck together)

contact ulcer/granuloma

Also sometimes known as a contact granuloma (see granuloma), a condition where an ulcer is found in the vocal folds.

resting tremor

This type of tremor occurs when the affected body part(s) are at rest and the involved muscle(s) are relaxed.

muscle tension dysphonia

This is a condition characterized by changes in voice quality in the absence of vocal fold or laryngeal pathology due to an imbalance between phonation, resonance, and/or respiration for speech.

aphonia

Complete voice loss or the inability to produce phonation.

vocal fold web

Tissue growing across the glottis between the two vocal folds, inhibiting normal fold vibration and often producing a high-pitched, rough sound during vibration.

auditory perceptual voice assessment

This is the gold standard for documentation of voice disorders and involves characterizing the auditory perceptual characteristics of an individual's voice.

flexible laryngoscopy

This type of endoscopy is performed with a flexible scope inserted through the nares and passed through the nasal cavity to the pharynx, just above the larynx.

maximum phonational frequency range

This is the maximum range of fundamental frequencies an individual can produce, from the lowest possible pitch to the highest possible pitch (including falsetto) on a sustained phonation.

s/z ratio

This is used as an indicator of glottal closure / lack of glottal insufficiency and by extension a possible indicator of laryngeal pathology if elevated above normative range. It is computed by dividing the maximum sustained /s/ out of three trials by the maximum sustained /z/ sound (again, out of three trials).

electroglottography

This instrumentation measures the relative conductance or impedance between two small electrodes placed on either side of the larynx; indicates vocal fold contact for each vibratory cycle.

voice handicap/quality of life assessment

This type of assessment looks for the functional impact of a voice disorder. In other words, any possible handicap caused by the disorder and/or reduction in quality of life.

chewing

This is a voice intervention that uses exaggered chewing motions in combination with voicing, then words and phrases, in other to treat vocal hyperfunction with the tendency to clench teeth and/or voice with hard glottal attack.

laryngectomy

This is the removal of the larynx (laryngeal cartilages, hyoid bone, muscles, and upper rings of trachea) due to cancer.

esophageal speech

Involves trapping air in the esophagus and then releasing it in a controlled manner, causing the esophageal walls to vibrate, replacing the missing vocal fold vibration.

vocal hygiene

These are practices that protect and preserve the health and function of the voice. It involves avoiding behaviors that can strain or damage the vocal cords, and promoting healthy vocal habits.

prevalence

An epidemiology term for the number of people who currently have a condition.

voiced

Speech or a speech sound produced with vocal fold vibration.

pulse

A voice register characterized by very low fundamental frequency and a low pitch. It is also sometimes referred to as creak or vocal fry.

rough voice

Rough voice or roughness is a voice quality that often correlates with irregularly vibrating vocal folds.

hoarse voice

Also known as hoarse voice, this voice quality is a combination of rough and breathy voice qualities.

strained-strangled voice

This is a voice quality that sounds like the name suggests, i.e. a voice with extreme strain or that is extremely difficult and/or effortful to produce.

monoloudness

Little to no variation in loudness during connected speech.

inappropriate loudness

A too-loud or too-quiet voice for societal norms and functional use.

action induced dysphonia

This type tremor occurs with the voluntary movement of a muscle, like a purposeful movement.

vocal nodules

This is the thickening of the superior layer of the lamina propria due to phonotrauma. It is a mass lesion much like a callus and develops over time, typically within the middle 1/3 of the vocal folds.

recurrent respiratory papillomatosis

A rare disorder characterized by the development of small, wart-like growths (papillomas) in the respiratory tract.

vocal fold hemorrhage

This is a burst blood vessel within the vocal folds and typically occurs due to phonotrauma.

sulcus vocalis

This is a condition in which the roof of the mouth does not form properly, leaving a cleft covered by the mucous membrane.

visual perceptual voice assessment

Visual inspection of the larynx is typically done through endoscopy, either with a rigid or flexible scope and optionally (for both types of scope) with videostroboscopy.

videostroboscopy

This is a state-of-the-art technique that provides a simulated slow-motion view of the vocal folds in action through a strobe-like flashing light.

maximum phonation time

This is the longest amount of time a sustained vowel can be prolonged after a maximal inhalation.

average glottal airflow rate

The average volume of air passing through the glottis in a fixed period during phonation.

intensity

The sound energy present in a signal; physically related to waveform amplitude and perceptually to loudness.

jitter

Also known as pitch perturbation; a measure of cycle-to-cycle variability in fundamental frequency.

harmonics to noise ratio

The mathematical ratio of periodic energy (signal) to random or aperiodic energy (noise) in a given signal.

glottal fry intervention

This is the use of glottal fry / creaky voice to counteract vocal hyperfunction, ventricular phonation, or puberphonia.

inhalation phonation

This is the use of inhalation phonation as a voice intervention.

voice rest

Voice rest is the act of refraining from speaking and singing to allow the vocal cords to heal and recover.