f&vd quiz 4

dysphonia

altered quality, pitch, loudness, or increased effort

aphonia

loss of voice

vocal fatigue

client perceives an increase in phonatory effort over time that may be accompanied by decreased phonatory function

globus sensation

feeling like something is in your throat

fixed abduction or adduction

when the vocal cords are stuck and cannot move (abduction = open, adduction = closed)

dyspnea & what are 2 potential/primary causes

feeling out of breath due to interference of airflow due to…

1. vocal pathology

2. uncontrolled adduction or abduction obstructing the airway

odynophagia

pain when swallowing

sharp pain

pain at other times besides odynophagia

vocal fold bowing & two causes

inward curvature of vocal fold due to lost muscle bulk caused by aging or nerve damage

vocal fold paresis

weak vocal fold movement

organic voice disorders

due to detectable physical or biochemical changes within cells, tissues, or organs

lesion

damage or abnormal change in tissue

neoplasm

growth of new tissue, either benign or cancerous

two subtypes of organic voice disorders

structural and neurogenic

organic structural voice disorders

something is physically wrong with the vocal mechanism’s laryngeal or velar structure, due either to lesions in tissue or joint tissue

examples of potential causes of organic structural voice disorders

phonotrauma, medical conditions, birth defects, puberty, smoking

organic neurogenic voice disorders

problems with central or peripheral nervous system innervation due to larynx causing trouble with motor movement and muscle tone

examples of potential causes of organic neurogenic voice disorders

neurological diseases, infectious diseases, growths, tumors

velopharyngeal disfunction

insufficient velopharyngeal closure resulting in a leakage of air to the nasal cavity; causes resonance voice disorders

3 causes of VPD

velum deformed due to congenital disorder, doesn’t close due to neurological disorder, or velum is normal but client is not using habitual sufficient velopharyngeal closure

examples of things that cause medical trauma

surgeries, medical procedures, intubation damage, injury, burn, excessive emotional stress

functional voice disorders

vocal mechanism being used inappropriately even though the physical structure is normal

what do voice alterations due to changes in vocal fold vibration cause

changes in quality and pitch

what do voice alterations due to changes in airflow through vocal cords cause cause

changes in quality and loudness

5 categories of organic disorders

1. growths — neoplasms

2. lesions

3. potential or established disease

4. chronic congenital & acquired

5. related to development/changes across lifespan

3 types of voice issues — growths

1. vocal nodules

2. vocal polyps

3. vocal cysts

4 types of voice issues — lesions

1. laryngeal hemorrhage

2. reinke’s edema

3. contact ulcers

4. sulcus vocalis

2 types of voice issues — potential or established diseases

1. laryngeal leukoplakia

2. laryngeal cancer

two types of chronic congenital and & acquired voice issues

1. laryngeal papilloma

2. laryngeal web

5 types of voice issues related to development/lifespan

1. laryngeal ankylosis

2. presbyphonia

3. puberphonia

4. laryngomalacia

5. VPD

vocal nodules

white soft growth that becomes hard, thick and fibrous like a callous

vocal polyps

blister filled with fluid or blood. can be directly on vocal fold usually at the midpoint (sessile), or attached by a separate piece of tissue (pedunculated)

vocal cysts

blockage in the glandular duct causing retention of mucus or blood

laryngeal hemorrhage

ruptured blood vessels in the submucosal layer of vocal folds (superficial lamina propria). often due to an acute event and increased risk if on blood thinners

reinke’s edema & alternate names for it

aka polypoid corditis, or if extreme called polypoid degeneration; buildup of fluids or polyps in the superficial lamina propria, which causes edema or swelling of the vocal folds

contact ulcers & what’s associated with it

aka laryngogranuloma; an open sore. leaves a bitter taste in mouth and causes odynophagia or sharp pain during coughing or throat clearing

sulcus vocalis

groove in the development or a narrow cut in the vocal fold

laryngeal leukoplakia

white plaque-like lesions and red patches; can be precancerous

laryngeal cancer

aka carcinoma; it can metastasize

laryngeal papilloma & two ways it can be contracted

benign tumor with wart-like bumps. chronic so it can reoccur

HPV 6 and 11 through skin or STD; congenital through mother’s amniotic fluid or infected area that makes contact during the birth process

laryngeal web & symptoms

sheet of tissue over the vocal folds, that can grow back if removed

stridor, shortness of breath, difficulty swallowing, weak cry in infants, higher pitch

laryngeal ankylosis & 2 typical causes

abnormal stiffening and immobility of the cricoarytenoid jount, that can causes fixed addiction, fixed abduction, dyspnea & odynophagia

typically caused by:

1. arthritis/joint disease

2. intubation

presbyphonia

voice issues that occur due to aging changes & anatomical changes. especially loss of muscle mass, muscle strength, and vocal folds becoming thinner, drier and less pliable (vocal atrophy)

puberphonia — organic & causes

remaining prepubescent voice after puberty

congenital laryngeal anomalies, underdevelopment, changes in hormonal development, debilitating disease during puberty

laryngomalacia

malformation of infraglottal tissue, where tissues fall over airway opening, partially blocking it

must resolve without surgery by 18-20 months

three kinds of organic neurogenic disorders, and what can cause them

1. essential tremor — caused by neurological disease or condition

2. spasmodic dysphonia — caused by neurological disease, condition, or acute event

3. unilateral/bilateral vocal fold paresis/paralysis — caused by neurological disease, condition, or acute event

essential tremor & what causes it

shake in the voice. due to involuntary movements of any muscles related to voicing — intrinsic laryngeal, extrinsic laryngeal, pharyngeal, chest wall, abdomen, diaphragm.

disorder is about movement

spasmodic dysphonia & 3 kinds

aka laryngeal dystonia; spasms or jerking movements due to muscle contractions or abnormal fixed postures. may see tremors in other parts of the body as well as in the voice

1. abductor

2. adductor

3. mixed (both)

the disorder is about movement

vocal cord paresis/paralysis & two types for both

weak or lack of movement of the vocal cords

may see vocal fold bowing, and there’s a unilateral type and a bilateral type. unilateral is more common

two kinds of functional use voice disorders

1. inappropriate use

2. psychogenic reasons

two kinds of inappropriate use functional disorders

1. muscle tension dysphonia

2. ventricular phonation

two kinds of psychogenic functional disorders

1. conversion aphonia

2. puberphonia

muscle tension dysphonia

habitual use of excessive muscle tension or constriction; aka functional dysphonia

ventricular phonation

habitual use of the false or ventricular folds during phonation

conversion aphonia

aphonia due to manifestation of stress, depression, or anxiety due to traumatic experience. aka psychogenic aphonia

this is a disorder of movement

puberphonia — functional & 3 possible causes

result of habitual use of a higher pitch or falsetto register. voice sounds the same as the type due to organic reasons

Possible causes:

1. resistance to pubertal changes

2. Difficulty accepting change of voice

3. voice does not match identity

4 specific voice qualities that often face misperception

1. glottal fry

2. upspeak

3. high pitched/nasal voice

4. monotone voice

glottal fry — definition and misperceptions

use of a low, gravely, crackly sounding voice

may be perceived as sexy, edgy or with the time; lazy or immature in the business world/a different generation

upspeak — definition and misperceptions

tendency to raise pitch of voice at the end of a sentence regardless of whether or not it’s a question

may be perceived as contemporary, immature, less confident & less intelligent

high pitched or nasal voice — definition and misperceptions

use of a higher pitch or a denasal/hypernasal voice

may be perceived as immature, less authoritative, less “manly”

monotone voice — definition and misperceptions

use of a vocal tone with no change in pitch or inflection

may be perceived as bored/disconnected, lacking enthusiasm, lacking concern

percentage of people affected by voice disorders and percentage that seek treatment

3-9% of the US population; however, less than 1% seek treatment

Populations that experience higher incidence

1. Female adults

2. Male children

3. Elderly adults

4. Professions who speak for long periods of time

Prevention — what three things to do

1. provide prevention information to individuals and groups; both those who are at a higher risk of them & those who work with those at risk

2. refer clients in need of medical or psychological intervention

3. Remain informed of best practices in vocal health

advocacy — what two things to do

1. support clients with voice disorders or clients who desire voice modification — give them a voice

2. remain informed of research in the area of voice — knowledge is power