318 voice LCs

What percentage of people experience a voice disorder during some point in their lives?

30

What muscle creates the glottis through its action?

posterior cricoarytenoid (PCA)

The true vocal folds are _____ to the ventricular folds

inferior

What are the subsystems of voice?

respiration, phonation, resonation

T/F: Without the intrinsic muscles of the larynx, the cricoarytenoid joint and cricothyroid joint would not move

true

Airway protection is aided by all of the following structures EXCEPT:

trachea

What makes up the cover of the vocal folds

epithelium + superficial lamina propria

What is the glottis?

the space between the vocal folds

What is the cuneiform?

small cartilage encased in the aryepiglottic folds

Vocal fold adduction is accomplished through motion of the _____ joint

cricoarytenoid

What is the vocal ligament made of?

intermediate and deep lamina propria

The vocal folds run between the _____ cartilage (anterior) and the _____ (posterior)

thyroid; arytenoid

Vocal fold thickness:

decreases with higher vocal pitch; increases when the vocal fold cover is relaxed

________ is the perception of audible air escaping through the glottis during phonation

breathiness

________ refers to how phonatory acoustic signals are modified in the pharyngeal, oral, and nasal cavities

resonance

Louder phonation involves:

vocal folds separating further (greater amplitude), vocal folds coming together more abruptly, vocal folds staying closed longer, greater buildup of subglottic pressure

T/F: vocal fold scar decreases the pliability of the vocal fold cover

true

Which vocal register is considered the “typical” register we use during speaking?

modal

What contexts might glottal fry (pulse register) be used more commonly?

at the end of statements, when physically tired or relaxed, when running out of air as you talk

The fundamental frequency of the voice is influenced by:

the size of the vocal folds, elevation of the entire larynx

Allow for vocal fold stretch while providing stability (i.e., restricting too much separation between thyroid and arytenoid)

vocal ligament

When contracts, vocal fold pitch typically decreases

vocal fold body

T/F: some adjectives that might describe vocal quality include breathy, strained, hypernasal, or rough

true

Suprahyoid muscle function includes:

promoting epiglottic inversion during laryngeal elevation, facilitating opening of the upper esophageal sphincter during swallowing, increasing muscle tension in the larynx when over-contracted during phonation

What nerve innovates the cricothyroid muscle?

superior laryngeal nerve- external branch

Ms. Rei’s voice is abnormally low and very rough. What would be the most likely diagnosis?

reinke’s edema

Which condition would most likely result in a breathy, weak voice quality?

presbyphonia

What is a possible scenario for someone having a breathy and weak voice and silent aspiration post-heart surgery?

injury to the recurrent laryngeal nerve, compromising vocal fold movement and subglottic sensation

Vocal nodules occur bilaterally and are usually the result of:

phonotrauma

What can increase vocal pitch?

increased VF length, increased VF tension, decreased VF mass, increased subglottic pressure

The primary function of the suprahyoid muscles is:

larynx elevator

Bernoulli’s principle states that at a constriction in a tube, the air velocity will be _____ and the air pressure will be_____

higher; lower

During a single cycle of phonation, the vocal folds open:

from bottom to top

What are some examples of phonotraumatic behaviors?

screaming, chronic throat clearing, speaking on very little air (i.e., reduced breath support)

Which nerve provides sensation to the larynx?

recurrent laryngeal nerve and superior laryngeal nerve- internal branch

A patient-reported complain is called a:

symptom

T/F: it is appropriate (within scope of practice) for SLPs to make certain medical diagnoses

false

Treatment for voice disorders may include:

voice therapy, prescription medication, phonosurgery

T/F: hormonal changes in the body precipitate changes to the voice during older adulthood only

false

What type of voice disorder is puberphonia?

functional voice disorder

A sign is an:

observable phenomenon

What are some potential signs or symptoms of unilateral vocal fold paralysis?

diplophonia, dysphagia, reduced loudness, breathing difficulty

What condition is characterized by involuntary spasms of laryngeal muscles during phonation?

laryngeal dystonia (spasmodic dysphonia)

Muscle tension dysphonia is best classified as a:

functional voice disorder

What voice disorder is most likely to be treated primarily with behavioral voice therapy?

muscle tension dysphonia

Damage to the left recurrent laryngeal nerve would likely cause ______ of the ______ vocal fold

paresis or paralysis; left

All of the following are ways that the infant larynx varies from the adult larynx EXCEPT:

• higher laryngeal position

• undifferentiated layer structure

• harder laryngeal cartilages

• shorter vocal folds

harder laryngeal cartilages

T/F: in infants, the velum and epiglottis typically touch making infants obligate nasal breathers

true

Rhythmic oscillations of the larynx or vocal folds resulting in a shaky sounding voice

essential voice tremor

Inefficient muscular activation for phonation secondary to a structural or neurological vocal pathology

secondary muscle tension dysphonia

Reduced, but not absent, vocal fold movement

vocal fold paresis

May cause dysphagia and weak, breathy voice

paralyzed vocal fold in abducted position

Involuntary abductory or adductory spasms of the vocal folds

laryngeal dystonia

Vocal fold closure on inhalation resulting in breathing difficulty

Inducible laryngeal obstruction

Typically results in normal voice, but may lead to shortness of breath

paralyzed vocal fold in adducted position

1 octave drop in fundamental frequency does not take place at puberty despite normal laryngeal structure and function

puberphonia

T/F: presbyphonia is a structural voice disorder related to age-related changes in the larynx

true

Subglottic air pressure and translaryngeal airflow are _______ measures

aerodynamic

Which 2 parameters can only be assessed with a stroboscopic light because they are vibratory parameters:

• vocal fold color

• free edge contour

• mucosal wave

• mucous

• amplitude

• mucosal wave

• amplitude

The minimal amount of air pressure required for initiating and sustaining vocal fold vibration is called what?

phonation threshold pressure

What is laryngopharyngeal reflux?

acid backflow from the stomach that may reach the vocal folds/ upper pharynx

A _________ is an instrument with a lens and light source that can be used to view the laryngeal structures

laryngoscope

Which of the following are considered objective voice assessments?

• aerodynamic measures

• acoustic measures

• auditory-perceptual measures

• laryngeal imaging measures

• aerodynamic measures

• acoustic measures

You want to view your patient’s laryngeal anatomy while they sing “Good luck, babe.” What imaging tool would be most appropriate?

flexible endoscope

The intermediate layer and deep layer comprise the _______ of the vocal folds

vocal ligament

This register of voice production corresponds to glottal fry:

pulse

Which of the following can facilitate decreases in vocal pitch:

• decreased VF tension

• increased VF mass

• decreased VF mass

• tighter vocal fold closure

• decreased VF tension

• increased VF mass

The following could be visualized on laryngeal imaging with stroboscopy EXCEPT:

• glottic closure

• amplitude

• subglottal pressure

• mucosal wave

• supraglottic compression

subglottal pressure

Frequency range, fundamental frequency, and quality measures (i.e., noise to harmonic ratio) are components of ________ assessment

acoustic

T/F: the CAPE-V is an objective tool with excellent intra and interrater reliability for assessing vocal quality

false

Perception of irregularity (such as extra noise) in the voicing source

roughness

Perception of increased effort; tense or harsh as if lifting and speaking at the same time

strained

Weak voice

asthenia

The _________ is a self-report measure related to one’s perception of how their voice is affecting their life

voice handicap index

Which of the following is NOT an auditory-perceptual feature of voice?

• quality

• phonation

• loudness

• pitch

phonation

Russell is a Madison-famous karaoke singer. His SLP asks him to sustain vowels, read sentences, and elicits a conversational sample. Russell is performing the steps of an _________ assessment

auditory-perceptual

T/F: Stroboscopy is useful for aperiodic voices without a reliable fundamental frequency

false

When the posterior cricoarytenoid contracts, the glottis should:

increase in size

Potential consequences of a voice disorder include:

inability to perform job duties, compromised swallowing and breathing, reduced quality of life