Voice Disorders Midterm

the primary function of the larynx is...

a. airway protection

b. linguistic function

c. emotional function

d. vocalization

a. airway protection

what is the most common type of voice disorder?

a. muscle tension dysphonia

b. vocal nodules

c. psychogenic disorders

a. muscle tension dysphonia

Reaction to trauma may manifest itself in a complete loss of voice often labeled as a ____ aphonia

conversion

T/F: The neurogenic voice disorder should be confirmed via referral by the SLP to an ENT

false; neurologist

Teachers are occupational voice users at risk for dysphonia due to...

a. high vocal loads

b. physical factors

c. psycho-emotional factors

d. all the above

d. all of the above

Which age group is more likely to experience a dysphonia?

Answers:

a. 70 years of age or older

b. 65 years of age or older

c. between 45 and 65 years of age

d. between 25 and 45 years of age

a. 70 and over

Psychogenic voice disorder can manifest in

a. dysphonia

b. pitch changes

c. aphonia

d. all the above

d. all of the above

An example of an organic voice disorder is

a. unilateral vocal fold paralysis

b. vocal nodules

c. vocal fold cyst

d. falsetto

c. vocal fold cyst

Vocal nodules are considered a product of a

:a. neurogenic voice disorder

b. organic voice disorder

c. functional voice disorder

d. psychogenic voice disorder

c. functional voice disorder

Primary functional voice disorders

a. show neurogenic symptoms upon examination

b. are rarely associated with vocal fatigue

c. reveal vocal hoarseness after prolonged voice use

d. are easy to eliminate without skilled intervention

c

Most children with dysphonia

a. grow out of it

b. are identified and treated

c. are in preschool

d. are at risk for negative academic achievement

d

Voice and resonance changes from a stroke would be classified under

a. neurogenic voice disorders

b. organic voice disorders

c. functional voice disorders

d. psychogenic voice disorders

a. neurogenic voice disorders

inferior most cartilage of larynx is ...

cricoid

all of the following cartilages are paired except...

a. arytenoid

b. cuneiform

c. corniculate

d. thyroid

d. thyroid

This cartilage articulates with the thyroid cartilage.

a. Corniculate

b. Cuneiform

c. Cricoid

d. Arytenoid

c. cricoid

This cartilage articulates with the superior aspect of the arytenoid cartilage.

a. Cuneiform

b. Corniculate

c. Epiglottis

d. Cricoid

b. corniculate

This cartilage articulates with the superior aspect of the arytenoid cartilage.

a. Cricoarytenoid

b. Thyohyoid

c. Cricoid lamina

a. cricoarytenoid

Which joint movement can lengthen the vocal cords?

gliding backward, rocking forward

Which layer of the vocal fold tissue cushions the vocal folds with elastin fibers?

superficial

T/F: Pressure build-up in the supraglottal cavity of the larynx starts vocal fold vibration.

false

Which of the following muscle(s) contribute in adducting the vocal folds?

a. LCA

b. Transverse arytenoids

c. Oblique arytenoid

d. All of the above

d. all of the above

Contraction of the cricothyroid muscle causes the vocal folds to ________.

tense

All the intrinsic laryngeal muscles are innervated by recurrent laryngeal nerve EXCEPT

cricothyroid

The vocal folds are _____ during abduction, resulting in _______ sounds

open, voiceless

Which aerodynamic forces are at work to close the vocal folds?

bernoulli, elasticity

The PCA muscles...

abduct the VFs (move them apart)

The modal register...

a. is the register used for most of conversational speech

b. includes frequencies that span approximately 150 to 500 Hz for adult men

c. includes frequencies that span approximately 80 to 450 Hz for adult women

d. may also be referred to as falsetto voice

a

Contraction of the interarytenoid muscles serve to

a. draw the arytenoids together

b. decrease the distance between the cricoid and thyroid cartilages

c. tilt the thyroid cartilage superiorly

d. pull the arytenoids apart

a. draw arytenoids together

the bernoulli affect states that:

a. at a constriction there will be a decrease in flow

b. at a constriction there will be equal numbers of molecules (air or water) as below or above the constriction

c. at a constriction there will be a decrease in pressure

d. none of the above

c

When VFs lengthen, pitch normally

a. increases, due to contraction of the cricothyroid

b. decreases, due to contraction of the thyromuscularis

c. remains the same, due to contraction of the thyroarytenoid

d. increases, due to contraction of the interarytenoid

a

vocal pitch is a perceptual attribute associated with...

frequency

the vocal ligament is attached...

a. posteriorly to the thyroid cartilage

b. anteriorly to the thyroid cartilage

c. posteriorly to the muscular process of the arytenoid cartilage

d. anteriorly to the muscular process of the arytenoid cartilage

b. anteriorly to the thyroid cartilage

breathy voice quality is often associated with

a. increased tension of the vocal folds

b. incomplete glottal closure

c. complete closure of the vocal folds

d. high intensity

b. incomplete glottal closure

The _________________________ mode of vibration is characterized as having the lowest fundamental frequency.

a. falsetto

b. glottal fry

c. modal

d. pressed

b. glottal fry

the intrinsic laryngeal muscles connect

a. the laryngeal cartilages to each other

b. the laryngeal cartilages to cartilages outside the larynx

c. the intrinsic laryngeal membranes to the intrinsic laryngeal ligaments

d. the laryngeal cartilages to intrinsic laryngeal ligaments

a

All the following physiologic features are among the features of MTD EXCEPT?

a. Larynx descends

b. Decreased space between hyoid and larynx

c. Increased extrinsic laryngeal muscle tone

d. Excessive laryngeal or supralaryngeal constriction

a. larynx descends

T/F: Habitual ventricular phonation is a compensatory response to true vocal cord dysfunction.

false

Which one is correct about the vocal cord polyps?

a. Not responsive to surgery

b. Bilateral

c. Result from continuous VF irritation

d. Focal abnormality of the superficial lamina propria

d

A temporary loss of voice that may occur for only part of a word, a whole word, a phrase, or a sentence is called____________.

a. Diplophonia

b. Pitch break

c. Phonation break

d. puberphonia

c. phonation break

primary muscle tension dysphonia

a. occurs in the presence of current organic pathology, with obvious psychogenic or neurologic etiology

b. occurs in the presence of current organic pathology, without obvious psychogenic or neurologic etiology

c. occurs in the absence of current organic pathology, with obvious psychogenic or neurologic etiology

d. occurs in the absence of current organic pathology, without obvious psychogenic or neurologic etiology

d

ventricular dysphonia involves

a. the loading of the false vocal folds by the true vocal folds

b. the loading of the false vocal folds by the aryepiglottic folds

c. the loading of the true vocal folds by the false vocal folds

d. the loading of the true vocal folds by the aryepiglottic folds

c

An inappropriate use of high-pitched voice beyond pubertal age in males is referred to as

a. juvenile resonance dysphonia

b. functional aphonia

c. diplophonia

d. puberphonia

d. puberphonia

MTD is often characterized by

a. vocal fatigue

b. an elevated larynx

c. patient complaints of neck and jaw pain

d. all the above

d. all of the above

Reinke's edema

a. is associated with smoking

b. is normally more localized than nodules or polyps

c. is resistant to voice therapy

d. involves the vocalis muscle

a. is associated with smoking

When it comes to differentiating patients with adductor spasmodic dysphonia from those with muscle tension dysphonia, researchers suggest that those with MTD tend to maintain hyperadduction

a. across all speech and phonation tasks

b. only when whispering

c. only on voiced phonemes

d. only on non-voiced phonemes

a

The type of voice characterized by the production of voice with two distinct frequencies occurring simultaneously is called

a. puberphonia

b. functional aphonia

c. diplophonia

d. somatization dysphonia

c. diplophonia

Voice therapy for puberphonia requires

a. careful review of the patient s medical history

b. a thorough understanding of the voice and speech mechanism post puberty

c. an appreciation that some young men might find the transition from boy to manhood to be difficult

d. all the above

d. all of the above

The most common benign lesions of the vocal folds in both children and adults are

nodules

The patient who, addition to a voice disorder, shows an array of possible conversion symptoms may be exhibiting

a. somatization dysphonia

b. functional aphonia

c. diplophonia

d. puberphonia

a. somatization dysphonia

the only bone of the larynx

hyoid

cartilages of the larynx

thyroid, cricoid, arytenoid, corniculate, cuneiform

superior cornu of thyroid

indirect attachment to greater cornu of hyoid

inferior cornu of thyroid

posterior attachment to cricoid

anterior arch of cricoid

room for VF movement

posterior lamina cricoid

point of articulation for arytenoid

articular facets of cricoid

2 with thyroid for rocking motion, 2 with arytenoids

arytenoid

-sit on superior surface of the posterior lamina of the cricoid

lateral projection of arytenoid

muscular process (adduction and abduction of VFs)

anterior projection of arytenoid

vocal process (attached to posterior portion of VFs)

arytenoids rocking forwards

abduction of VFs

arytenoids rocking backwards

adduction of the VFs

arytenoids gliding forward

shorten VFs

arytenoids gliding backward

lengthen VFs

cricothyroid movement

rock forward- lengthen VFs

intrinsic ligaments/membranes

conus elasticus, vocal ligament, posterior cricoarytenoid ligaament

muscles of adduction

interarytenoid, LCA

muscles of abduction

PCA

cricothyroid

tensing VFs

thyrovocalis

tensor

thyromuscularis

relaxer

opening of VFs

positive pressure

closing of VFs

bernoulli and elasticity

steps of phonation

1) VFs adducted

2) subglottal pressure built up

3) folds open and close

bernoulli effect

at a point of constriction there will be a decrease in air pressure perpendicular to the flow and an increase in velocity of the flow

Inward collapse of the supraglottic structures of the larynx during inspiration is called

laryngomalacia

All the following symptoms are associated with LPRD EXCEPT

a. Morning hoarseness

b. Sweet taste in mouth

c. Bad breath

d. Frequent throat clearing and coughing

b

Which of the following etiologies may cause contact ulcers

a. chronic irritants

b. abnormal bloackage of the ductal system of the laryngeal mucous glands

c. laryngeal intubation

d. all of the above

c

T/F: Cysts generally respond to voice therapy

false

All statement are correct about the laryngeal web EXECPT

A.

An abnormal growing between the two vocal folds.

B.

It can be congenital and acquired.

C.

The symptoms include low‐pitched voice and diplophonia

D.

Treatment include surgery and voice therapy

c

congenital organic abnormalities

laryngomalacia, subglottic stenosis, esophageal atresia and tracheoesophageal fistula

larygomalacia

-inward collapse of the supraglottic structures of the larynx during inspiration

-evident at birth or soon after

-typically resolves around 18-24 mo.

-severe cases require surgery

subglottic stenosis

narrowing of the space below the glottis and above the first tracheal ring

-acquired more dangerous than congenital

esophageal atresia

failure of the esophagus to develop as a continuous passage

tracheoesophageal fistula

opening between the trachea and esophagus

GERD

passage of gastric juices from the stomach into the esophagus

LPRD

stomach acid passes through the UES

-may cause other conditions

LPRD symptoms

hoarseness, chronic cough, throat clearing, globus sensation

laryngeal signs of LPRD

hypertrophy of the intra-arytenoid area, erythema and edema of mucosa overlying arytenoids, erythema and edema of vocal folds

contact ulcers (granulomas)

small ulcerations that develop on the medial aspect of the vocal processes of arytenoid cartilages due to irritation

granuloma etiology

LPRD, intubation, voice misuse

granuloma symtpoms

vocal fatigue, laryngeal pain, chronic throat clearing, lateralizing pain

granuloma treatment

removing source of irritation

- anti-acid and voice therapy

cysts

closed sac filled with fluid or semisolid

-unilateral

-vocal folds

-congenital or acquired

cysts etiology

abnormal blockage of the ductal system

cyst symptoms

hoarseness, breathiness, voice/pitch breaks

cyst treatment

surgical removal

hemangioma

soft, pliable, blood-filled sac that occurs on the posterior glottis

-rare

infantile hemangioma

found in the subglottis

adult hemangioma

occur in the supraglottis

hemangioma etiology

vocal hyperfunction, LPRD, intubation