shs 170 exam 2 chapters

what are 3 alternatives for oral speech after surgical removal of larynx:

Tracheoesophageal voice restoration

Esophageal voice

electrolarynx

Tracheoesophageal voice restoration

using voice prothesis to direct air into esophagus

Esophageal voice

swallowing air to vibrate the esophagus

electrolarynx

battery operated voice to create mechanical voice

result of paralyzed vocal folds

they are breathy because vocal folds cannot fully close

spasmodic dysphonia

involuntary spasms in muscles of the voice box

spasmodic dysphonia treatment and def of it

botulinum toxin—injections in affected laryngeal muscles

this weakens muscle to reduce spasms

vocal polyps

single, soft blister-like growth on one/both vocal cords

vocal nodules

bilateral, hard, callous-like growth on both vocal cords

how are voice disorders evaluated?

by physical exam of head and neck

name some techniques to help with voice disorders

-vocal exercises

straw phonation

vocal hygiene practices

resonant voice therapy

relaxation techniques

what do patients breathe through after laryngectomy?

a permanent stoma (neck opening) and cannot use vocal cords to speak naturally

treatment for nodules voice disorder

Alter phonatory behavior to

eliminate vocal abuse. The

nodules will almost always be

eliminated, however, surgery is

another option.

treatment for polyps

Can be treated with voice

therapy but if it is long-

standing, it can be surgically

removed

Papilloma and its treatments

-contractions were more over

layered (one flap almost over

the other)

-wart-like

treatment: usually goes away without

treatment

Carcinoma and treatment

unilateral, more uneven

circle

treatment: 15-20% need laryngectomy

surgery (removal of larynx)

Paralyzed VF and treatment

-one of the flaps aren’t moving

(right from her perspective)

-healthy looking and perfect

color

treatment:-vocal therapy

-move the affected fold closer

to the midline

abduction

vocal fold movement away from the midline

aphonia

loss of voice

atrophy

withering of tissues/organs

breathy

vocal folds do not completely close, resulting in excess air escaping the glottis

diplophonia

simultaneous vibration of 2 structures with differing vibration frequencies

dysphonia

disturbed phonation

dyspnea

difficulty/shortness of breath

edema

excessive amount of fluid in cells/tissue, resulting in swollen tissues

endoscopy

examination of interior of canal/hollow space

esophageal speech

alaryngeal speech in which phonation originates in upper portion of the esophagus 

harsh voice

excessive muscle tension; vocal folds are pressed tightly

hoarse voice

both harsh and breathy— irregular vocal fold vibrations

hypofunction

decreased vocal capacity from prolonged overuse, muscle fatigue or tissue irritation

instrumental assessment

camera that goes through throat and looks at vocal folds

Which neuromuscular disorders have involuntary movement? Why?

Parkinson's disease, Huntington's disease, dystonia, essential tremor, Tourette syndrome, and dyskinesias cause involuntary movements because of damage to the brain or nerves that control movement

How does the assessment of dysarthria differ for an adult compared to a child?

adult dysarthria involves an established motor system, while childhood dysarthria occurs within a developing motor, cognitive, and linguistic system

• What are the major causes of cerebral palsy?

damage to the nervous system because of low weight babies or premature birth

• What are two diseases that result in mixed dysarthria?

Amyotrophic Lateral Sclerosis (ALS) and Multiple Sclerosis (MS)

• How is speech intelligibility assessed? 

subjective methods, which involve human listeners transcribing or rating speech, and objective methods, which use algorithms to measure the quality of the speech signal and its background noise

• Acquired apraxia of speech

(AOS)

disorder in the planning and programming of speech movements due to left frontal lobe damage

• Acquired dysarthria

neuromuscular speech disorder that occurs after speech has been acquired

• Athetosis

congenital neuromuscular disorder characterized by involuntary movement caused by extrapyramidal tract damage

• Cerebral palsy (definition and causes of)

congenital neuromuscular disorder due to brain damage before, at the time of, or shortly after birth— can result in visual, auditory, cognitive, speech, and language disorders

cause: damage to developing brain

• Childhood apraxia of speech

(CAS)

congenital neuromuscular speech disorder with words dominated by simple syllable shapes, vowel errors, and sounds that develop early

• Childhood Dysarthria

pediatric neuromuscular speech disorder due to weakness and/or incoordination typically associated with cerebral palsy

• Comprehensibility

ability to understand language

• Dysarthria

neuromuscular speech disorder

• Herreflexia

an exaggerated or overly active reflex response in the body

hypotonicity

abnormally decreased background activity of a muscle resulting from nervous system damage

• Primary progressive apraxia of speech (PPAOS)

a neurodegenerative disorder that affects the ability to plan and coordinate the movements necessary for speaking

• Spastic dysarthria

abnormal muscle tone, primarily in antigravity muscles, resulting from upper motor neuron damage

ataxia

neuromuscular disorder characterized by errors in the direction, force, and timing of movements resulting from cerebellar damage

• Acquired stuttering

a type of stuttering that develops after a period of fluent speech

adaptation

the percentage of decrease in stuttering for each repeated reading when a passage is read multiple times in succession 

cancellation

a speech modification technique in which when you stutter, stop as soon as the stuttered word is completed, pause, and then say the word again in an easy, relaxed manner

CARE model

an approach that empowers individuals who stutter by focusing on Communication, Advocacy

cluttering

fluency disorder that is characterized by very rapid bursts of dysrhythmic, unintelligible speech

consistency

percentage of stuttered words from the first to the second repeated reading of the same passage

disfluency

flow of speech disrupted by repetitions, interjections, pauses, and revisions

fluency

speech that is continuous, easy, rhythmical, and evenly flowing

fluency shaping

therapy approach in which the clinician teaches the person who stutters a new way of talking that is designed to reduce likelihood of stuttering

neurogenic stuttering

stuttering due to impairment in the nervous system

• Non-stuttering-like disfluencies

phrase repetitions, interjections, or revisions

• Repetitions, prolongations, and blocks

repetition— repeated sounds/syllables

prolongations— sssssometimes

blocks— complete stoppage in speech

• Persistent stuttering

stuttering that continues for more than six months and does not improve significantly over time

• Preparatory set

technique in therapy for stuttering in which persons who stutter ease their way into words they believe are difficult to produce

• Prevalence

% of individuals who demonstrate a disorder at a given point in time

• Primary stuttering behaviors

repetitions, prolongations, block are like the core behaviors of stuttering

• Psychogenic stuttering

a type of stuttering that is caused by psychological factors

• Pull-out

therapy strategy for stuttering in which persons who stutter are taught to ease their way out of repetitions, prolongations, and blocks

• Secondary stuttering behaviors

behaviors associated with stuttering. most common are eye blinks, lip pursing, arm movements, and head nods

• Stuttering

unusual disruptions in the smoothness and rate of speech, accompanied by tension that interferes with communication

• Stuttering modifications

therapy approach in which the clinician teaches the client to alter the way they stutters

Give an example of the following primary behaviors of stuttering: single-syllable-word repetition, syllable repetition, sound repetition, prolongation, and block

single-syllable word repetition ("my-my-my" house), syllable repetition ("ba-ba-ball"), sound repetition ("s-s-s-sock"), prolongation ("M------"y name), and block (a silent pause before or during speech)

• What is the prevalence of stuttering?

prevalence— 1%

• List two basic facts about stuttering.

-Stuttering can be caused by problems with speech motor control

-stuttering can be caused by genetics

• What is the difference between primary and secondary stuttering behaviors?

-Primary stuttering behaviors are the core speech disruptions

-secondary behaviors are learned reactions to stuttering, such as eye blinking, jaw tension, word avoidance

What are two myths about the etiology of stuttering?

it is caused by nervousness or stress and that it is a result of imitation or being "caught" from others

• identify environmental/external conditions and individual capacities for fluency that may affect the development of stuttering.

stress, anxiety, and negative listener reactions, such as bullying or impatience

• What factors may contribute to persistent stuttering?

brain differences, family history, and emotional reactivity, along with co-occurring developmental disorders like ADHD or autism

• What types of assessment procedures are used in most stuttering evaluations?

speech fluency assessment

• During an evaluation, why is it important to measure the attitudes and feelings about communication of the person who stutters?

these attitudes significantly influence a person's willingness to engage in communication, their confidence, quality of life, and the effectiveness of therapy

• What are some general guidelines to adhere to when interacting with a person who stutters?

be patient, maintain natural eye contact, and listen to the message, not the speech

acoustic neuroma

tumor arising on the auditory (8th cranial) nerve

air-bone gap

the difference in decibels, between the air conduction threshold and the bone conduction threshold

air conduction

the pathway of sounds that includes the outer ear, middle ear, inner ear, and structures of the central nervous system 

audiogram

a graph depicting the threshold of audibility (in decibels) as a function of different frequencies

audiometer

device used to measure hearing

auditory brainstem response

measurable responses in the brainstem to a series of acoustic stimuli

auditory nerve

8th cranial nerve that carries information about hearing and balance from inner ear to the brain

bone conduction

the pathway of sound that bypasses the conductive mechanisms of the outer and middle ears by vibrating the skull and stimulating the cochlea

conductive hearing loss

a loss of hearing sensitivity caused by damage to the outer or middle ear

hearing level

the reference that uses normal hearing in the scale of decibels

hearing thresholds

the minimum sound level or intensity of a pure tone at a specific frequency that an average human ear can just detect

immittance

measurement of the impedance of the tympanic membrane or admittance of sound to the middle ear

mixed hearing loss

combo of conductive and sensorineural hearing loss in the same ear

otitis media

infection of middle ear

• Phonemically balanced

lists of 50 words that contain the phonetic elements of English speech. these lists are used for testing word recognition during a hearing assessment

sensation level

auditory signal, expressed in decibels, representing the level of intensity above the faintest sound that an individual can hear

• Sensorineural hearing loss

hearing loss caused by damage to the inner ear or auditory nerve

• Speech recognition threshold (SRT) 

the lowest intensity at which speech can be heard

spondees

two-syllable word pronounced with equal emphasis on both syllables— can be used to test speech recognition threshold

tinnitus

ringing, roaring, or other sounds heard in the absence of an external sound