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4.CD2-Voice Etiology
CommDis2 SLP405
Term | Definition |
---|---|
2 etiologies | Organic, Functional |
ORGANIC | Congenital, surgery, trauma, medical, acute/chronic illness, psychological |
Congenital | Laryngomalacia, Laryngeal web |
Surgery | Direct. Indirect - laryngeal web (rough intubation) |
Medical | Cancer. Leukoplakia (precancerous). Granuloma/Contact ulcers. Endocrine/pubertal changes. Papilloma |
Acute/chronic illness | Sinusitis. Respiratory illnesses. Allergies. Medications (drying). Stomach Disorder (acid). Nervous Disorder (tension) |
Psychological | Emotional disorders: tension, depression, anxiety. Laryngeal tension - poor respiration, fatigue. Medication: drying or other effects of antidepressants, anti-psychotics. Functional aphonia (mutism). |
FUNCTIONAL | Mutational falsetto. Functional aphonia. Polyps. Nodules. Granuloma/Contact ulcers. Vocal fold hemorrhage. Ventricular prolapse. Traumatic laryngitis. Vocal fold thickening. Ventricular phonation (false folds). |
Examples of Abuse | screaming & vocal noises, sporting events, animal sounds, car sounds, train sounds, sounds used in play shouting, loud talking, vocal noises, coughing, throat clearing |
Who is prone to functional disorders? | Children on the playground, Factory workers, Construction workers, Certain Families |
Voice exam/assessment goals | Identify. Describe (nature/severity). Prescribe. Predict. |
Assessment of voice systems | Phonation. Resonance. Respiration. |
Respiration: symptoms | Shallow Clavicular. Thoracic. Diaphragmatic. Poor efficiency. Reduced vital capacity. |
Respiration: Perceptual meas. | Max phonation time. Diaphragmatic-abdominal breathing. |
Respiration: Instrumental meas. | Spirometry (volumes/capacities). Water manometer (air flow pressure, 5 for 5). |
Phonation: Assessment | Use oral reading, monologue, or conversation to judge quality, attack/onset, rate, pitch, loudness. |
Phonation: Perceptual meas. of pitch | Pitch range (2-3 octaves), pitch matching, optimal pitch |
Phonation: Perceptual meas. of loudness | Inside and outside voice. Loud to soft. Soft to loud |
Phonation: Perceptual meas. of rate | fast/slow rate |
Phonation: Perceptual meas. of quality | Rating scales: 0 to +3; CAPE-V; GRBAS. S/z ratio (less than 1.5 WNL). Register, pitch breaks, stoppages. |
Phonation: Instrumental meas. of quality (acoustic) | Intensity, frequency, noise (harmonics), shimmer, jitter, turbulence, multi-dimensional voice profile (MDVP donut), spectogram. |
Phonation: Instrumental meas. of physiology | Laryngoscopy: mirror, biopsy, endoscopy (transoral or transnasal). High speed video & stroboscopy. Electroglottography. Glottal pulse shape, opening/closing phases, irregular motion/approximation, mucosal wave. |
Resonance qualities | Hypernasality (vowels/voiced consonants). Hyponasality (nasal consonants). Nasal emission (voiceless consonants). Assimilative nasality (vowels take on quality of adjacent nasals). Cul-de-sac (hollow muffled sound, mashed potatoes) |
Resonance: Instrumental meas. of physiology | Transnasal endoscopy, nasal manometer, pressure bulb. |
Resonance: Perceptual measures | Nasal and non-nasal sentences. Nares occluded. Nasometer or perceptual |
done |