ComD 10/31/13

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bamasi
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244990
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ComD 10/31/13
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2013-11-04 17:02:20
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comd
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  1. functional disorders
    • when vocal quality deteriorates in the absence of anatomic and neurological factors, there may be a functional disorder
    • nothing looks wrong with them
  2. functional dysphonia
    • symptoms will come and go
    • treat with laryngeal massage
    • more common in women
  3. mutational falsetto and juvenile voice
    • usually in men
    • when a boy's voice changes during puberty, the structure changes
    • they speak really high
    • can be treated by laryngeal massage
  4. neurogenic disorders
    • Vagus Nerve Lesion
    • Spasmodic dysphonia
    • ALS
    • Parkinson's
    • latrogenic etiology
    • Vocal tic, Tourette Syndrome
  5. what if you can't use the larynx?
    • Tracheostomy
    • Laryngectomy
  6. assessment for larynx
    • Strobe
    • Oral peripheral
    • Medical referral
    • Case history
    • Clinical observation
    • Listen for quality, loudness, pitch, etc.
  7. Things to do for nodules, polyps, granulomas
    • respiration- adequate breath support
    • relaxation training
  8. Things to stop doing for nodules, polyps, granulomas
    • limit vocal abuse
    • stop yelling, screaming, anything done with
    • excess tension
    • reduce loudness
    • stop smoke exposure
    • drinking is bad too
    • granulomas- diet and medication for GERD
  9. surgery for vocal nodules/polyps
    • iffy
    • difficult
    • must have SLP as well, or precipitating
    • factors will still be there
  10. different treatments for neurogenic disorders
    • botox for spasmodic dysphonia
    • other meds for other conditions
  11. what is voice?
    • phonation
    • resonance
    • frequency
    • intensity
  12. phonation
    producing sound by sending air through vocal folds
  13. resonance
    what happens to shape or sound after its produced in vocal folds
  14. frequency
    • the number of times the vocal folds oscillate 
    • the more they vibrate- the higher our pitch
    • the less they vibrate- the lower our pitch
  15. intensity
    how much air we send through those vocal folds; how loud
  16. habitual pitch
    • normal pitch
    • you use it the most
  17. optimal pitch
    the most healthy pitch for a person to use
  18. basal pitch
    lowest pitch your voice can produce
  19. ceiling pitch
    highest pitch your voice can produce
  20. vocal range
    difference between ceiling and basal pitch
  21. loudness
    • determined by volume
    • can be too loud (yelling)
    • can be too soft
  22. voice disorders
    voice differs in pitch, loudness, and/or quality compared to persons of a similar age, background, race, ethnicity to the extent that it calls negative attention to the speaker and/or interferes with communication
  23. ___ in 100 people will have a voice disorder at some poing
    6
  24. __ % of people may have voice problems in their life
    29%
  25. voice disorders are higher in ___ than in ___
    women; men (7% vs 5%)
  26. most common causes of voice disorders
    • vocal nodules 22%
    • edema 14%
    • polyps 11%
    • carcinoma 10%
    • vocal fold paralysis 8%
    • unknown 10%
    • other stuff
  27. voice disorders found in kids as well
    • 4-6% of kids have some
    • problems with voice
    • most common cause vocal nodules
    • more than 1 million kids develop nodules annually
  28. phonatory quality (disturbances)
    • hard glottal attack
    • glottal fry (tightly
    • approximated folds)
    • breathy phonation (aphonia)
    • spasticity or strain (too much tension, stoppage)
    • diplophonia- random pitch breaks
    • hoarseness (noise introduced-lose higher frequencies)- strain+breathiness
  29. types of voice disorders
    • structural- when something is wrong in the vocal folds
    • functional- in the way you use your voice
    • neurogenic- neurological cause for voice disorder
  30. vocal nodules- what are they?
    • What are they?
    • -small, bilateral, callous growths or protuberances on inner edges of vocal folds
    • you can't do surgery on them
    • bilateral
    • sounds scratchy
  31. what causes vocal nodules?
    • vocal abuse
    • over singing
    • singing the wrong way
    • yelling, screaming, cheering, etc.
    • basically, too much tension, hard attacks
    • talking or yelling when you have a cold, etc.
  32. what goes wrong?- vocal polyps
    • unilateral
    • can do surgery
    • tend to be more
    • vascular
    • broad term for a "protruding growth from a mucous membrane" (Dorland's 1988)
    • change mass of folds
    • may change approximation
    • hoarse, breathy voice
    • fold polyps
  33. contact ulcers and granulomas
    • contact ulcers are inflamed lesions or ulcers
    • posterior part of pharynx on arytenoid cartilages-sores
  34. causes of contact ulcers and granulomas
    • forceful contact (repeated), tissue dies
    • body forms a granuloma at site of ulcer
    • folds can't approximate- no smooth surface
    • may result from GERD (gastroesophageal reflux disease)- acid reflux, heartburn- acid backs up into esophagus

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