Voice Disorders Exam II Sp14

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andreaucoslp15
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Voice Disorders Exam II Sp14
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2014-02-26 14:51:13
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voice disorders mckaig
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2nd exam for McKaig's Voice Disorders class
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  1. True or False: Changes in speech are not manifestations of neurogenic disease.
    False. Changes in speech can be the first or only manifestation of neurogenic disease.
  2. The CNS is composed of the _________ and ________ ________ and is housed in the bony protective structures of the ___________ and ____________ ____________.
    • brain
    • spinal cord
    • skull
    • vertebral column
  3. The third frontal convolution in the left hemisphere, or _________ ________ has much to with preplanning a motor speech act, including voice response.
    Broca's Area
  4. The _________, medial to the temporal lobe, play an active role in _________ __________ for voice and speech.
    • insula
    • motor planning
  5. Language comprehension is associated with _________________ ___________.
    Wernicke's Area
  6. The pyramidal tract regulates the _____________ and ____________ activity of muscles.
    • voluntary
    • reflex
  7. The extrapyramidal tract regulates _________ ____________ and _____________.
    • muscle movement
    • posture
  8. Many of the diseases of the CNS cause ___________ or_____________ of neurotransmitters.
    • inhibition
    • overproduction
  9. The cerebellum functions as the great regulator of the ________________ _______.
    extrapyramidal tract
  10. The cerebellum coordinates __________ ________ with coordinated __________ ________.
    • sensory information
    • motor response
  11. Lesions to the cerebellum cause speech symptoms of _______ __________.
    ataxic dysarthria
  12. What are the voice-speech symptoms of ataxic dysarthria?
    changes in resonance, inarticulate speech, and prosodic slowdown
  13. Describe hemiplegia.
    One-sided spastic paralysis of extremities.
  14. A lower motor lesion would cause:
    unilateral vocal fold flaccid paralysis.
  15. What is the most significant cranial nerve in speech language pathology?
    CN X: Vagus
  16. Name the functions of the glossopharyngeal nerve (CN IX):
    • Taste in the posterior third of the tongue
    • Sensation to the fauces, tonsils, pharynx, and soft palate
    • Primary innervations to the larynx
  17. What are the two branches of the vagus nerve?
    • recurrent laryngeal nerve
    • superior laryngeal nerve
  18. What are the jobs of the two important branches of the vagus nerve?
    To innervate the larynx
  19. The sensory components of the vagus nerve include sensory innervations of the:
    • pharynx
    • larynx
  20. Name the motor innervations of the vagus nerve that affect the voice:
    • velum
    • base of the tongue
    • pharyngeal constrictors
    • larynx
    • autonomic ganglia of the thorax
  21. The primary function of CN XI, or the spinal accessory nerve, is to innervate the _______ accessory muscles.
    neck
  22. Lesions to the spinal accessory nerve (CN XI) will cause obvious problems of:
    • respiration
    • resonance
  23. What is the primary impact of the hypoglossal nerve (CN XII)?
    resonance and quality
  24. The CN XII has much to do with the positioning of the larynx, therefore, overuse implies...
    the larynx is bobbing up and down too much
  25. Name the muscles that affect the vocal folds.
    • cricothyroid muscle
    • thyroarytenoid muscle
    • posterior cricoarytenoid
    • transverse arytenoid
    • oblique arytenoids
  26. True or False. The cricothyroid muscles are paired.
    True.
  27. What is the primary symptom of cricothyroid disease or trauma?
    The inability to elevate vocal pitch.
  28. What happens in the case of unilateral cricothyroid paralysis?
    There may be extreme hoarseness and occasional diplophonia
  29. True or False. The recurrent laryngeal nerve is not vital to the abductory-adductory function of the larynx.
    False.
  30. True or False. The recurrent laryngeal nerve innervates the five muscles of the larynx.
    True.
  31. Name the muscle that makes up the main mass of the vocal fold.
    The thyroarytenoid muscle.
  32. Cutting or trauma to the recurrent laryngeal nerve will result in _____ ___________ of the ___________ muscle.
    • flaccid paralysis
    • thyroarytenoid
  33. Flaccid paralysis of the thyroarytenoid muscle will in time lead to...
    vocal fold atrophy resulting in weakness in vocal fold approximation, midfold bowing, and dysphonia.
  34. The paired posterior cricoarytenoid muscle is the _____ __________ muscle of the vocal folds.
    lone abductor
  35. Name the primary symptom of posterior cricoarytenoid paralysis.
    An inability to open the glottis on the involved side, creating a unilateral abductor paralysis.
  36. Name the primary adductor muscle of the vocal folds.
    The paired lateral cricoarytenoid muscles.
  37. What is the primary symptom of lateral cricoarytenoid paralysis?
    Vocal fold paralysis in the fixed, abducted paramedian position.
  38. True or False. Lateral cricoarytenoid paralysis is most likely to be bilateral.
    False. It is most likely to be unilateral.
  39. True or False. Oblique arytenoids contribute to to vocal fold abduction.
    False. They contribute to adduction, the paired posterior crisoarytenoid is the love abductor muscle of the vocal folds.
  40. What would happen if CN IX, the glossopharyngeal nerve, is cut?
    The glossophrayngeal nerve is mostly a sensory nerve, so you'd be likely to lose taste in the posterior third of the tongue, sensation in the fauces, tonsils and pharynx. It innervates the muscle that elevates the phraynx, that is its motor component, so if it is damaged, there would be some damage in elevation of the pharynx (which contributes to swallowing).
  41. What would happen if CN X, the vagus nerve, is cut?
    Because of the superior laryngeal and recurrent laryngeal nerve branching from the vagus nerve, there would be many things affected by a lesion or damage to the vagus nerve.
  42. Name the muscle innervated by the superior laryngeal nerve branch of the vagus nerve.
    The cricothyroid muscle
  43. Name the primary symptom of cricothyroid disease or trauma.
    An inability to elevate vocal pitch.
  44. Name the five intrinsic muscles of the larynx innervated by the recurrent laryngeal nerve branch of the vagus nerve.
    • thyroarytenoid
    • posterior cricotarytenoid (paired)
    • lateral cricoarytenoid (paired)
    • transverse cricoarytenoids
    • oblique arytenoids
  45. True or False. Lesions to the cricothyroid muscle are seldom due to viral neuropathy and are more likely to be caused by trauma.
    False. Lesions to the cricothyroid muscle are seldom due to trauma but more often are realted to some form of viral neuropathy.
  46. Describe the affects of cutting or trauma to the recurrent laryngeal nerve as it relates to the thyroarytenoid muscle.
    Flaccid paralysis of this muscle will lead to vocal fold atrophy resulting in weakness in vocal fold approximation, midfold bowing, and dysphonia.
  47. Describe the primary symptom of posterior cricoarytenoid paralysis.
    An inability to open the glottis on the involved side, creating a unilateral abductor paralysis. (The vocal fold will not open)
  48. Describe the primary symptom of lateral cricoarytenoid paralysis.
    Vocal fold paralysis in the fixed, abducted, paramedian position, most likely to be unilateral. (It will not close)
  49. How would a lesion to the recurrent laryngeal nerve branch affect the transverse arytenoids?
    It may produce weakness or paralysis in its function.
  50. Describe unilateral paralysis in the oblique arytenoids from lack of innnervation by the recurrent laryngeal nerve branch.
    It would further contribute to unilateral adductor paralysis.
  51. What sort of problems are caused by lesions to CN XI, the accessory nerve?
    Lesions to CN XI can cause obvious problems of resonance and respiration.
  52. What sort of impacts does CN XII, the hypoglossal nerve, have on voice?
    Resonance and quality. Which makes sense, since the tongue is a mobile articulator. It also makes sense since this nerve contrinutes to the positioning of the larynx.
  53. True or False. The superior laryngeal nerve is often injured by trauma.
    False. It is rarely injured by trauma because of its relatively direct course after branching out of the vagus down to the larynx.
  54. Name the most common cause of superior laryngeal nerve involvement.
    viral infection
  55. If the superior laryngeal nerve is damaged due to viral infection, (the common cause), is it unilateral or bilateral?
    Both.
  56. If the superior laryngeal nerve is damaged due to viral infection, (the common cause), which paired muscle will it affect?
    The cricothyroid muscle.
  57. What are a patient's primary voice symptoms if damage is done to the cricothyroid muscle?
    an inability to elevate or lower pitch, and some breathiness due to bowing
  58. True or False. virally-caused cricothyroid paralysis is permanent.
    False. It is temporary.
  59. What sort of treatment should be given in the case of cricothyroid paralysis?
    • cricosteroids
    • anitviral agents
  60. If a patient displays long-lasting cricothyroid paralysis, what treatment shows promising results?
    selective reinnervation of the cricothyroid muscle (done with surgery)
  61. Lesions to which nerve usually results in bilateral vocal fold paralysis?
    Vagus nerve CN X
  62. Name the lesions we can include in the case of damage to the vagus nerve (CN X).
    • tumors at the base of the skull
    • carcinoma
    • trauma
  63. True or False. Unilateral vocal fold paralysis is a common cause of neonatal stridor.
    False. Bilateral vocal fold paralysis is a common cause of neonatal stridor.
  64. Bilateral vocal fold paralysis may be of the __________ or __________ type.
    • abductory
    • adductory
  65. True or False. Bilateral vocal fold paralysis (abductory or adductory type) is life-threatening.
    True.
  66. In bilateral adductor paralysis, are the vocal folds unable to abduct or adduct?
    they cannot adduct (close)
  67. In bilateral abductor paralysis, are the vocal folds unable to abduct or adduct?
    they cannot abduct (open)
  68. If neither vocal fold is able to move to the midline (cannot adduct), this makes ______________ impossible and places the individual at risk for ____________.
    • phonation
    • aspiration
  69. If the vocal folds remain at the midline (cannot abduct), this causes serious ___________ problems and the patient will need a ___________.
    • respiration
    • tracheostomy
  70. What is the most common form of laryngeal paralysis?
    Disease or trauma to the recurent laryngeal nerve on one side.
  71. _____________ or ___________ to the _________ ___________ ___________ on one side is the most common form of laryngeal paralysis.
    • Disease
    • tramua
    • recurrent laryngeal nerve
  72. Which branch of the recurrent laryngeal nerve appears to be more prone to traumatic or surgical injury, the left or the right?
    The left.
  73. What is the most common etiology of injury to the recurrent laryngeal nerve?
    surgical trauma
  74. __________ trauma is the most common etiology of injury to the recurrent laryngeal nerve, followed by _________ and __________ causes.
    • surgical
    • viral
    • idiopathic

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