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4.CD2-Voice Etiology

CommDis2 SLP405

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
Created by: ashea01