Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Voice Ch. 6 pt 2
| Term | Definition |
|---|---|
| Visual Examination of the Larynx | -Indirect laryngoscopy - Direct laryngoscopy - Fiberoptic laryngoscopy (flexible/rigid) - Stroboscopy |
| Laryngoscopic Protocol | Disinfect Overview prod. Attach mic Let patient handle scope Attach camera Put pt. in pos Pt protrudes tongue, hold it Tell pt. breathe thru nose Pt. Phonate /i/ ~3-4s Pt. Pitch glides Pt. Increase loudness Repeat with strobe lighting |
| Laryngoscopic Observations | VF edge Glottal closure Amplitude of vibration Mucosal wave Approximation Supraglottic activity VF mobility Phase closure/symmetry Non-vibrating portion Regularity Overall laryngeal function |
| Vocal Fold Edge | - Inspect medial (free) edge of each fold, judge: smoothness, straightness, pretense of lesions/massess/pathologies - Occasionally, false VFs or mass lesions obscure the true VF edge |
| Glottic Closure | Rated - during norm. pitch/loudness & under strobe light Different closure configurations - Complete - Hour glass -Spindle - Incomplete - Irregular |
| Complete Glottic Closure | A glottis without evidence of any gapping during max. vocal fold adduction |
| Hour-Glass Glottic Closure | The presence of an anterior and posterior gap with mid-membranous vocal fold closure |
| Spindle-shaped Glottic Closure | A glottal appearance where both the anterior and posterior portions of the VFs are closed, but a large gap remains in the middle |
| Incomplete Glottic Closure | When the VFs fail to touch |
| Irregular Glottic Closure | One or both vocal folds approximate in an irregular fashion |
| Amplitude of Vibration | How far do the VFs move laterally from midline during phonation Can be affected by Fo and intensity - Higher Fo = decreased excursion - Greater intensity = increased excursion |
| Mucosal Wave | Ripple-like movement of mucosa over VF body Wave should travel 1/2 width of VF in medial to lateral direction Assessed in normal light and during normal pitch and loudness - Higher Fo = decreased wave - Greater intensity = increased wave |
| Vertical Level Approximation | Do the VFs meet on the same vertical plane (rare that they dont Affects VF approx. - one VF may overlap the other |
| Supraglottic Activity | Look for medio-lateral and antero-posterior involvement of supraglottic structures Rated during normal pitch and loudness Strobe not needed |
| VF Mobility | VF add/abd assessed for evidence of paralysis or paresis of either or both VF Mobility may be: normal, limited add/abd, or fixed. If fixed: define where (midline, paramedian, lateral) Assessed in normal light |
| Phase Closure | Observe the amount of time the VFs begin to part from midline until the lower lips of the VFs approximate Normally, open and closed phases are equal - Hypofunction: open phase predominates - Hyperfunction: closed phase predominates |
| Phase Symmetry | Refers to degree to which VFs appear to be mirror images of each other in motion - In-phase: moving in opposite direction - Out-of-phase: moving in same direction |
| Non-Vibrating Portion | Defined as immobility of any part of the membranous VF (body, mucosal cover) Estimate is made about the percent of the VF that is not vibrating |
| Regularity | Refers to the consistency of the duration of successive cycles of VF vibration Can use the running or locked mode during strobe |
| The Clinical Voice Laboratory | Computer-based hardware/software is becoming more affordable and automated, however, clinical instrumentation cannot replace the mind, eyes, and ears of a well-trained clinician |
| Equipment Considerations | - Sound isolation & ambient room noise - Mic choice - Sound level meter choice - Cable choice - Computer specifications - Recording software/video monitor size |
| To Ensure Acoustic Measure Validity | 3 things must occur - Needs to be able to discriminate the norm from dysphonic voice - Needs to correlate positively w/ clinicians auditory-perceptual judgments - Needs to be sufficiently stable to assess change across time |
| Acoustic Analyses | - Sound spectrography - Frequency-Related Parameters - Intensity-related parameters - Perturbation and Noise Measures |
| Frequency-Related Parameters | - Fundamental frequency - Frequency variability - Maximum phonation frequency range - Phonetograms |
| Intensity-Related Parameters | - Average habitual intensity - Intensity variability - Dynamic range (softest to loudest) - Phonetograms |
| Perturbation and Noise Measures | -Jitter - Shimmer - Signal to noise ratio |
| Phonetograms | Graphical representation of vocal capabilities and limitations across different pitches and loudness levels. It's a tool used in voice assessment to evaluate a person's vocal range, pitch control, and dynamic range. |
| Sound Spectrogram | Visual representation of the frequency and intensity of the sound as a function of time |
| Spectrogram | Reflects the harmonic structure of the glottal sound source and the resonant characteristics of the vocal tract. can be narrow/wide Visual rep. of speech/voice signal - Lowest band is F0 - Time: x-axis - Frequency: y-axis - Energy: z-axis (darkness) |
| Wideband Spectrogram | Good time resolution, poor frequency resolution (its smushed together and hard to distinguish) |
| Narrowband Spectrogram | Good frequency resolution, poor time resolution Individual harmonics, particularly well suited to inspecting the vocal acoustic signal in people w/ dysphonia Change in harmonics = observe stability in VF vibration |
| Fundamental Frequency (F0) | Average: rate of vibration in VFs (Hz)- determined by isolated vowels, reading, conn. speech Habitual pitch changes depending on: age, gender, race Use norms when making clinical judgments Piano or keyboard to measure pitch-related parameters |
| Average Speaking Fundamental Frequencies (Average SFF) | Adult Females: 212Hz Adule Males: 112 Hz (non-singer) |
| Frequency Variability | Normal voices have some variability perceived by listener as acceptable changes in prosody In some dysphonic speakers, freq. can be too variable or not variable enough |
| Maximum Phonational Frequency Range (MPFR) | The range of vocal frequencies encompassing both modal and falsetto registers. Extent is from lowest tone sustainable in modal register to the highest falsetto register Recorded in semi-tones 2 1/2 - 3 octaves (30-36ST) in healthy adults |
| Average/Habitual Intensity | Intensity = acoustic power of the speaker reported in dB SPL, correlates to loudness Habitual loudness is average loudness level used by speaker Level II sound meter to measure loudness, analog and digital versions Sensitive from 40-130 dB SPL usually |
| Intensity Variability | Range of intensities used in connected speech - normal voices have variability perceived by changes in intonation Measured in terms of the SD from average intensity: SD for neutral, unemotional sentence is around 10dB SPF |
| Dynamic Range | Physiologic range of intensities from non-whisper to loudest shout w/o strain Focus dynamic range around habitual loudness DR is dependent on F0 |
| Voice Range Profile (VRP)/Phonetogram | Pt is asked to phonate /i/ or /a/ at select frequencies across their frequency range (modeled by tone generator like a piano) both as softly and as loudly as they can Normal VPR: oval shape Upper contour: max intensity Lower: min intensity |
| VRP Characteristics that are usually reported | Habit freq Freq range Lowest & highest freq Habit intensity Intensity range Lowest & highest intensity VPR shape & contour |
| Pertubation | Cycle to cycle variability in vocal signal (short-term non-volitional variability) - sustained vowels Jitter: variation of freq during steady pitch Shimmer: variation of intense during steady loudness |
| Three ratios in noise measures of voice | Harmonics to noise ratio (HNR) Noise to harmonics ratio (NHR) Signal to noise ratio (SNR) Normal voice: high HNR or SNR & low NHR Dysphonic voice: low HNR/SNR and high NHR |
| Aerodynamic analysis | Lung: volumes, capacities, pressure Airflow Laryngeal resistance Durational measures |
| Lung Volumes | Tidal volume Inspiratory reserve volume Expiratory reserve volume Residual Volume |
| Tidal volume | The amount of air inspired and expired in a normal breathing cycle |
| Inspiratory reserve volume | The amount of additional air inspired after a tidal inhalation is completed |
| Expiratory reserve volume | Maximum volume of air expired after a normal tidal expiration |
| Residual volume | the air remaining in the lungs even after a maximum exhalation (need to have this to keep lungs from collapsing) |
| Lung Capacities | Inspiratory capacity Vital capacity Functional residual capacity Total lung capacity |
| Inspiratory Capacity | tidal volume + inspiratory reserve volume |
| Vital capacity | (capacity of air available for speech production) tidal volume + inspiratory reserve volume + expiratory reserve volume |
| Functional residual capacity | expiratory volume + residual volume |
| Total lung capacity | tidal volume + inspiratory reserve volume + respiratory reserve volume + residual volume |
| Air pressure | Pressures necessary for speech: in the lungs, below VFs, inside oral cavity Measures in cm H2O - total pressure may be > 50cm H2O, need 5-10cm H2O for speech Pressure below VFs measured indirectly thru oral pressure during /pi/ - transducer |
| Laryngeal airflow | Volume of air passing through glottis in a fixed period of time Measured in cubic centimeters (cc) or milliliters (mL) per second |
| Laryngeal resistance | Measured from peak oral resistance during /pi/ repeated at 1.5 syllables per second Pressure - /p/ Airflow - /i/ Breathy = decreased laryngeal resistance Strain/strangle = increased resistance |
| Durational measures | Maximum phonation duration (MPD)/Maximum phonation time (MPT) S/Z ratio |
| Maximum Phonation Time | Indirect index of laryngeal airflow MPT: greatest time over which the /a/ can be sustained at comfortable pitch and loudness Longest of 3 trials High airflow: MPT lower Low airflow: MPT longer |
| S/Z Ratio | Indirect index of laryngeal airflow Normal subjects: 1:0 >1:4 - reduction in voicing ability |
Created by:
jessicawalker
Popular Speech Therapy sets