yawn-sign, singing, inhalation phonation, falsetto during speech
Cough, clear throat
Sing
Read passage
Voice therapy probes
Easy onset; phonation inhalation
Relaxation techniques & abdominal breathing
Alternate loudness & pitch
Say "mmm" before speaking
Effortful glottal closure/glotall attack
obtain info about ONSET, DURATION, CAUSES, AND VARIABILITY of voice problems
obtain info about associated symptoms
Voice Case History (rationale)
identify factors
gather info regarding previous therapy, medical intervention, or other attempts to
deal with voice problem
the specialist uses a bright light source and a small, round 21-25-mm mirror, angled
on a long, slender handle, to lift the velum and press slightly against the patient's
Indirect Laryngoscopy (Mirror posterior pharyngeal wall area
Laryngoscopy)
the mirror should be positioned to view the laryngeal structures during phonation
and quiet respiration
-patient is knocked out
direct laryngoscopy -VFs are looked at but patient cannot phonate
-used for taking a biopsy when assessing laryngeal cancer
-uses thin, flexible tube with lens and light
Flexible Fiber-Optic Laryngoscopy -passes through nose
-patient can talk and prolonged view of VFs is obtained
flexible = through the nose
rigid = orally
Endosopy
structured illuminated by light, can be attached to video camera
flexible: can view velopharyngeal mechanism
2/16
, .
spectogram: graphic representation of sound wave
acoustic analysis
used to obtain baseline measurements prior to therapy or surgery + post-treatment
a cancer arising in the epithelial tissue of the skin or of the lining of the internal
organs.
Carcinoma
Smoking is a common etiology of cancer. The client complains of an occasional sore
throat, and since she is a mild smoker, carcinoma must be considered.
instruct patient to touch their belly and feel it move in and out with their breath (little
to no shoulder movement)
Abdominal breathing
RATIONALE: increase breath support
for post VF surgery
- speak with low intensity, minimal effort
- use softest loudness level for all speaking situations
Confidential Voice Therapy - use fewer words per breath
- increase fluid intake
RATIONALE: allows time for the person's voice to heal
-inappropriate ab- or adduction of VFs during inhalation, exhalation, or both
-appear asthmatic
Paradoxical Vocal Fold Motion (PVFM)
-display stridor
-due to psychological or physiological reasons
SIGNS & SYMPTOMS
- hoarseness & roughness
- discomfort and dryness in throat
- pitch level higher or lower than normal
- difficulty speaking loudly
EXPECT TO SEE
- inflammation of VF and larynx
- redness, small dilated blood vessels
Laryngitis
- dry, thickened epithelium
- increased asymmetry and aperiodicity
EXPECT TO SEE
Myasthenia gravis
- HYPOadduction
- greater airflow
ETIOLOGIES
- chronic immune neuromuscular disease characterized by degrees of weakness of
voluntary muscles
3/16
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