Criado por Linnea Larson
quase 8 anos atrás
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Questão | Responda |
The Voice Center Components | MULTIDISCIPLINARY CLINIC --Laryngeal Surgeon --High-def laryngeal imaging --Voice Specialized SLP --Voice lab with acoustics and aerodynamics |
Voice Patients | teachers, preachers, lawyers, sales representatives, call center employees, entertainers, etc. All patients with hoarseness!! Anyone who relies on voice for livlihood |
Laryngology involves... | Diagnosis and treatment of disorders of: airway voice elements of swallow |
Largyngeal Function | Protection of airway Provision of Airway Phonation |
Intrinsic Laryngeal Musculature (adductory muscles, abductory muscles, and tensor) | Adductory: lateral cricothyroid, thyroarytenoid, interarytenoid (bilateral innervation) Abductory: posterior cricoarytenoid Tensor: cricothyroid |
Extrinsic Laryngeal Musculature Functions | Strap muscles and extrinsic muscles of tongue Elevators Depressors Function: Swallowing and Vocal Tract |
Requirements of Phonation | -Adequate breath support -Approximation of vocal folds -Favorable vibratory properties -Favorable vocal fold shape -Control of length and tension |
Process of videostroboscopy | Vocal Fold vibration 100-200 cycles per second Videostroboscopy illuminates different parts of the cycle and the human eye/brain fills in the gaps |
Laryngeal Function Studies | Acoustical Measurements Quality/Perturbation Measurements Aerodynamic Measurements |
Acoustical Measurements : | Frequency evaluation (mean fundamental frequency and frequency range) Intensity (mean speaking intensity) |
Quality/Perturbation: | Quality/Perturbation: Jitter, Shimmer, Noise-to-Harmonic Ratio, Degree and number of subharmonics increased |
Aerodynamic Measurements: | Vital capacity Maximum Phonation time Phonation Quotient S/Z Ratio (1.4 or greater = clinically significant) |
Cough Reflex | Laryngeal Chemoreflex -Nociceptive nerve endings in mucosal epithelial cells of epiglottis, aryepiglottic folds, and interarytenoid space -Efferent = syperior laryngeal nerve -Afferent = recurrent laryngeal nerve |
Laryngeal Chemoreflex (Cough Reflex) Heightened by... | Inflammation, infection, frequent stimulation |
Cough (types and descriptions) | 1. Behavioral/Habitual -Lasts longer than 8 weeks -Concomitant with other pulmonary or GI comorbidities -Quality of life implications 2. Neurologic/Psychogenic |
Treatment for Chronic Cough/Irritable Larynx | Medical Tx SLP: Break/abort cough; prevent cough and further irritation |
Respiratory Retraining Therapy: Vocal Cord Dysfunction, Irritable Larynx, Cough | Treat muscular etiology by relaxing larynx and pharynx Eliminate inefficiencies in phonation and coordinated phonation with respiration. |
Respiratory Retraining Therapy: Low CO2 Syndrome, hyperventilation | Change blood gas composition Nasal breathing, relaxation, reduction of respiratory rate |
Reinke's Edema | Swelling of superficial lamina propria Occurs in smokers "smokers voice" |
Polypoid Corditis and Treatment | Treatment: Smoking cessation Microflap resection or KTP laser treatment |
Airway Disorders | 1. Dynamic -vocal fold dysfunction -paradoxical vocal fold motion 2. Static -bilateral vocal fold paralysis -subglottic stenosis |
Vocal Cord Dysfunction | 1. Paradoxical VF closure -Stridor -Exercise induced -Young, female, Type A 2. Laryngospasm -Reflux -Functional |
Common Laryngeal Pathologies | Benign Malignant Functional Neurologic |
Benign Largyngeal Pathology | Infectious Traumatic Inflammatory Examples: Granuloma, acute laryngitis, reflux, fungal laryngitis |
Malignant Laryngeal Pathology | Example: Largyngeal Cancer |
Functional Laryngeal Pathology | Example: Muscle Tension Dysphonia |
Muscle Tension Dysphonia and Treatment | Recruitment of extralaryngeal muscles during phonation Compensatory maneuvers Alters glottic and vocal tract configuration and closure Cervicalgia (tightness and pain in cervical musculature) Treatment: Voice therapy & physical therapy to treat upper body tension (neck, back, and shoulders) |
Neurologic Laryngeal Pathology | Example: Unilateral vocal fold paralysis, Parkinson's, Spasmodic Dysphonia |
Treatment of Vocal Fold Paralysis | Injection Laryngoplasty |
Spasmodic Dysphonia and Treatment | Laryngeal Dystonia Adductor - vocal stops; Abductor - breathy; Mixed Tremor Treatment: Laryngeal Botox Injections; improve effort; weaken dystonia |
Vocal Tremor | Intrinsic and extrinsic laryngeal muscles Present in 25-35% of patients with essential tremor Also seen in spasmodic dysphonia, Parkinson's, and Parkinson plus syndromes |
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