Exam 4 Part 1

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Respiratory system

Produces "air under pressure" which generates speech

Main component of respiratory system

Lungs

Inhalation

Drawing air into lungs

Exhalation

Expelling air from lungs

Larynx

Function: set molecules from breath stream into vibration (vocal folds)

Pharyngeal cavity, oral cavity, nasal cavity

the vocal tract contains 3 cavities

Peripheral nervous system, central nervous system, autonomic nervous system

Motor system contains

Vocal fold vibration

Is a result from buildup of air pressure below vocal fold which is responsible for making exhaled air vibrate

Length, mass, and tension

Rate of vibration is determined by

Pitch

Varies by varying tension of vocal folds
Occurs by moving thyroid cartilage to either an anterior or posterior direction

Tension increases

When thyroid cartilage rocks forward

Tension decreases

When thyroid cartilage rocks backward

Folds widely deprecated (glottis open)

Unrestricted flow of air into lungs

Phonation

Folds adducted at midline

Source filter theory

Sound source (vocal folds)
Filter (vocal tract)
Radiation (lips)

Laryngoscopy

Used to view the vocal folds

Organic

Associated with some form of structural deviation or change in phonation mechanism

Functional

Not associated with tissue changes in the vocal folds and related to structure

Aphonia

Loss of voice
vocal folds are abducted

Dysphonia

any kind of vocal disorder

breathiness, harshness, hoarseness

disorders of vocal quality

breathiness

vocal folds slightly open
edema (swelling)

harshness

vocal folds pressed together too tightly
neurological diseases, vocal abuse

hoarseness

irregular vocal fold vibration
neurological disease
abnormal growths on folds (nodules, polyps)

oral resonance

results from position of tongue and extent of jaw movement

hypernasality

excessive nasal resonance, insufficiencies with velum, cleft palate, short velum, injury to velum

hyponasality

inability to produce nasal resonance, usually stems from an organic disorder, chronic sinus infection

vocal fold paralysis

paralyzed folds

carcinoma

laryngeal cancer
found more frequently in men than women
physically based disorder

papilloma

hard waterlike growths
grow quickly
occupy much of glottal area
breathy hoarse voice
surgically removed
recurring
physically based disorder

laryngeal web

membranous growth across vocal folds, congenital

vocal nodules

due to frequent friction between folds
bilateral
usually have breathy, hoarse, voice
treatment: vocal rest (generally clears them)
abused based disorder

polyps

softer than nodules
may be filled with fluid
tend to be unilateral
breathiness and hoarseness occur
surgically removed
abuse based disorder

contact ulcers

sores that develop on one or both sides of posterior end
seen in someone who talks excessively
results in low, breathy, hoarse voice
abuse based disorder

behavioral trauma, mechanical trauma, burns

3 primary causes of trauma related disorders

behavioral trauma

vocal abuse/misuse
can cause vocal nodules

mechanical trauma

external sources (car accident, blunt obj striking larynx)
internal sources (improper endoscopic examination, endotracheal intubation, nasogastric tube)

most severe form of mechanical trauma

laryngectomy (removal of vocal folds)

burns

thermal (inhaling hot air or gas/ swallowing hot food/liquid)
chemical (swallowing/inhaling dangerous substance)
can cause a hoarse, breathy voice or loss of voice

ventricular dysphonia

using false vocal folds to produce voice

sex change

conversion voice dysphonia

talking to high

mutational falsetto

spasmodic dysphonia

involuntary muscle movement (abnormal muscle tone)

vocal fold dysfunction

ex: inhaling air and vocal folds closing (not opening)

evaluation of voice disorders

must have medical clearance before beginning voice therapy
(laryngoscopy, endoscopy)

cleft

opening that passes through one or more structures that are normally closed

cleft palate

opening running through the soft palate up to the bony roof of the mouth (hard palate)
may also include upper lip

hard palate

bony roof of the mouth and floor of the nasal cavity
formed from the maxillary bones

premaxilla

small bone right under the nose
holds 4 front teeth

palatine bones

back of the hard palate

soft palate

group of muscles covered with mucosal tissue

velum

soft palate

velopharyngeal port

space between the soft palate and posterior pharyngeal wall (back of throat)

nasal cavity

divided by the septum
adds nasal resonance to the voice

false

clefts are more common in females than males

true

clefts are highest among Chinese Americans

clefts can affect

lip, alveolar ridge, hard palate, soft palate

unilateral cleft

cleft on one side

bilateral cleft

cleft on both sides

complete cleft

2 palatal shelves totally separated

incomplete cleft

palatal shelves are partially fused

type I

cleft of the soft palate only

type II

cleft of the soft and hard palate up to the premaxilla, normal lip and premaxilla

type III

complete unilateral cleft of the soft palate, hard palate, the lip, and the alveolar ridge, one one side is affected

type IV

complete bilateral cleft of the soft palate, the hard palate, the lip, and the alveolar ridge; both sides are affected

submucous cleft

rare
may not affect speech
palate appears normal
tissue covers palate
can have cleft under tissue
bifid uvula

problems associated with cleft palates

parents are not informed
feeding problems
middle ear disease and hearing impairment
dental problems
communicative disorders

language disorders

variable
possibly due to hearing loss

speech disorders

articulation
nasal emission: discharge of air through the nose during speech production. can be silent or audible

resonance and voice disorders

hypernasality
hoarseness
soft spoken

lip surgery

repaired at earliest possible time (6 months)

palatal surgery

improves swallowing and reduced middle ear infection (12-18 months)

pharyngeal flap surgery

helps close the velopharyngeal port (6-12 years)

orthodontics

corrects malocclusions

Right hemisphere injury

Primarily resulting from damage to the right side of the brain

Aphasia

Primarily resulting from damage in left hemisphere (strokes, tumors)

Traumatic brain injury (TBI)

Externally induced injury dispersed throughout the brain

Dementia

Decline of intellectual capacity

Causes of brain damage

Strokes, neoplasms, traumatic brain injury

Stroke

Blockage or bursting of an artery causing disruption of blood flow to the brain and resulting in neurological damage to the area of the brain that is supplied by that artery
Also known as CVA

Ischemic

Embolism (clot forms in an artery outside the cerebral artery)
Thrombosis (clot forms inside the cerebral artery)

Hemorrhage

Cerebral artery bursts, causing blood to be released into the brain tissue causing intense inflammation and swelling (aneurysm)

Neoplasms

Malignant or benign
Can impede functioning of adjacent tissue by pressing against it or by obstructing blood circulation

Aphasia

An impaired ability to comprehend or express linguistic symbols, or both

Anomia

Difficulty naming things

Paraphasia

Word substitution problem

Phonemic paraphasia

Based on phonemic similarity

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