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voice

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pitch
perceptual correlate of frequency. frequency with which the vf vibrate is "fundamental frequency" ff is generally considered a persons habitual or typical pitch
3 things which determine pitch
1. mass, 2. tension, 3. elasticity of vf.
high pitch= thin, more tense vf
lower pitch= thicker more relaxed vf
frequency perturbation
jitter. variations in vocal frequency. (often heard in dysphonic pts)
volume
perceptual correlate of intensity and loudness. more intense the sound signal the greater its perceived loudness
sound
disturbance in air particles
amplitude
from of waves that move forward and backward in a medium such as air or water.
amplitude perturbation
shimmer. cycle to cycle variation of vocal intensity.
hoarsness
combo of breathy and harsh.
harshness
rouch, "gravelly". associated with excessive muscular tension and effort. vf adducted too tightly and air is then released to abruptly
strain-strangle
effortful phonation (sound as if pt is "squeezing" voice at the glottal level. initiating and sustaining phonation are difficult. talking fatigues pts. become tense when speaking
breathiness
resulfs from the vocal folds being slightly open during phonation. air escpaes through the glottis and adds noise to the sound produced by the vf. pts often complains it feels like they are running out of air.
glottal fry
vocal fry. vocal folds vibrate very slowly. resultant sound slow but discrete burts, very low pitch. "crackly" usually occurs at end of phrase. slightly elevating pitch can help
diplophonia
'double voice" two distince pitches during phonation. vf vibrate at diff frequencies due to differing defrees of mass or tension. (unilateral polyp)
stridency
shrill, unpleasant, somewhat high pitched, "tinny"
hypertonicity or tension of the pharyngeal constrictors and elevation of the larynx. tense pts may sound strident.
tidal volume
amount of air inhaled and exhaled during a normal breathing cycle
vital capacity
the volume of air that the patient can exhale after a max inhalation
total lung capacity
total volume of air in the lunges
resonance
modification of sound by the structures through which the sound passes.
hypernasality
sounds like speaking through nose. velopharyngeal inadequate (VPI). air and sound escape through the nose, adding nasal resonance to non-nasal speech sounds. insufficient intraoral breath pressure. VPI, cleft repair, submucous clefts
insufficient intraoral breath pressure
impacts the production of fricatives, affricates and plosives. produced "weakly"
hyponasality
densality. lack of appropriate nasal resonance or nasal sounds. frequent subs b/m d/n and g/ng
k, nasalglide stimulation visual aidslarynx
biological valve at top of tracha, build air pressure needed for coughing,lifting,childbirth,
hypernasality tx
biofeedback : visual aid, ear training, increased pts mouth opening, increasing pts loudness, improve artics, change ros, decrease pitch
hyponasality tx
biofeedback: direct tone into facial ma
supraglottic
above vf
glottic
at level of vf
subglottic
below level of vf
papilloma
often seen in children, wart like growths pinkish white
symptoms of papilloma
hoarseness, breathiness and low pitch.
paradoxical vf motion (pvfm)
inappropriate closure or adduction of true vfs during inhalation, exhalation or both
symptoms of PVFM
appear asthmatic,stridor and dysphonia
gastroesohphogeal refulx disease (GERD)
gastric contents spontaneouly empty in esophagus,
symptoms of GERD
hearburn, acid indigestion, sore throat and hoarsness. contact ulcers
tx techniques to acheive firmer vf closure
elevation in pitch, increased loudness, increased breath support, pushing approach, hard glottal attacks, head turning or positionig
spasmodic dysphonia
focal laryngeal dystonia
MS voice symptoms
impaired prosody, pitch and loudness control, harshness, breathiness, hypernasality,artic breakdown, and nasal air escape
myasthenia gravis voice symptoms
fatiue and musle weakness, hypernasal, breathy, hoarse, soft in volume.
ALS voice symptoms
degeneration of UMN and LMN breathy, low pitch, monotonous and poor respiratory contorl. aac eventuall needed
parkinsons voice symptoms
breathy, low pitched, and monotonous
tx=LSVT
mutational falsetto
aka puberphonia. young man speak with a high pitch althought the laryns has grown normally and puberty is complete
tx for mutational falsetto
relaxation, yawn sigh, open mouth approach.
Ahonia tx techniques
masking, relaxation, coughing, grunting, throat clearing, humming, prolonging cough into a normal vowel, yawn-sigh,
blom-singer device
used to shunt air from tracha to esphagus so pt can speak on that air
jitter
frequency perturbarion. should be less than 1% when speaker sustains vowel
shimmer
amplitude pertubation, eval cycle to cycle variation of vocal intensity. more than 1dB variation across cycles may cauase pt to sound dysphonic.
speech spectrograph.
useful for quantitative analysis of speech, often used to obain baseline measurements before pts surgery.