1
Q
True or False: Management of voice disorders usually involves only the SLP.
A
False
2
Q
The overall goal of voice treatment is:
A
To create a voice that is functional, efficient, and healthy
3
Q
What is NOT an example of hygenic voice therapy?
A
Surgical removal of nodules
4
Q
Symptomatic approaches target?
A
Specific symptoms like pitch, loudness, or resonance
5
Q
The psychogenic approach focuses on:
A
Psychological/emotional factors
6
Q
Physiologic approaches aim to balance:
A
Respiration, phonation, and resonance
7
Q
An example of a physiologic technique is:
A
Vocal Function Exercises (VFE)
8
Q
Which is an important guideline for professional voice users?
A
Emphasize prevention, efficiency, and hygiene
9
Q
What is one key difference between hypofunctional and hyperfunctional voice therapy?
A
Hypofunctional therapy focuses on increasing vocal fold closure and strength, while hyperfunctional therapy aims to reduce excessive tension and strain.
10
Q
Why might a patient with a weak, breathy voice benefit from hypofunctional therapy?
A
Hypofunctional therapy can help strengthen the vocal folds and improve breath support, addressing the weak, breathy quality of the voice.
11
Q
Hyperfunctional Therapy and Hypofunctional Therapy is for who?
A
Hyperfunctional Therapy for Hypofunctional Voices.
Hypofunctional Therapy for Hyperfunctional Voices.
12
Q
True or False: Hyperfunctional voice will have increased subglottic pressure.
A
True
13
Q
Which intrinsic muscle is the primary abductor of the vocal folds?
A
Posterior Cricoarytenoid
14
Q
Which intrinsic muscles are adductors?
A
Lateral Cricoarytenoid, Interarytenoids
15
Q
Which nerve innervates the cricothyroid muscle?
A
Superior Laryngeal Nerve
16
Q
Which nerve innervates all intrinsic laryngeal muscles except the cricothyroid?
A
Recurrent Laryngeal Nerve
17
Q
Van den Berg’s aerodynamic-myoelastic theory explains vocal fold vibration as a result of:
A
Aerodynamic forces and issue elasticity
18
Q
The body-cover theory of phonation was proposed by:
A
Hirano
19
Q
The “body” in the body-cover theory corresponds to:
A
Thyroarytenoid Muscle
20
Q
Which parameter of voice is primarily changed by adjusting subglottal pressure?
A
Loudness
21
Q
Which intrinsic muscle lengthens and tenses the vocal folds to raise pitch?
A
Cricothyroid
22
Q
Which of the following is a functional etiology of voice disorders?
A
Chronic throat clearing
23
Q
A patient with weak voice after thyroid surgery likely has injury to the:
A
Recurrent Laryngeal Nerve
24
Q
Psychogenic voice disorders are caused by:
A
Emotional/psychological stress
25
Which cranial nerve carries the superior and recurrent laryngeal nerves?
CN X (Vagus)
26
All of the following are environmental risk factors except:
Hydration
27
A teacher with chronic hoarseness most likely has which etiology?
Organic
28
Which intrinsic muscle is primarily responsible for relaxing and shortening the vocal folds?
Thyroarytenoid
29
Which category best describes voice changes associated with Parkinson’s disease?
Organic
30
The Bernoulli effect contributes to phonation by:
Creating negative pressure that helps draw the folds together
31
Which of the following is an extrinsic laryngeal muscle?
Sternothyroid
32
A singer develops aphonia following sever emotional trauma, but exam shows no structural damage. Which category best describes this disease?
Psychogenic
33
True or False: The posterior cricoarytenoid is the only vocal fold abductor.
True
34
True or False: The cricothyroid muscle shortens the vocal folds.
False
35
True or False: The recurrent laryngeal nerve is more vulnerable on the left side because it loops under the aortic arch.
True
36
True or False: The epithelium is the most superficial layer of the vocal folds.
True
37
True or False: The vocal ligament consists of the intermediate and deep layers of the lamina propria.
True
38
True or False: The aerodynamic-myoelastic theory emphasizes the importance of the nervous system in initiating vibration.
False
39
True or False: Pitch is controlled by the cricothyroid and thyroarytenoid muscles.
True
40
True or False: Loudness is directly related to subglottal pressure.
True
41
True or False: Psychogenic voice disorders always present with structural changes in the larynx.
False
42
True or False: Teachers and singers are at increased risk of functional voice disorders.
True
43
True or False: The superior laryngeal nerve provides motor innervation to the cricothyroid.
True
44
True or False: The thyroarytenoid muscle is an extrinsic laryngeal muscle.
False
45
True or False: The Bernoulli effect contributes to vocal fold closure during vibration.
True
46
True or False: Organic disorders include structural and neurological causes.
True
47
True or False: The body-cover theory describes how different tissue layers of the vocal folds vibrate.
True
48
True or False: Air quality and allergens can contribute to organic etiologies.
True
49
True or False: A functional disorder may eventually lead to organic changes.
True
50
True or False: The Vagus nerve is cranial nerve XI
False
51
True or False: Conversion aphonia is an example of a psychogenic disorder.
True
52
True or False: All extrinsic muscles of the larynx directly control vocal fold vibration.
False
53
Pathologies of the vocal folds that alter its histological structure are classified as what?
Structural pathologies
54
The term “dysphonia” can include?
Breathiness, Roughness, Increased strain or effort.
55
Which voice disorder below does chronic smoking cause?
Malignant epithelial dysplasia
56
Which voice disorder below is a fluid-filled lesion composed of gelatinous material?
Vocal fold polyps
57
Which voice disorder below, in its chronic form, is hard benign lesions that are bilateral and symmetric?
Vocal nodules
58
Which voice disorder below is a fluid-filled sessile growth, sometimes caused by blockage of a mucous gland?
Vocal fold cyst
59
Which voice disorder below occurs when the superficial layer of the lamina propria becomes filled with viscous fluid because of long-standing trauma (e.g., smoking, vocal abuse)?
Reinke’s edema
60
Which voice disorder below involves vocal fold scarring that leads to a ridge or furrow in the vocal fold tissue?
Sulcus vocalis
61
Which voice disorder below may form after intubation causes irritation to the vocal fold tissues?
Vocal fold granuloma
62
Which voice disorder’s name below means “white plaque”? It is named this because it appears as a thick, white, patchy substance on the vocal folds.
Leukoplakia
63
Which of the following conditions involves having a floppy epiglottis?
Laryngomalacia
64
Which voice disorder below involves a tissue bridge between the vocal cords?
Congenital web
65
Which voice disorder involves post-pubescent boys with falsetto voices and girls with childlike voices?
puberphonia
66
Which voice disorder below involves inflammation of laryngeal joints?
Arthritis
67
Which voice disorder below involves changes to the larynx due to aging?
Presbyphonia
68
Which voice disorder below involves gastric fluids leaking into the pharynx and larynx causing voice changes?
Laryngopharyngeal reflux
69
Which voice disorder below involves damage because of intubation/extubation?
Internal laryngeal trauma
70
Which voice disorder below is caused by an upper respiratory infection and involves inflammation of the vocal cord mucosa?
Laryngitis
71
Which voice disorder below may result from external trauma to the neck (e.g., car accident)?
Arytenoid dislocation
72
Which voice disorder below could be caused by exposure to a perfume or scent and may result in dysphonia, weak voice, and vocal fatigue?
Irritable larynx syndrome
73
What term is used to describe a patient who purposefully feigns illness or injury for psychological gain?
Malingering
74
Which voice disorder below involves real or imagined stress or trauma that results in voice changes, but with normal anatomy?
Conversion aphonia
75
Which voice disorder below involves a fungal infection?
Candida
76
What condition is a viral infection that affects babies/preschool children, resulting in a harsh, barking cough?
Croup
77
Which condition below involves gastroesophageal reflux that affects the posterior laryngeal mucosa and can result in dysphonia?
LPR
78
True or False: The most common neurologic voice disorder is vocal fold paralysis?
True
79
Which of the following is NOT a problem associated with superior laryngeal nerve damage?
Vocal pain
80
Which of the following is the most severe form of vocal fold paralysis?
Bilateral recurrent laryngeal nerve paralysis
81
Types of Nerve Damage?
unilateral recurrent laryngeal nerve
bilateral recurrent laryngeal nerve
unilateral superior laryngeal nerve
bilateral superior laryngeal nerve
82
Which type of spasmodic dysphonia involves strained-strangled voice?
Adductor type
83
What are the types of spasmodic dysphonia?
Adductor
Abduction
Mixed
84
Which voice disorder below involves lower motor impairment of the neuromuscular junction that results in rapid muscle fatigue leading to a weak voice?
Myasthenia gravis
85
Which voice disorder is characterized by rhythmic tremors in the larynx?
Essential voice tremor
86
Which disorder below is an extrapyramidal disorder that arises from a loss of dopamine in the basal ganglia resulting in rigidity and bradykinesia?
Parkinson disease
87
Which disorder below is a genetic autosomal dominant disease that arises from cell death in the basal ganglia and cortex?
Huntington’s chorea
88
Which disorder below is a degenerative neurological disorder whose primary pathology involves both the upper and lower motor neurons resulting in mixed dysarthria.
Amyotrophic lateral sclerosis
89
Which disorder below is a progressive inflammatory disease that results in both sensory and motor impairments?
Multiple sclerosis
90
True or False: Diagnosis is the process of discovering the cause of certain symptoms.
True
91
Who is trained to examine the laryngeal mechanism for pathology and to diagnose the voice disorder?
Otolaryngologist
92
Who is trained to identify the causes of voice disorders, evaluate vocal symptoms, and establish improved vocal function?
Voice pathologist (i.e., SLP)
93
Who refers the majority of voice patients to the voice pathologist?
Otolaryngologist
94
True or False: It is acceptable for the voice pathologist to treat a person who has not had a prior examination by an otolaryngologist.
False
95
True or False: The voice pathologist is the “owner” of the voice problem, and he or she is ultimately responsible for resolving the problem.
False
96
Which device is a long flexible and rigid tube that is passed through the patient’s nose and allows for direct viewing of the vocal folds?
Laryngoscope
97
True or False: Patients are sometimes confused when an otolaryngologist refers them to a “speech therapist” for evaluation and treatment.
True
98
True or False: The presence of laryngeal mass lesions will yield longer voiceless /s/ than the voiced /z/.
True
99
True or False: s/z ratios greater than 1:4 are considered abnormal.
True
100
The CAPE-V is intended to measure what?
Quality, Pitch, and Intensity
101
True or False: Normal voices are mostly periodic while dysphonic voices have large aperiodic or noisy components.
True
102
Which of the following is an acoustic measure of the perceptual judgment of pitch?
Fundamental frequency
103
Which of the following is an acoustic measure of the perceptual judgment of loudness?
Intensity
104
Which of the following assess the cycle-to-cycle variation in the acoustic waveform for either frequency or intensity?
Perturbation
105
Which of the following is used as a code or shorthand for fundamental frequency?
F o
106
The perturbation measure of cycle-to-cycle variation in amplitude is known as what?
Shimmer
107
The perturbation measure of cycle-to-cycle variation in frequency is known as what?
Jitter
108
True or False: The degree of noise (e.g., hoarseness) in the voice is expressed in a harmonics-to-noise ratio (HNR).
True
109
Which of the following is an aerodynamic measurement?
Subglottic pressure and Transglottic flow
110
True or False: Excessive average flow rates usually reflect an underlying glottal incompetence, whereas increased subglottic pressure is often associated with hyperfunctional voice use patterns.
True
111
True or False: In phonation, subglottic pressure acts as a force building up above the abducted vocal folds, lowering until it overcomes vocal fold resistance.
False
112
What is the minimal driving pressure required to set the focal folds into oscillation?
Phonation Threshold Pressure (PTP)
113
True or False: Inverse filtering is a technique that theoretically isolates the glottal sound wave and the resonance sound wave.
True
114
An endoscopic evaluations are what?
Direct visual perceptual measure
115
True or False: Rigid endoscopy is limited because people have a scope in their mouth and can only phonate vowels (/i/).
True
116
True or False: In terms of optics, flexible endoscopy offers a better picture with less optic artifacts than rigid endoscopy.
False
117
True or False: Flexible endoscopy is slightly more invasive than rigid endoscopy.
True
118
True or False: The use of endoscopy by a Speech-Language Pathologist (SLP) is considered to be within the scope of practice for a SLP according to the American Speech Language Hearing Association.
True
119
What is stroboscopy most useful in viewing?
Vocal fold function (physiology)
120
True or False: Stroboscopy is not real-time slow motion, but rather a composite of separate flashes across many waveforms.
True
121
Which term below refers to “abnormal cell development”?
Dysplasia
122
Which condition is known as screamer’s or singer’s nodes?
Vocal fold nodules
123
True or False: One treatment for spastic or spasmodic dysphonia is Botox injections, which permanently paralyzes the vocal cords and thus should be used with caution.
False
124
Which of the following can cause vocal cord paralysis
Stroke, Infection, Trauma
125
Which pathology does NOT have hoarseness as a symptom?
Myasthenia gravis
126
What is a secondary objective for a voice evaluation?
Determine patient motivation
127
What is resonance?
Modification of the glottal tone by the different chambers in the head and neck.
128
What do extrinsic muscles do?
Move the larynx up or down but do not control vibration.
129
What do suprahyoid muscles do?
Elevate the larynx
130
What do infrahyoid muscles do?
Depress the larynx
131
Name the five histological layers of the vocal folds (superficial → deep).
1. Epithelium (cover)
2. Superficial LP
3. Intermediate LP (transition)
4. Deep LP
5. Vocalis Muscle (body)
132
Where does the blood supply for the larynx branch from?
External Carotid Artery
133
Parameter of Voice: Quality
The clarity of the voice.
GRBAS - Grade, Roughness, Breathiness, Asthenia, Strain
134
Parameter of Voice: Pitch
The perceived highness or lowness of the voice.
Fundamental Frequency/Hz/
Stretch, lengthen, tense the vocal folds.
135
Parameter of Voice: Loudness
The perceived strength or weakness of the voice.
Intensity/dB
Increased breath support and resonance
136
Define Jitter
disturbance in frequency (pitch)
137
Define Shimmer
disturbance in amplitude (loudness)
138
Define perturbation
irregular vibration/noise in voice (quality)
139
What is dysphonia?
Change in voice quality
140
What is diplophonia?
Two pitches
141
What is a voice disorder?
Any deviation of parameters, can be consistent with interference with daily, psychologically, inappropriate for patient.
142
Do False Vocal Folds move?
NO
143
Phonotrauma?
When vocal folds adduct too aggressively, too much pressure, over coughing.
144
Direct surgeries?
Larynx Area
145
Indirect surgeries?
Anything else besides Larynx area
146
Steps to Phonation?
First - Inhalation
Last - Recoil elasticity
147
Vocally traumatic behaviors?
Screaming, coughing, excessive talking, throat clearing, weird sounds, overuse, too loud.
148
What is focus?
In relation to where resonance sits, facial focus, in front of face not in the neck.
149
What is a globus?
Lump in the throat sensation.
150
True or False: Direct pitch modification can sometimes be harmful.
True
151
Some problems that professional voice users can have?
They are going to push which is not good because problems.
152
What does phonosurgery improve?
Surgery to the vocal folds, improves mucosal lining, edge of the vocal folds, and improves quality.
153
What is odynophagia?
Pain with swallowing.
154
What is the Hygienic Approach?
Teaching patients to reduce vocal misuse/abuse.
155
What is the Symptomatic Approach?
Targets specific voice symptoms. (pitch, loudness, quality)
156
What is the Psychogenic Approach?
Focus on voice disorders caused by emotional factors and psychological factors.
157
What is the Physiologic Approach?
Focuses on strengthening and balancing voice subsystems like respiration, phonation, and resonance.
Voice Disorders
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