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Peter R. LaPine, Ph.D. Department of Audiology and Speech Sciences Michigan State University

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Peter R. LaPine, Ph.D. Department of Audiology and Speech Sciences Michigan State University. The “Plan”. RELAX!!! Be comfortable Ask questions Get answers Go home with new information Take with you material that you can use. Common Terms. Voice Disorder Hyperfunction Hypofunction

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slide1
Peter R. LaPine, Ph.D.

Department of Audiology

and

Speech Sciences

Michigan State University

the plan
The “Plan”
  • RELAX!!!
  • Be comfortable
  • Ask questions
  • Get answers
  • Go home with new information
  • Take with you material that you can use
common terms
Common Terms
  • Voice Disorder
  • Hyperfunction
  • Hypofunction
  • Aphonia
  • Dysphonia
  • Laryngeal Pathology
  • Vocal Pathology :{ )
speech dynamics
Speech Dynamics
  • Speech on exhalation from lungs
  • Activates the vocal folds
  • Voiced sound (phonation) passes through the pharynx and oral cavity
  • Articulators modulate
prosection of the larynx
Prosection of the Larynx
  • 9 cartilages; 1 bone
  • 5 intrinsic laryngeal muscles to regulate mass, length and tension of the vocal fold
  • It is a VALVE; it’s binary
slide8
TVF = true vocal fold
  • FVF = false vocal fold
  • Trachea = “windpipe”
coronal section of the larynx
Coronal Section of the Larynx
  • TVF and FVF
  • TVF shape and histology
valve functions of the larynx
Valve Functions of the Larynx
  • Abduct: Posterior cricoarytenoid m.
  • Adduct: Lateral Cricoarytenoid m. (and the Transverse and Oblique Arytenoid muscles.
  • “Open” at rest
vocal fold activity
Vocal Fold Activity
  • Closed-Open-Closed
  • Medial Compression
  • Vocal “cord”, ligament and fold
  • Frequency, Amplitude and Waveform
  • Perturbation values: jitter and shimmer
slide12
1 cycle of vocal fold vibration
  • “closed-open-closed”
  • Aerodynamic process
  • Myoelastic process
  • Frequency perceived as “pitch”
vocal fold movement
Vocal Fold Movement
  • Closed-Open-Closed
  • Stroboscopic view
  • Medial compression
  • Male Frequency Range: 118-150 Hz
  • Female Frequency Range: 180-240 Hz
speech is a motor act
Speech is a MOTOR act
  • Nerves activate and fire
  • Muscles are “moved” by the nerve impulse
  • Cranial nerves that control speech: Trigeminal, Facial, Hypoglossal, Vagus, and Accessory
recurrent laryngeal nerve
Recurrent Laryngeal Nerve
  • Asymmetrical branch of CX
  • “Feeds” the intrinsic laryngeal muscles
    • PCA
    • LCA
    • OA/TA
    • TA
nerve damage
Nerve Damage
  • CX: The Vagus
  • Recurrent Laryngeal Nerve
  • Image of unilateral cord paralysis
  • Dec’d pitch
  • Respiration for speech is inefficient
medications
Medications
  • Coordination and proprioception (stimulants, sedatives,nervousness, tremors, pain masking)
  • Airflow (bronchodilators, constrictors, nervousness, tremor)
  • Fluid balance (decongestants,---”rebound effect”--edema, sedating, decreased energy
medications cont
Medications, cont.
  • URT secretions--(antihistamines, dryness, sedation)
  • Hormonal (androgens, increasing vocal mass)
  • Gastrointestinal Reflux Disorder: GERD---OTC medications, diet.
laryngeal pathology
Laryngeal Pathology
  • An ANATOMICAL CHANGE in the size, structure or shape of the larynx
  • A pathology is a deviation in the normal structure caused by disease or other systemic variation
benign lesions
Benign Lesions
  • Vocal Nodules
  • Vocal Polyps: Sessile Peducunlated
  • Contact Ulcers
  • Granuloma
  • Papilloma
added mass
Added Mass
  • Top view: vocal nodules (bilateral)
  • Bottom view: vocal polyp (sessile)
swelling
Swelling
  • Reinke’s Edema
  • Increased mass, decreased pitch (frequency)
  • Atypical perturbation values
plicae ventricularis
Plicae Ventricularis
  • False vocal fold vibration
  • Decreased pitch and decreased frequency (< 90 Hz)
  • Limited Pitch e.g., “Monopitch”
bowed vocal cords
“Bowed Vocal Cords”
  • Chronic Laryngitis
  • Presbylaryngis
  • Fatigue/Overuse
  • Symptoms:
    • decreased intensity
    • decreased respiratory control
    • decreased pitch range
granuloma
Granuloma
  • Associated with physical irritation; abrasion of the mucous cover of the vocal fold
  • Adds mass: decreases pitch (frequency), increases perturbation values
intracordal cyst
Intracordal cyst
  • Note left side of body (slide right!)
  • Added mass
  • Incomplete medial compression of true vocal fold
  • Result: increased mass and air escape
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