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COSD chapter 6 notes

by: Maycie Tidwell

COSD chapter 6 notes COSD 10303

Maycie Tidwell
GPA 3.8

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These notes cover what we learned for chapter 6!
Survey of Communication Disorders
Class Notes
COSD, survey of communication disorders
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This 6 page Class Notes was uploaded by Maycie Tidwell on Thursday March 3, 2016. The Class Notes belongs to COSD 10303 at Texas Christian University taught by Watson in Spring 2016. Since its upload, it has received 13 views. For similar materials see Survey of Communication Disorders in Nursing and Health Sciences at Texas Christian University.

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Date Created: 03/03/16
COSD Ch. 6 Part 1: Voice and Resonance Disorders: Normal processes of phonation and resonance Perceptual signs of voice and resonance disorders Voice disorders Voice and resonance evaluation and treatment Your Voice gives info about your: Gender Age Personality Moods Attitudes (include beliefs) Feelings Health (your voice may change due to physical health problem) Resonance: Quality of voice from sound vibrations in the pharyngeal, oral and nasal cavities Pharyngeal: throat Velopharyngeal: the soft palate comes up and back and couples and de-couples your nasal and oral cavities. Adenoids: when removed kids get hyper nasality but then they adjust to it. Optimal Pitch: most suitable for you r size, gender and age. Habitual Pitch: speaker’s average fundamental frequency *Goal is for your habitual pitch to match your optimal pitch. Average Fundamental Frequency: # of times your VF open and close per second Pitch change is done by changing the VF length and tension. Length increases with age:  At birth = 3 mm (~ .28 inches)  Adulthood = 12.5 – 20 mm (17 mm ~ .68 inches)  Modifications in VF length and tension change pitch Vocal loudness:  Loudness is the perceptual correlate to intensity  Measured in decibels (dB)  Normal conversation at dinner table 60 dB  Vocal loudness increases with an increase in subglottic/alveolar pressure (below the level of the glottis and the VF stay closed longer when they’re vibrating) ***that’s why it can hurt when your screaming a lot. TEST Q: Frequency and intensity is what you measure. What you hear is pitch and loudness. Loudest woman in the world: Jill Drake (129 dB) **Vocal abuse is when you scream too much and ruin your voice. Disorders of Voice:  Can affect people of any age  In children  3-6% of school-age children  Abnormal pitch, loudness, and/or quality  Related to vocal abuse or misuse  In adults  3-9% of population  More common in men  Adversely affects occupation  About 10% of US workforce are heavy occupational voice users (ie. Singers, public speakers, teachers, politicians, telecommunicates, businessmen, salesmen) Perceptual Signs of Disorders of voice: *Pitch (monopitch, too high or too low) *Loudness (monoloudness, too loud or too soft) *Quality (hoarseness, breathiness, tremor, and strain) *Nonphonatory: (not when you’re talking) -Stridor -Excessive Throat clearing -Consistent aphonia (without a voice): someone who consistently talks in a whisper. -Episodic aphonia (uncontrolled aphonia) Perceptual signs of disorders of voice: 1. Pitch 2. Loudness 3. Quality 4. Nonphonatory 5. Aphonia Visipitch: actually measures your sound and your voice. (gives you a ton of info about your features and quality of the voice). Three General Etiologies of Voice Disorders: 1. Abuse or misuse of voice 2. Medical or physical conditions 3. Psychological or stress conditions 4. May have multiple causes Vocal disorders associated with each etiology: Misuse and Abuse:  vocal nodules  contact ulcers  vocal polyps  sessile polyp  pedunculated polyp  acute and chronic laryngitis Misuse: -abrupt voicing onsets -high laryngeal position -lack of pitch variability Abuse: -screaming or yelling -excessive alcohol -excessive throat clearing or coughing Vocal Nodules: -Occur as a result of misusing or abusing your VF  Start soft and become hard  Usually bilateral  At the junction of anterior 1/3 and posterior 2/3  Mostly females 20 – 50 years and children  Hoarseness; breathiness  Need to alter vocal behavior  Kids can also get this if they abuse their voice a lot - If you have hoarseness for 2 weeks, then you should go to the doctor and get it checked out. Contact Ulcers  Posterior surface of fold  Bilateral  Can be painful  Use to think aggressive speech, now gastric reflux  Mild hoarseness to aphonia; breathiness  Occur more often in men  The bump makes patient have breathiness  Ulcers are harder and painful compared to nodules. They are also farther back on the vocal folds. Vocal Polyp  Caused by trauma by vocal misuse/abuse  Feel something in throat  Unilateral, longer than nodule & vascular (fluid filled)  Prone to hemorrhage (bleed)  2 kinds: Sessile & pedunculated  Hoarseness; breathiness’ roughness Acute/Chronic Laryngitis  Inflammation of folds  Exposure to noxious agents (Clorox), allergies or vocal abuse  Acute: temporary swelling- hoarseness  If you have acute but you continue to yell it can lead to chronic  Chronic: vocal abuse during acute laryngitis  If persists atrophy of folds  From mild hoarseness to aphonia (without a voice)  Surgery and then voice therapy Vocal Disorders Associated with Medical /Physical Conditions  Caused by central nervous system disorders, organic disease, or laryngeal trauma  Hypoadduction*  Hyperadduction*  Papilloma  Congenital laryngeal webbing  Laryngeal cancer * adduction is when the VF comes together completely Hyperadduction Vocal Disorders (over-adducting)  Spastic dysarthrias  Great difficulty swallowing and speaking  Harshness, pitch breaks, strained or strangled voice quality  Emotional lability (no tie to real emotions or feelings)  Bilateral brain damage  Spasmodic dysphonia  Strained, effortful, tight voice, intermittent voice  Neurological, psychological, idiopathic (unknown cause) Hypoadduction Vocal Disorders (not adducting or closing enough)  Parkinson’s disease  Voice symptoms  Monopitch, monoloudness, harshness, breathiness  Vocal fold paralysis: recurrent nerve (CN X: cranial nerve 10)  Hoarse, weak, breathy  Unilateral (one VF doesn’t move to come together)  Diplophonia (perception of 2 frequencies)  Bilateral (both VF don’t come together)  Weak or absent voice  After 6 mos., surgery/Teflon or collagen Laryngeal Pappilloma  Wart-like growths  Caused by papovavirus (causes warts)  Common in children < 6 years  Noncancerous  Surgically removed – Often recurring Congenital Web -Can interfere with breathing -Must be removed surgically -High pitch, hoarse voice Laryngeal Cancer  Esophageal speech  Electolarynx  Written communication  Tracheoesophageal puncture / shunt (TEP)  Signs: persistent hoarseness (no cold/allergies)  Remove larynx-stoma Tips for talking to people with laryngectomy: -Listen carefully -Keep eye contact -Focus -Be aware of ambient noise Granuloma  Due to trauma – like surgical intubation  Requires surgery Vocal Disorders Associated with Psychological or Stress Conditions  Also referred to as (psychogenic voice disorders)  Conversion disorders  Conversion aphonia Resonance Disorders  Hypernasality  Audible nasal emission  On high pressure consonants (e.g., /p/, /b/, /s/, sh, ch, j)  Hyponasality  Partial blockage in naso-pharynx or nasal cavity


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