SLP PRAXIS - VOICE DISORDERS QUESTIONS AND ANSWERS RATED A+

SLP PRAXIS - VOICE DISORDERS QUESTIONS AND ANSWERS RATED A+ In which breathing pattern is thoracic enlargement achieved by expansion of the lower thoracic and abdominal cavities during inspiration? Diaphragmatic-abdominal breathing The maximum volume of air that can be exhaled after a maximum inhalation is: Vital capacity Men have a vital capacity in the range of: In the range of 4L to 5L What is the function of the visceral and parietal pleura? To prevent the lungs from collapsing What is the function of the interpleural space? To allow the lungs to contract and expand within the thoracic cavity without friction The three passive forces of expiration are: Elastic recoil, torque and gravity The primary muscles of inspiration are: External intercostal muscles Ms. Clarke, age 28, is currently in graduate school studying to become an opera singer. Although she uses abdominal and diaphragmatic breathing adequately on inhalation, she complains of "running out of air" and is unable to completely sing a long phrase with adequate breath support. A voice specialist has concluded that Ms. Clarke requires better coordination of the muscled of controlled expiration. Which set of muscles is the voice specialist referring to? Internal intercostal muscles On expiration, the diaphragm: Flattens What is phonation quotient? Phonation quotient is the rate at which air is expelled through the glottis per second during sustained phonation What is vital capacity? Vital capacity is the maximum volume of air that can be exhaled after a maximum inhalation In relation to the vertebral column, the larynx is located from approximately the level of the: C3 to C6 vertabrae The superior opening of the larynx is formed by the: Aryepiglottic fold Increase in interthoracic pressure for coughing and sneezing is enabled by the approximation of: The ventricular folds What cartilage is shaped like a signet ring? Cricoid cartilage Elevation and lowering of the larynx for respiration and phonation is carried out by the: Extrinsic laryngeal muscles The three major cartilages of the larynx related to phonation are: The thyroid, arytenoid and cricoid The most anterior prominence of the arytenoid cartilage, where the vocal folds attach, is called what? The vocal process The prominence of the arytenoid cartilage that forms the attachment for the posterior and the lateral crico-arytenoid muscles is known as: The muscular process A 15 year old boy who is undergoing a voice evaluation complains of a high-pitched voice, frequent pitch breaks, and an inability to project his voice. Videostroboscopic evaluation has demonstrated no mass lesions, paresis or paralysis leading to a diagnosis of functional falsetto. The problems that this patient is experiencing with his voice may result from misuse of which intrinsic laryngeal muscles? Thyroarytenoid, cricothyroid and vocalis. (In falsetto, the cricothyroid muscles lengthen and tense the vocal folds along the medial edge of the vocalis muscles, and the more lateral thyroarytenoid muscles disengage.) The muscles responsible for elevation of the larynx in the neck are: The suprahyoid muscles Through videostrobic evaluation, a SLP who specializes in voice has determined that a patient has sufficient glottal closure during phonation, but the patient is having difficulty abducting the vocal folds again after phonation. Which intrinsic muscle is affected? Posterior cricoarytenoid Mr Angelo has come to a SLP for a voice evaluation. His major complaint is difficulty altering the pitch of his voice. Which muscle and nerve are likely to be affected? The cricothyroid muscle and external branch of the superior laryngeal nerve. Which muscles aid in more complete adduction of the posterior aspect of the vocal folds? Transverse and oblique interarytenoid muscles The recurrent laryngeal branch of the vagus nerve innervates all of the intrinsic laryngeal muscle EXCEPT the: Cricothyroid muscle This layer of the vocal fold helps to maintain the integrity of the vocal fold shape: Epithelium The two layers of the vocal fold that form the vocal ligament are: Intermediate and deep layers Ms Thomas complains of persistent diplophonia and breathy voice. A possible pathological process consisting with this vocal characteristic is what? Unilateral vocal fold paralysis Jenny is a 19 year old high school student who is undergoing a voice evaluation. Jenny complains of a gradual onset of a hoarse vocal quality and also stated that her voice is "harder to produce" (requires more effort). Jenny is a cheerleader and sings in the school choir. Jenny also often babysits for her two younger brothers and must raise her voice to hold their attention. Which pathological process of the vocal folds has developed or is likely to develop? Vocal fold nodules The myoelastic-aerodynamic theory of phonation was proposed by: Van den Berg The three steps necessary before normal glottal tone initiation are: Adduction of the vocal folds, tension and elongation of the vocal folds, and airflow from the lungs. An increase in pitch is brought about by increased contraction of the _________ muscle and a decreased contraction by the ___________muscle. Cricothyroid; thyroarytenoid The fundamental frequency of the voice in healthy women ranges from: 180 to 220 Hz Jitter is an acoustic measure of: Cycle-to-cycle variation in frequency Shimmer is an acoustic measure of: Cycle-to-cycle variation in amplitude How long is a normal adult male's vocal fold? 17 to 21 mm The main goal of ___________ is to identify the primary vocal misuses and to modify or eliminate these behaviors. Hygienic voice therapy The main goal of _________ is to use facilitating techniques to directly modify vocal components such as pitch, loudness, and laryngeal tension. Symptomatic voice therapy The main goal of _________ is to evaluate the subsystems responsible for voice production (respiration, phonation, resonance) and develop direct therapy exercises to improve that relative balance. Physiological voice therapy The main goal of ___________ is to explore the psychodynamics of the voice. Psychogenic voice therapy Spasmodic dysphonia is thought to be a pathological process of the: Central nervous system Mr Pitt was recently intubated in an acute care facility. After extubation, he exhibited a dysphonic voice quality. What vocal pathological process probably occurred as a result of extubation? Granuloma "Think loud" or "be loud" is the primary goal of what voice therapy program? Lee Silverman Voice Treatment Ms Qin is 45 years old and has been smoking two packs of cigarettes per day for 25 years. She now complains of hoarseness and decreased pitch. What is the likely disease process? Reinke edema Both maximum phonation time and s/z ratio (measures of breath support and glottal efficiency) are methods of evaluating: Respiration and phonation ______________ demonstrates the characteristics of vocal fold vibration and the integrity of the mucous membrane of the vocal folds. Laryngeal videostroboscopy A spectrogram represents ____________ on the horizontal axis and _______________ on the vertical axis. Time; frequency Gray scale (darkness) on the spectrogram represents: Intensity On a spectrogram, which of the following acoustic features is indicative of a stop-plosive? Noise burst at the moment of release The relative timing of stop-release and the initiation of phonation is known as: Voice onset time Nasal sounds are weak sounds because of: Creation of antiresonances within the vocal tract A patient has bilateral vocal nodules that are adding mass to the vibratory tissues. What would be expected to occur at the first harmonic on a spectrogram? Falls What is the phenomenon in which two articulators are moving at the same time to produce different phonemes? Coarticulation Subglottal pressure is which of the following? The measure of air pressure beneath the vocal folds necessary to initiate and maintain phonemes. Instrumental measurement of vocal function is beneficial because: It aids in increased reliability and validity of perceptual judgements. The average performance of a target group can be more clearly defined. Progress in therapy sessions may be more effectively gauged. Objective acoustic and physiological data are obtained. I a(n)_____________, the total phonatory capabilities of the voice with regard to frequency (in hertz) and intensity (in decibels) are plotted. Phonetogram Phonation threshold pressure is: A measure of minimal subglottal air pressure required to initiate phonation. Talbot's law - that images linger on the retina for 0.2 seconds after exposure - is the basic principle of: Stroboscopy Stroboscopy yields laryngeal images in: Simulated slow motion _______________ is a method by which nonlaryngeal acoustic features added by the resonators are subtracted from the radiated acoustic signal, which restores the signal to a simpler form that represents what the vocal folds produced. Inverse filtering The focus of _____________ is to produce voice with slightly abducted vocal folds and minimal subglottic pressure. Resonant voice therapy The ratio of abductor to adductor duration in the larynx is called: Speed quotient ____________ can be defined as aperiodic noise caused by rapidly flowing air through the glottis. Whisper Which is the only direct physiological measure of laryngeal muscle function? Electromyography Recommendations for good vocal hygiene may include: Hydration, Decreased throat clearing, Smoking cessation If environmental stressors become so severe, a patient may develop maladaptive voice production in the presence of a structurally normal laryngeal mechanism. This maladaptive vocal behavior is knows as: Muscle tension dysphonia What is the major disadvantage of using electrolarynx? Mechanical-sounding voice A ____________ is created from the back wall of the trachea into the esophagus, allowing placement of a valved tube that enables speech in persons who undergo a total laryngectomy. Trachoesophageal puncture Which type of speech is produced by taking air in through the mouth, trapping it in the upper esophagus, and releasing it? Esophageal speech A 53 year old man comes to your office with a note from his physician that reads: "Unilateral true vocal fold paralysis after cardiac surgery 2 weeks ago." Is the paralysis probably on the left or right side, and what branch of the vagus has been damaged? Left side, recurrent laryngeal nerve A 37 year old woman comes to you with complaints of chronic hoarseness and difficulty breathing in conjunction with voice use,. The patient reports having asthma and gastroesophageal refulx. A likely diagnosis might be: Vocal dysfunction A 15 year old high school singer, heavily involved with choir, has received a diagnosis of bilateral vocal nodules. What should the primary intervention be? Physiological voice therapy approaches On laryngeal videostroboscopy, lesions were found bilaterally at the junction of the anterior one third and posterior two thirds of the vocal folds. These lesions most likely....? Nodules A 34 year old woman complains of sudden onset of severe hoarseness during attendance at a sporting event. The likely diagnosis is? Vocal fold hemorrhage A 25 year old man complains of muscular pain of the neck muscles, hoarseness, and vocal fold fatigue. He has no significant medical or surgical history. Stroboscopic finding revealed strong medial compression of the ventricular folds and erythema. The likely diagnosis is? Muscle tension dysphonia