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The Voice & Voice Disorders

The Voice & Voice Disorders. SPPA 2000 Stephen Tasko. What is voice? Do voice and speech mean the same thing? If not, how are they different?. Source-filter theory simplified. Same source, different filters. Where is the voice produced?

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The Voice & Voice Disorders

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  1. The Voice & Voice Disorders SPPA 2000 Stephen Tasko SPPA 2000 Voice Lecture Stephen Tasko

  2. What is voice? • Do voice and speech mean the same thing? • If not, how are they different? SPPA 2000 Voice Lecture Stephen Tasko

  3. Source-filter theory simplified SPPA 2000 Voice Lecture Stephen Tasko

  4. Same source, different filters SPPA 2000 Voice Lecture Stephen Tasko

  5. Where is the voice produced? • What anatomical structures do we need to produce voice? SPPA 2000 Voice Lecture Stephen Tasko

  6. Location of Larynx SPPA 2000 Voice Lecture Stephen Tasko

  7. SPPA 2000 Voice Lecture Stephen Tasko

  8. Larynx: View From Above back esophagus glottis True vocal fold epiglottis front SPPA 2000 Voice Lecture Stephen Tasko

  9. Muscular Action on Vocal Folds Key Actions • Move together • Move apart • Tense • Slacken • Lengthen • Shorten Glottis closed (phonation) Glottis open (breathing) SPPA 2000 Voice Lecture Stephen Tasko

  10. SPPA 2000 Voice Lecture Stephen Tasko

  11. How is voice produced? Essentials for producing voice • Vocal folds must be approximated • Vocal folds must be tensed • Air pressure from respiratory system SPPA 2000 Voice Lecture Stephen Tasko

  12. SPPA 2000 Voice Lecture Stephen Tasko

  13. How Do We Characterize Our Voice? • Pitch • Loudness • Register • Quality SPPA 2000 Voice Lecture Stephen Tasko

  14. Why do men, women & children speak at different pitches? • Men ↑ VF mass and length = ↓ pitch • Women ↓ VF mass and length = ↑ pitch • Children ↓ VF mass and length = ↑ pitch SPPA 2000 Voice Lecture Stephen Tasko

  15. How Do We Vary Pitch? • Make VF thinner and tenser = ↑ pitch • Make VF thicker and slacker = ↓ pitch SPPA 2000 Voice Lecture Stephen Tasko

  16. How Do We Vary Loudness? • Respiratory Pressure • ↑ pressure ↑ loudness • Tighten the Valve • ↑ tightening of valve = ↑ loudness SPPA 2000 Voice Lecture Stephen Tasko

  17. What is a Vocal Register? • Modal: Where we typically speak • Falsetto: High pitched, thin voice • Glottal fry: Low pitched, creaky voice SPPA 2000 Voice Lecture Stephen Tasko

  18. What is Voice Quality? SPPA 2000 Voice Lecture Stephen Tasko

  19. General Clinical Terms Phonation Dysphonia Aphonia How Do We Describe Disordered Voice? SPPA 2000 Voice Lecture Stephen Tasko

  20. Broad Types of Voice Disorders • Organic Voice Disorders • Neurological Voice Disorders • Functional Voice Disorder SPPA 2000 Voice Lecture Stephen Tasko

  21. Case History Clinical Evaluation Voice Sample Collection Instrumental Assessment Diagnostic Therapy Diagnosis Plan Prognosis How Do We Perform a Voice Assessment? SPPA 2000 Voice Lecture Stephen Tasko

  22. What is the Range of Voice Treatment Options? • Voice Therapy • Medical Treatment • Surgical Treatment • Combination of above SPPA 2000 Voice Lecture Stephen Tasko

  23. Organic Voice Disorders:Common Vocal Fold Pathologies SPPA 2000 Voice Lecture Stephen Tasko

  24. Vocal use patterns Misuse Abuse/phonotrauma Exposure to Laryngeal Irritants Smoke Pollutants Acid reflux Alcohol Infection Bacterial Viral Improper hydration Side effects from medication Why do we get vocal fold pathologies? SPPA 2000 Voice Lecture Stephen Tasko

  25. Normal Larynx SPPA 2000 Voice Lecture Stephen Tasko

  26. Laryngitis SPPA 2000 Voice Lecture Stephen Tasko

  27. vocal fold nodules Before Treatment • Following Treatment • 3 months • voice therapy SPPA 2000 Voice Lecture Stephen Tasko

  28. Vocal Fold Polyps Before Treatment • Following Treatment • 6 months • voice therapy • surgery SPPA 2000 Voice Lecture Stephen Tasko

  29. Vocal Fold Cyst Before Treatment • Following Treatment • 2 months • surgery SPPA 2000 Voice Lecture Stephen Tasko

  30. Other common pathologies Contact Ulcer Reinke’s Edema Intubation Granuloma Laryngeal papilloma SPPA 2000 Voice Lecture Stephen Tasko

  31. Neurological Voice Disorders SPPA 2000 Voice Lecture Stephen Tasko

  32. Vocal Fold Paralysis SPPA 2000 Voice Lecture Stephen Tasko

  33. Vocal Tremor SPPA 2000 Voice Lecture Stephen Tasko

  34. Spasmodic Dysphonia SPPA 2000 Voice Lecture Stephen Tasko

  35. Functional Dysphonia(e.g. muscle tension dysphonia) Pre-Tx Pst-Tx SPPA 2000 Voice Lecture Stephen Tasko

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