PRAXIS Voice 2 Video

posterior cricoarytenoids

- the only muscle involved in abduction

abducted

- air pressure system, vibratory system, resonating system

diaphragm, chest muscles, ribs, abdominal muscles, lungs

- provides or regulates air pressure to cause vocal folds to vibrate

larynx, vocal folds

vocal folds vibrate, changing air pressure to sound waves producing "voiced sound", frequently described as a "buzzy sound", varies pitch of sound

vocal tract: throat, oral cavity, nasal cavities

changes the "buzzy sound" into a person's recognizable voice

- thyroarytenoid (vocalis)

- lateral cricoarytenoid

- interarytenoid

- cricothyroid

- CN X RLN

- both adducting the cords and decreasing the tension of the vocal ligament to modulate pitch

- CN X RLN

- adducts the cords and internally rotates the arytenoid

- CN X RLN

- works with the lateral cricoarytenoid by maintaining the closure of the glottis after the cords have adducted

- CN X SLN external

- displaces the thyroid cartilage downward and tenses the vocal cords

- CN X RLN

- abduct and externally rotate the arytenoid in antagonism to the lateral cricoarytenoid muscle

- open glottis

- vocal folds abduct during breathing

- adduct, then abduct glottis

- larynx closes the glottis to build up pressure, then opens it for the forceful expelling of air during cough

- adduct glottis

- muscles of the larynx coordinate to bring both vocal folds to the midline to prevent aspiration

- adduct glottis and adjust vocal fold tension

- muscles of the larynx brings both vocal folds to the midline to allow vocal fold vibration during speaking and singing

- muscles of the larynx adjusts vocal fold tension to vary pitch (how high or low the voice is) and changes in volume (such as loud voice production)

voice disorder

no voice/absence of voicing

age related voice changes

puberty related voice changes

double voicing

excessive voice use that causes trauma to the vocal folds

pain with voicing

physiological voice disorders that result from alterations in respiratory, laryngeal, or vocal tract mechanisms

- structural

- neurogenic

organic voice disorders that result from physical changes in the vocal mechanism, such as

- alterations in vocal fold tissues (e.g., edema, vocal nodules) and/or

- structural changes in the larynx due to aging

organic voice disorders that result from problems with the central or peripheral nervous system innervation to the larynx that affect functioning of the vocal mechanism, such as vocal tremor, spasmodic dysphonia, vocal fold paralysis

voice disorders that result from inefficient use of the vocal mechanism when the physical structure is normal, such as vocal fatigue, muscle tension dysphonia or aphonia, diplophonia, or ventricular phonation

- organic voice disorder

- causes: phonotrauma (excessive voice use)

- tx: voice therapy, surgery should be considered last

- most commonly seen in professional voice users

- hoarseness, breathy voice, vocal fatigue, loss of upper range

- causes: phonotrauma (overworking voice for extended period of time)

- Tx: voice therapy, surgery

- breathiness, hoarseness, diplophonia

- causes: phonotrauma, congenital

- Tx: surgery

- hoarseness, vocal fatigue

- causes: phonotrauma, iatrogenic

- Tx: voice rest

- causes: irritants, smoking, alcohol

- Tx: surgery, radiation therapy, chemotherapy

- hoarseness, sore throat, cough, swallowing difficulty

- causes: smoking, irritation

- Tx: voice therapy, surgery

- low, breathy, raspy voice, shortness of breath

- causes: aging

- Tx: voice therapy or vocal fold medialization via injections

- breathy voice, more effort, fatigue, low powered voice

- causes: physical trauma, iatrogenic, inflammatory response to infection

- Tx: prevention, voice therapy

- neurogenic voice disorder

- no structural abnormalities

- movement abnormalities - wavering movement in voice

- abductor or adductor (more adductor)

- adductor: voice breaks

- tx: botox

- abductor: breathy intermittent changes

- tx: vocal fold medialization via injection or thryoplasty

- causes: surgery, viral infection

-

- hyper function of muscles of the larynx

- hoarseness, effortful voicing, vocal fatigue, difficulty projecting voice

- supraglottic compression

- causes: post URI, presence of other voice disorders, traumatic life events, etc.

- tx: voice therapy

- PPI/HR blockers: acid reducing medications to manage GERD or acid reflux

- allergy medication: manage irritants to the larynx

- Parkinson's medication: manage Parkinson's symptoms

- thyroplasty: vocal fold paralysis, implant behind non functioning vocal fold for better voicing

- injections: vf atrophy, vf paralysis, glottic gap to bring the vocal folds closer by bulking them up so that they can get better closure

- botox: spasmodic dysphonia

- steroids: laryngeal edema or inflammation

- fat/filler

- removal of lesion

- vocal hygiene, reduce phono traumatic behaviors, proper voice use

- vocal exercises that optimize the voice and improve efficiency

- resonant voice therapy: forward resonance & feeling sounds in the front of the face rather than back in the throat

- semi-occluded vocal tract: lip trill, cup bubbles

- abdominal breathing

- reduce irritants: smoking, allergies, acid reflux, throat clearing, excess caffeine & alcohol

- stay hydrated: system hydration, drink plenty of water, surface hydration (inhale steam)

- healthy lifestyle choices: sleep, eat healthy foods

- voice use: avoid loud voice use, voice naps