CDIS 4313 1st EditionFinal Exam Study GuideChapter 6I. Electroglottography (EGG)A. Noninvasive way to evaluate vocal fold function1. A Velcro band holds electrodes at both sides of the thyroid cartilage. 2. A high frequency, low voltage current passes through the electrodes and to the vocal folds. 3. Because human tissue conducts electricity better than air, the current will come back through the system quicker when the vocal folds are touching than when they are apart.B. The process generates an Lx wave form.1. The waveform shows the duty cycle of vibration.a) The duty cycle refers to the phases in the cycle of vocal fold vibration. These phases include closing, closed, opening, and open.b) The maximum (highest) peak on the waveform is the point where the vocal folds are the closest together, but not necessarily touching.c) You can find the F0 (fundamental frequency) by counting the number of peaks in a specific amount of time.(1) Lower could mean pulse register.d) The shape can tell you how the vocal folds are opening and closing.2. EGG slope quotientsa) Closed quotient (CQ): compares length of closed phase to the whole cycle.b) Open quotient (OQ): compares the length of time the glottis is open to the whole cyclec) Contact index (CI): (length of closing phase – length of opening phase)/length of closed phased) Closed-to-open ratio (C/O): compares the duration of closed and open phases of the duty cycle. This can tell you the degree of hyper or hypo function in a person’s voice.(1) Longer closed phase and shorter opened phase = higher C/O ratio.(2) Shorter closed phase and longer opened phase = higher C/O ratio.e) Speed quotient (SQ): the distance between the lowest and highest amplitude values on the Lx compared to the distance between the highest and lowest values.(1) SQ=1 means opening and closing phases are equal(2) SQ>1 means opening phase is longer than closing phase(3) SQ<1 means closing phase is longer than opening phaseII. EndoscopyA. A flexible (for the nose) or rigid (for the mouth) tub/scope is put into the pharynx to illuminate the larynx.B. The image is videoed and projected onto a monitor.III. VideostroboscropyA. A strobe light is part of the scope that is inserted into the pharynx.B. Only the phases of movement that are lit can be seen. This creates an optical illusion and allows a viewer to see the vocal folds as if they were vibrating in slow motion.IV. VideokymographyA. One horizontal line of the vocal folds is videoed.1. It is better to think of this as the camera taking thousands of pictures pf the vocal folds per second.B. The pictures are then displayed vertically one after another in the order that they are taken. C. This creates a reconstructed moving image of the vocal folds.V. Advantages of acoustic and visual measures of phonatory function.A. Provide a starting point for treatment and a way to assess the patient’s progressB. Strengthen clinician accountabilityC. Can serve as feedback during therapy and as measures to document the effectiveness of therapy techniquesD. Can detect early voice changes that can be missed by earE. Used to screen for voice disordersF. Helps validate clinicians’ judgements by providing norms to compare to vocally healthy with vocally disordered speakersVI. Laryngeal aging and acoustic changes over the lifespanA. F0 starts out high in infants.B. Men’s F0decreases through puberty and Women’s stays about the same.C. In elderly men the F0 increases.D. In elderly women the F0 decreases.VII. Amyotrophic Lateral Sclerosis (ALS)A. Motor functions deteriorate because of damage to the motor nerves.B. Patients have increased jitter levels, smaller maximum phonational frequency ranges, abnormal F0 levels, and reduced frequency ranges.VIII. Parkinson’s Disease (PD)A. Reduction of the neurotransmitter dopamine muscle rigidity, bradykinesia, and tremors.B. Higher F0, higher jitter, lower intensity during connected speech, decreased frequency variability, and decreased dynamic rangeIX. Unilateral vocal fold paresis/paralysisA. Partial or full loss of vocal muscle strength and movement caused by damage to the vagus nerve and its branchesB. Breathiness, weak intensity levels, and elevated jitter, shimmer, and noise to harmonic ratio levels.X. Spasmodic DysphoniaA. Spasms of the vocal foldsB. Strained-strangled voice qualityXI. Paradoxical vocal fold motionA. Inappropriate vocal fold spasms during inspirationB. Hoarseness, strain, breathiness, aphoniaC. Higher than normal jitter and shimmer and, lower than normal HNRXII. Laryngeal cancerA. Therapy options for laryngectomy patients:1. Artificial larynx: electronic device generates sound when held against the neck. The tone is transmitted through the tissue and into the vocal tract where it is articulated.2. Esophageal speech: air is taken into the esophagus, and when it is released, the ring of muscles that form the sphincter (neoglottis) between the upper esophagus and lower pharynx vibrate to produce sound.3. Tracheoesophageal speech: surgical connection between the back wall of the trachea and the front wall of the esophagus allows an inserted prosthesis to channel air from the trachea to the esophagus. The rest of the process is similar to esophageal speech.XIII. Hearing impairment’s effects on speech are:A. Segmental: substitution, omission, distortion, additionB. Suprasegmental: intonation, prosody, high pitch because there is no auditory feedbackChapter 7 I. Pulmonary Function Testing: tests that assess the amount of air a patient can inhale and exhale and how efficiently the air moves in and out of the lungs.1. Spirometry is the most common type of testing.a) The patient exhales as much as possible into the spirometer, then inhales as much as possible from the spirometer.b) Spirometry generates a graph called the flow-volume loop. (1) Airflow velocity is on the y-axis and air volume is on the x-axis.(2) Expiration is positive on the graph and inspiration is negative.(3) In a normal flow-volume loop, the expiratory part quickly rises to its peak then then decreases sharply as the person exhales. The inspiratory part is more symmetrical and increases and decreases at a more steady rate. (4) Different diseases have characteristically different flow-volume relationships.c) Spirometry only measures static volumes and flows.2. Plethysmographya) Body plethysmograph(1) Patient is in a closed airtight chamber. Patient breaths against a mouthpiece while