Speech Language Pathologist Identify assesses treat and prevent expressive and receptive communication disorders in all modalities Provide services for swallowing disorders May modify dialects Audiologist identifies assess manage and prevent disorders of hearing and balance Includes auditory processing disorders May dispense hearing aids Efficacy ideal conditions Effectiveness average conditions Efficiency quick effective methods bringing about greatest positive change Definition of and general categories of communication disorders speech language and hearing disorder Speech disorder atypical production of speech sounds interruption in the flow of speaking abnormal production and or absence of voice quality pitch loudness resonance duration Language disorder impairment in comprehension and or use of spoken written and or symbol systems Hearing disorder a result of impaired sensitivity of the auditory or hearing system Chapter 3 Understand the components of the 3 sub systems and how they work to support speech respiratory phonatory and articulatory systems The Respiratory System The driving force for speech Anatomical structures vibrate setting air molecules in the vocal tract into multiple frequencies of vibration o Primary biological functions Supply oxygen to the blood and remove excess carbon dioxide o Also serves as the generating source for speech o Structures Pulmonary apparatus Lungs trachea pulmonary airways Chest wall thorax Rib cage abdominal wall abdominal content diaphragm o Inspiratory Muscles Diaphragm Contracts during inspiration pulling down and forward increasing lung volume Also numerous thoracic and neck muscles o Muscles of Expiration Generally below diaphragm Most important muscles are located in the front and on the sides of the abdomen Assist diaphragm s movement back to its relaxed position Other muscles may be used depending on body position pathological states and environmental conditions Trachea part of the respiratory system air moves to and from the lungs via trachea Phonatory system Acoustic filter allowing certain frequencies to pass while blocking others Larynx vocal folds thyroid hyoid bone Larynx The phonatory system Air valve composed of cartilages muscle other tissue Known as the voice box o Main sound generator for speech production o Sits on top of the trachea and opens up into the pharynx o Appears to be suspended from the hyoid bone o Primary biological function is to prevent foreign objects from entering the o Consists of the thyroid arytenoid and cricoid cartilages attached via trachea and lungs ligaments and membranes Vocal folds attached at the front near the midline of the thyroid cartilage and at the back to the vocal processes of the arytenoid cartilages via the vocal ligament Abduct during respiration and adduct during phonation o vocal folds are part of phonotory system which creates the voice Hyoid bone Larynx is suspended from hyoid moves up and down when speaking Thyroid Cartilage biggest cartilage in larynx Forms the front and sides of the laryngeal skeleton Upper part has v shaped in neck Cricoid Cartilage base of the larynx and below the thyroid cartilage Ring shaped structure Arytenoid Cartilage s on the upper sloping rim of the posterior border of each cricoid cartilage Pyramidal shaped Back attachment Arytenoid cartilages via the vocal ligament Epiglottis folds over vocal cords to protect airway Glottis space between the vocal folds is glottis The Articulatory Resonating System extends from the opening of the mouth to the vocal folds and compromises the oral cavity the nasal cavity and pharyngeal cavity vocal tract o Vocal tract Acoustic tube that shapes sound energy produced by respiratory and laryngeal systems into speech sounds o Facial skeleton and cranium 22 bones o Teeth o Tongue o Velum soft palate o Uvula Pharynx Pharyngeal Cavity wall helps move food and drink down the esophagus Be able to identify laryngeal structures on a diagram Chapter 8 Pitch frequency Hz perpetual counterpart to fundamental frequency associated with the speed of vocal fold vibration measured in Hertz Hz Intensity loudness dB measure of the magnitude of a sound generally expressed in decibels Perceptual correlate of intensity Loudness of conversational speech averages 60dB Resonance is the quality of the voice that is produced from sound vibrations in the pharyngeal oral and nasal cavities Largely determined by velopharyngeal structures and the adequacy of Structures include the velum lateral pharyngeal walls posterior their function pharyngeal wall Velopharyngeal port remains open most of the time but most close for production of oral speech sounds Hyper Hypo Nasality a lack of nasal resonance Vocal Hygiene establish improved vocal habits proper care of the voice Videofluoroscopy A motion picture X ray recorded on DVD that permits the imaging of velopharyngeal function from three perspectives VPI velopharyngeal insufficiency inability to separate the oral and nasal cavities during swallowing and speech Names symptoms of voice disorders associated with vocal misuse medial or physical conditions or associated psychological or stress conditions Vocal nodules Localized growths resulting from frequent hard vocal fold collisions abuse o Newly formed nodules are often treated with vocal rest o Voice therapy and education is usually recommended o Longstanding nodules may require surgical removal Contact ulcers a benign lesion that may develop on the posterior surface of the o Primary voice symptoms are hoarseness and breathiness o Throat clearing and vocal fatigue o Vocal Polyps Fluid filled lesions that develop when blood vessels in rupture and vocal fold R swell o Congenital laryngeal webbing Extraneous tissue that Form anteriorly and can interfere with breathing o Must be surgically removed o Webs produce a high pitched hoarse voice quality o Laryngeal Cancer carcinoma of supraglottal glottal or subglottal structures o Persistent hoarseness in the absence of colds or allergies o Frequently necessary to remove the entire larynx o Granuloma Ruptured capillaries covered with epithelial tissue associated with infection o Severity is directly related to tube size and length of time it is in place o Treatment is surgical removal followed by voice therapy Types of voice disorders Disorders of pitch Monopitch Lacks normal inflectional variation and sometimes the ability to change pitch or personality May be a sign of neurological impairment psychiatric