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Elliot, a 69-year-old man, presented with a 5-year history of difficulty getting in and out of chairs, stiffness during walking, and difficulty turning in bed. He also had voice and handwriting difficulty. No history of encephalitis, toxic exposure, or drug use was noted that might be related to his symptoms, nor was there any family history of neurodegenerative disorders.   On neurologic exam, his arm-swing was diminished and his neck and extremities were rigid. He had a mild static/rest tremor of the left hand, and upper limb movements were bradykinetic. Facial expression was masked and postural reflexes were mildly impaired. An MRI scan was normal. He was referred for a speech-language pathology consult “to see if there are any clues in his voice to the type of problem that he has.”   During speech evaluation, the patient described a one-year history of uncertainty “if words would come out.” He believed his speech had become quieter and perhaps slower, and that this was more obvious in the evening or after extended speaking. He reported occasional difficulty “getting going” with his speech even though he knew what he wished to say. The SLP diagnosed “hypokinetic dysarthria, mild-moderate severity.”

Vivienne presents with no systemic diseases, and she is very willing to comply with your recommendations for increased vocal quality and amplitude. Suggested intervention techniques would include: (Select all that apply)

This type of dysphonia is known as ________________.

  The description used when the VFs touch along most of the VF edge, but are open/do not touch near the arytenoid cartilages is ____________.

Who would be a cridical team member in this case?  

Aisha asks how common it is for other student teachers to experience voice disorders. The SLP informs Aisha that ____________________.

For this case, which of the following mechanisms primarily accounts for the patient running out of air when she speaks?  

Laryngostroboscopic examination will most likely reveal:  

A 38-year-old music salesman presented to the clinic with pain in the the laryngeal area following a bout of bronchitis and extensive coughing and throat clearing. He reported occasionally coughing up small amounts of blood. He said he lifts weights but reported the healthy strategy of exhaling while flexing. He does not smoke and he reports minimal water intake. Vocal quality was normal in pitch and quality. He coughed and throat-cleared throughout the assessment. The salesman was overheard chastising an employee on his cell phone using hard glottal attack. He said he was recently prescribed anti-reflux medication by his physician. The patient’s F0 for a sustained /a/ revealed 161Hz with a RAP of .236% and shimmer of 1.56%. Transglottal airflow was 138ml/s.

The ENT’s report of the stroboscopic laryngeal exam noted “moderate laryngeal constriction.” Based on this information, which structures are most likely involved? (Select all that apply)