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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)

Which of these behavioral suggestions would be optimum for Harriet?

The ENT’s report of his stroboscopic laryngeal exam noted “Reinke’s edema, bilaterally.” Based on this information, which of the following laryngeal structures were affected?

During the interview, the SLP models a number of behaviors and asks Aisha to replicate them. After a few minutes, Aisha senses a relaxation of the throat and neck muscles and feels and hears a better and more easily produced voice. These diagnostic probes introduced by the SLP are:

Which perceptual observations would be made about this patient’s voice on a standardized voice protocol?

Which of the following findings primarily accounts for the patient’s low speaking pitch?

Which of the following behavioral Ax task would provide additional information related to loudness for this case?  

The otolaryngologist writes a prescription for voice therapy and refers Aisha to a speech-language pathologist. The most likely diagnosis is ___________________.

Aisha is a student teacher who has just begun her fall semester’s teaching practicum at a local elementary school. Aisha finds herself spending 10 hours a day or more teaching, staffing with colleagues, meeting with parents and then transitioning to night classes, where she is required to participate in small groups. After a month, Aisha notices that her voice is becoming progressively hoarse and that she feels a sense of fullness and tightness at the level of the larynx.  She also reports vocal fatigue, especially at the end of the day. At her medical appointment, she reports to the otolaryngologist that she has no history of allergies and she does not feel flu-like symptoms; just the tightness and fullness.