SLP Voice, Resonance, and Motor Speech 3 — Questions and Answers
Question 1: A speaker with mixed spastic-flaccid dysarthria most likely has damage to which neurological regions?
- Cerebellum and basal ganglia
- Both upper and lower motor neurons (Correct answer)
- Extrapyramidal system only
- Right hemisphere cortex only
Correct answer: Both upper and lower motor neurons
Mixed spastic-flaccid dysarthria results from combined upper motor neuron (spastic) and lower motor neuron (flaccid) damage, as seen in ALS.
Question 2: Which perceptual feature is the hallmark of ataxic dysarthria?
- Strained-strangled voice quality
- Irregular articulatory breakdowns and excess/equal stress (Correct answer)
- Short rushes of speech with festination
- Hypernasal resonance
Correct answer: Irregular articulatory breakdowns and excess/equal stress
Ataxic dysarthria from cerebellar damage is characterized by irregular articulatory breakdowns and scanning/excess-equal stress patterns.
Question 3: Submucosal cleft palate is best identified during clinical assessment by:
- Acoustic analysis showing hypernasality
- Palpation of the posterior hard palate for a notch, bifid uvula, and zona pellucida (Correct answer)
- Nasometry scores above 32%
- Mirror condensation test
Correct answer: Palpation of the posterior hard palate for a notch, bifid uvula, and zona pellucida
The classic triad of submucosal cleft includes a bony notch at the posterior hard palate, bifid uvula, and translucent midline zona pellucida visible through the soft palate.
Question 4: Which voice therapy technique is MOST appropriate as a first-line behavioral treatment for muscle tension dysphonia (MTD)?
- Vocal function exercises (VFE)
- Circumlaryngeal massage and resonant voice therapy (Correct answer)
- Lee Silverman Voice Treatment (LSVT)
- Confidential voice technique
Correct answer: Circumlaryngeal massage and resonant voice therapy
Circumlaryngeal massage reduces extrinsic laryngeal muscle tension in MTD, often combined with resonant voice to establish efficient, effortless phonation.
Question 5: Dysphonia diplegia refers to:
- Bilateral vocal fold paralysis
- Voice disorder resulting from bilateral upper motor neuron lesions affecting the larynx (Correct answer)
- Unilateral vocal fold paresis with compensatory hypertension
- Functional voice disorder with psychological etiology
Correct answer: Voice disorder resulting from bilateral upper motor neuron lesions affecting the larynx
Dysphonia diplegia (spastic dysphonia in the context of pseudobulbar palsy) involves bilateral upper motor neuron lesions causing spastic voice disorder.
Question 6: During the acoustic analysis of voice, jitter refers to:
- Cycle-to-cycle variation in amplitude
- Cycle-to-cycle variation in fundamental frequency (Correct answer)
- Signal-to-noise ratio of the voice
- Degree of aperiodicity in vocal fold vibration
Correct answer: Cycle-to-cycle variation in fundamental frequency
Jitter measures perturbation in the period (fundamental frequency) of consecutive glottal cycles, reflecting vocal fold vibratory irregularity.
Question 7: Spasmodic dysphonia of the adductor type is best treated with:
- Voice rest and hydration
- Botulinum toxin injection into the thyroarytenoid muscle (Correct answer)
- Resonant voice therapy
- Cricothyroid muscle exercises
Correct answer: Botulinum toxin injection into the thyroarytenoid muscle
Botulinum toxin injected into the thyroarytenoid muscle temporarily weakens spasmodic adductor contractions, reducing the strained-strangled voice quality.
SLP Voice, Resonance, and Motor Speech 3
A speaker with mixed spastic-flaccid dysarthria most likely has damage to which neurological regions?