SLP Voice, Resonance, and Motor Speech 4 — Questions and Answers
Question 1: The s/z ratio is used clinically to assess:
- Velopharyngeal function during connected speech
- Glottal pathology by comparing fricative durations requiring and not requiring voicing (Correct answer)
- Respiratory support for speech
- Tongue strength and endurance
Correct answer: Glottal pathology by comparing fricative durations requiring and not requiring voicing
The s/z ratio compares maximum /s/ and /z/ phonation times; a ratio greater than 1.4 suggests laryngeal pathology affecting voicing.
Question 2: Which resonance disorder is characterized by nasal air emission and reduced intraoral pressure during pressure-sensitive consonants?
- Hyponasality
- Cul-de-sac resonance
- Hypernasality with VPI (Correct answer)
- Mixed resonance
Correct answer: Hypernasality with VPI
Velopharyngeal insufficiency (VPI) causes hypernasality plus audible or inaudible nasal air emission, reducing pressure for consonant production.
Question 3: A 55-year-old patient presents with a unilateral vocal fold paralysis in the paramedian position. Which surgical intervention restores glottic closure most efficiently?
- Arytenoidectomy
- Type I thyroplasty (medialization) (Correct answer)
- Cordectomy
- Cricotracheal resection
Correct answer: Type I thyroplasty (medialization)
Type I thyroplasty medializes the paralyzed vocal fold by inserting an implant through a window in the thyroid cartilage, improving glottic closure.
Question 4: In Lee Silverman Voice Treatment (LSVT LOUD), the primary target behavior is:
- Slowed speech rate with precise articulation
- Increased vocal loudness through recalibrated sensory awareness (Correct answer)
- Nasal resonance elimination
- Coordinated inhalation timing
Correct answer: Increased vocal loudness through recalibrated sensory awareness
LSVT LOUD targets increased vocal effort and loudness, leveraging recalibration of sensory feedback in hypokinetic dysarthria from Parkinson's disease.
Question 5: Bernoulli effect during vocal fold vibration refers to:
- Increased pressure below the vocal folds forcing them apart
- Decreased pressure between approximated vocal folds causing passive adduction during airflow (Correct answer)
- Resonance of the pharyngeal cavity amplifying certain frequencies
- Muscular contraction closing the glottis at end of each cycle
Correct answer: Decreased pressure between approximated vocal folds causing passive adduction during airflow
As air accelerates through the narrowed glottis, pressure drops (Bernoulli effect), drawing the vocal folds together and contributing to cyclical vibration.
Question 6: Pseudobulbar palsy causes dysarthria primarily through:
- Peripheral nerve damage to cranial nerves IX and X
- Bilateral upper motor neuron lesions disrupting corticobulbar pathways (Correct answer)
- Cerebellar damage affecting motor coordination
- Basal ganglia lesions reducing movement amplitude
Correct answer: Bilateral upper motor neuron lesions disrupting corticobulbar pathways
Pseudobulbar palsy results from bilateral corticobulbar tract lesions, producing spastic dysarthria with strained voice, slow rate, and hyperreflexia.
Question 7: A client's videostroboscopy reveals a mucosal wave that stops at the midpoint of the vocal fold on one side. This finding is most consistent with:
- Vocal nodule at the vibratory margin
- Scar tissue or stiffness in the superficial lamina propria (Correct answer)
- Functional dysphonia with incomplete closure
- Reinke's edema filling the superficial layer
Correct answer: Scar tissue or stiffness in the superficial lamina propria
A mucosal wave that is absent or stops mid-fold indicates stiffness or scarring in the superficial lamina propria, preventing normal wave propagation.
SLP Voice, Resonance, and Motor Speech 4
The s/z ratio is used clinically to assess: