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oftentimes if vocal chords are weak and not producing great voice we try to compensate for that by squeezing other muscles inappropriately and oftentimes thats a compensatory behavior that we can see an exam and youll take a look for in complete closure which is another way saying the vocal cords are too weak to close completely and these are all changes in laryngeal or voice box behavior that do have measurable impacts on voice quality so if you take patients with myasthenia gravis who are complaining about their voice and you measure the frequency of their voice the pitch of their voice the stability of their voice theyll all show up as abnormal as compared to patients who dont have any voice complaints and we can measure these different variables such as annoys the harmonic ratio shimmer things like that is it necessary to do that no is it an interesting research tool sure because it shows us that you know were not making it up its not something that were only hearing we can