04 - Anatomy & Physiology - Nerves? Flashcards

1
Q

What are the two types of Laryngeal Muscles?

A

Extrinsic (Origin or Insertion point outside of the Larynx)

Intrinsic (Both Origin or Insertion points inside the Larynx)

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2
Q

What are the Extrinsic Muscles that ELEVATE the Larynx?

4

A

Digastric

Mylohyoid

Stylohyoid

Geneohyoid

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3
Q

What are the Extrinsic Muscles that DEPRESS the Larynx?

3

A

Thyrohyoid

Omohyoid

Sternohyoid

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4
Q

What are the Intrinsic Thyroid Muscles?

7

A

Cricothyroid

Posterior Crico-Arytenoid (PCA)

Lateral Crico-Arytenoid (LCA)

Transverse + Oblique Arytenoids

Aryepiglottic

Thryo-Arytenoid

Vocalis

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5
Q

What does the Cricothyroid connect?

A

Cricoid -> Thyroid

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6
Q

What does the PCA connect?

A

Cricoid -> Arytenoid

Posterior Crico-Arytenoid

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7
Q

What does the LCA connect?

A

Cricoid -> Arytenoid

Lateral Crico-Arytenoid

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8
Q

What do the Transverse + Oblique Arytenoids connect?

A

One Arytenoid to the other Arytenoid

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9
Q

What does the Aryepiglottic connect?

2

A

It is a continuation of the Oblique Arytenoid

It goes into the Aryepiglottic fold

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10
Q

What does the Thyro-Arytenoid connect?

A

Thyroid -> Arytenoid

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11
Q

What does the Vocalis connect?

A

Thyroid -> Arytenoids

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12
Q

Which Intrinsic Laryngeal muscles are innervated by the SUPERIOR Laryngeal Nerve?

A

Cricothyroid

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13
Q

Which Intrinsic Laryngeal muscles are innervated by the RECURRENT Laryngeal Nerve?

(6)

A

Posterior Crico-Arytenoid (PCA)

Lateral Crico-Arytenoid (LCA)

Transverse + Oblique Arytenoids

Aryepiglottic

Thryo-Arytenoid

Vocalis

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14
Q

What is the function of the Cricothyroid?

What does it do?

What kind of joint is it?

A

Changes pitch

Lengthens, tenses, and adducts

Tense

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15
Q

What is the function of the PCA?

A

ABDUCTS Vocal Folds

Posterior Crico-Arytenoid

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16
Q

What is the function of the LCA?

A

Adducts vocal folds

Lateral Crico-Arytenoid

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17
Q

What is the function of the Transverse + Oblique Arytenoids?

A

Adducts vocal folds

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18
Q

What is the function of the Aryepiglottic?

A

Adducts aryepiglottic folds

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19
Q

What is the function of the Thryo-Arytenoid?

A

Probably relaxes vocal folds

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20
Q

What is the function of the Vocalis?

A

Alters vocal fold in phonation

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21
Q

What do we call the membrane that connects the Hyoid + Thyroid Cartilages?

A

Thyro-Hyoid Membrane

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22
Q

What is the Quadrangular Membrane?

3

A

It covers the Thyroid and Arytenoid Cartilages all the way to the Epiglottis

It also covers the upper part of the Aryepiglottic folds

The inferior margin makes the Ventricular Folds (False Vocal Folds)

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23
Q

What is the name for the ligament that connects the Thyroid + Cricoid Cartilages?

A

Cricothyroid Ligament

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24
Q

What is the name for the ligament that connects the Epiglottis to the Thyroid Lamina?

A

Thyroepiglottic Ligament

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25
Q

What is the name for the ligament that connects the Epiglottis to the Hyoid Bone?

A

Hyoepiglottic Ligament

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26
Q

What is the Conus Elastics?

2

A

An elastic membrane that starts at the Cricoid Cartilage

It connects to the inner surface of the Thyroid Cartilage and the Vocal Processes (Arytenoids)

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27
Q

What does the Cricothyroid Joint increase the distance between?

(2)

A

Anterior Commissure (junction of the vocal folds)

Vocal Processes

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28
Q

What muscles are associated with the Cricothyroid Joint?

A

Vertical + Oblique Cricothyroids

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29
Q

What is the Cricoarytenoid Joint?

A

Connects the Cricoid with the base of the Arytenoid

30
Q

What does the Cricoarytenoid Joint do?

4

A

Rotates

Slides

Tilts anteriorly + posteriorly

Helps tense + relax vocal folds

31
Q

What muscles are associated with the Cricoarytenoid Joint?

5

A

PCA

LCA

Transverse + Oblique Arytenoids

Thyro-Arytenoid

Vocalis

32
Q

What are the three folds in the Larynx?

A

Ary-Epiglottic Folds

False Vocal Folds (Ventricular/Vestibular Folds)

True Vocal Folds

33
Q

What are the three REGIONS of the Larynx?

A

Supraglottal

Glottal

Subglottal

34
Q

What are the two CAVITIES of the Larynx?

A

Laryngeal Vestibule (Between epiglottis + false vocal folds)

Laryngeal Ventricle (Between true + false vocal folds)

35
Q

What do we call the disorder when a speaker uses their false vocal folds more than the true ones?

A

Ventricular Dysphonia

36
Q

What are the three layers of the Vocal Folds?

A

Cover (loosely packed)

Transition Layer

Body (tightly packed)

37
Q

What is in the Cover of the Vocal Folds?

2

A

Stratified Squamous Epithelium

Superficial Lamina Propria (LP) / Reinke’s Space

38
Q

What is in the Transition Layer of the Vocal Folds?

2

A

Middle Lamina Propria (LP)

Deep Lamina Propria (LP)

39
Q

What is in the Body of the Vocal Folds?

A

Vocalis

40
Q

What is the Mucosal Wave?

2

A

The compliant cover interacting with the more stiff Basement Membrane Zone

The Transitional Layer balances this dichotomy

41
Q

What innervates the Larynx?

2

A

Vagus Nerve (X)

Glossopharyngeal Nerve

42
Q

The Vagus Nerve divides into 4 branches. Which are the three that supply the Larynx?

A

Pharyngeal Nerve

Superior Laryngeal Nerve (SLN)

Recurrent Laryngeal Nerve (RLN)

43
Q

What are the two branches of the Superior Laryngeal Nerve (SLN)?

A

External Branch

Internal Branch

44
Q

Where does the INTERNAL Branch of the Superior Laryngeal Nerve pass?

A

Through the Thyrohyoid membrane

45
Q

Where does the EXTERNAL Branch of the Superior Laryngeal Nerve pass?

A

Inferiorly with the Superior Thyroid Vessels

46
Q

What innervates the Cricothyroid Muscle?

A

The External Branch of the Superior Laryngeal Nerve (SLN)

47
Q

What supplies most of the mucosa above the Glottis?

A

The Internal Branch of the Superior Laryngeal Nerve (SLN)

48
Q

What are the three divisions of the Internal Branch of the Superior Laryngeal Nerve (SLN)?

A

First division

Middle division

Inferior division

49
Q

What is another name for the Recurrent Laryngeal Nerve (RLN)?

A

Inferior Laryngeal Nerve (RLN)?

50
Q

What is different about the two branches of the Recurrent Laryngeal Nerve (RLN)?

A

The right loop is shorter because the left has to go around the aorta

51
Q

What is unique about the Cricothyroid?

A

It is the only intrinsic laryngeal muscle not supplied by the Recurrent Laryngeal Nerve (RLN)

52
Q

What is unique about the Posterior Crico-Arytenoid (PCA)?

A

It is the only muscle that abducts

53
Q

What are three possible voice pathologies associated with nerve damage?

(3)

A

Vocal Fold Paralysis

Monotoneness

Inability to increase loudness

54
Q

What might be the effect of a lesion on the External Branch of the Superior Laryngeal Nerve (SLN)?

A

Trouble changing pitch due to malfunction of the Cricothyroid

55
Q

Which branch of the Superior Laryngeal Nerve (SLN) is sensory?

A

The Internal Branch

56
Q

What will a lesion on the Recurrent Laryngeal Nerve (RLN) cause?

(2)

A

Trouble with abduction and adduction

It will be more specific the further down the lesion is

57
Q

What is Paralysis?

A

Complete loss of function

58
Q

What is Paresis?

A

Partial loss of function

59
Q

What is the Cover-Body Theory?

2

A

The cover of the vocal folds is lax and the body is dense creating a difference in the vibratory properties of each

This makes a vertical phase difference when vibrating = mucosal wave

60
Q

What is the Myo-Elastic Aerodynamic Theory?

3

A

When air reaches the vocal folds, the velocity decreases and air pressure increases

The pressure overcomes the strength holding the VF together and they are blown apart.

This reduces subglottal pressure and the VF’s elasticity and the Bernoulli Effect cause the VF to adduct again

61
Q

What is the Bernoulli Effect?

2

A

An increase in velocity is always accompanied by an increase in pressure

This creates areas of high and low pressure

62
Q

What is the Vertical Phase Difference?

2

A

Vocal folds open from superior to inferior aspects

They close from inferior to superior

63
Q

What is the Neurochronaxic Theory?

2

A

That every vibration of the vocal fold is cause by a muscle contraction

No accepted as a valid theory

64
Q

How is vocal pitch modified?

A

By modifying the length, tension, and mass of the VF

65
Q

What is the primary muscle that controls pitch?

A

Cricothyroid

66
Q

What happens when the Cricothyroid contracts?

3

A

The distance increases between the thyroid and arytenoid cartilages

This increases the tension and length of the VF which reduces mass per unit

This causes the VF to vibrate at higher frequencies

67
Q

What happens when the Thyroarytenoid contracts?

2

A

Relaxes the VF by reducing their length

This decreases the pitch

68
Q

What are some other processes that affect pitch?

3

A

Increased subglottal pressure

Increased medial compression of the VF

Increased glottal airflow

69
Q

What affects loudness?

3

A

Subglottal pressure

Medial compression of the VF (stay closed longer)

Duration, degree, + speed of VF closure

70
Q

What increases subglottal pressure?

A

More air in the lungs creating a greater buildup

71
Q

What affects vocal quality?

2

A

Glottal source

Resonance characteristics

(Not as well understood)

72
Q

What creates breathiness?

Hoarseness?

Vocal strain?

A

Incomplete glottal closure

Aperiodicity or irregularities in the mucosal wave

Subglottal muscle tension and possible involvement of the false VF