5. Speech Flashcards
Requirements for Speech Production:
____
Phonation
____/ Resonance
respiration
articulation
Sound Production:
Two things required:
____/ Energy Source ____ element
For speech, power source is air from the ____ and the vibrating element is the vibrating ____
power
vibrating
lungs
vocal folds
Respiration: The upper respiratory tract \_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_
The lower respiratory tract ____
____
____
nasal cavity
oral cavity
pharynx
larynx
trachea
bronchi
lungs
Phonation:
Occurs in the ____ or “Voice Box”
The Larynx is composed of:
Cartilages (6)
Single cartilages: ____, Thyroid, ____
Paired cartilages: ____, Corniculate, and ____
larynx epiglottis cricoid arytenoid cuneiform
Anatomy of the Larynx: Cartilages
- The thyroid cartilage is the ____ of the single cartilages. It’s a shield-shape, and it comes to a prominence or a notch in the front, and that’s what we recognize as an Adam’s Apple.
- Then there’s the cricoid cartilage, which supports the ____ on the bottom there,it’s sort of shaped like a ring and then lower underneath.
- Then there’s the epiglottis, which is like a leaf in shape, and the attachment allows it to invert over the airway as we swallow. So it ____ the airway, protects the vocal folds as we swallow, and ____ the food and liquid into the esophagus.
- The paired cartilage includes the Arytenoid Cartilages and they’re little pyramid shapes and ____ attach into them. So they allow the vocal folds to open and close. And then there’s Cuneiform and Corniculate Cartilages. They’re very small. They really don’t have any clear- cut function there.
largest vocal cords protects directs vocal cords
Anatomy of the Larynx: Muscles
Muscles and Ligaments
Support and connect ____ of the larynx with adjacent structures
Form the ____
cartilages
vocal folds
Anatomy of Larynx: Muscles
Intrinsic
Both of their attachments are within the ____
Extrinsic
Attach to a site within the larynx and to a site ____ of the larynx (such as the hyoid bone, jaw, etc.)
larynx
outside
Anatomy of the Larynx: Intrinsic Muscles
____, lateral cricoarytenoid, ____, cricothyroid, and ____ (true vocal fold) muscles
All of the intrinsic muscles are ____- with the exception of the ____.
All of the intrinsic laryngeal muscles work together to ____ (close) the vocal fold with the exception of the posterior cricoarytenoid, which is the only muscle that ____ (opens) the vocal folds.
interarytenoid
posterior cricoarytenoid
thyroarytenoid
paired
transverse interarytenoid
adduct
abducts
Intrinsic muscles of the larynx
Points out the transverse arytenoid muscle between the two arytenoid cartilages
The PCAs (posterior crico-arytenoid muscles) are back here. they ____ the vocal folds
So these are all the intrinsic muscles, all within the vocal folds themselves
open
• I don’t need to go over all of these, but this just shows the actions of the muscles and how they work in terms of moving the vocal folds either into closed position, open position, or for this cricothyroid, it ____ the vocal folds and makes them tense and makes the pitch go up.
elongates
Anatomy of Larynx: Extrinsic
muscles
Suprahyoid group (above the hyoid bone)
____, mylohyoid, ____, and ____ muscles.
work together to ____ the larynx
Infrahyoid group (below the hyoid bone)
____, sternohyoid, ____, and ____ muscles
work together to ____ the hyoid bone and larynx
stylohyoid
geniohyoid
digastric
raise
sternthyroid
thyrohyoid
omohyoid
lower
Anatomy of the Larynx: Nerves
Recurrent Laryngeal Nerve
Branch of the ____
Travels up the side of the ____ to the larynx
Innervates all the intrinsic muscles except for the ____
Provides sensation to the larynx-____ vocal folds
____- innervated by this nerve
Not ____- the left nerve looping under the right subclavian artery and the traveling upwards
vagus trachea cricothyroid below PCA symmetric
RLN Paralysis
Unilateral/ Bilateral
____- tumors of the skull base, neck, and chest
____- iatrogenic, complication during intubation, blunt neck or chest trauma
____
Results in ____, dysphagia, ____
neoplastic
trauma
idiopathic
dysphonia
dyspnea
Anatomy of the Larynx: Nerves
SLN: External branch
Lies immediately posterior to the ____
Innervates cricothyroid muscle- which ____ the vocal folds to increase pitch
Branches to ____ plexus and superior portion
of the inferior pharyngeal constricto
SLN: Internal branch
Descends to the thyrohyoid
membrane with the ____ artery
Sensory branches to ____, base of tongue, aryepiglottic fold
Essentially all laryngeal sensation ____ the vocal folds
superior thyroid artery
tenses
pharyngeal
superior laryngeal
epiglottis
above
SLN paralysis
Known to cause ____, decreased ____, decreased ____, and ____ fatigue
Patients with SLN paralysis may have normal ____ voice but an abnormal ____ voice
hoarseness
vocal projection
pitch range
vocal
speaking
singing
Anatomy of the Larynx:Vocal Folds
Housed within the ____
Attached anteriorly to the ____ cartilage and posteriorly to the ____ cartilages.
Vocal folds are stretched by the forward rotation of the ____ cartilage and posterior rotation of the ____ cartilage.
Loosen by ____ muscles
larynx thyroid arytenoid thyroid arytenoid thyroarytenoid
Vocal folds:
Closed when we swallow to ____ our airway
Open when we are ____ in order to allow air in/out of lungs
In order to produce sound, ____ muscles (the “vocal cord closers”) are activated, providing resistance to exhaled air from the lungs. Air then bursts through the closed vocal folds. As the air rushes through the vocal folds, the pressure between the folds ____, sucking them back together.
protect
breathing
adductor
drops
Phonation:
When air is forced through the closed vocal folds, the vocal fold ____ and phonation occurs
The pitch of the sound produced in the larynx is dependent upon the ____ of the vocal folds
____ and tension of the vocal folds results in the faster vibration= high frequency pitch/ pitch
____ and relaxation of the vocal folds results in slower vibration= lower frequency range
Fundamental Frequency for male= ____ Hz
Fundamental Frequency for females= ____ Hz
vibrate tension elongation shortening 130 220
Phonation:
The loudness of sounds produced in the larynx is dependent upon the ____ of air flowing through the glottis (space between vocal folds)
The air speed is greatest when the pressure build up ____ the vocal folds (subglottic pressure) is high.
speed
below
Articulation: \_\_\_\_ Teeth \_\_\_\_ Alveolar Ridge (gums behind upper teeth) \_\_\_\_ Soft Palate The variable action of the tongue on all the structures listed above result in our ability to produce different speech sounds
lips
tongue
hard palate
Articulation: lips
Muscles:
____- principal muscle acting upon the lips. Its an oval shaped ring of muscle fibers located within the lips and completely encircles the mouth
____- muscle in the cheek
Nerves: ____- innervates all muscles of facial expression
orbicularis oris
buccinator
facial nerve (VII)
Articulation: lips
Speech sounds can be articulated with ____ movement of the lips
Lips are involved with ____ sounds (p,b)
Lip closure builds intraoral air pressure, and released in a ____ manner (both lips involved)
minimal
labial
plosive
Lips:
Short Upper Lip: dysmorphology and/ or cleft palate
____ causes lip to shorten
Can cause difficulty with bilabial ____ at rest
Can affect bilabial competence during speech production of ____ speech sounds (p, b, m)
scarring
competence
bilabial
Articulation: Teeth
Major function is chewing
Directly involved in speech production
Consonants- the tongue makes contact with the ____ during production of many sounds
Nerves: ____ nerve (VII) carries sensory fibers to the teeth
teeth
trigeminal
Articulation: teeth
Normal dentition and occlusion is important for aesthetics, chewing, and speech
Most consonants are produced in the ____ part of the oral cavity (near teeth)
Abnormalities of the anterior dental arch can interfere with the movement of the tongue tip and lips
____ maxillary arch can cause oral cavity crowding and distorted speech and resonance
anterior
narrow
Articulation: Tongue
Primary biological function is taste, mastication, and deglutition.
Most important and most active articulator for speech Has 4 intrinsic and 4 extrinsic muscles:
Intrinsic muscles are ____ the substance of the tongue and do not insert on bone
Extrinsic muscles originate ____ the tongue and insert within in
Muscles do not act in ____, intrinsic muscles alter the ____ of the tongue and extrinsic alter its ____.
within outside isolation shape position
Tongue: muscles
Intrinsic
Intrinsic muscles are within the substance of the organ and do not insert on bone
____, Inferior longitudinal, ____, Vertical
Alter the ____ of the tongue
Extrinsic
Originate outside the tongue and insert within it
____, Hyoglossus, ____, Palatoglossus
Alter ____ of the tongue
superior longitudinal
transverse
shape
genioglossus
styloglossus
position
Intrinsic Muscles of the Tongue
Superior Longitudinal Muscle- ____ the tongue and thereby turns tip of tongue ____
Inferior Longitudinal Muscle- ____ the tongue or pulls the tongue tip ____
Transverse Muscle- contraction of this muscle causes the tongue to ____ and to become ____
Vertical Muscle- ____ the tongue
shortens
upward
shortens
downard
narrow
flattens
Extrinsic Muscles of the Tongue:
Genioglossus-strongest, ____ muscle of the tongue
Posterior fibers- draws the whole of the tongue ____ to ____ the tip from the mouth or to press the tip against the teeth and alveolar ridges
Anterior fibers- responsible for ____ of the tongue, while contraction of the entire muscle draws the tongue ____, thus making the dorsum like a trough
Styloglossus Muscle- draws the tongue ____ and backward and thus may be considered to a true ____ of the genioglossus muscle.
anteriorly
protrude
retraction
downward
upward
anatgonist
Extrinsic muscles of the tongue:
Palatoglossus-upon contraction, it may either ____ the soft palate or ____ the back of the tongue to the groove the dorsum.
Hyoglossus-____ and ____ the tongue
lower
raise
retracts
depresses
Articulation: Tongue
Stops airf low and releases it in ____ manner (t,k,d,g) Constricts air passage, creating ____ noises (s,z)
Stop airf low and release with ____ noise (ch, j)
plosive
fricative
fricative
Tongue: nerves
Motor innervation for all of the muscles of the tongue comes from the ____ nerve -with the exception of the palatoglossus, which is supplied by the ____ nerve.
General sensation of the anterior two thirds of the tongue is supplied by the ____ nerve - specifically the ____ branch
The posterior third of the tongue (taste and sensation is innervated by the ____ nerve (
hypoglossal
vagus
trigeminal
glossopharyngeal
Tongue: nerve injury
Injury to the hypoglossal nerve (cranial nerve XII) results in deviation of the tongue ____ the paralyzed side during protrusion. The tongue also ____ over time on the paralyzed side.
May cause speech and swallowing difficulty
toward
atrophies
Anomalies of the Tongue
Macroglossia- ____ Syndrome
Lingual ____, open mouth posture
Interferes with all tongue tip sounds
Microglossia
____ to cause speech problems
Pseudomacroglossia- associated with a very small jaw, such as ____ and Treacher Collins syndromes
Black, Hairy Tongue-papillae become elongated- can be associated with chronic intraoral ____ or prolonged ____ therapy.
downs protrusion rare pierre robin bleeding antibiotic
Articulation: The palate
Commonly called the roof of the mouth
Consists of three parts: the ____, the hard
plate, and the____
Hard palate in front is a fixed bony plate and soft palate is a muscular valve
Alveolar arch consists of the bony, tooth-bearing process of the maxillae and its mucous membrane covering
alveolar ridge
soft palate
Articulation: the palate
Soft palate retracts and ____ during speech to separate the oral cavity from the nasal cavity in order to produce the oral speech consonants.
When this separation is incomplete, air escapes through the ____, causing speech to be perceived as nasal
elevates
nose
Muscles of the soft palate
Tensor Veli Palatini and Levator Veli Palatini muscles form a “____,” lifting the soft palate ____ and backwards, ____ off the entrance to the nasal cavity.
Palatoglossus and Palatopharyngeus muscles ____ off the opening to the oropharnx
sling
up
closing
close
The Palate: nerves
All muscles are innervated by the pharyngeal plexus via the ____ nerve , with the exception of the tensor veli palatini (innervated by the ____ nerve, ).
vagus
trigeminal
Articulation: hard palate
____ arch is not problem
Low, f lat arch can cause lingual ____ and
abnormal resonance due to small cavity size
Position of ____ relative to tongue is most importance
Palatal fistula- effect on speech depends on ____ and size
high
crowiding
alveolar ridge
location
Articulation: soft palate
____ for all oral sounds
Particularly important for “pressure sensitive”
consonants and all vowels
____ valve is open for nasal sounds (m, n, ng)
Hx of cleft, enlarged tonsils, irregular adenoids
Velopharyngeal Incompetence- ____,
neuromuscular disorders
Velopharyngeal Insufficiency- ____ defect, not neurological problem
closed
velopharyngeal
dysarthria
anatomical
Articulation: Vowels Vowel Sounds- there are 5 vowels in the English language (a, e, i, o, u), but there are 12 different vowel sounds. The articulation of the different vowels sounds depends on: The point of \_\_\_\_ The degree of \_\_\_\_ The degree of \_\_\_\_ The degree of \_\_\_\_ tension Vowels make up \_\_\_\_% of our speech
constirction
constriction
lip rounding
muscle tension
Articulation: Consonants Consonants in English are classified by: Place of \_\_\_\_ Manner of \_\_\_\_ Degree of \_\_\_\_ Consonants make up \_\_\_\_% of our speech
articulation
articulation
voicing
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Consonants: place of articulation
Bilabial: ____ lips come together (p,b,w,m)
Labio-dental: ____ lip and upper teeth make contact
(f,v)
Dental: the tongue makes contact with the ____ teeth (th)
Alveolar: the tip of the tongue makes contact with the ____ (t,d,s,z,n,l)
Palatal: the tongue approaches the ____ (j,r,sh)
Velar: back of the tongue contacts the ____ (k,g,ng)
Glottal: an ____ vowel (h)
both lower upper alveolar ridge palate velum unvoiced
Consonants: Manner of articulation
Manner of articulation refers to the degree of constriction as the consonant starts or ends a syllable
Stops: complete ____ of the lips and subsequent release (p,b)
Fricatives: ____ closure of the lips to create turbulent noise (f,s,sh)
Affricates: combination of a stop and an ____ (ch)
Nasals: resonate through the ____ (m,n)
Glides and Liquids: produced when the tongue approaches a point of articulation within the mouth but does not come close enough to ____ or constrict the flow of air enough to create turbulence (l,r,w)
closure incomplete turbulent noise nasal cavity obstruct
Voiced vs. Voiceless consonants
Voiced consonants are produced with the vocal folds ____
Voiceless consonants are produced with the vocal folds ____
Example: The sound of /f/ and /v/ are both labiodental fricatives, however, /f/ is ____ and /v/ is ____.
vibrating
open
voiceless
voiced
Resonance
Dependent upon the size and shape of the
____
____
____
The resonant frequency of each of our voices will differ depending on the size and shapes of the structures above.
Nasopharynx adds ____ to nasal sounds (m, n, ng) Nasal cavity is normally ____
vocal tract oral cavity nasal cavity resonance closed
Speech Errors:
Obligatory: errors of distortion where ____ (articulation) is normal, but ____ is abnormal
Treatment is correction of structure
Compensatory: errors of distortion where ____ (articulation) is changed in response to abnormal function
Treatment is correction of function (speech therapy) After correction of structure as needed
function structure
function
Results:
Speech intelligibility is 80% with obturator in place, ~ 60% without prosthetic to an unfamiliar listener.
Increased ____ also noted without upper obturator in place.
Pt happy with improved aesthetics
drooling
