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Voice Disorders > A & P/Voice production > Flashcards

A & P/Voice production Flashcards

1
Q

Why do we need the thyroid cartilage?

A

The larynx and trachea are vulnerable

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2
Q

The true vocal folds should have ______ glottic closure.

A

Complete

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3
Q

Why are vocal folds white and shiny?

A

Mucous

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4
Q

What role do the ventricular folds have in normal voicing?

A

No role, avoid vocal fold phonation.

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5
Q

What is it called when ventricular folds/false vocal folds phonate?

A

Hyperfunction: False vocal folds come together

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6
Q

What is the framework of the larynx? Label the picture on power point.

A
  1. hyoid bone
  2. epiglottis
  3. Thyroid cartilage
  4. corniculate cartilage
  5. arytenoid cartilages
  6. cuneiform cartilages
  7. cricoid cartilage
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7
Q

What is the only bone in the larynx that does not articulate with another bone?

A

Hyoid

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8
Q

What happens to the epiglottis when we swallow?

A

It does a backflip

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9
Q

What do the arytenoid cartilages do?

A

They help open/close vocal folds

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10
Q

_________ only floating bone in body besides patella

A

Hyoid bone

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11
Q

_______ leaf-like cartilage that acts as a protective structure when it inverts to cover the laryngeal opening during swallowing.

A

Epiglottis

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12
Q

Describe the epiglottis.

A

leaf-like cartilage that acts as a protective structure when it inverts to cover the laryngeal opening during swallowing.

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13
Q

Describe the hyoid bone.

A

only floating bone in body besides patella

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14
Q

Describe the Thyroid cartilage.

A

Largest of the laryngeal cartilage

It protects larynx and trachea

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15
Q

Describes the arytenoid cartilages.

A

Ride on the high-backed upper surface of the cricoid cartilage, forming the posterior point of attachment for the vocal folds.

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16
Q

_______ cartilages ride on the high-backed upper surface of the cricoid cartilage, forming the posterior point of attachment for the vocal folds.

A

Arytenoid

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17
Q

Describe corniculate cartilages.

A

Sit at the apex of the arytenoid cartilages, horn-like shaped.

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18
Q

_______ cartilages sit at the apex of the arytenoid cartilages, horn-like shaped.

A

Corniculate

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19
Q

______ cartilages are paired wedge-shaped rods embedded within the aryepiglottic folds.

A

Cuneiform

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20
Q

Describe Cuneiform cartilages.

A

paired wedge-shaped rods embedded within the aryepiglottic folds.

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21
Q

______ cartilage is a complete ring sitting on top of the trachea, on lateral view it gives the appearance of a signet ring (back arches up relative to the front).

A

Cricoid

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22
Q

Describe the cricoid cartilage.

A

Complete ring sitting on top of the trachea, on lateral view it gives the appearance of a signet ring (back arches up relative to the front)

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23
Q

What are the characteristics of the Hyoid bone?

A
  • Osseous
  • U shaped (opens posteriorly)
  • Supports tongue and serves as attachment point for 9 muscles
  • Three elements of the hyoid bone:
    1. greater horn
    2. lesser horn
    3. Corpus (body)
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24
Q

The hyoid bone supports the _____ and serves as attachment point for ____ muscles.

A

tongue

9

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25
Q

What are the three elements of the hyoid bone?

A
  1. greater horn
  2. lesser horn
  3. Corpus (body)
    - corpus/body of hyoid is shield-like structure that forms the front of the bone
    - point of attachment for muscles
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26
Q

Look at larynx framework and label the different components.

A
  1. hyoid bone
  2. epiglottis
  3. Thyroid cartilage
  4. corniculate cartilage
  5. arytenoid cartilages
  6. cuneiform cartilages
  7. cricoid cartilage
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27
Q

Look at the hyoid bone and label the three elements.

A
  1. greater horn
  2. lesser horn
  3. Corpus (body)
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28
Q

What are the two processes of the arytenonid cartilage?

A
  1. Vocal process

2. Muscular process

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29
Q

_____ process projects anteriorly toward the thyroid notch, the vocal folds attach here. (innermost)

A

Vocal

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30
Q

_______process point of attachment for muscles that adduct and abduct the vocal folds. (outermost)

A

Muscular

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31
Q

Describe what is the function of the vocal process.

A

They project anteriorly toward the thyroid notch, the vocal folds attach here. (innermost)

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32
Q

Describe the function of the muscular process.

A

Point of attachment for muscles that adduct and adduct the vocal folds.

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33
Q

The arytenoid cartilage provides attachments for what muscles?

A
  1. Thyromuscularis (attaches to muscular process)

2. Thyrovocalis (attaches to vocal process)

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34
Q

Look at arytenoid cartilage and label the two processes.

A
  1. Vocal process

2. Muscular process.

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35
Q

What does the conus elasticus connect?

A
  • thyroid cartilage
  • cricoid cartilage
  • arytenoid cartilages
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36
Q

Describe the Quadrangular membranes (paired).

A

The upper porting of the elastic membrane lining the larynx.

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37
Q

What do the intrinsic ligaments connect?

A

Intrinsic ligaments connect the cartilages of the larynx and form the support structure for the cavity of the larynx as well as the vocal folds.

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38
Q

Look at the laryngeal membranes and label them.

A
  • intrinsic ligaments
  • quadrangular membranes (paired)
  • Conus elasticus
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39
Q

What are the aryepiglottic folds?

A

Folds of mucous membrane which enclose ligamentous and muscular fibers, extend from the sides of the epiglottis

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40
Q

______ _____ are of mucous membrane which enclose ligamentous and muscular fibers, extend from the sides of the epiglottis

A

Aryepiglottic folds

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41
Q

Epithelial cells are white hence ____ _____ are white.

A

vocal folds

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42
Q

How many layers of tissue compose the vocal folds?

A

Five layers.

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43
Q

The vocal folds are composed of a thin sheet of ____ ______. Deep to this layer is the _______ _____ which is comprised of three different tissues. The fifth layer of the vocal folds is the _______ _____.

A

squamous epithelium
lamina propria
Thyroarytenoid muscle

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44
Q

What are the five layers of tissue that compose the true vocal folds?

A 
1. Epithelium
lamina propria
 2. Superficial layer
3. Intermediate layer
4. deep layer
5. Thyroarytenoid muscle (thyrovocalis & thyromuscularis)
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45
Q

What tissues comprise the cover of the vocal folds?

A
  • epithelium layer

- Lamina propria: superficial & intermediate layer

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46
Q

What tissue comprise the vocal ligament of the true vocal folds?

A

-Lamina propria:
Intermediate layer
-Deep layer

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47
Q

What tissue comprises the body of the true vocal folds?

A 
Deep layer of the lamina propria
Thyroarytenoid muscle (thyrovocalis & thyromuscularis)
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48
Q

What happens if a client loses epithelial or its removed which can happen with surgery?

A

Clients loses vibrations

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49
Q

What happens to the lamina propria of smokers?

A

Fluid comes in to try and heal it

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50
Q

What needs to happen to the vocal folds to breathe?

A

abduct (separate)

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51
Q

What needs to happen to the vocal folds to speak?

A

adduct (come together)

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52
Q

Look at the aryepiglottic fold.

A

Label it.

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53
Q

Look at the vocal folds and name the layers

A
  1. Epithelium
    Lamina propria:
  2. superficial layer
  3. Intermediate layer
  4. Deep layer
  5. Thyroarytenoid muscle (thyrovocalis & thyromuscularis)
    Cover: epithelium, lamina propira:superficial & intermediate layer
    Vocal ligament: deep layer & intermediate layer of lamina propria
    body: thyroarytenoid muscle and deep layer (lamina propria)
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54
Q

The false vocal folds are also known as what?

A

ventricular folds

vestibular folds

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55
Q

What are the ventricular folds?

A

Thick folds of mucous membrane that are above the true vocal folds

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56
Q

Where are the ventricular folds?

A

above true vocal folds

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57
Q

What do the ventricular folds during normal phonation?

A

Not used in normal phonation

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58
Q

What do the ventricular folds do?

A

Hold the larynx structurally

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59
Q

What does the cricothyroid muscle do?

A

control pitch

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60
Q

If a client is monopitch, what does it imply?

A

There has been damage to the superior laryngeal nerve (nothing organic)

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61
Q

What innervates the cricothyroid muscle?

A

superior laryngeal nerve

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62
Q

What muscles does the recurrent laryngeal nerve innervate?

A

All laryngeal muscles, except cricothyroid muscle and is responsible for some sensation

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63
Q

Name the intrinsic laryngeal muscles

A

Adductor
abductor
tensors
relaxers

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64
Q

What are the intrinsic laryngeal muscles that adduct vocal folds?

A
  • lateral cricoarytenoid muscle

- Interarytenoid: transverse & oblique

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65
Q

What is the intrinsic laryngeal muscle that abducts the vocal folds?

A

posterior cricoarytenoid muscle

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66
Q

What are the intrinsic laryngeal muscles that tense vocal folds?

A

circothyroid & Thyrovocalis

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67
Q

What is the intrinsic laryngeal muscle that relaxes vocal folds?

A

Thyromuscularis

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68
Q

What is the cranial nerve that innervates the larynx for motor control?

A

Vagus nerve:

superior (external branch) and recurrent laryngeal nerve

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69
Q

What cranial nerves provide sensation to the larynx?

A
  • glossopharyngeal (CN IX)
  • superior laryngeal nerve (internal branch) above the vocal folds
  • RLN below the vocal folds
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70
Q

Damage to the left recurrent laryngeal nerve means what?

A

Left vocal fold paralysis

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71
Q

What does damage to the right recurrent laryngeal nerve mean?

A

Right vocal fold paralysis

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72
Q

What causes a hoarse or breathy voice and paralyzed vocal folds?

A

damage to the recurrent laryngeal nerve

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73
Q

What are the three voice sub-systems?

A
  1. Respiration (power source)
  2. Phonation (Sound source)
  3. Resonation (Filter)
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74
Q

What are the voice organs that comprise the respiration system?

A 
Lungs
diaphragm
chest muscles
ribs
abdominal muscles
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75
Q

What are the voice organs that comprise the phonatory system?

A
  • larynx

- vocal folds

76
Q

What are the voice organs that comprise the resonation system?

A

Vocal tract: throat (pharynx), oral cavity, nasal passages

77
Q

What is the role of the respiration system in sound production?

A

Provides and regulates air pressure to cause vocal folds to vibrate.

78
Q

What is the role of the phonation system in sound production?

A
  • Vocal folds vibrate changing air pressure to sound waves producing “voiced sound”; frequently described as a buzzing sound
  • varies pitch of sound
79
Q

What is the resonating system role in sound production?

A

Changes the “buzzing sound” into a person’s recognizable voice.

80
Q

What are the four laryngeal functions?

A
  1. Respiration: breathing for life (open glottis)
  2. Protection: with cough reflex: close, then open glottis with help of respiratory system
  3. Protection during swallowing: close glottis with help of respiratory system
  4. Phonation with voice: close/open glottis and adjust vocal fold tension
81
Q

What happens to the respiratory system during inspiration

A

Active muscle contraction occurs
lungs inflate
rib cage moves in a series of movements
diaphragm pulls down (contracts)

82
Q

What happens to the thoracic cavity during inspiration?

A

The space in the thoracic cavity increases and pressure decreases creating a negative pressure. At this point, atmospheric pressure is greater so this positive pressure moves toward the negative pressure and follows the path of least resistance.

83
Q

During the inhalation phase of breathing, the dimensions of the thoracic cavity increases in _____ _____.

A

three planes

84
Q

What are the three planes of the thoracic cavity that increase during the inhalation phase of breathing?

A
  1. vertical dimension: is increased by the contraction of the dome-shaped diaphragm
  2. transverse dimension (side to side): is increased by raising of the curved ribs.
  3. anterior-posterior dimension is increased by simultaneous forward and upward movement of the sternum.
85
Q

What needs to happen in order for inspiration to occur?

A

Lungs must be expanded

86
Q

What is inspiration?

A

An active process stimulated by muscle contraction

87
Q

Inspiration is an ______ process stimulated by _____ _____.

A

active

muscle contaction

88
Q

What are the first steps to increasing the lung volume?

A

Involves contraction of principal inspiratory muscles - diaphragm and the external intercostal muscles

89
Q

What happens if the diaphragm stops contracting?

A

You stop breathing.

90
Q

What is diaphragm breathing?

A

deep abdominal breathing

91
Q

What is clavicular breathing?

A

shallow breathing from excessive use of accessory muscles

92
Q

What do you use most during quiet breathing?

A

diaphragm

93
Q

What do you use when you begin forced respiration?

A

Diaphragm and accessory muscles

94
Q

What happens during forced inspiration?

A

Accessory muscles of inspiration are also involved in increasing the size of the thoracic cavity.
Contraction of the sternocleidomastoid elevates the sternum
Contraction of the scalenes elevates the superior ribs

95
Q

What happens when the sternocleidomastoid muscle contracts during forced inspiration?

A

It elevates the sternum

96
Q

What happens when the scalene muscle contracts during forced inspiration?

A

It elevates the superior ribs

97
Q

What muscle elevates the sternum during forced inspiration when contracted?

A

sternocleidomastoid

98
Q

What muscle elevates the superior ribs when contracted during forced inspiration?

A

scalenes

99
Q

What is the function of the diaphragm?

A 
Muscle contracts (flattens)
muscle fibers shorten
100
Q

What is the primary muscle of inspiration?

A

diaphragm

101
Q

The diaphragm sets as separation between what?

A

thorax and abdomen

102
Q

The diaphragm is shaped like an inverted bowl with its attachments along what structures?

A

rib cage
sternum
vertebral column

103
Q

Where does the force of contraction directs the diaphragm?

A

toward the abdominal viscera

104
Q

The diaphragm is _____ ____ muscle because it moves skeletal structure.

A

striated skeletal

105
Q

The middle portion of the diaphragm is made up of a large leafy aponeurosis called the ______ _______.

A

central tendon

106
Q

What is the central tendon?

A

It is a large leafy aponeurosis that makes up the middle portion of the diaphragm.

107
Q

What is aponeurosis?

A

A sheetlike tendon is a connective tissue which functions to attach muscle to bone.

108
Q

Muscle fibers of the diaphragm radiate out from the ______ ______ forming the sternal, costal, and vertebral attachments.

A

central tendon

109
Q

What nerve is the diaphragm innervated by?

A

Phrenic

110
Q

The diaphragm is primarily under ______ control (breathing for life sustaining purposes - no choice but to breathe.

A

involuntary

111
Q

The diaphragm can be placed under _____ control.

A

voluntary

holding your breath

112
Q

How can you stop hiccups?

A

Change the pattern of the phrenic nerve

113
Q

Name the anterior accessory muscles of inspiration

A 
External intercostal
internal intercostal (interchondral portion)
114
Q

Name the posterior accessory muscles of inspiration.

A 
Levatores costarum (brevis and longis)
serratus posterior superior
115
Q

Name the accessory muscles of the neck for inspiration

A

sternocleidomastoid
scalenes
trapezius

116
Q

Name the accessory muscles of the thorax, back, and upper limb for inspiration

A 
Pectoralis major
pectoralis minor
serratus anterior
subclavis
levator scapulae
rhomboideus major
rhomboideus minor
117
Q

Look at the accessory muscles.

A

label the picture

118
Q

What are the thoracic muscles of expiration?

A 
Internal intercostal (interosseous portion)
transverse thoracis
subcostal
serratus posterior  inferior
innermost intercostal
latissimus dorsi
119
Q

What are the abdominal muscles of expiration?

A 
Transversus abdominis
internal oblique abdominis
external oblique abdominis
rectus abdominis
quadratus lumborum
120
Q

What are the anterior thorax muscles of expiration?

A
  • internal intercostal(bony portion) - support, protect & space ribs
  • Transversus thoracic - depress rib cage
121
Q

what do the anterior and posterior thorax muscles of expiration do?

A

decrease the volume of the thoracic cavity

122
Q

What are the posterior thorax muscles of expiration?

A

subcostal - depresses thorax
serratus posterior inferior- depresses lower ribs
Innermost intercostal -depresses rib cage
latissimus dorsi - stabilizes chest

123
Q

What is the function of the abdominal muscles?

A

-compression of the abdominal viscera which aids in respiration and lifting

124
Q

What is the function of the transversus abdominis in expiration?

A

contraction reduces the abdominal volume

125
Q

What is the function of the internal oblique abdominis during expiration?
In unilateral contraction
in bilateral contaction

A

Unilateral - rotates the trunk

bilateral - creates flexion of the trunk & compresses the abdomen

126
Q

What is the function of the external oblique abdominis during expiration? during unilateral and bilateral contraction.

A

Bilateral: flexes the vertebral column

unilateral : bends the vertebral column laterally and rotates it

127
Q

What is the function of the rectus abdominis in expiration?

A

contraction compresses the abdominal contents flexes the vertebral column

128
Q

What is the function of the quadratus lumborum?

A

unilateral: bends bodily laterally
bilateral: fixes the abdominal wall to support abdominal compression

129
Q

What are the natural forces during passive expiration that go into play to restore the muscle back to relaxation state?

A

Torque
elasticity
gravity

130
Q

Is normal expiration a passive or active process?

A

Passive because no muscular contractions are involved

131
Q

Expiration simply involves eliminating what?

A

waste product of respiration

132
Q

When does expiration begin?

A

When inspiratory muscles relax

133
Q

What is torque?

A

Refers to the twisting of a shaft (or a rib) while not permitting one end to move

134
Q

What is elasticity?

A

It refers to the chondral portion of the rib cage

135
Q

What does gravity do during passive expiration?

A

It allows the restoration of the rib cage to drop down to its resting state

136
Q

What happens in active expiration?

A

Further reduces the size of the thoracic cavity by pressing the abdomen and forcing more air out of the lungs beyond the passive expiration level.

137
Q

How is a cycle of quiet respiration defined?

A

one inspiration one expiration

138
Q

How many cycles of respiration will an adult complete during quiet breathing?

A

12-18 cycles

139
Q

What are the types of respiration?

A

Quiet inspiration
forced inspiration
passive expiration
active expiration

140
Q

What happens in quiet inspiration?

A

utilizes the diaphragm and external intercostal muscles, but not the accessory muscles

141
Q

What happens in forced inspiration?

A

Uses the diaphragm, extenral intercostal muscles and many of the accessory muscles (used for speech)

142
Q

What happens in passive expiration?

A

allows forces to go back to resting position after inspiration

143
Q

What happens in active expiration?

A

use of muscular effort to push beyond the resting position

144
Q

What are two ways to measure respiration?

A

spirometer

manometer

145
Q

What does the spirometer measure?

A 
Respiratory flow
volumes
lung capacities
-FVC
FEV1
146
Q

What does the manometer measure?

A

Measures air pressure:
maximum inspiratory pressure (MIP)
Maximum expiratory pressure (MEP)

147
Q

air pressure is measured in what?

A

centimeters of water

148
Q

Which ones is well researched, spirometer or manometer?

A

spirometer

149
Q

_____ applies a number to the amount of air in each compartment of the respiratory system?

A

volumes

150
Q

Volumes are measured in what units?

A

milliliters or liters

151
Q

_______ are more functional units of measurement that represent combination of volumes.

A

capacities

152
Q

Capacities are measured in what units?

A

milliliters or liters

153
Q

What is tidal volume (TV)?

A

volume of air exchanged in one cycle of respiration

154
Q

What is inspiratory reserve volume (IRV)?

A

volume of air that can be inhaled after tidal inspiration

ex yawn

155
Q

What is expiratory reserve volume (ERV)?

A

volume of air that can be exhaled after tidal expiration

FEV1 = Forced expiratory volume in the 1st second

156
Q

Residual volume (RV):

A

The amount remaining in the lungs after maximum exhalation

157
Q

What is vital capacity (VC) or forced vital capacity (FVC)?

A

volume or air that can be inhaled following maximal exhalation
-IRV +ERV+TV=VC

158
Q

What does vital capacity represent?

A

the capacity available for speech

159
Q

What is total lung capacity (TLC)?

A

Sum of inspiratory reserve volume, tidal volume, expiratory reserve volume and residual volume
TLC = IRV +ERV +RV

160
Q

What is air pressure?

A

The force exerted on the walls of a chamber by molecules of air.
P = F/A

161
Q

What kind of air pressure is required to drive the vocal folds?

A

subglottal pressure

162
Q

The minimum power source to make the vocal fold move would elevate a column of water between what?

A

3cm - 5 cm of water

163
Q

Conversational speech requires how many cm of water or dB

A

7 cm of water or 60dB

164
Q

TO be heard you need a minimal of how many cm of water?

A

3-4 cm of water

165
Q

Louder speech requires how many cm of water?

A

12 cm of water or 85 dB

166
Q

What are the pressures of the respiratory system?

A
  • atmospheric pressure is used in discussion of respiratory system
  • Intraoral pressure in the oral cavity
  • subglottal pressure below the vocal folds
  • alveolar or lung pressure wihtin the thoracic activity
167
Q

What is the function of the thyroarytenoid muscle?

A

Pull the arytenoid cartilage forward & backward thereby loosening and tightening the vocal folds

168
Q

What is the function of the lateral cricoarytenoid muscle?

A

adducts the arytenoid cartilages to close the glottis (brings vocal folds together)

169
Q

What is the function of the posterior cricoarytenoid muscle?

A

Rotates the arytenoid cartilages laterally (abduct) causing the vocal folds to separate from one another, opening the glottis

170
Q

What is the function of the cricothyroid muscle?

A

It rotates the thyroid cartilage forward around an axis through the cricothyroid joint. The action stretches the vocal fold thereby tensing it (amount of tension depends on pitch desired).

171
Q

What parts of the larynx are involved in breathing?

A 
vocal folds
arytenoid cartilage (vocal processes & muscular processes)
172
Q

What is the Bernoulli effect?

A

At a constant volume flow of air, at a point of constriction, pressure decreases as there is an increase of velocity in the flow explaining vocal fold vibration.

173
Q

The Bernoulli effect closes or opens the vocal folds?

A

It suctions them to close.

174
Q

The vocal folds open and close in what direction?

A

bottom to top

175
Q

Look at vibratory cycle

A

explain it

176
Q

Pitch is associated to ______

A

frequency (Hz)

177
Q

Loudness is associated with _______

A

intensity (dB)

178
Q

Pitch can be treated using

A

MDVP

visipitch

179
Q

Loudness is treated using

A

sound pressure level

LSVT companion software

180
Q

What are the forces properties of phonation

A
  • subglottal pressure (Ps) (open)
  • Tissue elasticity (Vfs close) > aerodynamic myoelastic theory
  • constriction of airflow> Bernoulli effect (VF close)
  • laryngeal muscles
181
Q

Female have a frequency range of _____

A

180 - 240 Hz

182
Q

Males have a frequency range of ____.

A

100-110 Hz

183
Q

Children have a frequency of ____.

A

300 Hz

184
Q

The frequency of the male voice tends to be lower because there is more ______ to muscles.

A

mass

185
Q

What is normally good measurement for Forced vital capacity?

A

Over 3 liters

186
Q

What is the percentage of air that has to be exhaled within the first second of forced expiratory volume (FEV1)?

A

70%

187
Q

What do you need to remember about the FVC and FEV1 ratio?

A

FVC= over 3 liters

FEV 1= 70% of air exhaled within the first second

Voice Disorders (6 decks)

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