Anatomy

Question 1

Respiration Structures

Answer 1

The Ribs & the Diaphragm

Question 2

Ribs

Answer 2

12 thoracic vertebrae: muscles play an impt. role in respiration
Ribcage wall: expands for inspiration & collapses for expiration

Question 3

Diaphragm

Answer 3

Base of thorax: separates the thoracic from the abdominal cavity
As it contracts, it descends & increases vertical dimension of thorax
As it relaxes, it ascends back to higher position

Question 4

Primary Muscle of Inspiration

Answer 4

Diaphragm

Question 5

Secondary Muscles of Inspiration

Answer 5

External intercostals, pectoralis major & minor, costal elevators, serratus posterior, neck accessory muscles primarily the sternocleidomastoid

Question 6

Primary Muscles of Expiration

Answer 6

4 abdominal muscles: Internal oblique abdominal, external oblique abdominal, transverse abdominal, rectus abdominal

Question 7

Air stream flows for inhalation thru the following passage:

Answer 7

nostrils, nasal cavity, nasopharynx, VP port, oropharynx, hypopharynx, larynx, b/t the ventricular fold (false VFs), b/t the true VFs, trachea, divides into the 2 bronchial tubes, branch into bronchioles, terminate in lungs @ alveolar sacs

Question 8

When the thorax enlarges

Answer 8

Lungs within the thorax enlarge

Air in the lungs becomes less dense than atmospheric air & inspiration begins

Question 9

Expiration

Answer 9

When the lung pressure exceeds atmospheric pressure by an amount sufficient to overcome resistance, air flows out of the lungs

Question 10

Speaking on residual air

Answer 10

Resulting lack of sufficient air flow & subglottal pressure usually produces an increase in glottal tension as 1 attempts to maintain phonation; voice lacks adequate intensity & resonance

Question 11

Phonating with Insufficient Loudness

Answer 11

Intensity of the voice is directly related to the amount of airflow & degree subglottal air pressure; individual should increase overall inspiration b/c as he/she increases his/her airflow, voice will be perceived as louder
Use diaphragmatic abdominal breathing

Question 12

Speaking with Shortness of Breath

Answer 12

Some pts w/ certain physical conditions (emphysema, TB, quadriplegia) have serious problems in inspiration-expiration

Question 13

Struggling to Take in a Breath

Answer 13

Pt uses clavicular rather than diaphragmatic-abdominal breathing

Question 14

Key Problem for Many Voice-Disordered Patients

Answer 14

Tendency to “squeeze” the glottis closed to produce “power” rather than using abdominal muscles
Excessive effort becomes basis of a hyperfunctional voice d/o which may lead to: nodules, contact ulcers, polyps, laryngitis, loss of voice

Question 15

Speaking & singing both require…

Answer 15

An outgoing air stream capable of activating vocal vibration

Question 16

When looking at respiration (& speaking/singing) we need to look at:

Answer 16

How many phrases can we sing

How much emphasis we can use on 1 expiration

Question 17

Laryngeal Functions & Respiration

Answer 17

Cough productions & valsalva maneuver

Question 18

Laryngeal Functions & Deglutition

Answer 18

Prevents aspiration

Question 19

Laryngeal Functions & Phonation

Answer 19

Develops subglottic air pressure; modifies air flow to vibrate VFs

Question 20

Cartilaginous Framework of Larynx

Answer 20

1 thyroid, 1 cricoid, 1 epiglottis, 2 arytenoids, 2 corniculates, 2 cuneiforms

Question 21

Extrinsic Laryngeal Muscles

Answer 21

Stylohyoid, posterior digastric belly, anterior digastric belly, geniohyoid, thyrohyoid, sternohyoid, sternothyroid, omohyoid

Question 22

Strap Muscles of Neck

Answer 22

Geniohyoid, thyrohyoid, sternohyoid, sternothyroid, omohyoid

Question 23

Intrinsic Laryngeal Muscles

Answer 23

Thyroarytenoid, Posterior cricoarytenoid, Lateral cricoarytenoid, interarytenoid, cricothyroid

Question 24

Thyroartyenoid/vocalis Function

Answer 24

Shorten the VFs

Relaxation

Question 25

Posterior cricoarytenoid Function

Answer 25

Abduction of the VFs

Question 26

Lateral cricoarytenoid Function

Answer 26

Adduction of the VFs

Question 27

Interarytenoids Function

Answer 27

Adduction of the VFs

Question 28

Cricothyroid Muscle

Answer 28

Anteriorly placed paired muscles that lie external to the laryngeal cartilage

Question 29

Cricothyroid Muscle Innervation

Answer 29

Superior laryngeal nerve

Question 30

VF Histology

Answer 30

Divided into 3 layers: Cover, Lamina Propria, Muscular layer

Question 31

Cover of VFs

Answer 31

Composed of epithelial layer & superficial connective tissue layer

Question 32

Lamina Propria of VFs

Answer 32

Superficial, Intermediate, and Deep layers

Question 33

Median Position of VFs

Answer 33

Position VFs take during phonation

Question 34

Paramedian Position of VFs

Answer 34

Position most VFs take when paralyzed

Question 35

Intermedian Position of VFs

Answer 35

Between the paramedian position and full adduction

Question 36

Full Abduction Position of VFs

Answer 36

Similar to breathing, VFs are wide open

Question 37

Myoelastic Aerodynamic Theory of Phonation

Answer 37

Phonation begins w/ expiration, setting the closed VFs in vibration as airflow passes b/t folds Subglottal air pressure builds up, resulting in increased velocity of airflow Subglottal increases & VFs are blown apart =izing supraglottic & subglottic pressure B/c of mass of VFs & Bernoulli Effect, they come back together again

Question 38

Bernoulli Effect

Answer 38

Occurs when velocity of subglottal air is increased while approaching & passing thru the constricted glottis Increased velocity of airflow creates a (-) pressure b/t medial edges of VFs VFs will be "sucked" back together producing the repetitive vibratory cycle of folds blown apart & sucked back together 100s of times/sec. Is the suction action that draws the folds together

Question 39

The Vibratory Cycle

Answer 39

Repeated approx. 100 times per second for an adult male and approximately 200 times per seconds for and adult female

Question 40

Fundamental Frequency

Answer 40

Directly related to how many vibratory closings & openings the VFs make in 1 sec. Short, thick, lax fold vibrates at a slow rate producing a low pitch Long, thin, tense fold vibrates at a fast rate producing a high pitch

Question 41

Falsetto

Answer 41

VFs can elongate/stretch only so far; extending range Folds appear long, stiff, very thin along edges, & often somewhat bow-shaped Gives the breathy quality of this Often called "loft" register

Question 42

Glottal Fry

Answer 42

Pitch opposite falsetto in quality & airflow rate Described as the pulse register, the lowest range of notes Sounds like a sputter of a low-powered outboard motor Produced when the folds are approximated tightly, particularly at the arytenoids

Question 43

Pulse/Chest Register

Answer 43

Lowest range of phonation

Question 44

Modal/Midvoice Register

Answer 44

Range of fundamental frequency

Question 45

Loft/Falsetto Register

Answer 45

Higher range of fundamental frequencies

Question 46

Modes of Attack

Answer 46

Hard, glottal, or stopped Even or static Breathy

Question 47

Short, thick, lax fold vibrates

Answer 47

at a slow rate producing a low pitch

Question 48

Long, thin, tense fold vibrates

Answer 48

at a fast rate producing a high pitch