Anatomy of Phonation Flashcards
Corniculate Cartilages
-Cone shaped
-Cap on arytenoids
-Function: Perhaps assist forceful adduction
-Crucial Roles: Regulation airway, protecting airway, stabilizing larynx
Epiglottis
-Leaf shaped
-Behind hyoid at root of tongue
-Attached interior of thyroid cartilage below thyroid notch
-Ligaments connects root of tongue on anterior
-Protects larynx from food
Cuneiform Cartilages
-Embedded on each side of the aryepiglottic folds
-Support and stiffen aryepiglottic folds
Aryepiglottic Folds
-Flaps of mucus lining lateral epiglottis opening of larynx
-Triangular mucus membrane folds connect epiglottis and arytenoid cartilages
Laryngeal Joints
-Cricothyroid joint
-Cricoarytenoid Joint
Cricoarytenoid Joint
-Connects cricoid and arytenoid cartilages
-Shallow ball and socket joint
-Allows rotation and gliding motion
-Controls vocal fold adduction and abduction
Cricothyroid Joint
-Connects thyroid cartilage to cricoid cartilage
-Articular facets on inferior cornu thyroid
-Synovial Joint (Joint that allows wide range of movement between bones)
-Pivot for thyroid
-Rotates forward: Rocks maybes glides
-Increases distance between arytenoids and anterior thyroid
-Increases vocal fold tension: elongates them
-Used for pitch adjustments
Supraglottic Space
-Space in upper part larynx above vocal folds to epiglottis
-Made up of several structures
-Epiglottis
-Ventricular Folds
-Arytenoid Cartilages
Ventricle of Morgagni
-AKA: Laryngeal ventricle, laryngeal sinus
-Between true and false vocal folds
Plicae Vocalis
-AKA vocal folds
-Beneath false folds
-Attached in the back through the arytenoid cartilages
-Attached in the front via Broyles ligament to thyroid cartilage
Glottis
-Opening between vocal folds
-Primary valve between mouth and lungs
-Affects voice modulation through expansion or contraction
Infraglottal Space
-Space lower part of larynx below vocal folds to cricoid
-Lined with ciliated beating epithelium from bronchi to vocal folds
Membraneous and Cartilaginous Vocal Fold Portions
-Membraneous portion
-Anterior part primarily composed soft tissues
-Thyroarytenoid muscle and vocal ligament
-Part vibrates during phonation
-Cartilaginous Portion
-Posterior part
-Comprised of arytenoid cartilages and vocal process
-Responsible vocal folds movement and tension adjustments through muscle attachments
Extrinsic Muscles
-One component on larynx and one outside larynx
-Laryngeal support and fixation
-thyrohyoid
-sternohyoid
Infrahyoid Muscles
-Muscles attach hyoid and structures below hyoid
-Laryngeal depressors
-Omohyoid: superior and inferior
-Sternohyoid
-Thyrohyoid
Omohyoid Superior Head Muscle
-Origin: Intermediate tendon
-Course: up
-Insertion: Corpus hyoid side
-Function: depress hyoid
-Innervation: C1 spinal nerve
Omohyoid Inferior Head Muscle
-Origin: Upper border scapula
-Course: up and laterally
-Insertion: Intermediate tendon\
-Function: depress hyoid
-Innervation: C2 and C3 spinal nerves
Thyrohyoid Muscles
-Origin: oblique line of thyroid cartilage
-Course: up
-Insertion: inferior border of body and hyoid bone greater horn
-Function: elevates larynx and depress hyoid
-Innervation: C1 spinal nerve
Sternothyroid Muscle
-Origin: Posterior surface manubrium of sternum and costal cartilage of rib 1
-Course: up
-Insertion: Oblique line of thyroid cartilage
-Function: depress hyoid and larynx
-Innervation C1 and C2
Suprahyoid Muscles
-Muscles attach hyoid and structures above hyoid
Laryngeal Elevators
-Digastricus anterior
-Digastricus posterior
-Stylohyoid
-Geniohyoid
-Mylohyoid
Digastricus Anterior Muscle
-Origin: Inner surface of mandible near symphysis
-Course: medially and down
-Insertion: hyoid body via intermediate tendon
-Function: Pulls hyoid up, depresses mandible
-Innervation: CN V (Trigeminal)
Digastricus Posterior Muscle
-Origin: mastoid process of temporal bone
-Course: medially and down
-Insertion: body of hyoid via intermediate tendon
-Function: pulls hyoid up, depresses mandible
-Innervation: CN VII (7, Facial)
Stylohyoid Muscle
-Origin: stylohyoid process of temporal bone
-Course: medially and down
-Insertion: body of hyoid
-Function: elevate and retract hyoid
-Innervation: CN VII (7, Facial)
Geniohyoid Muscle
-Origin: mandible mental spines
-Course: Back and down
-Insertion: corpus hyoid
-Function: elevate hyoid and depress mandible
-Innervation CN XII (12, Hypoglossal) and C1 nerve
Mylohyoid Muscle
-Origin: mylohyoid line of inner mandible
-Course: fanlike to median fibrous raphe and hyoid
-Insertion: corpus hyoid
-Function: elevates hyoid and depresses mandible
-Innervation: CN V (Trigeminal)
Intrinsic Muscles
-Both origin and insertion within larynx
-Provide adjustment for phonation
-Lateral cricoarytenoid
-Posterior cricoarytenoid
-Oblique arytenoid
-Transverse arytenoid
-Cricothyroid: pars recta, pars oblique
-Thyroarytenoid: thyrovocalis, thyromuscularis
Lateral Cricoarytenoid
-Origin: cricoid cartilage superior lateral surface
-Course: up and back
-Insertion: arytenoid cartilage muscular process
-Function: adduct and shorten vocal folds
-Innervation: CN X (Vagus), through recurrent laryngeal muscle
Posterior Cricoarytenoid Muscle
-Origin: cricoid cartilage posterior surface
-Course: up and out
-Insertion: Arytenoid cartilage muscular posterior process
-Function: Only abduction muscles
-Innervation: CN X (10, Vagus)
Oblique Arytenoid Muscle
-Origin: Posterior base of muscular process of arytenoid cartilage
-Course: Obliquely up
-Insertion: Apex of opposite arytenoid cartilage
-Function: pulls apex medially, assists adduction of vocal folds
-Innervation CN X (10, Vagus), through recurrent laryngeal nerve
Transverse Arytenoid Muscle
-Origin: Lateral margin and muscular process arytenoid cartilage
-Course: Laterally
-Insertion: Lateral margin and muscular process opposite arytenoid cartilage
-Function: adduct vocal folds
-Innervation: CN X (10, Vagus), through recurrent laryngeal nerve
Cricothyroid Pars Recta Muscle
-Origin: anterior surface of cricoid cartilage beneath arch
-Course: up and out
-Insertion: lower surface of thyroid lamina
-Function: depresses thyroid cartilage, rotates cricothyroid joint, raise cricoid meet thyroid cartilage, tenses and lengthens vocal folds
Innervation: external branch of superior laryngeal nerve of CN X (10, Vagus)
Cricothyroid Oblique Muscle
-Origin: cricoid cartilage lateral to pars recta
-Course: obliquely up
-Insertion: thyroid cartilage between lamina and inferior horns
-Function: depresses thyroid and tenses vocal folds
-Innervation: external branch of superior laryngeal nerve of CN X (10, Vagus)
Thyrovocalis Muscle
-Medial most muscle of vocal folds
-Origin: Angle thyroid cartilage and adjacent cricothyroid ligament
-Course: posteriorly
-Insertion: anterolateral surface of arytenoid cartilage-arytenoid vocal process
-Innervation: CN X
-Function: tense vocal folds (vibrates) for voiced speech
Thyromuscularis Muscle
-Lateral portion of vocal folds
-Origin: Inner thyroid lamina near notch of vocalis
-Course: posteriorly
-Insertion: muscular process and base of arytenoid cartilages
-Innervation: CN X, recurrent laryngeal nerve
-Function: adduct and lengthen vocal folds, may also relax vocal folds
Larynx Intrinsic Muscles Function
-Abductors
-Adductors
-Tensors
-Relaxers
Vocal Fold Adductors
-Lateral cricoarytenoid
-Oblique arytenoid
-Transverse arytenoid -
Vocal Fold Abductors
-Posterior cricoarytenoid
Vocal Fold Tensors
-Thyroid Vocalis
-Cricothyroid (pars oblique and rectus: primary muscle of pitch change)
Vocal Fold Relaxers
-Thyromuscularis
Vocal Folds
-Made up of muscle and ligament
-Thyrovocalis: medial muscle
-Thyromuscularis: lateral muscle
-Vocal ligament: medial boundary
Vocal Folds Fine Structure: 5 Tissue Layers
1.) Squamous epithelium: most superficial tissue layer, provide white appearance
2.) Basement Membrane: between epithelium and lamina propria, bind it to next layer
3.) Superficial lamina propria: gelatinous
4.) Intermediate lamina propria: elastic fibers
5.) Deep lamina propria: collagen fibers, supportive
Vocal Fold Layers: Cover
-superficial epithelium
-primary layer of lamina propria
-secondary lamina propria -
Vocal Fold Layers: Body
-muscle layer
-third layer of lamina propria
-thyroarytenoid muscle: thyrocalis and thyromuscularis
Squamous Epithelium
-maintains vocal folds shape
-protects vocal folds
-keeps VF hydrated
Basement Membrane
-Holds epithelium to superficial layer of lamina propria
-Made up of collagen: fibrous and strong
Superficial Lamina Propria
-Gelatinous
-Mostly loose fibers and elastic components in matrix
-Actually “space” or “matrix”: AKA Reinke’s space
-Secreted by osteoblasts
-Varies widely based on location
-Cushions vocal folds
Intermediate Lamina Propria
-Elastic: adds elastic mechanical integrity
-Bundle of soft rubber bands
Deep Lamina Propria
-Supportive
-Not as elastic
-Composed of mostly collagenous fibers
-contributes durability
Vocal Ligament of Vocal Folds
-ILP: Elastic
-DLP: supportive
Thyrovocalis
-body of vocal folds
-passive and active qualities
-passively: consistency stiff rubber bands
-actively: contractile properties control stiffness
Layers Contribute to Vibratory Characteristics of Vocal Folds
1.) Outer: maintain structure
2.) Basement: attaches epithelium tightly to SLP
3.) SLP: gelatinous, cushion
4.) ILP: highly elastic
5.) DLP: strong
6.) Muscle adjusts tension
