Chapter 4 Unit 3 Flashcards
1
Q
What is phonation?
A
Phonation is the product of vibrating vocal folds.
Also known as voicing
Respiration is the energy source that allows for phonation
In speech there are voiced and voiceless sounds
2
Q
Where is the Larynx?
A
Located at the superior end of the trachea (sits atop the rings of trachea)
3
Q
What is the Larynx for?
A
Protects lower passageway from foreign materials
Can be used to hold air in lungs (good for lifting heavy objects)
Generates sound
4
Q
T or F- Women typically have a longer larynx than men.
A
False. Men typically have a longer larynx than women in overall length of the larynx
Men 44 mm
Women 36 mm
5
Q
T or F Everyone has the same framework for their larynx.
A
False. Varies among individuals
6
Q
Skeleton of the Larynx ( 5 components)
A
Thyroid cartilage Cricoid cartilage Arytenoid cartilages Corniculate caritlages Epiglottis
7
Q
Thyroid Cartilage- characteristics and parts
A
Articulates inferiorly with cricoid cartilage Largest of the laryngeal cartilages Consists of: Thyroid laminae Thyroid angle Thyroid notch Thyroid prominence Cornu
8
Q
Thyroid Laminae
A
Can be called quadrilateral plates. Looks like Micky mouse ears.
9
Q
Thyroid Angle
A
Point at which the two thyroid laminae come together
10
Q
Thyroid Notch
A
Superior-most point of thyroid angle
11
Q
Thyroid Prominence
A
“Adam’s Apple”
Found at the base of the thyroid notch
Flares out to protect anterior and lateral larynx
12
Q
Thyroid Cornu
A
Found on the posterior portion of thyroid
2 sets
Superior-Point towards hyoid bone
Inferior-Rest on cricoid cartilage
13
Q
Cricoid Cartilage
A
Most inferior cartilage of larynx Unpaired, signet ring-shaped Consists of: Arch Posterior quadrate lamina
14
Q
Cricoid Cartilage
Arch
A
Low narrow portion in front
Provides clearance for the vocal folds
15
Q
Posterior quadrate Lamina (Lamina)
A
Wide and thick portion in back
Provides point of articulation for arytenoid cartilages
16
Q
Cricothyroid Joint
A
Diarthroidal joint found between the thyroid and cricoid cartilages
Point of articulation is the articular facets on cricoid cartilage and the inferior cornu of the thyroid cartilage
Allows for rotation and pivoting
17
Q
Phonatory Apparatus-5 parts
A
Arytenoid Cartilages Corniculate Cartilages Cuniform Cartilages Epiglottic Cartilage Hyoid Bone
18
Q
Arytenoid Cartilages
A
Found on superior surface of cricoid cartilage Allows for onset and offset of voicing Pyramidal shape which includes: Base Apex
19
Q
Arytenoid Cartilages Vocal Process
A
Projects anteriorly toward the thyroid notch
Vocal folds attach
20
Q
Arytenoid Cartilages Muscular Process
A
Projects laterally on the arytenoid
Point of attachment for muscles that adduct and abduct the vocal folds
Holds lateral portion of vocal folds and lateral, posterior cricoarytenoid muscles
21
Q
Arytenoid Cartilages- Vocal Ligament
A
Attaches to vocal process & medial fibers of vocal muscles
22
Q
Arytenoid Cartilages-Ventricular Ligament
A
Superior and lateral to vocal process
Attaches to inner surface of thyroid cartilages
23
Q
Corniculate Cartilages
A
Small horn-shaped, extensions of arytenoids
Support aryepiglottic fold
24
Q
Cuniform Cartilages
A
Small cartilages embedded within the aryepiglottic fold
Anterior to corniculate cartilages
Provide support for laryngeal covering
25
Epiglottic Cartilage
Leaflike structure
Stem (Petiolus) arises from the inner surface of the thyroid angle, just below notch
Attaches by means of the thyroepiglottic ligament
Protects airway by deflecting food and liquids from being swallowed
Surface of epiglottis is covered with a mucous membrane lining
26
hyoepiglottic ligament
attaches Epiglottis to the hyoid bone
27
aryepiglottic folds
Joins epiglottis with arytenoid cartilages
28
Hyoid Bone
U-shaped bone
Forms union between the tongue and the laryngeal structure
Located at the level of the 3rd cervical vertebrae
Includes:
Body (Corpus)
Greater Cornu
Lesser Cornu
Attaches to 9 pairs of muscles
Very mobile
Does not connect to any other bone in the body
Forms a base for the tongue
29
Hyoid Bone- Body/corpus
Shieldlike structure forming the front of the bone
You can feel it by placing your finger on thyroid notch and pushing lightly back toward your vertebral column
Corpus is convex, inner surface is concave
30
Hyoid Bone- Greater Cornu
Arms that extend posteriorly and slightly horizontally.
| Ends of greater horns articulate with the superior horns (cornu) of thyroid cartilage.
31
Hyoid Bone-lesser cornu
Cone shaped; rise superiorly.
32
Cricothyroid Joint -where is it and what does it do?
Junction of the cricoid cartilage and the inferior cornu of the thyroid cartilage
Synovial (diarthrodial) joint that allows for the cricoid and thyroid to rotate and glide
Joint provides the major adjustment for change in vocal pitch
Pivot joint
33
Cricoarytenoid Joint
Saddle joint formed between the cricoid and arytenoid cartilages
Concave portion of arytenoids articulates with convex portion of cricoid lamina
Synovial joint allows for rocking, gliding, and minimal rotation
34
Posterior Cricoarytenoid Ligament
Extends from posterior surface of the cricoid lamina to the base of the posterior surface of the arytenoid cartilage
Restricts the extent of forward movement of the arytenoid cartilage
35
Anterior Cricoarytenoid Ligament
Extends from the cricoid cartilage to the anterolateral base of the arytenoid cartilage.
Often absent
May limit backward movement of the arytenoid cartilage
36
Intrinsic Laryngeal Muscles
Have both origin and insertion on laryngeal cartilages
| Make fine adjustments to the vocal mechanism
37
Extrinsic Laryngeal Muscles
One attachment on laryngeal cartilage and the other attachment on a nonlaryngeal structure
Make major adjustments to larynx
Elevating
Depressing
38
Importance of Laryngeal Muscles
```
Regulate openings of respiratory pathway
Regulate valve openings and closings
Valves include:
Epiglottic valve
Ventricular fold valve
Vocal fold valve
```
Provide movement of laryngeal cartilages for speech
39
Laryngeal Valve
Valves include:
Epiglottic valve
Ventricular fold valve
Vocal fold valve
40
Intrinsic Muscles - purpose, consists of..
Regulate valvular action of laryngeal cavities
Muscles consist of:
Tensor-tighten muscles
Adductor-bring together
Abductor-pull apart
Relaxers-relax muscles
Situated on or within cartilaginous skeleton of larynx
Responsible for the control of speech production
41
Cricothyroid Muscle -Tensor
Primary tensor of the vocal folds
Pulls cricoid backward and upward and thyroid forward and downward
Increase length of vocal folds
Composed of two heads
Pars Recta
Pars Oblique
Both the pars recta and pars oblique are responsible for laryngeal adjustments associated with pitch change
42
Cricothyroid Muscle Cont…
| Pars Recta
Medial-most component of cricothyroid muscle
Originates on anterior surface of cricoid cartilage and inserts into the lower surface of the thyroid lamina
Rocks thyroid downward
43
Cricothyroid Muscle Cont…Pars Oblique
Originates from cricoid cartilage and courses obliquely up to insert into the juncture between the thyroid laminae and inferior horns
Allows for thyroid to slide forward and backward which tenses the vocal folds
44
Thyroarytenoid Muscle (may be called Thyrovocalis) TENSOR
```
Runs from the inner surface of the thyroid cartilage and inserts on lateral surface of arytenoid vocal process, parallel to glottis (opening between vocal folds)
Primary mass of vocal folds
Tenses the vocal folds
Consists of 2 parts:
Thyromuscularis
Thyrovocalis (A.K.A. vocalis)
```
45
Thyroarytenoid (thyrovocalis-Vocalis
| TENSOR
Thyrovocalis/vocalis (medial thyroartenoid)
Portion where internal central fibers run alongside vocal ligament
Origin: inner surface, thyroid cartilage near notch
Insertion: lateral surface of the arytenoid vocal process
Action: tenses vocal folds
46
Thyroarytenoid (thyrovocalis) cont…
Thyromuscularis (lateral thyroarytenoid)
TENSOR
Larger segment of thyroarytenoid
Immediately lateral to each thyrovocalis
Origin: inner surface of the thyroid cartilage, near the notch
Insertion: base and muscular process of arytenoid cartilage
Action: relaxes vocal folds
47
Vocal Folds- layers
There is a five layer structure of the vocal fold (superficial to deep)
Epithelium
Lamina Propria
Superficial layer (extracellular gelatin matrix)
Intermediate layer (elastin)
Deep layer (collagen fibers)
Vocalis Muscle
48
Vocal Folds- 3 sections
Can also be split into 3 sections
Cover: epithelium and superficial layer of lamina propria
Transition: Intermediate and deep layers of lamina propria
Body: vocalis muscle
49
Thyroepiglotticus Muscle
Can also be classified as an auxiliary muscle
Helps dilate the laryngeal opening
Sphincter of aditus
Involved in closing entrance of larynx in swallowing
Origin: Inner surface of thyroid at angle
Insertion: Lateral epiglottis
Action: Dilates airway
50
Lateral Cricoarytenoid
Origin: cricoid cartilage
Insertion: muscular process of the arytenoid
Action: When this muscle adducts, the arytenoids squeeze the anterior tips of the vocal process (and vocal ligaments) tightly together
This movement lengthens the vocal folds
51
Transverse Arytenoid Muscle
Only unpaired intrinsic muscle
Origin: lateral margin of the posterior surface of one arytenoid
Insertion: corresponding surface of the other arytenoid
Action: pulls arytenoids together, thus approximating the vocal folds
52
Oblique Arytenoid Muscle
Superficial to the transverse arytenoid muscles
Origin: posterior base of the muscular processes
Insertion: apex of the opposite arytenoid (forms an “X”)
Action: adduction, enforces medial compression, as well as rocks the arytenoid and vocal folds down and in
53
Posterior Cricoarytenoid -ABDUCTOR
Sole abductor of the vocal folds
Origin: posterior wall of cricoid cartilage.
Insertion: muscular processes of the arytenoid cartilages.
Action: ABDUCTION. They are the major muscles responsible for rocking and gliding the arytenoids apart.
54
Extrinsic Membranes & Ligaments of Larynx
```
Group of ligaments and membranes that connect laryngeal cartilages to other structures
Includes:
Thyrohyoid Membrane and Ligament
Hyoepiglottic Ligament
Cricotracheal Membrane
Conus Elasticus
Quadrangular Membrane
Aryepiglottic Folds
```
55
Thyrohyoid Membrane & Ligament-extrinsic
Can also be called hyothyroid
Found between hyoid bone and superior border of thyroid cartilage
Membrane thickens medially and laterally
Medial thyrohyoid ligament
Lateral thyrohyoid ligament
Triticial cartilage is embedded in lateral hyothyroid ligament
56
Triticial cartilage
embedded in lateral hyothyroid ligament
57
Hyoepiglottic Ligament
Unpaired ligament
| Midline ligament extending from anterior surface of epiglottis to the upper border of the body of the hyoid bone
58
Cricotracheal Membrane
Connects lower border of cricoid cartilage with upper border of first tracheal ring.
59
Intrinsic Ligaments
Connect the cartilages of the larynx and form the support structure for the cavity of the larynx and vocal folds
Help regulate direction and degree of movements
Made up of one sheet of connective tissue (elastic membrane)
Continuous sheet that lines the entire larynx (except at vocal & ventricular ligaments)
Consists of:
Quadrangular Membranes (upper portion)
Conus Elasticus (lower portion)
Aryepiglottic Folds
60
Conus Elasticus
Also known as Cricovocal Membrane
Connects thyroid, cricoid, and arytenoid cartilages with one another
Divided into a medial (or anterior) cricothyroid ligament and two lateral cricothyroid membranes.
61
Conus Elasticus
| Medial Cricothyroid Ligament
Band of yellow elastic tissue
| Runs from midline of superior border of cricoid arch to inferior border of thyroid cartilage.
62
Conus Elasticus
| Lateral Cricothyroid Membranes
Thinner ligament at midline
Originates from superior border of cricoid cartilage which eventually become the vocal ligaments
Run from vocal processes of arytenoids to angle of thyroid cartilage
The conus elasticus extends from superior border of the arch and lamina of cricoid cartilage to the upper limits of the vocal folds (vocal ligament)
63
Quadrangular Membrane
Paired
Arises from lateral margins of epiglottis and adjacent thyroid cartilage near the angle
Attaches to the corniculate cartilages and medial surfaces of arytenoids
Inferiorly the fibers thicken and become the ventricular ligament
64
Aryepiglottic Folds
Forms at the superior margins of quadrangular membranes
The aryepiglottic completely seal off the spaces in the laryngeal structure and direct the airstream into the aditus and upward into the resonatory passageways
65
Mucous Membranes
Laryngeal cavities are lined with mucous membrane from trachea up
The cells are columnar in shape and have cilia which beat towards the pharynx except at margins of vocal folds
The ciliated tissue is replaced by squamous epithelial tissue at vocal folds
66
T or F Vocal fold tissue is multi-layered and tightly bound
TRUE. also Vocal fold tissue is multi-layered and tightly bound
67
Ventricular folds
lateral to vocal folds
are pink and plump
Made of thick folds of mucous membrane
68
Divisions of Laryngeal Cavity
3 Divisions of the Laryngeal Cavity:
Laryngeal Vestibule
Laryngeal Ventricle
Inferior Laryngeal Ventricle
69
Laryngeal Vestibule
```
Area in larynx above ventricular folds
Opening is called aditus
Anterior wall = epiglottis
Lateral walls = aryepiglottic folds
Posterior wall = upper parts of arytenoid cartilages
Inferior limits = ventricular folds
```
70
Laryngeal Ventricle
Space between vocal folds and ventricular folds
Superior limits = ventricular folds
Inferior limits = vocal folds
Anterior wall = none
Posterior wall = arytenoid
Lateral walls = inner wall of thyroarytenoid muscle
71
Inferior Laryngeal Ventricle
```
Portion below the true folds
Extends through to the trachea
Anterior walls = cricothyroid ligament
Lateral walls = cricoid cartilage
Posterior walls = cricoid cartilage
```
72
Sphincter
Sphincter is a ring like muscle which closes an orifice or passage
73
Sphincters of the larynx include:
Aryepiglottic Sphincter
Ventricular Sphincter
True Vocal Fold Sphincter
74
Aryepiglottic Sphincter
Muscle fibers embedded in aryepiglottic folds surrounding a pear shaped opening (aditus) into laryngeal cavity
First line of defense against foreign objects
Closes during swallowing and vomiting
Prevents food/liquid from entering respiratory tract
Opening is called upper sphincter of larynx.
75
Ventricular Sphincter
Found between laryngeal vestibule and laryngeal ventricle
During normal phonation, ventricular folds remain in quiet, open position
When the ventricular muscles contract, they meet at midline, closing or sealing the sphincter
True vocal folds will always adduct first!
Increases subglottic pressure by adding another “door” to keep air in lungs and foreign objects out.
76
True Vocal Fold Sphincter
Third door of closure
Not effective in preventing outflow of air during effort closure
Third line of defense in keeping foreign objects out of lungs
May close independently of other two sphincters
All three sphincters close during swallowing
77
Extrinsic Muscles 4 types
Infrahyoid
Attach to the hyoid and runs to a structure below the hyoid bone
Suprahyoid
Attaches to the hyoid and runs to a structure above the hyoid bone
Elevators
Muscles that elevate the hyoid and larynx
Depressors
Muscles that depress the hyoid and larynx
78
Hyoid and Laryngeal Elevators 7
```
Digastricus anterior and posterior
Stylohyoid muscle
Mylohyoid muscle
Geniohyoid muscle
Genioglossus muscle
Hyoglossus muscle
Thyropharyngeus muscle
```
79
Digastricus
Composed of 2 separate bellies (anterior and posterior)
Small muscle under mandible
Third line of defense in keeping foreign objects out of lungs (third door of closure)
May close independently of other 2 sphincters; however all 3 close during swallowing
80
Digastricus
| anterior
Origin: inner surface of the mandible
Insertion: hyoid bone
Function: draws hyoid up and forward; elevate hyoid
81
Digastricus posterior
Origin: mastoid process of temporal bone
Insertion: hyoid bone
Function: draws hyoid up and back; elevate hyoid
82
Mylohyoid Muscle
Makes up floor of oral cavity
Mylohyoid raphe is a tendonous strip at midline
Connects the two muscles and supports tongue
Innervated by V nerve
Origin: Mylohyoid line; inner surface of mandible
Insertion: Corpus of hyoid
Action: Elevates hyoid or depresses mandible
83
Geniohyoid
Geniohyoid
Superior to the mylohyoid
Runs from inferior mental spine of mandible into upper ½ of hyoid
Origin: mental spines, inner surface of mandible
Insertion: corpus of hyoid bone
Action: Elevates hyoid bone
84
Stylohyoid
Located superior and anterior to the posterior belly of digastric muscle
Origin: styloid process of temporal bone
Insertion: corpus of hyoid bone
Action: moves hyoid up and back
85
Hyoglossus Muscle
In addition to elevating the hyoid, this muscle can also depress the tongue
Classified as on of the tongue muscles
Origin: hyoid bone (greater cornu and corpus)
Insertion: sides of tongue
Action: elevates hyoid; depresses tongue
86
Genioglossus Muscle
Forms the primary muscle of the tongue
Origin: inner surface of mandible
Insertion: tongue and corpus hyoid
Action: elevates hyoid
87
Hyoid and Laryngeal Depressors-4
```
Sternohyoid muscle
Omohyoid muscle
Sternothyroid muscle
Thyrohyoid muscle
Depressors depress and stabilize the larynx via attachment to the hyoid
```
88
Sternohyoid Muscle
Runs from sternum to hyoid bone
Origin: Manubrium of sternum and clavicle
Insertion: Inferior margin of hyoid corpus
Action: Depresses hyoid
89
Omohyoid Muscle
```
Two bellies (superior and inferior)
Origin: superior: intermediate tendon
inferior: upper border of scapula
```
Insertion: superior: lower border, hyoid
inferior: intermediate tendon
Action: depresses hyoid
90
Sternothyroid Muscle
Assists on producing high and low pitch
Helps make fine adjustments to vocal folds
Origin: manubrium sterni and first costal cartilage
Insertion: Oblique line, thyroid cartilage
Action: depresses thyroid cartilage
91
Thyrohyoid Muscle
Superior to the sternothyroid
Origin: oblique line, thyroid cartilage
Insertion: greater cornu, hyoid
Action: depresses hyoid or elevates larynx
92
Suspensory System
Suspends the larynx in the throat
Major ligament of the suspensory system is the STYLOHYOID LIGAMENT
Suspends hyoid from base of skull
Other ligamentous membranes connect hyoid bone to thyroid cartilage, thyroid cartilage to cricoid cartilage, and cricoid cartilage to upper tracheal ring
