Chapter 4 Unit 3 Flashcards
What is phonation?
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
Where is the Larynx?
Located at the superior end of the trachea (sits atop the rings of trachea)
What is the Larynx for?
Protects lower passageway from foreign materials
Can be used to hold air in lungs (good for lifting heavy objects)
Generates sound
T or F- Women typically have a longer larynx than men.
False. Men typically have a longer larynx than women in overall length of the larynx
Men 44 mm
Women 36 mm
T or F Everyone has the same framework for their larynx.
False. Varies among individuals
Skeleton of the Larynx ( 5 components)
Thyroid cartilage Cricoid cartilage Arytenoid cartilages Corniculate caritlages Epiglottis
Thyroid Cartilage- characteristics and parts
Articulates inferiorly with cricoid cartilage Largest of the laryngeal cartilages Consists of: Thyroid laminae Thyroid angle Thyroid notch Thyroid prominence Cornu
Thyroid Laminae
Can be called quadrilateral plates. Looks like Micky mouse ears.
Thyroid Angle
Point at which the two thyroid laminae come together
Thyroid Notch
Superior-most point of thyroid angle
Thyroid Prominence
“Adam’s Apple”
Found at the base of the thyroid notch
Flares out to protect anterior and lateral larynx
Thyroid Cornu
Found on the posterior portion of thyroid
2 sets
Superior-Point towards hyoid bone
Inferior-Rest on cricoid cartilage
Cricoid Cartilage
Most inferior cartilage of larynx Unpaired, signet ring-shaped Consists of: Arch Posterior quadrate lamina
Cricoid Cartilage
Arch
Low narrow portion in front
Provides clearance for the vocal folds
Posterior quadrate Lamina (Lamina)
Wide and thick portion in back
Provides point of articulation for arytenoid cartilages
Cricothyroid Joint
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
Phonatory Apparatus-5 parts
Arytenoid Cartilages Corniculate Cartilages Cuniform Cartilages Epiglottic Cartilage Hyoid Bone
Arytenoid Cartilages
Found on superior surface of cricoid cartilage Allows for onset and offset of voicing Pyramidal shape which includes: Base Apex
Arytenoid Cartilages Vocal Process
Projects anteriorly toward the thyroid notch
Vocal folds attach
Arytenoid Cartilages Muscular Process
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
Arytenoid Cartilages- Vocal Ligament
Attaches to vocal process & medial fibers of vocal muscles
Arytenoid Cartilages-Ventricular Ligament
Superior and lateral to vocal process
Attaches to inner surface of thyroid cartilages
Corniculate Cartilages
Small horn-shaped, extensions of arytenoids
Support aryepiglottic fold
Cuniform Cartilages
Small cartilages embedded within the aryepiglottic fold
Anterior to corniculate cartilages
Provide support for laryngeal covering
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
hyoepiglottic ligament
attaches Epiglottis to the hyoid bone
aryepiglottic folds
Joins epiglottis with arytenoid cartilages
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
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
Hyoid Bone- Greater Cornu
Arms that extend posteriorly and slightly horizontally.
Ends of greater horns articulate with the superior horns (cornu) of thyroid cartilage.
Hyoid Bone-lesser cornu
Cone shaped; rise superiorly.
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
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
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
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
Intrinsic Laryngeal Muscles
Have both origin and insertion on laryngeal cartilages
Make fine adjustments to the vocal mechanism
Extrinsic Laryngeal Muscles
One attachment on laryngeal cartilage and the other attachment on a nonlaryngeal structure
Make major adjustments to larynx
Elevating
Depressing
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
Laryngeal Valve
Valves include:
Epiglottic valve
Ventricular fold valve
Vocal fold valve
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
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
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
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
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)
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
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
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
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
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
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
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
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
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.
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
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
Triticial cartilage
embedded in lateral hyothyroid ligament
Hyoepiglottic Ligament
Unpaired ligament
Midline ligament extending from anterior surface of epiglottis to the upper border of the body of the hyoid bone
Cricotracheal Membrane
Connects lower border of cricoid cartilage with upper border of first tracheal ring.
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
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.
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.
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)
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
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
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
T or F Vocal fold tissue is multi-layered and tightly bound
TRUE. also Vocal fold tissue is multi-layered and tightly bound
Ventricular folds
lateral to vocal folds
are pink and plump
Made of thick folds of mucous membrane
Divisions of Laryngeal Cavity
3 Divisions of the Laryngeal Cavity:
Laryngeal Vestibule
Laryngeal Ventricle
Inferior Laryngeal Ventricle
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
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
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
Sphincter
Sphincter is a ring like muscle which closes an orifice or passage
Sphincters of the larynx include:
Aryepiglottic Sphincter
Ventricular Sphincter
True Vocal Fold Sphincter
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.
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.
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
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
Hyoid and Laryngeal Elevators 7
Digastricus anterior and posterior Stylohyoid muscle Mylohyoid muscle Geniohyoid muscle Genioglossus muscle Hyoglossus muscle Thyropharyngeus muscle
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
Digastricus
anterior
Origin: inner surface of the mandible
Insertion: hyoid bone
Function: draws hyoid up and forward; elevate hyoid
Digastricus posterior
Origin: mastoid process of temporal bone
Insertion: hyoid bone
Function: draws hyoid up and back; elevate hyoid
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
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
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
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
Genioglossus Muscle
Forms the primary muscle of the tongue
Origin: inner surface of mandible
Insertion: tongue and corpus hyoid
Action: elevates hyoid
Hyoid and Laryngeal Depressors-4
Sternohyoid muscle Omohyoid muscle Sternothyroid muscle Thyrohyoid muscle Depressors depress and stabilize the larynx via attachment to the hyoid
Sternohyoid Muscle
Runs from sternum to hyoid bone
Origin: Manubrium of sternum and clavicle
Insertion: Inferior margin of hyoid corpus
Action: Depresses hyoid
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
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
Thyrohyoid Muscle
Superior to the sternothyroid
Origin: oblique line, thyroid cartilage
Insertion: greater cornu, hyoid
Action: depresses hyoid or elevates larynx
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
