Final Flashcards
1
Q
The lungs are lined with _________ pleura and the thoracic cavity is lined with ________ pleura
A
visceral; parietal
2
Q
The pleura serves two functions:
A
reducing friction and allowing the lungs and thoracic cavity to move as one unit
3
Q
The pressure in between the visceral and parietal pleura is called______ and should be ________
A
intrapleural and should be negative
4
Q
- Boyle’s Law
A
pressure and volume are inversely proportional when temperature is held constant (when pressure goes up volume is down)
5
Q
- Air tends to move from an area of ________ pressure to an area of _________ pressure
A
higher; lower
6
Q
Palv; alveolar pressure
A
pressure within the lungs
7
Q
Ppl; intrapleural pressure
A
the pressure between the parietal and visceral pleura
8
Q
Ptrans; transpulmonary pressure
A
the difference between intrapleural pressure and alveolar pressure. should be positive
9
Q
Tidal breathing
A
breathing that occurs at rest; inhalation occurs due to contraction of the diaphragm; exhalation uses no muscular effort
10
Q
Inhalation for Tidal Breathing
A
- diaphragm and external intercostals contract, increasing the volume of the thoracic cavity
- because of Boyle’s law, alveolar pressure drops below atmospheric pressure (negative pressure)
- this causes air to flow into the lungs because of the drop in alveolar pressure
11
Q
Exhalation for Tidal Breathing
A
- the diaphragm and the external intercostals relax, causing the volume of the thoracic cavity to decrease
- because of Boyle’s Law, alveolar pressure rises above atmospheric pressure (positive pressure)
- the lungs’ elastic recoil also helps to passively decrease their volume
- air rushes out of the lungs
12
Q
Tidal Volume
A
the volume inhaled and exhaled in a cycle of tidal breathing
13
Q
Inspiratory Reserve Volume
A
the volume that can be inhaled past your tidal volume
14
Q
Expiratory Reserve Volume
A
the volume of air that can be exhaled below your tidal volume
15
Q
Residual Volume
A
the air remaining in the lungs after a maximum expiration
16
Q
Vital Capacity
A
inspiratory reserve volume + tidal volume + expiratory reserve volume (the 3 important ones)
17
Q
Functional Residual Capacity
A
expiratory reserve volume + residual volume
18
Q
Inspiratory Capacity
A
tidal volume + inspiratory reserve volume
19
Q
Total Lung Capacity
A
inspiratory reserve volume + tidal volume + expiratory reserve volume + residual volume (all 4)
20
Q
Forced Vital Capacity
A
the amt of air that someone can exhale forcefully after a maximum inhalation
21
Q
Body Plethysmography
A
patients are placed in a booth and their nose is clipped, they breathe into a mouthpiece. the changes in air pressure within the airtight booth indicate changes in lung volume. measures TOTAL LUNG CAPACITY
22
Q
Two types of graphs that pulmonologists use to diagnose respiratory disorders
A
Spirograms and Flow volume loops
23
Q
How does speech breathing differ from tidal breathing?
A
- vol of air (uses more vol)
- location of air intake
- ratio of time for inhale and exhale (more time for exhale)
- muscle activity for exhalation (more muscular activity for speech breathing?)
24
Q
Other Respiratory Variables
A
Rate- stopwatch or pulse oximeter in hospital setting; should be 12-18 breaths per minute
Blood oxygen levels- pulse oximeter; should be above 90%
25
Two types of Respiratory Disorders
Obstructive- inflammation, narrowing or bronchi, or increase in mucous
Ex: asthma or bronchitis
Restrictive- something within or outside the lungs keeping them from inflating completely
Ex: ALS, broken ribs, pneumonia
26
Dyspnea
patient self-report of discomfort or difficulty breathing, often due to C02 buildup
27
Both SLPs and MDs use
ICD-10 diagnostic codes
28
Cartilages and articulation points in vocal tract:
Paired cartilages: cuneiform, corniculate, and arytenoid
Unpaired Cartilages: thyroid, cricoid, epiglottis
Articulation Points: cricoarytenoid joints and cricothyroid joints
29
Arytenoid Cartilages
where VF attach
30
Points of Articulation
Cricoarytenoid joints: allow the arytenoids to rotate in and out causing VF adduction and abduction
Cricothyroid joints: allow the thyroid cartilage to tilt, lengthening and tensing VF
31
Valving System
the larynx's soft tissue forms 3 sets of valves to keep food and liquid out of the lungs and produce pressure
Aryepiglottic folds, false folds, and true VFs
32
Layers of VFs
1. Thyroarytenoid muscle (body)
2. Lamina Propria
a. deep layer (vocal ligament)
b intermediate layer (vocal ligament)
c. superficial layer (cover)
3. Squamous layer (cover)
33
External muscles of larynx
-have one pt of attachment at the larynx and one pt of attachment outside the larynx
-surround the larynx and anchor it in place withing the neck
-move the larynx up and down
34
Internal muscles of larynx
-both pts of attachment are within the larynx
-responsible for phonation
35
Internal muscles of larynx
1. Lateral cricoarytenoid (ADDUCTOR)
2. Interarytenoid (ADDUCTOR)
3. Posterior cricoarytenoid (ABDUCTOR)
4. Cricothyroid (ELONGATES AND TENSES VF)
5. Thyroarytenoid (THE VF)
36
Myoelastic aerodynamic theory of phonation (look at notes)
1. person inhales and as soon as they start to exhale...
2. the VFs adduct bc of the contraction of the interarytenoids and lateral cricoarytenoid muscles. this exerts medial compression on the folds
3. when the VF adduct, they reduce the vol of the sub-laryngeal space, so subglottal pressure increases
4. eventually the pressure is enough to blow the folds apart and release a burst of air, creating a complex periodic sound wave
5. because of Bernouilli's principle, the air flowing through the narrow constriction of the opening increases air velocity and decreases air pressure. this negative air pressure, along with the elasticity of the folds bring them back to midline adduction
6. this cycle repeat itself. the number of cycles per second gives us the fundamental frequency or perceived pitch
37
Bernoulli's Principle
when air passes through a constriction the velocity of the air increases and the pressure of the air decreases. if the material of the constriction is flexible and elastic, the negative pressure will cause the wall of the tube to pull together
38
Vertical phase difference
describes how vocal folds move in 3-dimensional space; medially and laterally, superiorly and inferiorly
when first adducted, the folds make a convergent shape, adducted at the most superior portion
after being blown open, they adduct into a divergent shape, adducted at the most inferior portion
39
Dysphonia
subjective term of describing abnormal voice quality
40
Voice Quality
how we subjectively perceive a person's voice
41
What impacts F0?
1. Thickness 2. Tension 3. Length 4. Density
42
Frequency variables (how effectively is your larynx able to shorten and lengthen to adjust pitch?)
1. average fundamental frequency
2. speaking fundamental frequency- what is your average pitch in connected speech?
3. maximum phonational frequency range
4. frequency variability- when having a convo what is the avg range of your pitch?
jitter- when you phonate "ah" are your vocal folds vibrating at a consistent rate or inconsistently?
43
loudness variables (how effective are you at building up subglottal pressure beneath the folds to adjust loudness?)
1. average DB
2. average DB in speech
3. dynamic range
4. DB variability- range of softest to loudest you use in speech
5. shimmer- the consistency of loudness over time
44
Voice range profile
a graph of a person's dynamic range and maximum phonational frequency range
45
Laryngeal visualization
1. endoscopy, nasal endoscopy
a. low-def
2. videostroboscopy
3. high speed digital imaging
46
The pharynx
a hollow muscular tube that makes up what we think of as the throat
can be subdivided into the: laryngopharynx, oropharynx, and nasopharynx
-constricts to bring pharyngeal walls together during swallowing and closes of the VP port
47
The velopharyngeal port
"doorway" bn the oral and nasal cavity
the "door" is shut by the combination of
-the elevation of the velum
-the squeezing of the superior pharyngeal constrictors
48
Hard Palate
separates the oral and nasal cavities; its alveolar process is important for sounds like n, s, and t
49
Velum
made up of muscles and tendon, and important for determining oral and nasal resonance. works with the pharyngeal walls to form the velopharyngeal port
50
Tongue (muscular hydrostat)
moveable articulator that is the primary articulator for most sounds. Has INTRISNIC muscles that change its shape and position. EXTRINSIC muscles move it within the oral cavity.
51
F1
tells us about tongue height; the higher the tongue's position, the lower the F1 (inverse relationship)
52
F2
tells about tongue advancement; the more fronted the tongue is, the higher the F2 (positive correlation)
53
Stops
will have darker coloring bc they have more energy from voicing
54
Nasals
dampen sound energy instead of increasing it and use nasal resonance
55
Glides
ALWAYS voiced and have dynamic movement
56
Fricatives
longer in duration and we hear two things in a fricative if it's voiced:
-the voicing at the lvl of the larynx
-the noise created by the turbulent air exiting the oral cavity
57
Forced vibration
when an object is forced into vibration because a sound wave nearby is close to the object's resonant frequency
58
Hyponasality
if the VP port is closed off when it should be open, therefore reducing nasal resonance
59
Hypernasality
if the VP port is open when it should be closed, therefore increasing nasal resonance
60
Oral motor exam
completed by speech-lang pathologist and done to rule out underlying issues in structure and function to the oral cavity that may impact speech production
61
Electropalatography
palate implant that is filled with electrodes and measures where the tongue contacts with the hard palate for certain sounds, giving biofeedback during therapy.
62
MRI
used in research to quantify normal v. abnormal production of speech
63
Endoscope
let us view the nasal cavities, pharynx, and larynx. it is often used to rule out VP port dysfunction or determine the impact of palatine tonsils on the upper airway. can be completed by an SLP, but more often completed by an ENT.
64
Energy Transducer
converts energy from one form to a different form, this is the role of the auditory system: transduces acoustic energy into mechanical vibrations through tiny bones, to an electric neural impulse.
65
Parts of the Outer Ear
1. Pinna
2. External Auditory Meatus- 1/3 cartilage, 2/3 bone, and functions as an acoustic resonator and amplifies high-frequency sounds
3. Tympanic Membrane- 3-layered membrane that transduces pressure waves into mechanical vibration when it is set into motion by a sound wave
66
Function of the outer ear
protects the middle and inner ear, keeps foreign matter out of the ear, amplifies high-frequency sounds, and aids in sound localization
67
The TM
1. lateral layer
2. fibrous layer
3. medial layer
Landmarks:
-umbo, handle of the malleus, pars tensa, pars flaccida, cone of light
68
Middle Ear
air-filled space with a volume of approximately 2 ml which is bounded by the TM laterally and the oval window medially. it includes the eustachian tube which runs to the nasopharynx.
1. Ossicles
-malleus, incus, stapes
2. MUSCLES
-tensor tympani m., stapedius m.
69
Function of Middle Ear
overcome the impedance mismatch, equalize middle ear pressures, and attenuate(lessen) loud sound with the acoustic reflex
70
What is impedance mismatch?
IMPEDANCE- how difficult it is for sound to travel through a medium
when sound traveling through one medium encounters a new medium, it does not flow freely from one to another. Due to the different densities of gas, liquids, and solids, much of the sound wave is reflected off the new medium. To overcome this mismatch in impedance, the amplitude or energy of the acoustic signal must increase.
71
How does the middle ear overcome the impedance mismatch?
1. by the decrease in surface area from the TM to the oval window
2. by the lever and fulcrum mechanism of the ossicles
despite the inc in energy only half of the sound energy that enters at the TM will reach the oval window
72
Parts of the Inner Ear
1. cochlea
2. vestibule
3. semicircular canals
4. vestibulocochlear nerve
73
Function of Inner Ear
aids in balance, transduce mechanical energy (vibration of a fluid) into neural transmissions
74
The Cochlea
shell-shaped bony structure. at its core is a bony structure called the modulus. wrapped around it is the SPIRAL LAMINA which can be divided into three sections:
1. scala vestibuli- filled with perilymph
2. scala media(cochlear duct- filled with endolymph
3. scala tympani- filled with perilymph
75
Membrane separating the scala vestibuli and scala media is called the...
vestibular membrane (Reissner's membrane)
76
Membrane separating the scala media and scala tympani is the
basilar membrane
77
The organ of corti
-sits on top of the basilar membrane
-where transduction of fluid vibrations within the cochlea is turned to neural impulses
-consists of hair cells and the tectorial membrane
-inner hair cells run in a single file line and are closest to the modiolus of the cochlea
-outer hair cells run in rows of 3-5 and sit laterally to the modiolus
-inner hair cells are responsible for causing the branch of cranial nerve 8 to fire, outer hair cells help to amplify and specify the frequencies in complex sounds
78
Screening
results in pass and fail outcome or pass and refer. SLPs scope of practice to screen hearing either using an Audiometer or OAE
79
Evaluation
results in differential diagnosis and identification of severity, audiologist does this
80
Types of Hearing Loss
1. conductive
2. sensorineural
3. mixed
81
Tympanometry
measures pressures within the tympanic membrane
-uses a tympanogram
82
OAE
a normal cochlea produces "echoes" in response to sounds called "otoacoustic" emissions
-OAE alone cannot diagnose hearing loss but can be used as a hearing screen or part of a diagnostic battery
83
Auditory Brainstem Response Testing
checks the function of the vestibulocochlear nerve by placing electrodes on a child's head and measuring nerve responses in response to sound, does not require a patient's response and completed asleep or sedated
