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Voice and Upper Airways Disorders > GSM 2: Laryngeal Anatomy and Physiology > Flashcards

GSM 2: Laryngeal Anatomy and Physiology Flashcards

1
Q

the importance of knowing laryngeal anatomy

A
  • allows us to more fully appreciate the nature of the normal and pathologic voice, therapy allowing for appropriate and effective management
  • allows us to demonstrate a knowledge-base when working with other professionals in the management of vocal pathologies/voice disorders
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2
Q

constituent structures of the phonatory system

A
  • cartilaginous structure of the larynx
  • hyoid bone
  • all the muscles and ligaments that bind the larynx together and move its constituent parts
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3
Q

larynx

A

funnel shaped structure that sits below the base of the top of the trachea

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4
Q

dimensions of the larynx

A
  • larynx prevents things from getting into the trachea
  • when larynx is removed, the first ring of the trachea and some muscles within the base of the tongue is also removed
  • tongue mobility becomes impaired
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5
Q

tongue mobility becomes impaired meaning

A
  • dysphagia
  • clearing the sides of residue
  • articulation (important when addressing speech)
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6
Q

primary function of larynx is not voice production, what is it?

A

biologic and the preservation of life

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7
Q

2 concepts as to why the larynx is involved in voice production

A
  1. overlaid explanation
  2. adaptive function of the larynx
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8
Q

overlaid explanation of the larynx

A

the primary function of the larynx is biologic, however, its anatomy and physiology make it uniquely suited for voice production

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9
Q

adaptive function of the larynx

A

the primary function of the larynx is biologic, however, over time its anatomy and physiology have been modified so that it is also capable of voice production

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10
Q

biologic functions of the larynx

A
  • controls air flow during respiration
  • protection of the airway from foreign bodies
  • thoracic fixation/glottal effort closure reflex
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11
Q

larynx controls air flow during respiration

A
  • if your vocal folds are abducted, air from environment flows freely in and out of respiratory system
  • if your vocal folds are abducted, there is no free exchange of air
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12
Q

larynx protects of the airway from foreign bodies

A
  • stage actors when smoke is being used
  • someone is choking
  • allergies
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13
Q

thoracic fixation/glottal effort closure reflex

A
  • occurs when there are things weight bearing
  • allows you to bear weight
  • people who lost larynx may not be able to do weight bearing activities
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14
Q

steps in order during weight bearing activities

A
  • brief inhale in
  • vocal folds close
  • air pressure builds up
  • when you lift, your shoulder girdle and the muscles of your neck fixate around the larynx
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15
Q

larynx represents the point of division between

A

the throat area and the digestive system

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16
Q

food goes through the ___, and air goes through the ___

A

pharynx, larynx

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17
Q

posterior wall of the larynx is the anterior wall of the…

A

esophagus (clefts can occur along this wall)

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18
Q

cartilages of the larynx

A
  • cricoid cartilage
  • thyroid cartilage
  • epiglottis
  • arytenoid cartilages
  • corniculate cartilages
  • cuneiform cartilages
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19
Q

cricoid cartilage

A
  • unpaired
  • most inferior cartilage
  • ring of cartilage
  • narrower in the front, wider in the back
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20
Q

where is the cricoid cartilage?

A

sits directly atop the trachea

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21
Q

landmarks of the cricoid cartilage

A
  • anterior cricoid arch
  • posterior quadrate/cricoid lamina
  • articular facets
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22
Q

posterior quadrate/cricoid lamina

A

2 of which are the point of union between the cricoid cartilage and the arytenoid cartilage

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23
Q

cricoarytenoid joint of the posterior quadrate/cricoid lamina

A

formed by the combination of the facets and the 2 facets on 1 side of the lamina

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24
Q

articular facets

A

2 that are the point of union between the thyroid cartilage and the arytenoid cartilage

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25
Q

cricothyroid joint of the articular facets

A

formed by the combination of the facets and the thyroid cartilage

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26
Q

thyroid cartilage

A
  • unpaired
  • largest cartilage of the larynx
  • functions like a shield protecting the entrance to the respiratory system
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27
Q

landmarks of the thyroid cartilage

A
  • thyroid lamina
  • thyroid horns/cornu
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28
Q

thyroid lamina

A

sides of the thyroid cartilages

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29
Q

thyroid lamina consists of…

A
  • thyroid angle
  • thyroid notch
  • thyroid/laryngeal prominence
  • oblique line
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30
Q

thyroid angle of the thyroid lamina

A

formed by the sides of the thyroid cartilages coming together at midline

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31
Q

thyroid notch of the thyroid lamina

A

atop of the thyroid angle

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32
Q

thyroid/laryngeal prominence of the thyroid lamina

A

the part that sticks out

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33
Q

oblique line of the thyroid lamina

A
  • raised area diagonally on each side
  • serves as a point of muscle attachment
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34
Q

epiglottis

A
  • unpaired
  • leaf shaped cartilage
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35
Q

where is the epiglottis?

A
  • extends from just above the vocal folds
  • up through the hyoid bone
  • to the base of the tongue
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36
Q

epiglottis has no function in ___, it functions in ___

A

voice, swallowing

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37
Q

arytenoid cartilages

A
  • paired
  • sit atop the cricoid cartilages and form the cricoarytenoid joint
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38
Q

processes of the arytenoid cartilage

A
  1. vocal process
  2. muscular process
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39
Q

vocal process of the arytenoid cartilages

A
  • projecting anteriorly
  • towards the thyroid cartilage
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40
Q

vocal process of the arytenoid cartilage serves as the ___ point of attachment for the ___ ___

A

posterior, vocal folds

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41
Q

embedded in the vocal process is the…

A

upper 3rd of the vocal folds

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42
Q

muscular process of the arytenoid cartilage

A

on the base of each arytenoid projecting outward

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43
Q

muscular process is the point of attachment for the…

A

muscles that open and close the vocal folds

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44
Q

corniculate cartilages

A
  • paired
  • small horn-like cartilages
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45
Q

where are the corniculate cartilages?

A

atop each arytenoid cartilage

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46
Q

function of the corniculate cartilages

A

help support the vocal folds

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47
Q

cuneiform cartilages

A

paired, if present

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48
Q

where are the cuneiform cartilages?

A
  • located anterior and superior to the arytenoid cartilages embedded in the epiglottic folds
  • membrane extends from the arytenoids to the sides of the epiglottis
  • serve no purpose and are dissappearing
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49
Q

cricothyroid joint

A

formed by inferior horns of the thyroid cartilage attaching to the cricoid cartilage

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50
Q

synovial joint: which direction does it rock the thyroid cartilage?

A

downward

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51
Q

synovail joint, rocking: physiologically, it decreases the distance between the ___ and the ___

A

thyroid, cricoid

52
Q

synovial joint, rocking: physiologically, it increases the distance between the ___ and the ___

A

thyroid, arytenoid

53
Q

synovial joint: functions of the rocking motion

A
  • lengthen vocal fold
  • decrease vf mass
  • increase vf tension
  • primary tensor of the vfs
  • responsible for production of higher pitches
54
Q

synovial joint: which direction does it glide

A

forward

55
Q

synovial joint, gliding: it increases the distance between the ___ and the ___

A

thyroid, cricoid

56
Q

synovial joint, gliding: it decreases the distance between the ___ and the ___

A

thyroid, arytenoid

57
Q

synovial joint, gliding function

A

reinforces the rock, so it also helps increase the pitch

58
Q

synovial joint, both functions

A

both rocking and gliding happen simultaneously

59
Q

cricoarytenoid joint

A

formed by the union of the arytenoid and the cricoid cartilages

60
Q

rocking motion of the cricoarytenoid joint

A
  • arytenoids rock down and inward closing the vocal folds
  • arytenoids rock back and outward opening the vocal folds
61
Q

gliding motion of the cricoarytenoid joint

A
  • gliding backwards, the vocal folds stretch (reinforce increase in pitch)
  • gliding forwards, the vocal folds compress against each other
62
Q

these joints are subject to…

A

anything else that other joints in our body are subject to (can get arthritis)

63
Q

hyoid bone

A
  • the only bone in the body that is not attached in some manner to another bone
  • junction between tongue and the larynx
64
Q

landmarks of the hyoid bone

A
  • corpus (front)
  • greater horns/cornu
  • lesser horns/cornu
65
Q

greater horns/cornu of the hyoid bone

A

projecting posteriorly off the corpus

66
Q

lesser horns/cornu of the hyoid bone

A

projecting superiorly

67
Q

membranes/linings of the larynx

A
  • extrinsic membranes/ligaments
  • intrinsic membranes/ligaments
68
Q

function of extrinsic ligaments

A

used to hold the larynx together, attach laryns to other structures

69
Q

functions of intrinsic ligaments

A
  • completely line the internal larynx, which helps hold all of the structures of the larynx together
  • increases arodynamic nature of the internal larynx
70
Q

extrinsic membranes/ligaments of the larynx

A
  • cricotracheal ligament/membrane
  • middle cricothyroid ligament
  • thyrohyoid membranes
  • lateral thyrohyoid ligament
  • median/middle thyrohyoid ligament
71
Q

cricotracheal ligament/membrane

A

attaches the cricoid, and by extension the larynx, to the trachea

72
Q

middle cricothyroid ligament

A

attach the thyroid cartilage to the cricoid cartilage

73
Q

thyrohyoid membranes

A
  • paired
  • attach the thyroid lamina to the greater horn
74
Q

lateral thyrohyoid ligament

A
  • triticial cartilage
  • attach superior horn of the thyroid to the end of the greater horn of the hyoid
75
Q

median/medial thyrohyoid ligament

A

attach the front of thyroid cartilage to the corpus of the hyoid

76
Q

intrinsic membranes/ligaments of the larynx

A

fibroelastic membrane

77
Q

fibroelastic membrane of the larynx consists of

A
  1. quadrangular membranes
  2. aryepiglottis muscle
  3. conus elasticus
78
Q

course of the quandrangular membranes

A

inferior to the aryepiglottic membrane, runs from the sides of the arytenoids anteriorly to the sides of the epiglottis

79
Q

function of the quadrangular membranes

A

form the ventricular/false vocal folds

80
Q

course of the aryepiglottic muscle

A

runs from the tips of the arytenoids/corniculates anteriorly to attach to the sides of the epiglottis

81
Q

course of the conus elasticus

A
  • most inferior
  • drape over the true vocal folds and then continue downward and line up the upper trachea
82
Q

function of the conus elasticus

A

outer most layer of the true vocal folds

83
Q

length of true vocal folds: males

A

17-20 mm

84
Q

length of true vocal folds: females

A

12-15 mm

85
Q

layers of the true vocal folds

A
  • stratified squamous epithelium
  • lamina propria
  • mucosa
86
Q

stratified squamous epithelium

A
  • thinnest layer
  • gives the vocal folds their pearly-white color
87
Q

lamina propria

A

composed of 3 different layers, each of which has a different tissue structure

88
Q

3 layers of the lamina propria

A
  1. superficial layer/Reinke’s space
  2. intermediate layer
  3. deep/innermost layer
89
Q

superficial layer/Reinke’s space: function

A
  • vibrates most markedly during phonation
  • will become increasingly stiff in the presence of pathologies
90
Q

disorder of the superifical layer of the lamina propria is called

A

Reinke’s edema

91
Q

superficial layer of the lamina propria also has what zone?

A

basement membrane zone

92
Q

basement membrane zone

A
  • series of filaments that connect the outer and middle layer
  • easily injured due to the vibratory and shearing forces of the vocal fold movement
93
Q

intermediate layer of the lamina propria

A

denser and stiffer than the superficial layer

94
Q

deep/innermost layer of the lamina propria

A

denser and stiffer than intermediate layer

95
Q

mucosa of the true vocal folds

A

deep layer demonstrates the least activity of any layer during vocal folds vibration

96
Q

the vocalis muscle __ __ __ delineated from the deep layer of the lamina propria

A

is not clearly

97
Q

purpose of the body-model by Hirano

A

wave of disturbance across the mucosa that travels from medially to laterally

98
Q

structures of the true vocal folds per the body-cover model

A
  1. cover
  2. transition
  3. body
99
Q

cover of the true vocal folds per the body-cover model

A
  • superior ficial layer
  • epithelium
100
Q

transition of the true vocal folds per the body-cover model

A
  • intermediate layer
  • deep layer
101
Q

body of the true vocal folds per the body-cover model

A

thyroarytenoid muscle

102
Q

the true vocal folds as multilayered vibrators

A

each layer is uniquely deformed by the outgoing airstream

103
Q

mucosal wave

A
  • travels across the mucosa from medial to lateral
  • direction of mucosal wave movement
104
Q

ventricular/false vocal folds: location

A

above and to the sides of the true vfs

105
Q

false vfs: structural composition

A

mucous membrane draped over a ligament

106
Q

because of the structural composition, it is difficult to regulate the ___, ___, and ___ of the false vfs

A

mass, length, tension

107
Q

do the ventricular folds typically vibrate during normal phonation?

A

no, they do not vibrate during normal phonation

108
Q

ventricular phonation

A
  • false vfs move toward midline
  • atypical and aberant
  • sign of using a lot of muscle tension
109
Q

is there a space between true and false vfs?

A

yes, there should always be that space

110
Q

cavities of the larynx (superior to inferior)

A
  • aditus
  • vestibule
  • ventricles/laryngeal sinus/ventricles of mogagni
  • glottis/true glottis/rima glottis
111
Q

aditus: location

A

entrance from pharynx to larynx

112
Q

boundaries of the aditus

A

space surrounded by the hyoid bone

113
Q

vestibule is also called

A

laryngopharyx

114
Q

boundaries of the vestibule

A

space extending from the aditus to the top of the ventricular vfs

115
Q

ventricles/laryngeal sinus/ventricles of mogagni: boundaries

A

space between false vfs and true vfs

116
Q

ventricles/laryngeal sinus/ventricles of mogagni contains laryngeal succules which

A

produce and secrete mucous

117
Q

___ is the vfs natural lubricant and is directly related to ___

A

mucous, hydration

118
Q

glottis/true glottis/rima glottis: location

A

space between true vfs

119
Q

glottis is a ___ ___

A

variable sphincter

120
Q

if open the glottis is

A

larger

121
Q

if phonating, the glottis is

A

small

122
Q

2 divisions of the glottis

A
  1. cartilagenous glottis
  2. membranous glottis
123
Q

cartilagenous glottis: size

A

posterior 2/5ths of the glottal space

124
Q

cartilagenous glottis: function during voice production

A

where the cartilagenous portion of the vfs are

125
Q

membranous glottis: size

A

anterior 3/5ths of the glottal space

126
Q

membranous glottis: function during voice production

A

portion bordered by membraneous vfs

Voice and Upper Airways Disorders (19 decks)

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