Lesson 3 Flashcards
Phonation
- a product of vibrating vocal folds
- AKA voicing
hyoid bone
- location: level of 3rd cervical vertibrae
- STRUCTURES:
1. body
2. greater corni
3. lesser cornu - very mobile
- doesnt connect to any other bone in body
greater cornu
articulates with the superior horns (cornu) of thyroid cartilage
lesser cornu
cone shape
rise superiorly
larynx - FUNCTION
- protects lower passageway from foreign materials
- can be used to hold air in lungs
- generates sounds
what are the laryngeal cartilages?
- thyroid cartilage
- cricoid cartilage
- arytenoid cartilage
- corniculate cartilages
- cuneiform cartilage
- epiglottic cartilage
TACCCE
thyroid cartilage
laryngeal cartilage
- largest laryngeal cartilage
- articulates inferiorly with cricoid cartilage
- STRUCTURES:
1. thyroid laminae
2. thyroid angle
3. thyroid notch
4. thyroid prominance
5. cornu
thyroid laminae (thyroid cartilage structure)
aka quadrilateral plates (square shape)
thyroid angle (thyroid cartilage structure)
point at which the 2 thyroid laminae come together
thyroid notch (thyroid cartilage structure)
superior point of thyroid angle
thyroid prominence (thyroid cartilage structure)
adams apple (sticks out)
cornu
thyroid cartilage structure
- located on the posterior portion of thyroid
- 2 sets:
1. superior- points towards hyoid bone
2. inferior- rest on cricoid cartilage
cricoid cartilage
laryngeal cartilage
- most inferior cartilage of larynx
- unpaired, ring shaped
- STRUCTURES
1. arch
2. posterior quadrate lamina
arch
cricoid cartilage structure
- low narrow portion front
- provides clearance for the vocal folds
posterior quadrate lamina
cricoid cartilage structure
- wide and thick portion back
- provides point of articulation for arytenoid cartilages
arytenoid cartilages
laryngeal cartilage
- location: superior surface of cricoid cartilage
- allows for rocking gliding and rotating (important for onset and offset voicing)
- STRUCTURES: pyramidal shape
1. base
2. apex
3. vocal process
4. muscular process
vocal process
arytenoid cartilage
- projects anteriorly toward the thyroid notch
- location of vocal fold attachment
muscular process
arytenoid cartilage
- projects laterally on arytenoid
- point where muscles adduct and abduct vocal folds (open close vocal folds)
corniculate cartilage
laryngeal cartilage
- small horn shaped, extension of arytenoids
- supports aryepiglottic fold
cuneiform cartilages
laryngeal cartilage
- small cartilages embedded within the aryepiglottic fold
- anterior to corniculate cartilages
- provide support for laryngeal covering
epiglottic cartilage [epiglottis]
laryngeal cartilage
- leaf like structure
- stem arises from inner surface of thyroid angle,below notch
- attaches by means of thyroepiglottic ligament
- protects airway by deflecting food and liquids from being swallowed
- epiglottis attaches to hyoid bone via epiglottic lig
- surface of epiglottis is covered w/ mucous membrane lining
what are the laryngeal joints?
- cricothyroid joint
2. cricoarytenoid joint
cricothyroid joint (laryngeal joint)
- synovial (diarthrodial) joint that allows thryoid to tilt downard.
- stretches and tenses vocal folds
- joint provides major adjustments for chagne in vocal pitch
cricoarytenoid joint (laryngeal joint)
- saddle joint
- concave portion of arytenoids articulates with convex portion of cricoid lamina
- synovial joint allows for rocking, gliding, and minimal rotation
- involved in adduction and abduction of vocal folds
EXTRINSIC laryngeal membranes and ligaments
- group of ligaments and membranes that connect the cartilages of larynx to each other and to the hyoid bone and trachea
- structures:
1. thyroid membrane
2. hyoepiglottic ligament
3. thyroepiglottic ligament
4. cricotracheal membrane
thyroid membrane
extrinsic laryngeal membranes and ligaments
- hyothyroid
- connects hyoid bone to thyroid cartilage
hyoepiglottic ligament
extrinsic laryngeal membranes and ligaments
connects epiglottis to the hyoid bone
thyroepiglottic ligament
extrinsic laryngeal membranes and ligaments
connects epiglottis to thyroid
cricotracheal membrane
extrinsic laryngeal membranes and ligaments
connects cricoid cartilage to the first tracheal ring
INTRINSIC laryngeal membranes and ligaments
- continuous sheet of connective tissue *elastic membrane
- quadrangular membranes (upper portion)
- conus elasticus (lower portion)
aryepiglottic folds
quadrangular membrane
- completley seal off spaces in laryngeal structures
- directs the airstream into the aditus and upward into the resonatory passagways
- first line of defense against foreign objects
- closes during swallowing and vomiting/ prevents food/liquid from entering respiratory tracts
ventricular folds
quadrangular membrane
- aka false vocal folds
- pink and plump
- found between laryngeal vestibule & laryngeal ventricle
- when ventricular folds contract, they meet at midline, closing or sealing off airway
- close during swallowing, during effortful activites such as lifting heavy objects
conus elasticus (intrinsic laryngeal membranes and ligaments)
- lower portion
- vocal folds
- cricothyroid ligament
vocal folds
conus elasticus
- white cus of lack of vascular supply
- third line of defense in keeping foreign objects out of lungs
cricothyroid ligament
conus elasticus
connects cricoid cartilage to thyroid cartilage
What are the cavities and spaces of the larynx ? (6)
- laryngeal vestibule
- laryngeal ventricle
- inferior laryngeal ventricle
- valleculae
- pyriform sinus
- glottis
laryngeal vestibule
cavities and spaces of the larynx
- area in larynx above ventricular folds
- opening in called aditus
laryngeal ventricle
cavities and spaces of the larynx
space between vocal folds and ventricular folds
inferior laryngeal ventricle
cavities and spaces of the larynx
- portion below the true folds
- extend through to the trachea
valleculae
cavities and spaces of the larynx
- area between tongue root and epiglottis
- impaired swallow can cause food/liquid to pool in valleculae which increases risk for aspiration
pyriform sinus
cavities and spaces of the larynx
- between lateral wall of thyroid cartilage & aryepiglotic folds
- impaired swallow can cause food/liquid to pool in pyriform sinus which increases risk for aspiration
glottis
cavities and spaces of the larynx
- opening between vocal folds
- triangular shape during quiet respiration
- anterior commissure: anterior most region of glottis
- posterior commissure: posterior most region of glottis
what are layers of the vocal folds
- cover
- transition/vocal ligament
- body
cover
layers of the vocal folds
- epithelium
- superficial lamina propria (aka reinke’s space)
epithelium
cover layer of vocal fold
- mucosal covering of stratified squamous cells
- needs a thin layer of mucous lubrication for best oscillation
superficial lamina propria
cover layer of vocal fold
- extracellular gelatin matrix
- helps cushion the vocal folds
transition/ voice ligament
layer of vocal fold
- intermediate lamina propria
- deep lamina propria
intermediate lamina propria
transition/ voice ligament layer of vocal fold
- compose of elastic fibers
- part of vocal ligament
deep lamina propria
transition/ voice ligament layer of vocal fold
- collagen fibers
- supportive
- part of vocal ligament
body
layer of vocal fold
vocalis muscle (thyroidarytenoid)
- thyrovocalis + thyromuscularis
- provides tone, stability & mass
laryngeal musculature - FUNCTION
- regulate valve openings and closings
1. epiglottic valve
2. ventricular fold valve
3. vocal fold valve - provide movement of laryngeal cartilage for speech
INTRINSIC MUSCLES (laryngeal musculature)
- have both origin and insertion w/in larynx
- make fine adjustments
1. ADDUCTOR
2. ABDUCTOR
3. TENSORS
4. RELAXER
Adductor
intrinsic muscles-laryngeal
- bring together
- lateral cricoarytenoid
- transverse arytenoid
- oblique arytenoid
lateral cricoarytenoid (adductor intrinsic muscle)
- attaches: lateral surface of cricoid to arytenoid muscular process
- action: adducts vocal folds
transverse arytenoid (adductor intrinsic muscle)
- only unpaired intrinsic muscle
- attaches: arytenoid to arytenoid
- action: adducts vocal folds
oblique arytenoid (adductor intrinsic muscle)
- attaches: base of one arytenoid upward and across to apex of the other forming an X
- action: adducts vocal folds (how tightly VF are pressed against each other) rocks arytenoid and VF down and inward
abductor
intrinsic muscle- laryngeal
- pull apart
- posterior cricoarytenoid
posterior cricoarytenoid (abductor intrinsic muscle)
- attaches: posterior wall of cricoid cartilage to arytenoid
- action: abducts vocal folds
tensors
intrinsic muscle- laryngeal
- tighten muscles
- cricothyroid
- thyrovocalis
cricothyroid
tensor intrinsic muscle
- primary tensor of vocal folds
- responsible for laryngeal adjustments associated with pitch change
- PARS RECTA
- PARS OBLIQUE
pars recta
cricothyroid tensor
attaches: cricoid to inferior border of the thyroid lamina
action: rotates thyroid cartilage downward
pars oblique
cricothyroid tensor
attaches: cricoid to inferior cornu of the thyroid
action: rotates thyroid cartilage downward, stretch vocal folds
thyrovocalis
tensor intrinsic muscle
- part of thyroarytenoid
- body of vocal folds
- attaches: anterior commissue of thyroid to vocalprocess
- action:tenses vocal folds
relaxer
intrinsic muscle- laryngeal
- relax muscles
- thyromuscularis
thyromuscularis
relaxer tensor
- part of thyroarytenoid
- body of vocal folds
- attachments: anterior commissure of thyroid to muscular process
- action:shorten and relax vocal folds
EXTRINSIC MUSCLES (laryngeal musculature)
- one attachment to the larynxx and other attachment on a structure outside the larynx
- forms network that surrounds the larynx & anchors it in portion withing the neck
- makes major adjustments to larynx
- elevating
- depressing
- hyoid and laryngeal elevators
- hyoid and laryngeal depressors
what are the hyoid and laryngeal elevators?
extrinsic muscles
- diagastricus
- stylohyoid musle
- mylohyoid muscle
- geniohyoid muscle
- genioglossus muscle
- hyoglossus muscle
ANTERIOR Digastricus
hyoid and laryngeal elevators
attaches: mandible to hyoid
function: elevates hyoid anteriorly
POSTERIOR Digastricus
hyoid and laryngeal elevators
attaches: mastoid process of temporal bone to hyoid
function: elevates hyoid posteriorly
stylohyoid muscle
hyoid and laryngeal elevators
attaches: styloid process of temporal bone to hyoid
action: elevates hyoid posteriorly
mylohyoid muscle
hyoid and laryngeal elevators
- makes up floor of oral cavity
- attaches: mandible to hyoid
- action: elevates hyoid anteriorly
geniohyoid muscle
hyoid and laryngeal elevators
- attaches: mandible to hyoid
- action: elevates hyoid anteriorly
hyoglossus muscle
hyoid and laryngeal elevators
attaches: sides of tongue to hyoid
action: elevates hyoid and depresses tongue
what are the hyoid and laryngeal depressors?
extrinsic muscles
- sternohyoid muscle
- omohyoid muscle
- sternothyroid muscle
- thyrohyoid muscle
sternohyoid muscle
hyoid and laryngeal depressors
attaches: sternum to hyoid
action: depresses hyoid
omohyoid muscle
hyoid and laryngeal depressors
attaches: scapula to hyoid
action: depresses hyoid
sternothyroid muscle
hyoid and laryngeal depressors
- assist on producing high & low pitch
- helps make fine adjustments to vocal folds
- attaches: sternum to thyroid
- action depresses thyroid cartilage
thyrohyoid muscle
hyoid and laryngeal depressors
attaches: thyroid to hyoid
action: depresses hyoid or elevates larynx
vocal fold vibration
-vibration of vocal folds is NOTTTTT the product if repeated adduction and abduction of the vocal folds
-Myoelastic- Aerodynamic Theory of Phonation
(myo= muscle)
myoelastic
Myoelastic- Aerodynamic Theory of Phonation
elasticity
stiffness
inertia
elasticity
myoelastic
- returns to original shape after being displaced
- VF are muscles covered by delicate membranes
- this soft tissue allows them to move when sufficient force is exerted
stiffness
myoelastic
-strength of material that restores it to original shape
inertia
myoelastic
-a body in motion tends to stay in motion
bernoulli’s principle (aerodynamic)
- there will be an increase in velocity of airflow at a point of constriction
- & a decrease in air pressure perpendicular to the flow
What are the Laryngeal functions?
- attack
- sustain phonation
- termination
attack
laryngeal function
adduct vocal folds to initiate phonation
sustain phonation (laryngeal function)
maintain laryngeal posture, ongoing airflow maintains the vibration
termination
laryngeal function
abduct vocal folds to stop phonation
frequency
- rate of vibration of an object
- measured in cycles per second
pitch
- perception of sounds frequency
- vibration rate related to vocal fold
1. thickness (mass),
2. length
3. elasticity - higher /lower pitch
higher pitch
- faster the vibration (higher the frequency) the higher the sounds will be perceived
- contraction of cricothyroid muscles lengthens vocal folds and thins medial edge
lower pitch
- slower the vibration (the lower the frequency) the lower the sound will be perceived
- contraction of thyromascularis
1. brings thyroid cartilage & arytenoids closer together
2. shortens vocal fold length making them more massive & less tense
amplitude
amount of displacement of an object from its rest position
loudness
- perception of sounds amplitude
- increase loudness
increase loudness
- the greater the amplitude the louder is the sound that is heard and vice versa
- increase medial compression of Vocal Folds
1. VF press together more tightly
2. VF press together for a more longer period of time
what are normal voice qualities?
- maximum frequency range
- minimum-maximum amplitude
- maximum phonation time
- minimal additive noise
maximum frequency range
normal voice quality
-voice is flexible in pitch during conversation
minimum-maximum amplitude
normal voice quality
-voice is able to vary loudness
maximum phonation time
normal voice quality
- measured by the longest period of time that an individual can sustain a vowel on one breath
- > adults:15-25 seconds
- > children:at least 10
- coordinated air flow w/vocal fold adduction
minimal additive noise
normal voice quality
minimal breathiness or roughness
what are abnormal voice qualities?
- dysphonia
- breathiness
- rough/hoarse voice
dysphonia
abnormal voice quality
generic term for any voice that sounds deviant in terms of quality,pitch & loudness
breathiness
abnormal voice quality
- vocal folds dont close completely during each vibratory cycle
- air leakage at the glottis creates a friction noise
- breathy noise is measured at the higher frequencies
rough/hoarse voice
- excessive vocal fold closure during phonation
- vocal folds vibrate in a less periodic cycle
- rough/hoarse noise is measured at lower frequencies
what are the vocal fold disorders?
- laryngitis
- vocal nodules
- vocal polyps
- vocal fold paralysis
laryngitis
vocal fold disorder
- inflammation of vocal folds
- caused by excessive use of the voice, infections, inhaled irritants or reflux
vocal nodules
vocal fold disorder
- noncancercous growths on vocal cords
- most often caused by vocal abuse
vocal polyps
vocal fold disorder
soft noncancerous growth, similar to a blister
vocal fold paralysis
vocal fold disorder
- one or both vocal fold doesn’t open or close
- caused by:
- > injury
- > problem in surgery
- > stroke
- > cancer
- > neurological disorder
what are the facilitative and aversive activites of the vocal folds?
- whisper
- yawning
- coughing
- throat clearing
- laughing
- crying
relaxed whisper
facilitative and aversive activites of the vocal folds
- less stressful to vocal folds
- more open and softer
forced whisper
facilitative and aversive activites of the vocal folds
- strong, funneled air stream
- stiffened folds
- turbulence just about glottis
yawning
facilitative and aversive activites of the vocal folds
facilitates relaxation of vocal tract musculature
coughing
facilitative and aversive activites of the vocal folds
- airway protection
- encourage adduction of vocal folds
- prolonged cough abusive to vocal folds
throat clearing
facilitative and aversive activites of the vocal folds
- can help remove irritants
- entire larynx goes into stressful movements
- > encourage very soft and breathy clearing
- > loud or frequent- abusive to vocal folds
laughing
facilitative and aversive activites of the vocal folds
- laryngeal musculature are reflexively relaxed
- can help generate efficient vocal physiology in voice therapy
- can cause excessive laryngeal pressure and stress if done too loudly or excessively
open- relaxed cry
facilitative and aversive activites of the vocal folds
enriched resonane between the vocal folds and the supraglottic resonating spaces
tight- loud or excessive crying
facilitative and aversive activites of the vocal folds
laryngeal and supraglottic musculature are tensed
