midterm Flashcards
What are the various functions of the larynx?
Describe them
EMOTIONAL:The larynx allows us to convey moods/emotional states, intentional or unintentional
BIOLOGICAL: larynx prevents fluids and food from being aspirated in to trachea
LINGUISTIC: larynx allows us to produce vocal stress [atterns or suprasegmental qualities that enhance the meaning of our utterances
SCHOOL-AGED CHILDREN
What is estimate of the prevalence of voice disorder?
prevalence rate of 6% to 9% suggests that there are between 4.5 & 6.6 million children w/ voice disorder
YOUNG ADULTS
What is estimate of the prevalence of voice disorder?
14,794 young adults aged 24-34 years, 6% experienced a voice disorder
65+
What is estimate of the prevalence of voice disorder?
-true prevalence unknown
-20%-30% completing survey about voice currently have voice disorder; lack QoL
- adults 70yrs+ were 2 1/2 times more likely to get VD
TEACHERS
What is estimate of the prevalence of voice disorder?
prevalence of VD in U.S. tchrs
4% - 57% or higher
FUTURE SLPs
What is estimate of the prevalence of voice disorder?
prevalence of VD in 104 US student SLPs (94% woman)
- 12% had features of dysphonia
-Higher prevalence rate than that of the general population of students
describe passive forces of respiratory cycle
-we let elastic forces retire the system to a resting position after inspiration
- Forces include: muscles, cartilages, ligaments, lung tissue, the surface tension of film that lines the alveoli and pull of gravity
-diaphragm: relaxes and rises
-reduce thorax size during expiration
describe active forces of respiratory cycle
-we use muscular effort to push just a little farther
-forces includes: muscle strength within chest wall, their patterns of movement, & amount of air contained in the lungs
-Abdominal Muscles contract: internal oblique, external oblique, transverse oblique, rectus abdominal
-inspiration
What is vocal pitch
-VP: perceptual attribute that is correlated with the frequency (rate) of vocal fold vibration
What is vocal loudness
perceptual attribute that is correlated with the intensity of the sound wave generated during phonation
Why should we be concerned about reflex? (GERD, LPRD)
-laryngeal exam findings: posterior glottal redness, ulcers, pharyngeal irritation, arytenoid hyperplasia w/ granuloma
-upper airway conditions: stridor, paradoxical VF movement, chronic nasal irritation, chronic cough and dysphonia
What is the mechanism of resonance?
-ORAL CAVITY essential for resonance as the pharynx due to moving structures (mandible)
-TONGUE most mobile articulator, possesses both extrinsic and intrinsic muscles to move it
-structural adequacy & normal functioning of the VELUM (tensing/elevating) important for development of normal resonance
What is hyper nasality?
excessive undesirable amount of nasal cavity resonance during the phonation of normally non nasal vowels and non nasal voice consonants
What is hypo nasality?
-reduced/ lack of nasal resonance for the 3 normally nasalized English phonemes /m/, /n/, and /ŋ/
-result of anatomical obstruction in nasal cavity
Why are vocal nodules located at the anterior one-third and posterior two-thirds of the vocal folds?
- because this is the point of maximum excursion of the membranous VF portion
Why is difficult to distinguish between function and organic voice disorder
traditional medical distinction between organic/function is misleading because vocal misuse/abuse (functional) can lead to a pathology of vocal nodules (organic) & vice versa
What is glottal fry?
-creaky voice
-normal voice register
-larynx vibrates different ways to adjust airflow
-frequency ranges from 35-90 Hz for both males/female
-average airflow rate- 12-20 cc
What is Glottal Fry technique
-shortens & relaxes thyroarytenoids
-produce on a vowel (i)
-resonance applies
-no linguistic features
-the focus is on the intrinsic
muscles
-lowest vocal fold vibration
-nodules are least reduced
valuable for pt’s w/:
vocal nodules
polyps,
cord thickening,
functional dysphonia,
spasmodic dysphonia
ventricular phonation
How do we change pitch?
we change pitch
1. LENGTH of vocal fold
2. TENSION of VF
3. MASS of VF per unit of length
How do we change vocal loudness?
Vocal loudness is changed by
1. sub glottal pressure
2. medial compression of the CF
3. duration, speed, & degree of VF closure
What are the intrinsic laryngeal muscles?
- Posterior Cricoarytenoid (PCA)
- Lateral Cricoarytenoid (LCA)
- Interarytenoid (IA)
- Thyroarytenoid (TA)
- Cricothyroid (CT)
What is the Innervation and Function of
POSTERIOR CRICOARYTENOID (PCA)
IN: Recurrent laryngeal nerve (CNX)
FU: Abducts the VF
What is the Innervation and Function of
LATERAL CRICOARYTENOID (LCA)
IN: Anterior branches of recurrent laryngeal nerve (CNX)
FU: Adducts the VF/closes membranous glottis
What is the Innervation and Function of
INTERARYTENOID (IA)
IN: Internal branch of the superior laryngeal nerve
FU: Composed of 2 muscle bundles
1.transverse arytenoid (unpaired)
2. Oblique arytenoid (paired)
Both assist in adduction and medial compression
What is the Innervation and Function of
CRICOTHYROID (CT)
IN: superior laryngeal nerve
FU: Vocal Folds
1. Length increases
2. Tension increases
3. mass per unit of length decreases
4. muscle involved in pitch change
lowers, elongates, and thins the VF
The intrinsic laryngeal muscle responsible for abducting the vocal folds is the …
posterior cricoarytenoid
The ___________ branch of Cranial Nerve _______ innervates thyroid arytenoid muscles
- recurrent laryngeal nerve
- X (vagus)
how do VF nodules develop?
-Acute or chronic stress applied to the vocal folds
-High subglottal pressure (i.e., yelling, from Lab1)
-Hyperadduction of the vocal folds
-Vocal fold lengthening (using a pitch higher than a habitual pitch)
-Dehydration of the vocal folds
-Inflammatory or infectious condition onset
-Edematous; unilateral → fibrous; bilateral
What is the Innervation and Function of
THYROIDARYTENOID (TA)
IN: Recurrent Laryngeal Nerve
FU:
1.vocalis
-Tenses vocal folds
2.muscularis
-Relaxes and adducts vocal folds
What are the 10 communication style measures or
ratings for targeting gender speech-voice presentation
- Altered lexicon
- Breathiness
- Facial expression
- Gesture
- Intonation
- Pitch
- Pitch flexibility
- Rate
- Volume and loudness
- Vowel prolongation
