Quiz 1 Flashcards
Stylohyoid muscle function
Draw hyoid up and back to potentially elevate the larynx
Digastric muscle: anterior belly origin
Lowers border of the mandible
Basement membrane zone
Secures epithelium to Superior Lamina Propria.
Susceptible to injury due to vibration and shearing forces – creates NODULES NOT polyps.
Disease and injury damage connecting links between epithelium and this
Fibronectin
Scar formation found on BMZ and also in nodules
Mucous membrane
COVER
Consists of epithelium and superficial lamina propria like jello with plastic wrap
Vocal ligament
TRANSITION
Consists of Intermediate lamina propria (like a bundle of rubberbands) and Deep lamina propria (like a bundle of cotton threads)
Thyroarytenoid muscle
BODY
Vocalis + Muscularis
Vocal fold layers: Outermost
Epithelium: thin, stiff capsule; part of cover
Vocal fold layers: Second
Superficial lamina propria; Reinke’s space; part of cover
Vocal fold layers: Third
Intermediate lamina propria; part of transition
Digastric muscle: anterior belly insertion
Intermediate tendon
Digastric muscle: anterior belly function
Pulls hyoid anteriorly and superiorly to elevate the larynx; depresses jaw/mandible
Digastric muscle: posterior belly origin
Mastoid process
Digastric muscle: posterior belly insertion
Intermediate tendon
Digastric muscle: posterior belly function
Pulls hyoid anteriorly and superiorly to elevate the larynx; depresses jaw/mandible
Digastric muscle is a _______ suprahyoid muscle.
suprahyoid
Geniohyoid muscle origin
Mental spine/symphysis of mandible
Geniohyoid muscle insertion
Hyoid body
Geniohyoid is a _____ muscle
suprahyoid
Mylohyoid inferior origin
mylohyoid line on inner surface of mandible
Mylohyoid inferior insertion
Midline raphe
Mylohyoid is a _____ muscle
suprahyoid
Geniohyoid and mylohyoid muscles’ functions
pull hyoid anterior and superiorly to potentially elevate larynx
Stylohyoid muscle origin
Stylohyoid process of temporal bone
Stylohyoid muscle insertion
body of hyoid bone
Stylohyoid muscle runs laterally to
posterior belly of digastric muscle
Stylohyoid is a _____ muscle
suprahyoid
Omohyoid muscle (inferior belly) origin
Scapula
Omohyoid muscle (inferior belly) insertion
Intermediate tendon
Omohyoid muscle (superior belly) origin
Intermediate tendon
Omohyoid muscle (superior belly) insertion
Greater horn of hyoid
Omohyoid muscles’ functions
Pull hyoid down and back to potentially lower/depress the larynx
Omohyoid muscles are _________ muscles
infrahyoid
Sternohyoid muscle
muscle that covers the ventral surface of throat
Sternohyoid muscle origin
manubrium of sternum and end of clavicle
Sternohyoid muscle insertion
lower border of hyoid bone
Sternohyoid muscle function
Pull hyoid bone down and lowers larynx
Sternohyoid is a ____________ muscle
infrahyoid
Sternothyroid muscle origin
posterior surface of manubrium and first costal cartilage
Sternothyroid muscle insertion
oblique line of thyroid cartilage
Sternothyroid muscle function
depresses thyroid cartilage and lowers larynx
Thyrohyoid muscle origin
oblique line of thyroid cartilage
Thyrohyoid muscle insertion
hyoid bone
Thyrohyoid muscle function
Elevates larynx OR depresses hyoid
Sternohyoid and thyrohyoid are ____________ muscles
infrahyoid
Intrinsic laryngeal muscle group origin and insertion are on the
larynx
Intrinsic laryngeal muscle group includes:
Posterior cricoarytenoids Lateral cricoarytenoids Arytenoids: transverse and oblique Cricothyroids Thyroarytenoids
Posterior Cricoarytenoid (PCA) origin
posterior surface of cricoid cartilage (lamina)
PCA insertion
muscular process of arytenoid cartilage
PCA function
ONLY abductor of the vocal folds
rocks AC back thus rotating vocal processes away from the midline
PCA innervation
Recurrent Laryngeal branch of CN X
Lateral Cricoarytenoid (LCA) origin
upper border and anterolateral arch of cricoid
Lateral Cricoarytenoid (LCA) insertion
muscular process of arytenoids
Lateral Cricoarytenoid (LCA) function
ADDUCTS vocal processes and adducts membranous portions of vocal folds
Lateral Cricoarytenoid (LCA) innervation
RLN of CN X
Interarytenoids (IAs) Oblique Origin
posterior part of the muscular process of AC
Interarytenoids (IAs) Oblique Insertion
Courses up and across to apex of opposite arytenoid
Interarytenoids (IAs) Transverse Origin
Lateral-posterior aspect of AC
Interarytenoids (IAs) Transverse Insertion
Courses across to opposite AC
Interarytenoids (IAs) Function
Adducts arytenoid cartilages and thus, cartilaginous glottis (posterior glottis)
Cricothyroid muscle (CT) pars oblique Origin
Anterolateral arch of cricoid
Cricothyroid muscle (CT) pars oblique Insertion
Inferior horn of thyroid
Cricothyroid muscle (CT) pars recta Origin
Anterolateral arch of cricoid
Cricothyroid muscle (CT) pars recta Insertion
Courses vertically to lower margin of thyroid
Cricothyroid muscle (CT) functions
Decreases distance between thyroid and cricoid cartilages
Increases distance between thyroid and arytenoid cartilages
Lengthens VFs which increases longitudinal tension of folds = increase in pitch
Cricothyroid muscle (CT) innervation
Superior laryngeal nerve
Thyroarytenoid Muscle (TA): Vocalis and Muscularis Origin
Deep surface of thyroid angle
Thyroarytenoid Muscle (TA): Vocalis and Muscularis Insertion
Lateral/inferior aspect of vocal processes of arytenoids, some fibers attach to muscular process
Thyroarytenoid Muscle (TA): Vocalis and Muscularis Functions
Decrease distance between thyroid and arytenoid cartilages Shortens vocal folds Relaxes cover Tenses body Bulks VFs Aids in adduction Can increase or decrease pitch
Internal branch of superior laryngeal nerve
It is in the Piriform Recess: it monitors sensations from the supraglottic larynx(on the final)
What nerve pierces thyroid membrane?
Internal branch of superior laryngeal nerve
What nerve provides sensory innervation to the larynx above the vocal cords?
Internal branch of superior laryngeal nerve
Is at risk for injury during thyroidectomy due to its proximity to the superior thyroid artery and vein.
This nerve innervates the cricothyroid muscle, which tenses the vocal cords (loss may lead to hoarseness)
Sensory info from surface of inferior pharyngeal constrictors
External branch of superior laryngeal nerve
RLN of Vagus Nerve (X)
Motor innervation to all intrinsic laryngeal muscles (except for CT)
Motor innervation to all intrinsic laryngeal muscles (except for CT)
Right RLN loops around what?
subclavian artery then ascends along side the trachea
Left RLN loops around what?
Left side of aortic branch then ascends along side trachea
RLN enters larynx at inferior cornu of TC, which is the point of
articulation for TC & CC
A continuous sheet of membrane, which connects the thyroid, cricoid, and arytenoid cartilages
Funnel or cone-shaped cavity–hence the name
Conus Elasticus/Cricovocal Membrane
The ____________________adduct the vocal processes and membranous vocal folds, while the ______________________adduct the cartilaginous or posterior glottis.
lateral cricoarytenoids ; interarytenoids
The cricothyroid muscle is responsible for increases in frequency and is innervated by the recurrent laryngeal nerve.
False
When the thyroarytenoid muscles contract they
- shorten the vocal folds
- increase medial compression by bulking the vocal folds
- can increase or decrease frequency
Changes in the composition of the___________can result in a decreased mucosal wave.
epithelium only
The deep layer of the laminia propria is composed of mainly elastin fibers and interstitial fluids.
deep lamina propria ; thyroarytenoid muscle
The superior laryngeal nerve is a branch of cranial nerve ___and provides motor innervation to _______and carries sensory information from the ______________________.
CN X ; the cricothyroid ; supraglottic area
The geniohyoid and mylohyoid muscles are ____________ and function to ______ the hyoid and larynx.
suprahyoid muscles ; elevate
The recurrent laryngeal nerve innervates _________. Injury to the recurrent laryngeal nerve is more common on the ______side.
all laryngeal muscles except cricothyroid ; left
The _________ and _________ muscles have their insertions on the _________ of the ________ cartilage.
posterior cricoarytenoid and lateral cricoarytenoid ; muscular processes ; arytenoid
True or False? Elastic recoil plays an important role in vocal fold closure during vibration.
True
The aerodynamic force that is responsible for opening the vocal folds is _______, while the aerodynamic force which
helps to close the vocal folds is __________ that results from the __________.
subglottal pressure ; negative pressue ; Bernoulli Effect
The Body - Cover Model of Frequency Control states that during high intensity phonation contraction of the TA muscle
will increase pitch as long as the cricothyroid muscle is not at maximum activity
Fundamental frequency of vocal fold vibration depends on
vocal fold length, mass, and elasticity
The convergent glottal shape occurs when the vocal folds are _____ and the net tissue velocity (i.e. movement) is ________.
opening ; outward
In the One Mass Model (Vocal Tract Inertance) of vocal fold vibration, sustained phonation is driven by
alternating positive and negative supraglottic and transglottic (intraglottic) pressures
A vocal register is
a series of pitches perceived to be of the same timbre or quality
a series of pitches produced in the same physiological manner
Vocal quality (i.e. roughness, breathiness etc.) is determined by
degree of glottic closure and periodicity of VF vibration
True or false? The mucosal wave is an apparent sliding motion of the vocal fold cover over the vocal fold body.
True
In order to produce high vocal intensity (loud phonation)
- the vocal folds must adduct completely
- the closed phase of vibration must be longer than the open phase
- respiratory drive must be adequate and subglottal pressure relatively high
- the vocal folds must close rapidly
Organic Voice Disorders: Name the diseases.
- Contact ulcers & Granulomas
- Infectious laryngitis
- Gastroesophageal reflux and
laryngealpharyngeal reflux - Vocal fold papilloma
- Candida
- Leukoplakia and Hyperkeratosis
- Sulcus Vocalis
- Laryngeal Cancer
Organic Voice Disorders: Name congenital and trauma
- Laryngeal web
- Laryngeal Cleft
- Subglottic stenosis
- Laryngomalacia
- CA joint Ankylosis
Contact Ulcers and Granulomas: What are the 3 typical causes?
- GERD or LPR
- Phonotrauma
- Intubation trauma
Which disease?
- Form on the medial aspect of the posterior third of the vocal folds (cartilaginous portion)
- Granulomas are comprised of lymphocytes and fibrotic connective tissue
- Usually unilateral but can be bilateral
- Variable glottic closure – complete to incomplete
- Mucosal wave may be decreased
Contact Ulcers and Granulomas
This is a description of what disease?
Excessive medial compression of posterior glottis during low pitched phonation, hard glottal attacks, increased loudness, throat clearing and coughing
Phonotrauma
This is a description of what disease?
Affects of stomach acid and enzymes on VF tissue. Signs are heartburn, chronic hoarseness worse in a.m., nocturnal coughing, excessive mucous, belching, sour/acid taste, burning in throat
GERD/LPR
This is a description of what disease?
Trauma to VFs from prolonged intubation due to endotracheal tube rubbing VFs
Intubation