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Voice Disorders Dr. Cho > VD Quiz One - Chapter Two > Flashcards

VD Quiz One - Chapter Two Flashcards

1
Q

List the 4 elements of voice.

A
  1. Pitch
  2. Loudness
  3. Quality
  4. Flexibilty
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2
Q

Describe “pitch.”

A

Frequency - average and range

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3
Q

Describe “loudness.”

A

The intensity of voice measured in dB

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4
Q

Describe “quality.”

A

“How” it sounds - harsh, breathy, flat

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5
Q

Describe “flexibility.”

A

A combo of frequency, intensity, rate and prosody.

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6
Q

List 3 “processes” of voice production.

A
  1. respiration
  2. phonation
  3. resonance
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7
Q

Are the 3 “processes” of voice production intra-dependent or inter-dependent?

A

Respiration, phonation, and resonance are inter-dependent.

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8
Q

What does interdependent mean?

A

dependent on each other

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9
Q

Are the 3 “processes” of voice production changing constantly or do they remain the same?

A

Respiration, phonation, and resonance are constantly changing at the same time (simultaneously).

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10
Q

List the 3 structure of respiration.

A
  1. Bony thorax
  2. Muscles of respiration
  3. Tracheobronchial tree
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11
Q

What are 2 types of muscles of respiration?

A
  1. inspiratory muscles

2. expiratory muscles

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12
Q

What does the bony thorax consist of?

A
  1. vertebrae and vertebral column
  2. thoracic cage (ribs and sternum, and associated muscles
  3. pectoral girdle
  4. pelvic girdle
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13
Q

List 3 parts of the thoracic cage?

A
  1. ribs
  2. sternum
  3. associated muscles
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14
Q

List 5 divisions of the vertebrae.

A
  1. cervical
  2. thoracic
  3. lumbar
  4. sacrum
  5. coccyx
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15
Q

How many segments of bone is the vertebrae composed of?

A

33 bone segments

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16
Q

C1

A

base of the nose and the hard palate

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17
Q

C2

A

teeth (when the mouth remains closed)

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18
Q

C3

A

Mandible and hyoid bone

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19
Q

C4-C5

A

thyroid cartilage

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20
Q

C6-C7

A

cricoid cartilage

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21
Q

How many total ribs are in the rib cage?

A

12 ribs total

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22
Q

How many true ribs are in the rib cage?

A

7 true ribs

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23
Q

How many false ribs are in the rib cage?

A

3 false ribs

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24
Q

How many floating ribs are in the rib cage?

A

2 floating ribs

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25
Q

Describe direction of the rib cage.

A

Rib cage slants down in front

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26
Q

What is the basis for respiration?

A

The rib cage having some ability to move.

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27
Q

What is the chondral of the rib cage?

A

The cartilaginous portion of the rib

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28
Q

What do the elastic properties of cartilage allow for the rib cage?

A

It allows the ribs to move without breaking.

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29
Q

What does inhalation do to the thoracic cavity?

A

it makes the thoracic cavity increase

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30
Q

What does exhalation do to the thoracic cavity?

A

it decreases the thoracic cavity

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31
Q

What dimension is the diaphragm muscle responsible for?

A

the vertical dimension

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32
Q

What dimension is increased by raising the ribs?

A

the transverse dimension

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33
Q

What dimension is increased by upward movement of the ribs

A

the anterior-posterior dimension

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34
Q

The bony thorax is the home of what 2 pieces of anatomy?

A

the heart and lungs

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35
Q

What is the structural support for respiration?

A
  1. vertebral column
  2. 12 ribs
  3. pectoral girdle
  4. sternum
  5. pelvic girdle
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36
Q

What 2 parts are in the pecoral girdle?

A
  1. scapula

2. clavicle

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37
Q

What 4 parts are in the pelvic girdle?

A
  1. ischium
  2. pubic bone
  3. sacrum
  4. ilium
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38
Q

What are the 3 major categories of respiration?

A
  1. the muscles of the rib cage
  2. the diaphragm
  3. the muscles of the abdominal wall
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39
Q

What does the action of the respiratory muscles change?

A

the dimensions of the thoracic cavity

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40
Q

What happens as a result of the thoracic cavity dimensions changing?

A

the pressure changes within the thoracic cavity

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41
Q

What do the resulting changes of pressure in the thoracic cavity result in?

A

inspiratory-expiratory cycle

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42
Q

Where can the inspiratory muscles be found?

A

within the thorax, back , neck, and upper limbs

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43
Q

List the 2 types of primary inspiratory muscles.

A
  1. diaphragm

2. external intercostal muscles

44
Q

What are the primary inspiratory muscles assisted by?

A

accessory muscles in the neck, back, and upper limbs

45
Q

Where can the expiratory muscles be found?

A

within the thorax, back, upper limbs, and abdomen

46
Q

What does the expiratory muscles include?

A
  1. internal intercostal muscles

2. abdominal muscles

47
Q

Expiratory muscles are associated with what kind of expiration?

A

active experation

48
Q

What 2 kinds of forces are in the respiratory cycle?

A
  1. active

2. passive

49
Q

When is voice normally produced?

A

during exhalation

50
Q

Mostly, what kind of process is exhalation?

A

a passive process

51
Q

What happens if passive exhalation is not enough for a situation?

A

then we use the abdominal muscles

52
Q

The use of abdominal muscles is considered more of what kind of process?

A

an active process

53
Q

What can much of the power required for normal speech be supplied by?

A

the passive forces of respiration

54
Q

Passive forces of respiration is also known as….

A

passive exhalation

55
Q

Passive forces of respiration (passive exhalation) include…..

A
  1. the natural recoil of muscles, cartilages, ligaments and lung tissue
  2. the surface tension of a special film that lines the alveoli
  3. the pull of gravity
56
Q

Passive forces of respiration (passive exhalation) reduces….

A

the size of the thorax during expiration

57
Q

Describe 2 ways in which forces of respiration reduce the size of the thorax during expiration.

A
  1. in a manner analogous to the recoil of a stretched spring

2. contribute to outward airflow of the lungs, which may be used in speech

58
Q

How can the mechanism of passive force be understood?

A

By examining the concept of relaxation pressure.

59
Q

What does the relaxation pressure curve reflect?

A

Pressures generated by the passive forces of the respiratory system.

60
Q

The relaxation pressure curve is a measure of what?

A

Restoring forces

61
Q

Vocal quality is affected by high or low what and what?

A
  • High or low air pressure

- High or low lung volume

62
Q

According to the relaxation pressure curve, when is the most efficient and most pleasing voice produced?

A

At mid-air pressure levels and mid-lung volume levels of air.

63
Q

During active force respiration, additional power required for normal speech can be supplied by what?

A

active forces of respiration (active exhalation)

64
Q

Three forces of active exhalation include….

A
  1. the strength of muscles within the chest wall
  2. their patterns of movement
  3. the amount of air contained in the lungs
65
Q

When breath support or breath control is a problem in a voice disordered patient, it is often related to what or what?

A
  1. failure to take breaths at appropriate places

2. the tendency to push too hard and results in a strained vocal quality

66
Q

Changes in general pulmonary functioning with aging become measurable at around what age?

A

40 years of age

67
Q

List 4 changes that occur in general pulmonary functioning around 40 years of age.

A
  1. increased stiffness of respiratory structures
  2. muscle weakness, muscle atrophy, and increased fibrotic content of muscle
  3. degeneration of nerve fibers and sensory receptors
  4. less efficient gas exchange
68
Q

What 2 factors should be considered when comparing life breathing vs. speech breathing.

A
  1. ratio of inhalation and exhalation
  2. lung volume
    (might need to know these ratios, ask Jordan)
69
Q

What kind of anatomy is in the phonatory system.

A

laryngeal anatomy

70
Q

What does structure determine in the laryngeal anatomy?

A

structure determines function

71
Q

What does the structure of the laryngeal anatomy say about its function.

A

If it is normal or disordered

72
Q

What would be a clue for abnormal function in the laryngeal anatomy?

A

structural abnormalities

73
Q

Where do the vocal folds lie?

A

Between the arytenoid and thyroid cartilages

74
Q

What is the space between the vocal folds called?

A

glottis

75
Q

What is above and below the vocal folds?

A

Above: supraglottal
Below: subglottal

76
Q

Which directions do the vocal folds stretch?

A

anteriorly and postiorly

77
Q

Is there more than one layer of tissue in the vocal folds?

A

yes, several layers of tissue

78
Q

What does it mean for laryngeal muscles to be intrinsic?

A

both points of attachment on laryngeal structures

79
Q

List 3 intrinsic laryngeal muscles adductors.

A
  1. lateral cricoarytenoid
  2. transverse (inter) arytenoid
  3. oblique arytenoid
80
Q

Name the one intrinsic laryngeal muscle abductor.

A

posterior cricoarytenoid

81
Q

What makes a laryngeal muscle extrinsic?

A

consist of muscles with one attachment to laryngeal cartilage

82
Q

How do the extrinsic muscles in the larynx make major adjustments to the larynx?

A

By elevating or depressing the larynx

83
Q

What other structure does the extrinsic muscles work together with? What motions are the extrinsic muscles cooperating with in order to coordinate with this other structure?

A

The extrinsic laryngeal muscles work together with the articulatory motions of the tongue.

84
Q

Many extrinsic laryngeal muscles are important for what?

A

swallowing

85
Q

List the 4 laryngeal elevators. What do they elevate?

A
  1. hypoglossus
  2. digastric
  3. stylohyoid
  4. mylohyoid

They elevate the larynx and the hyoid.

86
Q

List the 3 laryngeal depressors. What do they depress?

A
  1. omohyoid
  2. sternohyoid
  3. sternothryroid

They depress the larynx and the hyoid

87
Q

Vagus nerve (CN X) provides what to the larynx?

A

sensory and motor innervation

88
Q

On each side of the neck, the Vagus nerve (CN X) branches into what 3 parts?

A
  1. pharyngeal nerve
  2. superior laryngeal nerve (SLN)
  3. recurrent laryngeal nerve (RLN)
89
Q

What does the pharyngeal nerve innervate?

A
  • the pharynx

- most of the velum/soft palate

90
Q

Where does the superior laryngeal nerve emerge?

A

high in the neck from the main trunk of the vagus nerve

91
Q

Where does the superior laryngeal nerve descend?

A

into the neck adjacent to the pharynx

92
Q

The superior laryngeal nerve branches into what 2 part?

A
  1. internal laryngeal branch

2. external laryngeal branch

93
Q

Where does the internal laryngeal branch insert?

A

into the thyrohyoid membrane on each side

94
Q

Where does the internal laryngeal branch innervate?

A

it innervates the epiglottis, base of the tongue, and aryepiglottic folds

95
Q

Where does the external laryngeal branch insert?

A

inserts into the cicothyroid muscle on each side of the larynx

96
Q

Where does the external laryngel branch provide motor innervation?

A

to the cricothyroid muscle

97
Q

Where does the recurrent laryngeal nerve branch from?

A

the main trunk of CNX (much lower in the neck than the SLN)

98
Q

Why is the recurrent laryngeal nerve known as recurrent?

A

for its circuitous route

99
Q

Describe the route of the of the recurrent laryngeal nerve.

A

It descends into the thorax before rising up between the trachea and esophagus to reach the neck

100
Q

The recurrent laryngeal nerve provides motor innervation to all of the intrinsic laryngeal muscles except for which muscle?

A

the cricothyroid muscle

101
Q

List the 4 muscles that the recurrent laryngeal nerve provides motor innervation to:

A
  1. thyroarytenoid muslce (TA)
  2. posterior cricoarytenoid (PCA)
  3. lateral cricoarytenoid muscle (LCA)
  4. interarytenoid muscles (IA)
102
Q

Depending upon the site of lesion, trauma to the RLN may result in what or what?

A

unilateral or bilateral paralysis

103
Q

The most common type of trauma to the RLN is a result of what? Why is this?

A

surgery to the thyroid gland because the RLN courses just posterior to the thyroid gland

104
Q

What happens if trauma to the RLN occurs because the thyroarytenoid muscle is damaged?

A

there will be weakness in vocal fold approximation and adduction

105
Q

What happens if trauma to the RLN occurs because the posterior cricoarytenoid muscle is damaged?

A

an inability to abduct volcal folds on the side with the lesion

106
Q

What happens if trauma to the RLN occurs because the lateral cricoarytenoid is damaged?

A

vocal fold paralysis in the fixed, abducted, paramedian position

Voice Disorders Dr. Cho (9 decks)

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