VD Quiz One - Chapter Two Flashcards
List the 4 elements of voice.
- Pitch
- Loudness
- Quality
- Flexibilty
Describe “pitch.”
Frequency - average and range
Describe “loudness.”
The intensity of voice measured in dB
Describe “quality.”
“How” it sounds - harsh, breathy, flat
Describe “flexibility.”
A combo of frequency, intensity, rate and prosody.
List 3 “processes” of voice production.
- respiration
- phonation
- resonance
Are the 3 “processes” of voice production intra-dependent or inter-dependent?
Respiration, phonation, and resonance are inter-dependent.
What does interdependent mean?
dependent on each other
Are the 3 “processes” of voice production changing constantly or do they remain the same?
Respiration, phonation, and resonance are constantly changing at the same time (simultaneously).
List the 3 structure of respiration.
- Bony thorax
- Muscles of respiration
- Tracheobronchial tree
What are 2 types of muscles of respiration?
- inspiratory muscles
2. expiratory muscles
What does the bony thorax consist of?
- vertebrae and vertebral column
- thoracic cage (ribs and sternum, and associated muscles
- pectoral girdle
- pelvic girdle
List 3 parts of the thoracic cage?
- ribs
- sternum
- associated muscles
List 5 divisions of the vertebrae.
- cervical
- thoracic
- lumbar
- sacrum
- coccyx
How many segments of bone is the vertebrae composed of?
33 bone segments
C1
base of the nose and the hard palate
C2
teeth (when the mouth remains closed)
C3
Mandible and hyoid bone
C4-C5
thyroid cartilage
C6-C7
cricoid cartilage
How many total ribs are in the rib cage?
12 ribs total
How many true ribs are in the rib cage?
7 true ribs
How many false ribs are in the rib cage?
3 false ribs
How many floating ribs are in the rib cage?
2 floating ribs
Describe direction of the rib cage.
Rib cage slants down in front
What is the basis for respiration?
The rib cage having some ability to move.
What is the chondral of the rib cage?
The cartilaginous portion of the rib
What do the elastic properties of cartilage allow for the rib cage?
It allows the ribs to move without breaking.
What does inhalation do to the thoracic cavity?
it makes the thoracic cavity increase
What does exhalation do to the thoracic cavity?
it decreases the thoracic cavity
What dimension is the diaphragm muscle responsible for?
the vertical dimension
What dimension is increased by raising the ribs?
the transverse dimension
What dimension is increased by upward movement of the ribs
the anterior-posterior dimension
The bony thorax is the home of what 2 pieces of anatomy?
the heart and lungs
What is the structural support for respiration?
- vertebral column
- 12 ribs
- pectoral girdle
- sternum
- pelvic girdle
What 2 parts are in the pecoral girdle?
- scapula
2. clavicle
What 4 parts are in the pelvic girdle?
- ischium
- pubic bone
- sacrum
- ilium
What are the 3 major categories of respiration?
- the muscles of the rib cage
- the diaphragm
- the muscles of the abdominal wall
What does the action of the respiratory muscles change?
the dimensions of the thoracic cavity
What happens as a result of the thoracic cavity dimensions changing?
the pressure changes within the thoracic cavity
What do the resulting changes of pressure in the thoracic cavity result in?
inspiratory-expiratory cycle
Where can the inspiratory muscles be found?
within the thorax, back , neck, and upper limbs
List the 2 types of primary inspiratory muscles.
- diaphragm
2. external intercostal muscles
What are the primary inspiratory muscles assisted by?
accessory muscles in the neck, back, and upper limbs
Where can the expiratory muscles be found?
within the thorax, back, upper limbs, and abdomen
What does the expiratory muscles include?
- internal intercostal muscles
2. abdominal muscles
Expiratory muscles are associated with what kind of expiration?
active experation
What 2 kinds of forces are in the respiratory cycle?
- active
2. passive
When is voice normally produced?
during exhalation
Mostly, what kind of process is exhalation?
a passive process
What happens if passive exhalation is not enough for a situation?
then we use the abdominal muscles
The use of abdominal muscles is considered more of what kind of process?
an active process
What can much of the power required for normal speech be supplied by?
the passive forces of respiration
Passive forces of respiration is also known as….
passive exhalation
Passive forces of respiration (passive exhalation) include…..
- the natural recoil of muscles, cartilages, ligaments and lung tissue
- the surface tension of a special film that lines the alveoli
- the pull of gravity
Passive forces of respiration (passive exhalation) reduces….
the size of the thorax during expiration
Describe 2 ways in which forces of respiration reduce the size of the thorax during expiration.
- 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
How can the mechanism of passive force be understood?
By examining the concept of relaxation pressure.
What does the relaxation pressure curve reflect?
Pressures generated by the passive forces of the respiratory system.
The relaxation pressure curve is a measure of what?
Restoring forces
Vocal quality is affected by high or low what and what?
- High or low air pressure
- High or low lung volume
According to the relaxation pressure curve, when is the most efficient and most pleasing voice produced?
At mid-air pressure levels and mid-lung volume levels of air.
During active force respiration, additional power required for normal speech can be supplied by what?
active forces of respiration (active exhalation)
Three forces of active exhalation include….
- the strength of muscles within the chest wall
- their patterns of movement
- the amount of air contained in the lungs
When breath support or breath control is a problem in a voice disordered patient, it is often related to what or what?
- failure to take breaths at appropriate places
2. the tendency to push too hard and results in a strained vocal quality
Changes in general pulmonary functioning with aging become measurable at around what age?
40 years of age
List 4 changes that occur in general pulmonary functioning around 40 years of age.
- increased stiffness of respiratory structures
- muscle weakness, muscle atrophy, and increased fibrotic content of muscle
- degeneration of nerve fibers and sensory receptors
- less efficient gas exchange
What 2 factors should be considered when comparing life breathing vs. speech breathing.
- ratio of inhalation and exhalation
- lung volume
(might need to know these ratios, ask Jordan)
What kind of anatomy is in the phonatory system.
laryngeal anatomy
What does structure determine in the laryngeal anatomy?
structure determines function
What does the structure of the laryngeal anatomy say about its function.
If it is normal or disordered
What would be a clue for abnormal function in the laryngeal anatomy?
structural abnormalities
Where do the vocal folds lie?
Between the arytenoid and thyroid cartilages
What is the space between the vocal folds called?
glottis
What is above and below the vocal folds?
Above: supraglottal
Below: subglottal
Which directions do the vocal folds stretch?
anteriorly and postiorly
Is there more than one layer of tissue in the vocal folds?
yes, several layers of tissue
What does it mean for laryngeal muscles to be intrinsic?
both points of attachment on laryngeal structures
List 3 intrinsic laryngeal muscles adductors.
- lateral cricoarytenoid
- transverse (inter) arytenoid
- oblique arytenoid
Name the one intrinsic laryngeal muscle abductor.
posterior cricoarytenoid
What makes a laryngeal muscle extrinsic?
consist of muscles with one attachment to laryngeal cartilage
How do the extrinsic muscles in the larynx make major adjustments to the larynx?
By elevating or depressing the larynx
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?
The extrinsic laryngeal muscles work together with the articulatory motions of the tongue.
Many extrinsic laryngeal muscles are important for what?
swallowing
List the 4 laryngeal elevators. What do they elevate?
- hypoglossus
- digastric
- stylohyoid
- mylohyoid
They elevate the larynx and the hyoid.
List the 3 laryngeal depressors. What do they depress?
- omohyoid
- sternohyoid
- sternothryroid
They depress the larynx and the hyoid
Vagus nerve (CN X) provides what to the larynx?
sensory and motor innervation
On each side of the neck, the Vagus nerve (CN X) branches into what 3 parts?
- pharyngeal nerve
- superior laryngeal nerve (SLN)
- recurrent laryngeal nerve (RLN)
What does the pharyngeal nerve innervate?
- the pharynx
- most of the velum/soft palate
Where does the superior laryngeal nerve emerge?
high in the neck from the main trunk of the vagus nerve
Where does the superior laryngeal nerve descend?
into the neck adjacent to the pharynx
The superior laryngeal nerve branches into what 2 part?
- internal laryngeal branch
2. external laryngeal branch
Where does the internal laryngeal branch insert?
into the thyrohyoid membrane on each side
Where does the internal laryngeal branch innervate?
it innervates the epiglottis, base of the tongue, and aryepiglottic folds
Where does the external laryngeal branch insert?
inserts into the cicothyroid muscle on each side of the larynx
Where does the external laryngel branch provide motor innervation?
to the cricothyroid muscle
Where does the recurrent laryngeal nerve branch from?
the main trunk of CNX (much lower in the neck than the SLN)
Why is the recurrent laryngeal nerve known as recurrent?
for its circuitous route
Describe the route of the of the recurrent laryngeal nerve.
It descends into the thorax before rising up between the trachea and esophagus to reach the neck
The recurrent laryngeal nerve provides motor innervation to all of the intrinsic laryngeal muscles except for which muscle?
the cricothyroid muscle
List the 4 muscles that the recurrent laryngeal nerve provides motor innervation to:
- thyroarytenoid muslce (TA)
- posterior cricoarytenoid (PCA)
- lateral cricoarytenoid muscle (LCA)
- interarytenoid muscles (IA)
Depending upon the site of lesion, trauma to the RLN may result in what or what?
unilateral or bilateral paralysis
The most common type of trauma to the RLN is a result of what? Why is this?
surgery to the thyroid gland because the RLN courses just posterior to the thyroid gland
What happens if trauma to the RLN occurs because the thyroarytenoid muscle is damaged?
there will be weakness in vocal fold approximation and adduction
What happens if trauma to the RLN occurs because the posterior cricoarytenoid muscle is damaged?
an inability to abduct volcal folds on the side with the lesion
What happens if trauma to the RLN occurs because the lateral cricoarytenoid is damaged?
vocal fold paralysis in the fixed, abducted, paramedian position
