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Voice Disorders > Vocal Anatomy > Flashcards

Vocal Anatomy Flashcards

1
Q

What are the 4 biological functions of the larynx?

A
  1. PROTECTION
  2. VALVING
  3. THORACIC FIXATION
  4. CONNECTION
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2
Q

How does the larynx aid in PROTECTION?

A
  • clamps shut in response to intrusion by foreign objects
  • forcefully expels foreign objects from the airway opening (by way of a cough) in the event that they make their way down this far
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3
Q

How does the larynx aid in VALVING?

A
  • prevents air from escaping lungs

- seals respiratory system (e.g. can hold breath for swimming)

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4
Q

How does the larynx aid in THORACIC FIXATION?

A

Prevents air from escaping lungs

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5
Q

Purpose(s) of THORACIC FIXATION.

A

i) Fixation of the chest and build-up of pressure in the abdomen for weight-bearing activities

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6
Q

What particular population has difficulty with THORACIC FIXATION?

A

Individuals who have had laryngectomies

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7
Q

What two anatomical structures does the larynx connect?

A

1) Trachea

2) Pharynx

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8
Q

What is the 1 non-biological function of the larynx? How does it perform this function?

A
  • Sound production
  • Achieved as a result of VFs’ variable resistance to airflow
  • As expelled air is forced through the adducted VFs, it sets them into vibration; this is the sound source for voice!
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9
Q

What are the 3 laryngeal regions and what areas do they comprise?

A
  1. SUPRAGLOTTIC REGION:
    - Above the true vocal folds
    - Includes the epiglottis, aryepiglottic folds, arytenoids, vestibule, ventricular folds, ventricle and pyriform sinuses
  2. GLOTTIC REGION:
    - At the level of the true vocal folds themselves
    - Glottis = space between VFs when abducted
  3. SUBGLOTTIC REGION:
    - Below the true vocal folds
    mucous membrane lining; formed by ciliated epithelial cells; cilia sweep mucous/inhaled debris toward VFs where it can be coughed clear
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10
Q

What 3 landmarks comprise the laryngeal frame?

A

TOP = Mandible of the jaw
BACK = Spinal vertebrae
BOTTOM: Sternum

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11
Q

Define the following terminology:

1) Vestibule
2) Ventricle
3) Valleculae
4) Pyriform Sinuses

A

1) Area above the level of the false (ventricular) VFs
2) Space between the false (ventricular) and true VFs
3) Space between the root of the tongue and the epiglottis
4) Space between the aryepiglottic folds and the thyroid cartilage on either side

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12
Q

Via what two means is the hyoid bone suspended?

A

1) By the stylohyoid ligaments

2) 22 or 23 pairs of muscles

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13
Q

Where are the triticial cartilages located?

A

Suspended within the thyrohyoid ligament

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14
Q

How many laryngeal cartilages are there? What are they? Which ones are paired?

A
  • There are 9 laryngeal cartilages:
    1) The epiglottis
    2) The cricoid cartilage
    3) The thyroid cartilage
    4) 2 arytenoid cartilages
    5) 2 corniculate cartilages
    6) 2 cuneiform cartilages
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15
Q

Which of the laryngeal cartilages is the largest?

A

The thyroid cartilage

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16
Q

Which laryngeal cartilages are only sometimes present?

A

1) The corniculate cartilages

2) The cuneiform cartilages

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17
Q

Which laryngeal cartilage(s) is sometimes fused with the tip of the arytenoid cartilage?

A

The corniculates

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18
Q

Why isn’t the triticial cartilage considered a laryngeal cartilage?

A

Because it doesn’t fall within the cartilaginous confines of the larynx

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19
Q

List 3 features of the laryngeal cartilages (as a whole).

A
  1. No blood supply
  2. Composed of live cells (chondrocytes)
  3. Kept alive by perichondrium (fibrous, dense, connective tissue that surrounds the cartilages)
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20
Q

What are the three types of cartilage and which of the laryngeal cartilages fall under each category?

A
  1. Hyaline: thyroid, cricoid and arytenoids
  2. Elastic: epiglottis, corniculates, cuneiforms
  3. Fibrous: found in tendon attachments
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21
Q

List 5 roles of the laryngeal cartilages.

A
  1. Provide framework
  2. Support tissue
  3. Protect soft tissue
  4. Provide strength
  5. Provide leverage to transmit muscle forces
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22
Q

Describe the features of hyaline cartilage.

A
  • sturdy
  • tends to ossify with age (beginning at approximately 25)
  • found in respiratory tract
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23
Q

Describe the features of elastic cartilage.

A
  • less sturdy

- non-ossifying

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24
Q

During quiet exhalation the VFs are _____ in the _____ position. During exhalation for speech the VFs are _____

A

1) abducted
2) paramedian
3) adducted

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25
Q

In general, what influences the overall pitch, loudness and quality of the voice?

A

The interactive relationship between…

a) … the subglottal air pressure buildup and
b) … the transglottal airflow rate (passing through the vibrating VFs)

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26
Q

What are the 3 components of the acoustic speech product?

A

1) Glottal sound source
2) Vocal tract filtering
3) Resonant characteristics

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27
Q

The hyoid bone attaches to the thyroid cartilage through the _____ and articulates with the _____

A

1) Thyrohyoid membrane

2) Superior cornu

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28
Q

Excessive hyoid elevation is a sign of _____

A

Excessive muscular tension

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29
Q

What is the primary role of the epiglottis?

A

Airway protection.

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30
Q

The superior cornu of the thyroid cartilage articulate with _____ and the inferior cornu articulate with _____

A

1) The hyoid bone

2) The cricoid cartilage

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31
Q

Thyroid notch angles:

1) Infants
2) Females
3) Males

A

1) 130 degrees
2) 110 degrees
3) 90 degrees

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32
Q

The _____ of the cricoid articulate(s) with the inferior cornu of the thyroid cartilage. This comprises the _____ joint. This joint allows for _____ movement of the thyroid.

A

1) Lateral facets
2) Cricothyroid
3) Forward rocking

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33
Q

The _____ (_____) facets of the cricoid articulate with the _____ of the arytenoid cartilages. This forms the _____ joint.

A

1) Convex (cricoarytenoid)
2) Concave pyramidal bases
3) Cricoarytenoid

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34
Q

What are the 3 components of the 3-tiered laryngeal protection mechanism?

A

1) Epiglottis
2) Ventricular (false) folds
3) Vocal (true) folds

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35
Q

The posterior aspect of the cricoid - the thicker portion - is known as what?

A

The posterior quadrate lamina.

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36
Q

The anterior aspect of the cricoid - the thinner portion - is known as what?

A

The anterior cricoid arch.

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37
Q

What are the two pairs of facets on the cricoid cartilage? What do they articulate with?

A

1) The cricoarytenoid (convex) facets articulate with the concave, pyramidal bases of the arytenoids
2) The lateral facets articulate with the inferior cornu of the thyroid cartilage

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38
Q

Which laryngeal cartilage articulates with the first tracheal ring? Via what anatomical structure?

A

1) Cricoid cartilage

2) Cricotracheal ligament

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39
Q

What is the significance of the synovial membrane lining the cricothyroid and cricoarytenoid joints?

A

Arthritis = a loss of synovial fluid

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40
Q

Name and describe the 4 arytenoid surfaces.

A

1) Base: concave, forms arytenoid portion of the cricoarytenoid joint
2) Anterior: angle forms vocal process
3) Lateral: angle forms muscular process
4) Medial: faces it’s arytenoid pair

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41
Q

What are the 2 types of arytenoid movement?

A

1) Anterior-posterior (rocking)

2) Lateral (sliding)

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42
Q

What are 2 important functions of the arytenoids?

A

1) Permit onset and offset of voicing

2) Provide sites of attachments for AB- and ADductor muscles of the VFs as well as the VFs themselves

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43
Q

What are the 3 most important arytenoid processes and what do they provide sites of attachment for?

A

1) Vocal process: vocal ligament and vocal portions of the thyroarytenoid
2) Muscular process: lateral/muscular portions of the thyroarytenoid, posterior cricoarytenoid (PCA) and lateral cricoarytenoid (LCA)
3) Apex: corniculates (if present); also acts as the posterior part of the laryngeal sphincter mechanism

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44
Q

What are the muscles of inspiration?

A

1) Diaphragm
2) External intercostals
3) Sternocleidomastoid
4) Scalenes
5) Pectoralis major
6) Pectoralis minor

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45
Q

How many muscles attach to the lateral or posterior aspects of the arytenoids? What is their general purpose?

A

1) 3
2) To adjust the position of the arytenoid base on the cricoid rim and direct the vocal process tips to orient the VFs into varying degrees of abduction and adduction

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46
Q

The corniculate cartilages are _____ shaped while the cuneiform cartilages are _____ shaped. Both provide the same function, which is…

A

1) Horn
2) Rod
3) To provide support/reinforcement for the aryepiglottic fold

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47
Q

Why is it important to know about the potential presence, location(s) and appearance of the corniculate and cuneiform cartilages?

A

They appear as protuberances (tubercle) in the posterior region of the aryepiglottic folds so if one was unaware of their presence they might mistake these protuberances as cysts, growths, lesions, etc.

48
Q

The intrinsic laryngeal membranes are almost all part of a single layer of _____ known as _____ which is divided into two components: _____ and _____

A

1) Fibroelastic tissue
2) The elastic membrane
3) Quadrangular membrane
4) Conus elasticus

49
Q

The quadrangular membrane comprises the _____ portion of the elastic membrane while the conus elasticus comprises the _____ portion.

A

1) Upper

2) Lower

50
Q

What are the 2 parts of the quadrangular membrane?

A

1) Aryepiglottic folds (free, upper margin/border)

2) Ventricular ligaments (free, lower margin/border)

51
Q

What is the functional significance of the ventricular ligaments?

A

They serve as the POA for the ventricular (false) folds

52
Q

The conus elasticus connects the _____, _____ and _____ cartilages.

A

1) Cricoid
2) Thyroid
3) Arytenoid

53
Q

What ligaments does the conus elasticus form…

1) Inferiorly, and…
2) Superiorly

A

1) The median and lateral cricothyroid ligaments

2) The vocal ligament

54
Q

Which ligament, when covered with mucosal tissue, forms the true vocal folds?

A

The vocal ligament

55
Q

What is the result of incomplete separation of conus elasticus during development?

A
  • Fused VFs –> web

- Results in squeaky, high-pitched voice

56
Q

What are the two parts of the vocal folds and what comprises them?

A

1) The membranous part (the conus elasticus)

2) The muscular part [the vocalis muscle (i.e. the thyrovocalic portion of the thyroarytenoid)]

57
Q

What are the 3 laryngeal compartments?

A

1) The vestibule: space above the ventricular folds
2) The ventricle: space between the false and true folds
3) The Inferior laryngeal ventricle/infraglottic region: space below the true folds

58
Q

What is the name of the pocket of air enclosed by the cricoid cartilage?

A

The infraglottic region/inferior laryngeal ventricle

59
Q

What is the main difference between extrinsic and intrinsic laryngeal muscles?

A
  • Extrinsic muscles have either their origin or insertion on a laryngeal cartilage but their other attachment is on a structure outside of the larynx
  • Intrinsic muscles have both origin and insertion on a laryngeal cartilage
60
Q

Most extrinsic laryngeal muscles attach to the _____

A

Hyoid bone

61
Q

What are the two types of extrinsic laryngeal muscles?

A

1) Suprahyoid muscles

2) Infrahyoid muscles

62
Q

What classifies a muscle as…

1) A suprahyoid muscle?
2) An infrahyoid muscle?

A

1) A muscle that comes from a structure above the hyoid and insert somewhere along its superior margin
2) A muscle that comes from a structure below the hyoid and insert somewhere along its inferior margin

63
Q

What functional similarity do ALL suprahyoid muscles share and how do they achieve this?

A

They all RAISE the larynx via hyoid elevation.

64
Q

Is the diaphragm active in quiet breathing or speech breathing?

A

Both.

65
Q

What happens when the diaphragm contracts?

A

It depresses the abdomen and increases the thoracic cavity (thus the expanding potential of the lungs)

66
Q

What is tidal lung volume?

A

Inspiration and expiration during a typical cycle

67
Q

What is inspiratory reserve volume?

A

Maximum “extra” air that can be inhaled after a tidal cycle.

68
Q

What is expiratory reserve volume?

A

Maximum “extra” air that can be exhaled after a tidal cycle.

69
Q

What is vital capacity?

A
  • Total amount of air expired after a maximum inspiration

- Tidal volume + inspiratory reserve volume + expiratory reserve volume

70
Q

What is residual volume?

A
  • Volume of air remaining in lungs after maximal expiration

- Cannot be expired in normal atmospheric pressure

71
Q

What is total lung capacity?

A

Vital capacity + residual volume; can only be measured by plethysmography

72
Q

The hyoid bone is at the level of the _____ vertebrae

A

3rd cervical (i.e. C3)

73
Q

Which of the following may be fused with the arytenoids?

1) Cuneiform cartilages
2) Corniculate catrilages

A

2) Corniculate cartilages

74
Q

What is the main function of each of the following muscle groups?

1) Suprahyoid muscles
2) Infrahyoid muscles
3) Intrinsic laryngeal muscles

A

1) RAISE larynx
2) LOWER larynx
3) Determine configuration of the vocal folds

75
Q

What are the 7 suprahyoid muscles?

A

1) Stylohyoid
2) Mylohyoid
3) Anterior Digastric
4) Posterior Digastric
5) Geniohyoid
6) Hyoglossus
7) Genioglossus

76
Q

Stylohyoid: attachments and function(s)

A

A: Styloid process of temporal bone to hyoid bone
F: Raises hyoid posteriorly
- Important for swallowing: moves hyoid to clear path to esophagus

77
Q

Mylohyoid: attachments and function(s)

A

A: Mandible to hyoid bone
F: Raises hyoid anteriorly; forms floor of mouth

78
Q

Anterior Digastric: attachments and function(s)

A

A: Mandible to hyoid bone
F: Raises hyoid anteriorly

79
Q

Posterior Digastric: attachments and function(s)

A

A: Mastoid process of temporal bone to hyoid bone
F: Raises hyoid posteriorly

80
Q

Geniohyoid: attachments and function(s)

A

A: Mandible to hyoid bone
F: Raises hyoid bone anteriorly

81
Q

Hyglossus: attachments and function(s)

A

A: Hyoid bone to sides of tongue
F: Raises hyoid bone (but is primarily a tongue muscle)

82
Q

Genioglossus: attachments and function(s)

A

A: Mandible to tongue and hyoid bone
F: Raises hyoid bone (but primarily a tongue muscle)

83
Q

What are the 4 infrahyoid muscles?

A

1) Thyrohyoid
2) Sternothyroid
3) Sternohyoid
4) Omohyoid (2 heads)

84
Q

Thyrohyoid: attachments and function(s)

A

A: Thyroid to hyoid
F: Brings thyroid and hyoid closer

85
Q

Sternothyroid: attachments and function(s)

A

A: Sternum to thyroid
F: Lowers thyroid

86
Q

Sternohyoid: attachments and function(s)

A

A: Sternum to hyoid
F: Lowers hyoid

87
Q

Omohyoid: attachments and function(s)

A

A: Scapula to hyoid
F: Lowers hyoid

88
Q

Tension in _____ muscles helps predict if there’s tension in _____ muscles

A

1) Extrinsic

2) Intrinsic

89
Q

The suprahyoid and infrahyoid muscles are intrinsic laryngeal muscles. T/F?

A

F - The suprahyoid and infrahyoid muscles are extrinsic laryngeal muscles

90
Q

The intrinsic laryngeal muscles…

1) Are responsible for _____
2) Are innervated by _____ (EXCEPT for _____ which is innervated by _____)
3) Are paired (EXCEPT for _____)
4) All work to _____ (EXCEPT _____ which are the only muscles that _____)

A

1) Controlling sound production
2) Recurrent laryngeal nerve (RLN); Cricothyroid; external laryngeal branch of the superior laryngeal nerve (SLN)
3) The transverse interarytenoid
4) ADduct the VFs; the PCAs; ABduct

91
Q

The RLN and SLN are branches of _____

A

The vagus nerve

92
Q

Which laryngeal muscle has both respiratory and phonatory function? What are those functions? Is is intrinsic or extrinsic?

A

1) PCA
2) Respiratory: ABduct folds for passage of air + Phonatory: production of voiceless sounds
3) Intrinsic

93
Q

The intrinsic laryngeal muscles are divided into _____ and _____ (based on function). List the muscles that fall into each subdivision.

A

1) ADductors: lateral cricoarytenoids and interarytenoids (transverse and oblique)
2) Tensors: cricothyroid and thyroarytenoids (thyrovocalis and thyromuscularis)

94
Q

What functional similarity do all intrinsic laryngeal muscles share? How do they achieve this?

A

1) They all LOWER the larynx via hyoid DEPRESSION

95
Q

What are the 7 intrinsic laryngeal muscles?

A

1) Lateral cricoarytenoids (LCAs)
2) Transverse interarytenoid (IA)
3) Oblique interarytenoids (IAs)
4) Posterior cricoarytenoids (PCAs)
5) Cricothyroid (pars recta & pars oblique)
6) Thyroarytenoid (TA) - thyrovocalis
7) Thyroarytenoid (TA) - thyromuscularis

96
Q

Lateral cricoarytenoids (LCAs): attachments, “title” and function(s)

A

A: lateral cricoid to arytenoid (muscular process)
T: adductor/shortener
F: VF adduction; helps increase tension of VF closure (thus increasing volume) –> pulls arytenoid muscular process anteriorly, thus moving vocal process to midline

97
Q

Transverse interarytenoid (IA): attachments, “title” and function(s)

A

A: between lateral lamina of arytenoids (horizontally)
T: adductor
F: improves medial compression/promotes adduction; contribute to forceful closure –> brings arytenoids closer together/moves them to midline

98
Q

Oblique interarytenoids (IAs): attachments, “title” and function(s)

A

A: between one arytenoid’s base and the other arytenoid’s apex
T: adductor
F: improves medial compression/promotes adduction; contribute to forceful closure –> brings arytenoids closer together/moves them to midline

99
Q

Posterior cricoarytenoids (PCAs): attachments, “title” and function(s)

A

A: posterior cricoid (medially) to arytenoid (muscular processes)
T: abductor
F: VF abduction –> pull the arytenoids inferiorly; vocal processes move laterally

100
Q

Cricothyroid (CT): parts, attachments, “title” and function(s)

A

P: pars recta (more medial) & pars oblique (more lateral)
A: cricoid to thyroid (lamina)
T: tensor, lengthener
F: primary VF tensor; stretches/lengthens VFs (thus increasing pitch) –> decreases distance between cricoid and thyroid by rocking thyroid forward and down

101
Q

Thyroarytenoid (TA) - thyrovocalis: attachments, “title” and function(s)

A

A: thyroid to arytenoid (vocal process - more medial of the two parts)
T: adductor/shortener
F: comprises body of the VFs; contributes to lowering F0, increasing loudness and tightening glottic closure –> shortens VF length by drawing arytenoids anteriorly; increases mass of vibrating edge (allowing greater VF closure and larger vibratory amplitude)

102
Q

Thyroarytenoid (TA) - thyromuscularis: attachments, “title” and function(s)

A

A: thyroid to arytenoid (muscular process - more lateral of the two parts)
T: adductor/shortener
F: WITH vocalis… contributes to lowering F0, increasing loudness and tightening glottic closure –> shortens VF length by drawing arytenoids anteriorly; increases mass of vibrating edge (allowing greater VF closure and larger vibratory amplitude)

103
Q

List 3 differences between the true folds and the false (ventricular) folds.

A

1) False folds do not vibrate during normal phonation
2) False folds do not share the same intricate histologic layer structure
3) False folds do not perform discrete adjustments in movement range or position

104
Q

What is one of the most important roles of the false folds?

A

To create a strong adduction for vegetative maneuvers that require forceful midline closure, such as when coughing or during swallowing

105
Q

Which intrinsic laryngeal muscle must be active in order to differentiate pitch?

A

The vocalic portion of the thyroarytenoid (i.e. thyrovocalis)

106
Q

What glottic closure pattern is likely to result from the muscle atrophy associated with Parkinson’s or aging voice?

A

Bowing; leads to VF closure at anterior and posterior commissures, but not in between

107
Q

What are the 5 histologic layers of the VFs?

A

1) Epithelium
2) Superficial lamina propria
3) Intermediate lamina propria
4) Deep lamina propria
5) Vocalis muscle

108
Q

Which layers comprise the cover, transition/vocal ligament, and body?

A

COVER = epithelium + superficial lamina propria
TRANSITION/VOCAL LIGAMENT = intermediate & deep lamina propria
BODY = vocalis muscle

109
Q

What is another name for the vocal ligament?

A

The voice tendon

110
Q

The epithelium…

  • described as a _____
  • provides a _____ layer; it keeps VFs _____
  • composed of a this layer of _____
  • forms the _____ with the _____
A
  • pliable capsule
  • protective layer; moist
  • squamous cells
  • cover; superficial lamina propria
111
Q

The superficial lamina propria…

  • a.k.a. ____
  • described as a _____
  • responsible for _____ + _____
  • forms the _____ with the _____
A
  • Reinke’s space
  • soft, slippery, gelatinous mass
  • mucosal wave + strong vibration during phonation
  • cover; epithelium
112
Q

The intermediate lamina propria…

  • is composed of _____
  • contributes to _____ (though _____)
  • forms the _____/_____ with the _____
A
  • elastin fibers
  • vibration; has more mass than SLP
  • vocal ligament/transition; deep lamina propria
113
Q

The deep lamina propria…

  • is composed of _____; thus, provides _____
  • forms the _____/_____ with the _____
A
  • collagen fibres; structural support

- vocal ligament/transition; intermediate lamina propria

114
Q

The vocalis muscle…

  • is the only _____ of the VF
  • provides _____, _____ and _____
  • forms the _____/_____ of the VF
A
  • active component
  • tonicity, stability and mass
  • body/main body
115
Q

According to the _____ theory of VF vibration, the VFs have 3 _____: _____, _____ and _____

A
  • body-cover
  • vibratory divisions
  • cover, transition/vocal ligament & body
116
Q

What are the respective roles of each of the vibratory divisions in the body-cover theory of VF vibration?

A

COVER: compliant; fluid oscillation; where majority of vibration/mucosal wave takes place
TRANSITION: coupling between mucosa and muscle tissue
BODY: stiffer, underlying mass; provides fundament/acts like a foundation; does less of the active moving

Voice Disorders (1 decks)

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