Voice midterm Flashcards by Katie Cohen

Describe aryepiglottic folds. What kinds of fibers are they made of and what is their origin and insertion

Bundles of connective tissue that run from the sides of the epiglottis extending all the way back to the arytenoid cartilages

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What is the action that the aryepiglottic folds perform?

When they contract, they pull the epiglottis down and back

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What are the layers of the vocal folds according to the five-layered schema

Epithelium, Lamina propria- superficial, intermediate, deep layers, thyroarytenoid muscle

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What are the layers of the vocal folds according to the cover body model

Mucosa (epithelium, superficial lp),
vocal ligament (intermediate and deep lp),
muscle (thyroarytenoid)

Mucosa is the cover
Vocal ligament is the transition
Muscle is the body

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What kind of fibers make up the lamina propria?

Connective tissue

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What kind of fibrous proteins are contained in connective tissue?

Collagen and elastin

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What do collagen and elastin do?

Allow the tissue to maintain its shape and form and help it to withstand stress

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What is the function of interstitial proteins?

Provide connection between collagen fibrils

Influence tissue viscosity and vibratory characteristics of the vocal folds

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Function of hyoluronic acid (interstitial protein)

shock absorber

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Function of fibronectin (interstitial protein)

Wound healer

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Function of decorin (interstitial protein)

Regulates thickness of collagen fibers

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Histological composition (fibers) of superficial layer of the lamina propria

Loosely organized elastin fibers; high density of decorin, small amounts of collagen, Hyoluronic acid, and fibronectin

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Histological compositions (fibers) of the intermediate layer of the lamina propria

Densely organized elastin fibers, high concentration of hyoluronic acid

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Histological composition (fibers) of the deep layer of the lamina propria

Mostly collagen, some elastin fibers, some interstitial proteins

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What kinds of cells are found in epithelium

Squamous, stratified, non-keratinizing

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What are the valves of the larynx?

false vocal folds, true vocal folds, aryepiglottic folds

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A thorough understanding of structure and function of the larynx and vocal folds is essential for determining
1
2
3

How normal voice is produced
How breakdowns occur in voice production
Effects of breakdowns on vocal function

Plan and improve diagnostic and therapeutic strategies

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Larynx located between ___ and ___ vertebrae in adults

3rd and 7th

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What are the extrinsic membranes of the larynx?

Thyrohyoid, Cricotracheal, cricothyroid

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Type I Fibers characteristics

“slow twitch”
Small diameter
Slow contraction time
10-30 twitches/sec
Sustain muscle contraction for a long time without fatigue

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Type I Fibers found in….

muscles used to maintain posture

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Characteristics of type IIA fibers

“fast twitch”
higher fire rate
white
large amount of force for a brief amount of time
dominate rapid movement

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Characteristics of type IIx fibers

Faster contraction than type IIA

Relatively fatigue resistant but not as much as type I

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Muscles involved in glottal closure have a higher proportion of Type ____ fibers and are fast contracting

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Muscles involved in respiration and pitch change have a greater proportion of Type _____ fibers and are slower contracting

The infra hyoid muscles are .....

Sternohyoid, sternothyroid, omohyoid, thyrohyoid

Suprahyoids

Digastric, stylohyoid, mylohyoid, geniohyoid

List the intrinsic muscles of the larynx

Lateral cricoarytenoid, Interarytenoid, posterior cricoarytenoid, cricothyroid, thyroarytenoid, aryepiglottic muscle

Lateral cricoarytenoid origin and insertion

Originates on the lateral portion of the cricoid cartilage and inserts into the muscular process of each arytenoid

Action of the lateral cricoarytenoid

Pulls muscular processes of the arytenoids outward and brings vocal processes together Closes the membranous glottis

Where do the interarytenoids run

Between the arytenoids

Action of the interarytenoids

Pull the arytenoid cartilages toward each other | Adduct the vocal folds and close the glottis

Where do the fibers of the aryepiglottic muscle run?

Some fibers from the oblique arytenoids extend upward

Action of the aryepiglottic muscle?

Pull epiglottis down over the larynx

Posterior cricoarytenoid is the only vocal fold _______

abductor

Origin and insertion of the posterior cricoarytenoid

Posterior portion of the cricoid cartilage, inserts at muscular process of the arytenoid

Action of the posterior cricoarytenoid

Swings vocal processes up and out

Action of the cricothyroid muscle

Lengthens and shortens the vocal folds

Cricothyroid controls ______

pitch

2 parts of the cricothyroid are

pars recta, pars oblique

Origin and insertion of pars recta

Cricoid and insert into the inferior border the thyroid cartilage

origin and insertion of pars oblique

cricoid cartilage and insert into the inferior horn of the thyroid

What are the two parts of the thyroarytenoid muscle?

Medial (vocalis) and lateral (muscularis)

The medial thyroarytenoid (vocals) inserts into the ____ process of the arytenoid

vocal

The lateral thyroarytenoid (muscularis) inserts into the ______ process of the arytenoid cartilage

muscular

One cycle of vocal fold vibration is an interaction of ____, ____, and ______

Muscle forces, elastic recoil forces, and aerodynamic forces

Explain the Bernoulli effect

Air traveling through a narrow channel becomes negative in pressure and pulls objects closer together (i.e. closes the folds)

Positive pressure _____ the vocal folds

opens

Vertical phase difference: the vocal folds open from ____ to ____ and close from _____ to _____

bottom to top, bottom to top

Longitudinal phase difference: vocal folds open from ____ to ____ and close from _____ to ____

back to front, front to back

Throughout phonation _________ is active

medial compression

One vibration or duty cycle consists of ______

one opening and one closing

Vocal folds are closed for _____ amounts of time in each vibration cycle

equal

Phonation threshold pressure is measured in

cmH20

Normal speech phonation threshold pressure is _____

2 cm H20

Phonation threshold pressure for yelling is

15-40 cm

Limbic lobe controls _____

emotion

Three important areas important in initiating, sequencing, and planning movement are

primary motor cortex, premotor cortex, supplementary motor area

Three areas of subcortical gray matter are

Basal nuclei, thalamus, hypothalamus

Function of the basal nuclei

Inhibitory system that refines and smoothes movement by inhibiting excessive motor impulses originating from the cortex

The substantia nigra manufactures

Dopamine- inhibitory neurotransmitter

Three basal nuclei are

putamen, globus pallidus, caudate

Thalamus is involved with .....

consciousness, alertness, integration of emotional expression into motor activity

Cerebellum is involved in

integrating and controlling role of movements in other parts of the motor system, smooth, synergistic movements

Cerebellum involved in regulation of ____, ____, ____, and ____

posture, balance, background muscle tone, and coordination of muscle groups

Similarities between cerebellum and cerebrum

Both have a covering of gray matter, both have lobes

Interior of cerebellum called ________

arbor vitae

Cerebellum regulates aspects of movement including ___, ____, ____, _____, _____, ______

Force, speed, range, timing, direction, amount of displacement

___________ (part of brain) is deeply involved in regulating basic auditory and laryngeal gestures for voice

Periaqueductal grey (PAG)

In addition to coordination, PAG is also involved in

Involuntary laughing and crying

Corticospinal tract connects impulses _____

Cortex to spinal nerves

Corticonuclear tract

Connect cortex and cranial nerves

Corticospinal and corticonuclear tract together form the ________ system

direct/pyramidal system

Direct/ pyramidal system controls ....

skilled voluntary movement

Corticospinal pathway arises from....

Several areas in the frontal and parietal lobes (motor and sensory originations)

Corticospinal pathway decussates at _____

Pyramids of the medulla

Corticonuclear pathway arises from

the motor cortex and synapses with the motor nuclei of cranial nerves V, VII, X, XII

Indirect/extrapyramidal motor tract serves to...

smooth and refine voluntary movement originating in the cortex

UMN consists of ____ and ______

Pyramidal and extrapyramidal systems

LMN consists of ________ and _____

Spinal and cranial nerves

Cranial nerves innervate muscles of the _____ and ____

head and neck

Three branches of the vagus nerve

pharyngeal, superior laryngeal nerve, recurrent laryngeal nerve

RLN innervates .....

thyroarytenoid, posterior cricoarytenoid, lateral cricoarytenoid, interarytenoid

SLN innervates ......

cricothyroid

Pharyngeal branch innervates

Innervates muscles of the velum

The ____ side of the vagus nerve loops around the aorta of the heart

Left

The _____ side of the vagus nerve loops around the subclavian artery of the heart

right

Sensory nerve endings in the larynx are in...

mucosal layers, joints, and muscles

Sensory receptors respond to...

touch, movement, vibration, change in air pressure, chemicals

This reflex initiates a tight reflexive closure of the laryngeal valves which protects the airway

laryngeal adductor reflex

This pathway is important for purposeful voicing and speech

Corticobulbar tract to the nucleus ambiguous

This pathway is important for emotional vocalizations

limbic system-->PAG (periaqueductal gray)--->nucleus ambiguous

Infant larynx is between vertebrae ___ and ___

c3 and c4

Adult larynx is between vertebrae ____ and ____

c4 and c7

Name some characteristics of the infant laryngeal cartilages

- Hyoid overlaps the thyroid - Thyroid is flatter than in adulthood - Arytenoids look relatively larger - Epiglottis is bulky and omega shaped - Cartilages are soft and flexible

Length of infant vocal folds

1.5-3 mm

Fundamental frequency of newborn vocalizations

400-600 Hz

Most infant vocalizations consist of ____, ____, and ____

cries, coughs and burps

4 things that happen to the larynx during childhood

- Larynx starts to increase in size - Larynx starts to descend in the neck - Differentiation of the lamina propria begins - Fundamental frequency drops to around 230-250 Hz

In puberty male larynges increase ___ to ___ times more than in females

2-3

During puberty, male vocal folds increase by ___ mm

During puberty, female vocal folds increase by ___ mm

4 mm

During puberty, female pitch drops by _____

2-3 semitones

During puberty, male pitch drops by

around 1 octave

Estrogen causes ____ in the vocal folds

Increased glandular secretions and reduced mucosal viscosity

Progesterone causes ____ in the vocal folds

Decreased glandular secretions and mucosal dehydration

Premenstrual vocal syndrome can include ____, ___, and ____

Vocal fatigue, decreased range, and loss of high harmonics

Laryngoscopy during PM vocal syndrome shows ___, ____, ___, and _____

Mucosal edema, thickened and reduced glandular secretions, reduced amplitude of vibration, and vascular disturbances

Symptoms of premenstrual vocal syndrome can be relieved by ___

Contraceptive pills

Voice aging is related to ...

Structural and physiological laryngeal changes, individual's overall state of health, acoustic characteristics resulting from changes, influence of gender , related or unrelated vocal disorders

During menopause, influence of ____ decreases and influence of ____ increases

Estrogen, androgens

Name some vocal symptoms associated with menopause

Vocal fatigue, decreased vocal intensity, decreased range, reduced amplitude, loss of timbre, muscular atrophy, microvarices, reduced joint mobility vocal fold edema, hoarseness, dryness of throat

What are some structural changes associated with aging

Ossification of cartilages, joint damage, muscular atrophy, connective tissue changes in the lamina propria (become less elastic)

During aging fundamental frequency ___ in males

Increases (this is extremely variable)

During aging, fundamental frequency ____ in females

Decreases

During aging, intensity levels _____

Decrease

During aging, breathiness ______

Increases

Presbyphonia results in auditory perceptual changes in the voice such as

altered pitch, hoarseness, breathiness, strain, slowed rate

Presbyphonia results in visual perceptual changes in the larynx such as

vocal fold bowing, vocal fold atrophy, edema

Presbyphonia results in acoustic changes in the larynx such as

Change in fundamental frequency, decreased intensity, increased noise