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Voice Disorders > Voice midterm > Flashcards

Voice midterm Flashcards

1
Q

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

A

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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2
Q

What is the action that the aryepiglottic folds perform?

A

When they contract, they pull the epiglottis down and back

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3
Q

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

A

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

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4
Q

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

A

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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5
Q

What kind of fibers make up the lamina propria?

A

Connective tissue

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6
Q

What kind of fibrous proteins are contained in connective tissue?

A

Collagen and elastin

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7
Q

What do collagen and elastin do?

A

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

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8
Q

What is the function of interstitial proteins?

A

Provide connection between collagen fibrils

Influence tissue viscosity and vibratory characteristics of the vocal folds

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9
Q

Function of hyoluronic acid (interstitial protein)

A

shock absorber

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10
Q

Function of fibronectin (interstitial protein)

A

Wound healer

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11
Q

Function of decorin (interstitial protein)

A

Regulates thickness of collagen fibers

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12
Q

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

A

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

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13
Q

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

A

Densely organized elastin fibers, high concentration of hyoluronic acid

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14
Q

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

A

Mostly collagen, some elastin fibers, some interstitial proteins

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15
Q

What kinds of cells are found in epithelium

A

Squamous, stratified, non-keratinizing

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16
Q

What are the valves of the larynx?

A

false vocal folds, true vocal folds, aryepiglottic folds

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17
Q

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

A

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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18
Q

Larynx located between ___ and ___ vertebrae in adults

A

3rd and 7th

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19
Q

What are the extrinsic membranes of the larynx?

A

Thyrohyoid, Cricotracheal, cricothyroid

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20
Q

Type I Fibers characteristics

A
  • “slow twitch”
  • Small diameter
  • Slow contraction time
  • 10-30 twitches/sec
  • Sustain muscle contraction for a long time without fatigue
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21
Q

Type I Fibers found in….

A

muscles used to maintain posture

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22
Q

Characteristics of type IIA fibers

A
  • “fast twitch”
  • higher fire rate
  • white
  • large amount of force for a brief amount of time
  • dominate rapid movement
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23
Q

Characteristics of type IIx fibers

A

Faster contraction than type IIA

Relatively fatigue resistant but not as much as type I

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24
Q

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

A

II

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25
Q

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

A

I

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26
Q

The infra hyoid muscles are …..

A

Sternohyoid, sternothyroid, omohyoid, thyrohyoid

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27
Q

Suprahyoids

A

Digastric, stylohyoid, mylohyoid, geniohyoid

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28
Q

List the intrinsic muscles of the larynx

A

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

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29
Q

Lateral cricoarytenoid origin and insertion

A

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

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30
Q

Action of the lateral cricoarytenoid

A

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

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31
Q

Where do the interarytenoids run

A

Between the arytenoids

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32
Q

Action of the interarytenoids

A

Pull the arytenoid cartilages toward each other

Adduct the vocal folds and close the glottis

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33
Q

Where do the fibers of the aryepiglottic muscle run?

A

Some fibers from the oblique arytenoids extend upward

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34
Q

Action of the aryepiglottic muscle?

A

Pull epiglottis down over the larynx

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35
Q

Posterior cricoarytenoid is the only vocal fold _______

A

abductor

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36
Q

Origin and insertion of the posterior cricoarytenoid

A

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

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37
Q

Action of the posterior cricoarytenoid

A

Swings vocal processes up and out

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38
Q

Action of the cricothyroid muscle

A

Lengthens and shortens the vocal folds

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39
Q

Cricothyroid controls ______

A

pitch

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40
Q

2 parts of the cricothyroid are

A

pars recta, pars oblique

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41
Q

Origin and insertion of pars recta

A

Cricoid and insert into the inferior border the thyroid cartilage

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42
Q

origin and insertion of pars oblique

A

cricoid cartilage and insert into the inferior horn of the thyroid

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43
Q

What are the two parts of the thyroarytenoid muscle?

A

Medial (vocalis) and lateral (muscularis)

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44
Q

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

A

vocal

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45
Q

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

A

muscular

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46
Q

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

A

Muscle forces, elastic recoil forces, and aerodynamic forces

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47
Q

Explain the Bernoulli effect

A

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

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48
Q

Positive pressure _____ the vocal folds

A

opens

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49
Q

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

A

bottom to top, bottom to top

50
Q

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

A

back to front, front to back

51
Q

Throughout phonation _________ is active

A

medial compression

52
Q

One vibration or duty cycle consists of ______

A

one opening and one closing

53
Q

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

A

equal

54
Q

Phonation threshold pressure is measured in

A

cmH20

55
Q

Normal speech phonation threshold pressure is _____

A

2 cm H20

56
Q

Phonation threshold pressure for yelling is

A

15-40 cm

57
Q

Limbic lobe controls _____

A

emotion

58
Q

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

A

primary motor cortex, premotor cortex, supplementary motor area

59
Q

Three areas of subcortical gray matter are

A

Basal nuclei, thalamus, hypothalamus

60
Q

Function of the basal nuclei

A

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

61
Q

The substantia nigra manufactures

A

Dopamine- inhibitory neurotransmitter

62
Q

Three basal nuclei are

A

putamen, globus pallidus, caudate

63
Q

Thalamus is involved with …..

A

consciousness, alertness, integration of emotional expression into motor activity

64
Q

Cerebellum is involved in

A

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

65
Q

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

A

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

66
Q

Similarities between cerebellum and cerebrum

A

Both have a covering of gray matter, both have lobes

67
Q

Interior of cerebellum called ________

A

arbor vitae

68
Q

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

A

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

69
Q

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

A

Periaqueductal grey (PAG)

70
Q

In addition to coordination, PAG is also involved in

A

Involuntary laughing and crying

71
Q

Corticospinal tract connects impulses _____

A

Cortex to spinal nerves

72
Q

Corticonuclear tract

A

Connect cortex and cranial nerves

73
Q

Corticospinal and corticonuclear tract together form the ________ system

A

direct/pyramidal system

74
Q

Direct/ pyramidal system controls ….

A

skilled voluntary movement

75
Q

Corticospinal pathway arises from….

A

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

76
Q

Corticospinal pathway decussates at _____

A

Pyramids of the medulla

77
Q

Corticonuclear pathway arises from

A

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

78
Q

Indirect/extrapyramidal motor tract serves to…

A

smooth and refine voluntary movement originating in the cortex

79
Q

UMN consists of ____ and ______

A

Pyramidal and extrapyramidal systems

80
Q

LMN consists of ________ and _____

A

Spinal and cranial nerves

81
Q

Cranial nerves innervate muscles of the _____ and ____

A

head and neck

82
Q

Three branches of the vagus nerve

A

pharyngeal, superior laryngeal nerve, recurrent laryngeal nerve

83
Q

RLN innervates …..

A

thyroarytenoid, posterior cricoarytenoid, lateral cricoarytenoid, interarytenoid

84
Q

SLN innervates ……

A

cricothyroid

85
Q

Pharyngeal branch innervates

A

Innervates muscles of the velum

86
Q

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

A

Left

87
Q

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

A

right

88
Q

Sensory nerve endings in the larynx are in…

A

mucosal layers, joints, and muscles

89
Q

Sensory receptors respond to…

A

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

90
Q

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

A

laryngeal adductor reflex

91
Q

This pathway is important for purposeful voicing and speech

A

Corticobulbar tract to the nucleus ambiguous

92
Q

This pathway is important for emotional vocalizations

A

limbic system–>PAG (periaqueductal gray)—>nucleus ambiguous

93
Q

Infant larynx is between vertebrae ___ and ___

A

c3 and c4

94
Q

Adult larynx is between vertebrae ____ and ____

A

c4 and c7

95
Q

Name some characteristics of the infant laryngeal cartilages

A
  • 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
96
Q

Length of infant vocal folds

A

1.5-3 mm

97
Q

Fundamental frequency of newborn vocalizations

A

400-600 Hz

98
Q

Most infant vocalizations consist of ____, ____, and ____

A

cries, coughs and burps

99
Q

4 things that happen to the larynx during childhood

A
  • 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
100
Q

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

A

2-3

101
Q

During puberty, male vocal folds increase by ___ mm

A

12

102
Q

During puberty, female vocal folds increase by ___ mm

A

4 mm

103
Q

During puberty, female pitch drops by _____

A

2-3 semitones

104
Q

During puberty, male pitch drops by

A

around 1 octave

105
Q

Estrogen causes ____ in the vocal folds

A

Increased glandular secretions and reduced mucosal viscosity

106
Q

Progesterone causes ____ in the vocal folds

A

Decreased glandular secretions and mucosal dehydration

107
Q

Premenstrual vocal syndrome can include ____, ___, and ____

A

Vocal fatigue, decreased range, and loss of high harmonics

108
Q

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

A

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

109
Q

Symptoms of premenstrual vocal syndrome can be relieved by ___

A

Contraceptive pills

110
Q

Voice aging is related to …

A

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

111
Q

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

A

Estrogen, androgens

112
Q

Name some vocal symptoms associated with menopause

A

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

113
Q

What are some structural changes associated with aging

A

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

114
Q

During aging fundamental frequency ___ in males

A

Increases (this is extremely variable)

115
Q

During aging, fundamental frequency ____ in females

A

Decreases

116
Q

During aging, intensity levels _____

A

Decrease

117
Q

During aging, breathiness ______

A

Increases

118
Q

Presbyphonia results in auditory perceptual changes in the voice such as

A

altered pitch, hoarseness, breathiness, strain, slowed rate

119
Q

Presbyphonia results in visual perceptual changes in the larynx such as

A

vocal fold bowing, vocal fold atrophy, edema

120
Q

Presbyphonia results in acoustic changes in the larynx such as

A

Change in fundamental frequency, decreased intensity, increased noise

Voice Disorders (1 decks)

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