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165 Cards in this Set
- Front
- Back
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What are the three functions of the larynx?
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1. protection of the airway
2. pressure valving 3. phonation |
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What structures does the hyoid bone support?
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1. root of the tongue
2. larynx |
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How is the larynx attached to the body?
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1. ligaments
2. membranes 3. extrinsic laryngeal muscles |
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What are the landmarks of the hyoid bone?
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1. corpus
2. lesser cornu 3. greater cornu |
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What are the nine laryngeal cartilages?
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1. thyroid
2. cricoid 3. arytenoid (2) 4. cuneiform (2) 5. corniculate (2) 6. epiglottis |
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What are the features of the thyroid cartilage?
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1. lamina/alae
2. thyroid notch 3. superior cornu 4. inferior cornu 5. oblique line |
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What are the features of the cricoid cartilage?
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1. lamina (front of the ring)
2. arch (back of the ring) 3. cricoarytenoid articulatory facets 4. cricothyroid joint |
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What are the features of the arytenoid cartilages?
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1. vocal processes (tip)
2. apex 3. muscular processes (base near cricoid) |
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Where is the epiglottis attached?
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1. to the thyroid cartilage at the thyroid notch via the thyroepiglottic ligament
2. near the hyoid bone via the hypoepiglottic ligament |
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What is the function of the epiglottis?
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it protects the airway during swallowing.
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Define 'extrinsic laryngeal muscles'
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one attachment is in the larynx, one is outside the larynx
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List the suprahyoid muscles.
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1. digastric (anterior)
2. digastric (posterior) 3. geniohyoid (superior) 4. mylohyoid (inferior) 5. stylohyoid |
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What does the digastric muscle do?
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1. pulls hyoid anteriorly and up, or posteriorly and up, thereby potentially elevating the larynx.
2. depresses the jaw and mandible |
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1. Vallecula 2. Epiglottis 3. Ventricular Folds 4. Median Glossoepiglottic Fold 5. Piriform recess 6. Glottis 7. Vocal Folds 8. Aryepiglottic fold
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1. Epiglottis 2. Hyoid bone 3. Thyrohyoid membrane 4. Superior horn of Thyroid Cartilage 5. Thyroid Cartilage 6. Arytenoid Cartilage (ghost) 7. Inferior Horn of Thyroid Cartilage 8. Cricoid Cartilage 9. Trachea 10. Thyroid notch
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1. Epiglottis 2. Hyoid bone 3. Superior horn of thyroid cartilage 4. Thyrohyoid membrane 5. Thyroid cartilage 6. Inferior horn of thyroid cartilage 7. Vocal ligament 8. Trachea 9. Arytenoid cartilage 10. Cricoid cartilage
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1. Superior horn of thyroid cartilage 2. Epiglottis 3. Hyoid bone 4. Thyrohyoid membrane 5. Inferior horn of thyroid cartilage 6. Thyroid cartilage 7. Cricothyroid membrane 8. Cricoid cartilage 9. Trachea
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1. Superior horn of thyroid cartilage 2. Thyrohyoid membrane 3. Arytenoid cartilage 4. Muscular Process 5. Vocal Process 6. Vocal ligament 7. Trachea 8. Epiglottis 9. Hyoid bone 10. Thyroid cartilage 11. Cricothyroid membrane 12. Cricoid cartilage
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1. Arytenoid cartilage 2. Muscular process 3. Vocal Process 4. Cricoid cartilage
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1. Oblique head of Cricothyroid muscle 2. Vertical head of Cricothyroid muscle
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1. Aryepiglottic muscle 2. Oblique arytenoid muscle 3. Transverse arytenoid muscle 4. Posterior cricoarytenoid muscle
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1. Oblique and Transverse Arytenoid muscle 2. Posterior Cricoarytenoid muscle 3. Thyroarytenoid muscle 4. Oblique head of Cricothyroid muscle 5. Vertical head of Cricothyroid muscle
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1. Posterior Cricoarytenoid muscle 2. Transverse and Oblique Arytenoid muscle 3. Lateral Cricoarytenoid muscle 4. Vertical and Oblique Cricothyroid muscle 5. Thyroarytenoid muscle 6. Vocalis muscle 7. Muscular process 8. Vocal process 9. Vocal ligaments
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1. Superior Laryngeal Branch of Vagus 2. Internal Laryngeal nerve 3. External Laryngeal nerve 4. Inferior Laryngeal nerve 5. Recurrent Laryngeal nerve
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Cricothyroid muscle does what action?
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Tenses the vocal cord
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Posterior Cricoarytenoid does what action?
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Abducts the vocal cords
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Lateral Cricoarytenoid does what action?
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Adducts the vocal cords
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Transverse arytenoid does what action?
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Adducts the vocal cords
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Thyroarytenoid muscle does what action?
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Shortens the vocal cords
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Where are the attachments for the digastric anterior belly?
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O - lower border of mandible near mandibular symphysis
I - intermediate tendon |
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What are the attachments for the digastric posterior belly?
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O - mastoid process
I - intermediate tendon |
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What do the mylohyoid and geniohyoid muscles do?
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Both pull hyoid anterior and up, and potentially elevate the larynx
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What are the mylohyoid (inferior) attachments?
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O - mylohyoid line on inner surface and mandible
I - midline raphe |
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What are the geniohyoid (superior) attachments?
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O - mental spine mental symphysis of mandible
I - hyoid body |
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What are the attachments of the stylohyoid muscle?
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O - stylohyoid process of temporal bone
I - body of hyoid |
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What is the function of the stylohyoid muscle?
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1. draws hyoid up and back (like posterior belly of the digastric muscle)
2. potentially elevates the larynx |
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Name the infrahyoid muscles of the larynx.
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1. omohyoid
2. sternohyoid 3. sternothyroid 4. thyrohyoid |
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What are the attachments of the sternohyoid muscle?
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O - manubrium of the sternum & end of clavicle
I - lower border body of hyoid |
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What is the function of the sternohyoid?
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Pulls down on the hyoid bone. Effect on the laryngeal position: lowers the larynx
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What are the attachments of the omohyoid muscle (inferior belly)?
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O - scapula
I - intermediate tendon |
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What are the attachments of the omohyoid muscle (superior belly)?
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O - intermediate tendon
I - great horn of hyoid |
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What are the functions of the omohyoid muscle?
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1. pulls hyoid down and back
2. potentially lowers and depresses larynx |
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Define the following:
1. cornu 2. infra 3. supra 4. omo 5. crico 6. thyro 7. gastro 8. genio 9. glosso 10. myo 11. palato 12. sterno 13. sulco 14. thoraco 15. di 16. stylo |
1. cornu - horn
2. infra - below, beneath 3. supra - above, beyond 4. omo - shoulder 5. crico - ring 6. thyro - thyroid gland 7. gastro - stomach 8. genio - chin 9. glosso - tongue 10. myo - muscle 11. palato - palate 12. sterno - sternum 13. sulco - furrow, groove 14. thoraco - chest 15. di - two 16. stylo - pointed instrument |
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What are the attachments of the sternothyroid muscle?
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O - manubrium of sternum & first costal cartilage
I - oblique line of thyroid |
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What is the function of the sternothyroid muscle?
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lowers the larynx by pulling down on the thyroid cartilage
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What are the attachments of the thyrohyoid muscle?
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O - oblique line of thyroid
I - hyoid |
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What is the function of the thyrohyoid muscle?
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elevates the larynx or depresses hyoid **
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Define 'intrinsic laryngeal muscles'.
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have both origin and insertion in the larynx
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List the intrinsic laryngeal muscles:
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1. posterior cricoarytenoids
2. lateral cricoarytenoids 3. arytenoids - transverse and oblique 4. cricothyroids 5. thyroarytenoids |
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What are the attachments of the posterior cricoarytenoid muscles?
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O - posterior surface of cricoid cartilage (lamina)
I - muscular process of arytenoid cartilage (AC) |
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What is the function of the posterior cricoarytenoid muscles?
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abducts the vocal folds by rocking AC back, thus rotating vocal processes away from the midline
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The posterior cricoarytenoid muscles are the only laryngeal ___________.
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abductors
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What innervates the posterior cricoarytenoids?
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RLN (recurrent laryngeal nerve)
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What are the attachments of the lateral cricoarytenoids?
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O - upper border & anterolateral arch of cricoid
I - muscular process of arytenoids |
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What is the function of the lateral cricoarytenoids?
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adducts vocal processes and adducts membranous portions of vocal folds
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What innervates the lateral cricoarytenoids?
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RLN (recurrent laryngeal nerve)
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What are the attachments of the oblique (x-shaped) interarytenoids?
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O - posterior part of the muscular process of AC (arytenoid cartilage)
I - courses up & across to apex of opposite arytenoid |
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What are the attachments of the transverse (horizontal) interarytenoids?
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O - lateral-posterior aspect of AC (arytenoid cartilage)
I - courses across to opposite AC |
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What is the function of the interarytenoids?
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adducts arytenoid cartilages & thus cartilaginous glottis (posterior glottis)
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What are the two parts of the cricothyroid muscles, and how are they connected?
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1. pars oblique - lower muscle arises from anterolateral arch of cricoid & inserts on inferior horn of thyroid
2. pars recta - courses vertically to lower margin of thyroid |
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What happens when the cricothyroid muscles contract?
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decreases distance between thyroid and cricoid cartilages & increases distance between thryoid & artytenoid cartilages. Lengthens VFs, which increase longitudinal tension of folds and results in an increase in pitch
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What innervates the cricothyroid muscles?
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SLN (superior laryngeal nerve)
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What are the possible movements via articulation of thyroid and cricoid cartilages?
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1. rocking of the thyroid on the cricoid
2. slight anterioposterior movement |
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What are the two parts of the thyroarytenoid muscles?
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1. thyrovocalis (lateral to vocal ligament)
2. thyromuscularis (lateral to thyrovocalis) |
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What are are the connections of the TA (thyroarytenoid) muscles?
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O - deep surface of they thyroid angle
I- lateral/inferior aspects of the vocal processes of arytenoids, some fibers attach to muscular process |
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What is the function of the TA (thyroarytenoid) muscles?
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decrease the distance between thyroid and arytenoid cartilages, shorten vocal folds, relax cover, tense body, bulk VFs, aid in abduction, can increase or decrease pitch
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What is meant by "origin" and 'insertion"?
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The muscle's origin is attached to the immovable bone. At its other end, the insertion is attached to the movable bone. Body movement occurs when muscles contract across joints and their insertion moves towards their origin.
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What areas are involved in HIGHER CORTICAL speech movement control?
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1. (MOTOR) pre-central gyrus of frontal lobe/(SENSORY) post-central gyrus of parietal lobe (called the Rolandic area)
2. Broca's area (in frontal lobe) 3. supplementary motor area (in frontal lobe) |
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What areas are involved in SUBCORTICAL CONTROL
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1. Basal Ganglia
2. Thalamus 3. Midbrain - periaqueductal grey (PAG) 4. Brainstem - the medulla, houses nucleus ambiguous from which CN X, the Vagus nerve arises |
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Which cranial nerve innervates the larynx?
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Cranial Nerve X (Vagus nerve)
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What the function of the Vagus Nerve (Cranial Nerve X)?
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1. provides sensory innervation
2. provides motor innervation to intrinsic laryngeal muscles |
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Where are the cell bodies of the Vagus?
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in the Nucleus Ambiguus in the Medulla
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What two nerve branches serve the larynx?
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1. superior laryngeal nerve
2. recurrent laryngeal nerve |
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What are the two branches of the Superior Laryngeal Nerve (which is a branch of the Vagus Nerve)
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1. Internal Branch - which descends and enters larynx thru opening in thyrohyoid membrane
2. External Branch - descends on the larynx, beneath the sternothyroid muscle, to innervate the cricothyroid muscle |
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What does the Internal Branch of the SLN do?
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it retrieves sensory information from the surface of the inferior pharyngeal constrictors
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What does the External Branch of the SLN do?
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1. gives motor innervation to cricothyroid and inferior pharyngeal constrictor
2. retrieves sensory info from surface of inferior pharyngeal constrictors |
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What does the Recurrent Laryngeal Nerve (RLN) do?
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1. gives motor innervation to all intrinsic laryngeal muscles (except for the cricothyroid)
2. retrieves sensory info from infraglottic larynx |
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In the Recurrent Laryngeal Nerve (RLN), what is the path of the Right Nerve versus the Left Nerve?
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right - loops around subclavian artery, then ascends along side the trachea
left - loops around left side of aortic branch, then ascends along side the trachea |
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What is the path of the Recurrent Laryngeal Nerve (RLN)?
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it enters the larynx at inferior cornu of TC, which point of articulation for TC & CC
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What is the two-layer scheme to describe vocal fold layers?
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1. body
2. cover |
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What is the three-layer scheme to describe vocal fold layers?
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1. cover
2. transition 3. body |
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What is the five-layer scheme to describe the vocal fold layers?
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1. epithelium - outer then, stiff capsule
2. superficial layer lamina propria (Reinke's space) 3. intermediate lamina propria 4. deep lamina propria 5. thyroarytenoid |
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In the 3-layer VF scheme, the COVER is composed of...
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the mucous membrane, which is...
1. epithelium (squamous cell) 2. superficial lamina propria - mostly elastin fibers and some collagen - like jello covered with plastic wrap aka Reinke's Space |
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In the 3-layer VF scheme, the TRANSITION is composed of....
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the vocal ligament, which is...
1. intermediate lamina propria (more collagen and elastin, like a bundle of rubber bands) 2. deep lamina propria (lots of collagen, like a bundle of cotton threads) |
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In the 3-layer VF scheme, the BODY is composed of...
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the thyroarytenoid muscle, which is...
1. vocalis 2. muscularis |
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What does that Basement Membrane Zone do?
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It secures the epithelium to the Superior Lamina Propria
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Why is the Basement Membrane Zone susceptible to injury?
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1.vibration
2. shearing forces 3. disease and injury damage connections between epithelium and BMZ |
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Children have little or no vocal ligament until...
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1-4 years old
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In newborns, the lamina propria is...
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not yet differentiated as a 3 layer stucture; no differentiation between elastin and collagen
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By what age does a person develop a 3- layer lamina propria?
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15
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What cartilages are disproportionately large in infants?
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arytenoids (in relationship to thyroid and cricoid cartilages)
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In aging VF, the SLP becomes...
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1. edematous (swollen)
2. thicker |
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In aging VF, intermediate layer of lamina propria starts to thin due to...
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1. loosening
2. atrophy |
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In aging VF, deep layer of lamina propria becomes...
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1. thicker
2. denser |
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In aging VF, what happens to the TA muscle?
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it atrophies
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Other problems in aging VF...
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1. decreased innervation to laryngeal muscles
2. cartilages calcify |
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For VF adduction to occur, the following needs to happen...
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1. interarytenoids - adduct arytenoid cartilages & cartilaginous glottis
2. lateral cricoarytenoids - rocks muscular processes of VFs down/forward and adducts vocal processes & membranous VFs 3. thyroarytenoids - on contraction, shortens VFs, relaxes the cover but tenses the body. Aids in medial adduction by "bulking up" VFs |
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When does adduction occur in speech?
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Whenever a voiced sound occurs
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How does VF abduction occur?
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Posterior cricoarytenoids rotate arytenoid cartilages by pulling muscular processes down and medially moving vocal processes apart, thus abducting VFs
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How do the vocal folds open and close?
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1. open from bottom to top and close from bottom top
2. while top is opening, bottom is beginning to close 3. called "vertical phase difference" 4. VF close from anterior to posterior |
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What are the membranes/ligaments of the larynx?
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1. thyrohyoid membrane
2. conus elasticus(aka cricothyroid membrane) 3. cricotracheal membrane 4. aryepiglottic folds |
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What is the myoelastic aerodynamic theory of phonation?
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1. myoelastic - muscle activity during vibration and the elasticity of VFs
2. aerodynamic - determinants of the vibratory cycle (i.e., the opening and closing phases of vibration) |
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What are the aerodynamic forces that determine VF vibration?
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1. subglottal pressure (Ps)
2. negative pressure due to the Bernoulli effect |
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How does subglottal pressure (Ps) enable phonation?
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1. VFs adduct
2. air pressure (Ps) builds below Vfs-Ps is the opening force 3. VFs open, a puff of air escapes & glottis closes abruptly after 4. one puff follows another & an audible air pressure wave is set up at glottis & in the VT 5. for vibration to occur, pressure must be greater below the VFs than above |
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What is the average Ps for conversational speech?
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7-10 cm H2O
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What is Phonation Threshold Pressure (PTP)?
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the minimum amount of subglottal pressure required to initiate VF vibration
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What effects Phonation Threshold Pressure (PTP)?
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1. VF tension - PTP is higher for higher pitches
2. VF Viscosity - greater viscocity = increased PTP 3. VF Thickness - greater thickness = decreased phonation PTP (VFs are less stiff) |
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What is the formula for PTP?
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0.1 to 1.0 kPa or 1-10 cm H2O
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How does VF vibration occur?
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1. VFs abduct via PCA muscles; inhalation occurs
2. VF folds adduct via LCA, IA, TA muscles 3. Ps builds beneath VFs, folds are blown apart 4. VFs open at bottom first, then opening proceeds to top of VFs 5. As top of VFs open, bottom begins to close |
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What is a mucosal wave?
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The wave-like motion of of the cover of the VFs
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Opening phase of VF vibration is due to...
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build up of Ps
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Closing phase of VF vibration is due to...
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1. elasticity and mass of the VFs which moves VFs back to midline (closed) position
2. the Bernouli effect |
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How does the mucosal wave move?
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the wave appears to travel across the superior surface of the VFs about 1/3 to 2/3rds of the way from lateral edge of the fold
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What is the Bernoulli Effect?
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1. When a gas/liquid flows through a constricted passage, the velocity increases while the outward pressure of the molecules of the gas decreases
2. the pressure drop is perpendicular to the direction of the flow 3. if the walls are pliable, the decrease in the outward pressure of the flowing gas molecules moves the walls toward each other |
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How does the Bernoulli Effect work with the VFs?
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1. subglottal pressure forces VFs apart
2. the narrow space that's creased in the glottis causes velocity of the air molecules to increase as they pass through the glottis 3. the increase in air molecule velocity results in decrease in pressure between the VFs 4. Decrease in pressure causes the walls of the glottis (VFs) to come together, along with the natural elastic recoil of the Vfs, this closes the VFs |
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What is VF Inertance?
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build up and release of supraglottic pressure is delayed in respect to opening and closing of VFs; asymmetry between driving force tissue velocity due to the presence of VT
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Explain nonuniform tissue movement in a convergent versus a divergent glottis.
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1. convergent - VFs are opening from bottom to top, pressure is positive, net velocity is outward
2. divergent - VFs are closing bottom to top, pressure is negative, net tissue velocity is inward |
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An essential feature of self-sustained oscillation is...
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assymetry
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What kind of sound is generated by the VF?
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quasi-periodic complex tone composed of...
1. frequency 2. harmonics |
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define periodic
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a sound wave that repeats itself exactly the same way for each cycle of vibration
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define complex tone
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a sound with more than one frquency (ex: vocal folds, guitar string,etc.)
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define sine wave (pure tone)
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a sound with one and only one frequency (ex: tuning fork)
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Whole number number multiples of the fundamental frequency are...
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harmonics
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the lowest frequency of the complex tone (and the frequency of the VF vibration) is...
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fundamental frequency
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At what rate does the amplitude of harmonics decrease?
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12 dB per octave
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VB vibration is determined by...
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1. mass/thickness
2. length/tension 3. elastisicty |
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Compare average length of VF between men and women...
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Men: 17-24 mm
Women: 13-17 mm |
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What determines the fundamental frequency of the VF when AT REST?
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1. the longer the VF
2. the greater the mass/thickness = the LOWER the fundamental frequency |
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What is the average fundamental frequency for men vs women?
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Men: 125 Hz
Women: 225 Hz |
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Fundamental frequency for speech is a person's...
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average speaking pitch
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When VFs are lengthened and tensed, the the frequency INCREASES. Why?
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The lengthening increases VF tension and decreases the effective mass of the VFs
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How do parts of the larynx move to increase frequency?
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1. cricothyroid muscles contract
2. cricoid and thyoid cartilages move towards each other, while thyroid and arytenoid cartilages move further apart 3. posterior part of cricoid moves backwards while thyroid cartilage tilts down 4. VFs are stretched 5. this increase in longitudinal tension increases pitch |
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Which extrinsic muscles affect frequency and why?
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1.lowering frequency - sternoyhyoid, maybe sternothyroid
2. raising frequency - suprahyoids Both of these causes changes in the vertical tension in the conus elasticus, which is contiguous with the vocal ligament |
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How do the CTs control VF frequency?
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CTs can elongate the VFs, increasing longitudinal tension and thus increasing pitch
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How does elevation/depression of larynx by intrinsic muscles affect frequency?
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elevation - increase in frequency
depression - decrease in frequency |
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the contraction of which muscle can either increase or decrease frequency?
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thyroarytenoid
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Other than cartilage movement, increasing ________ ___________ can also increase frequency.
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subglottal pressure
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What are the two muscular mechanisms for pitch control?
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1. CT muscle and how it effects tension of the VF cover
2. TA muscle and how it can either increase or decrease pitch depending on the depth of VF vibration and level of activity in the CT muscle |
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At low-mod intensity speech or in falsetto, only the _______ ________ vibrates.
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VF cover (according to the Body-Cover theory of pitch control)
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At high intensity speaking and singing, what parts of the VF are involved in vibration?
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1. body
2. cover |
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At high intensity speaking/singing, when the ______ contracts, overall stiffness/tension of the VFs increases and pitch will INCREASE as long as ________ is not at maximum activity.
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1. TA (Thyroarytenoid)
2. CT (Cricothyroid) |
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To increase intensity, one must increase subglottal pressure (Ps), which often increases frequency. Is has to do with VFs lengthening and increasing tension. This is called...
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Dynamic Strain
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How do singers compensate for dynamic strain?
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They decrease cricothyroid or thyroarytenoid muscle activity while increasing subglottal pressure
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A series of frequencies that are perceptually similar in quality are are produced in the same physiological manner are called a...
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register
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A sudden change in vocal timbre is called a...
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register transition
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Why do register transitions occur?
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1. change in muscle activity that results in a change in mode or vocal fold vibration
2. subglottic resonances interfering with vibration |
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What is the register we speak in called?
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Modal (chest) voice
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What are the characteristics of the modal voice?
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1. thicker folds (rectangular glottis)
2. complete VF closure 3. closed phase of vibration is equal in duration or longer than open phase 4. greater energy in the mid and upper frequency harmonics 5. greater amplitude of vibration and mucosal wave excursion |
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What are the characteristics of the falsetto voice?
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1. VF appear elongated, thinner and stiff
2. incomplete or bow-shaped glottal closure 3. open phase of vibration is longer than closed phase 4. only anterior 2/3rd of VF vibrates 5. decreased energy in the mid & uppper harmonics 6. decreased amplitude of vibration and lateral excursion of mucosal wave 7. greater airflow than chest 8. sometimes a breathy quality |
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What state is this voice in?
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Rest
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What state is this larynx in?
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Falsetto
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What state is this larynx in?
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Modal
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what state is this larynx in?
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Whispering
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What state is this larynx in?
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Inhalation
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What is the lowest vocal register, and what frequency is it at?
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glottal fry = 70-90 Hz
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What are the characteristics of the glottal fry?
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1. tightly adducted but flaccid appearing VFs
2. a very long closed phase 3. a 'double' vibration followed by an extended closed phase (nearly 2/3 of vibratory cycle) 4. low air flow |
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At what three places in the vocal tract can intensity be controlled, and in what way?
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1. below the larynx (increase Ps)
2. at the larynx (increase VF adduction) 3. above the larynx (vocal tract adjustments) - any harmonic in the vicinity of a VT formant gets a boost in amplitude |
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What is MFDR (maximum flow declination rate)?
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how rapidly the air flow goes to 0 at VF closure
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What are the five primary parameters used to describe voice production?
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1. quality - breathy, hoarse, raspy, gravelly, strangled, strained, etc.
2. pitch - low, normal, high 3. loudness - soft, normal, loud 4. resonance - timber: dark, bright, throaty/back, nasal etc. 5. register - glottal fry, modal, falsetto |
