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55 Cards in this Set

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3 functions of the phonatory system

1) protect the airway during & after swallowing


2) generate phonatory source for vowels & voiced sounds


3) build up abdominal pressure for support

laryngeal framework

consists of: 1 bone, 9 cartilage (3 unpaired, 3 paired), 2 joints, 2 membranes, and cavities (supraglottis space, subglottis space, laryngeal vestibule/ventricle)

where is the larynx located?

- anterior to neck


- anterior to esophagus


- superior to trachea


- inferior to oral and nasal cavities



intrinsic muscles (broad)

- abductor, adductors, tensors/relaxers

extrinsic muscles (broad)

- laryngeal elevators


- laryngeal depressors

hyoid bone

- only "free floating" bone: not connected to any other bone


- serves as attachment to many muscles


- 3 landmarks: corpus, greater horns, lesser horns

thyroid cartilage

- largest cartilage of larynx


- made of hyaline cartilage


- shield like, open in posterior


- 3 landmarks: thyroid notch (laryngeal prominence, adams apple), superior horn, inferior horn

cricoid cartilage

- made up hyaline cartilage


- only completely closed cartilage of airway (closed mostly posteriorly)


- 2 landmarks: facet for thyroid cartilage & facet for arytenoid cartilage



arytenoid cartilage

- there's 2, made up hyaline


- vocal folds attached to end, so it opens & closes vocal folds


- 2 processes: muscular process (posterior) and vocal process (anterior)


- sits atop cricoid cartilage

corniculate cartilage

- theres 2, made up of hyaline


- used for structural support

cuneiform cartilage

- theres 2


- structural support


- embedded into aryepiglottic folds (skin, mucous lining)


- lateral to corniculate cartilage



epiglottis

- elastic cartilage


- helps protect airway during swallowing


- leaf like shape


- posterior to hyoid bone and thyroid cartilage

cricothyroid joint

- allows thyroid cartilage to rock forward and down


- lengthens true vocal folds (stretches like rubberbands)


- alters pitch

cricoarytenoid joint

- allows movement of arytenoids


- pulls artyenoids together (adducting) or aparting (abducting) -- how we open and close vocal folds


- changes position & tension of vocal folds to produce voice


- moves artyenoids in 3 dimensions


1) rocking: down & inward toward trachea


2) gliding: medial or lateral


3) rotation: clockwise or counter clockwise



larynx as a tube

- larynx = tube that connects upper & lower respiratory tracts


- quandrangular membrane holds bone and cartilage together (in upper)


- conus elasticus holds bone & cartilages (below)


- lined with epithelial tissue


- tube can constrict to produce disturbance in airflow by moving vocal cords into the air stream

supraglottic spaces

laryngeal spaces above the true vocal folds


- aditus: entryway into larynx


- laryngeal vestibule: space between aditus & false vocal folds


- laryngeal ventricle: space between true and false vocal folds

glottis

laryngeal space between true vocal folds

false vocal folds

- superior to true vocal folds


- can be used for screaming or forced holding breath (valsalva)


- not used for normal voicing


- protects airway

true vocal folds

- more mobile, moves in bottom-up wavelike motion


- inferior to false vocal folds


- anterior attachment to the thyroid cartilage


- posterior attachment to the vocal process of arytenoid cartilages

subglottic space

- below true vocal folds


- above trachea


- contains conus elasticus membrane

Layers of True Vocal Folds

1) Cover:


- thin outer epithelial layer


- superficial layer of lamina propria (gelatin)


- intermediate layer of lamina propria (soft rubberbands)


2) body:


- deep layer of lamina propria (cotton threads)


- thyroarytenoid (vocalis) muscle (stiff rubber bands)

intrinsic muscles

- have both origin & insertion on a laryngeal structure


- make fine adjustments to larynx


- especially important for voice production


- include: 3 adductors, 1 abductor, 2 tensors, 1 relaxer

extrinsic muscles

- especially important for swallowing (moves larynx out of harm's way)


- have one attachment on a laryngeal structure & other attachment on a distant structure


- make gross/large movements on larynx (raise or lower)


- 5 elevators (suprahyoid), 4 depressors (infrahyoid)

3 adductors

- transverse interarytenoid


- oblique interarytenoid


- lateral cricoarytenoid




- innervation: CN X Vagus, recurrent laryngeal branch


- action: adduct glottis

1 abductor

- posterior cricoarytenoid


- abducts glottis


- for termination of phonation or voiceless sounds


- origin: posterior of cricoid


- insertion: muscular process of arytenoid


- innervation: CN X, recurrent laryngeal branch

2 vocal fold tensors

- cricothyroid - tenses & lengthens TVF


- vocalis (medial thryoarytenoid): tenses TVF

1 vocal fold relaxer

- lateral thyroartenoid


- relaxes TVF


- pulls arytenoid down & in


- origin: thyroid cartilage (near notch)


- insertion: muscular process of arytenoid


- innervation: CN X vagus, recurrent laryngeal

laryngeal elevators (suprayhyoid)

- mylohyoid, anterior belly of digastric, posterior belly of digastric, stylohyoid, geniohyoid


- all inserted at hyoid bone

mylohyoid

- floor of mouth


- origin: inner surface of mandible


- insertion: hyoid bone


- innervation: CN 5, trigeminal


- moves hyoid up & forward (for swallowing)

anterior belly of digastric

- origin: inside midline of mandible


- insertion: hyoid bone


- innervation: CN 5 trigemnal


- moves hyoid up & forward

stylohyoid

- origin: styloid process of temporal bone (toothpick)


- insertion: hyoid bone


- innervation: CN 7 facial


- moves hyoid up & back

anterior belly of digastric

- origin: inside, midline of mandible


- insertion: hyoid bone


- innervation: CN 5 trigeminal


- moves hyoid up & forward



posterior belly of digastric

- origin: mastoid process of temporal bone


- insertion: hyoid bone


- innervation: CN 7, facial


- moves hyoid up & back

geniohyoid

- origin: inside midline of mandible


- insertion: hyoid bone


- innervation: CN 12, hypoglossal


- moves hyoid up & forward

laryngeal depressors (infrahyoid)

- sternohyoid, sternothyroid, superior belly of omohyoid, inferior belly of omohyoid


- no innervation


- action: move larynx down

sternohyoid

- beneath sternocleidomastoid


- origin: sternum


- insertion: hyoid bone


- move larynx down



sternothyroid

- origin: sternum


- insertion: thyroid cartilage (oblique line)


- move larynx down



superior and inferior belly of omohyoid

- origin: scapula


- insertion: hyoid bone


- move larynx down

most superior to inferior laryngeal elevators

geniohyoid -> mylohyoid -> anterior belly of digastric

most deep to surface laryngeal depressors

sternothyroid -> sternohyoid -> omohyoid (next to sternohyoid) -> sternocleidomastoid

phonation

- "voicing"


- occurs when TVF are adducted and vibrate in the upper airway

whispering

- TVF are slightly adducted to create turbulence in airstream, but not so much as to achieve phonation (not vibrating)

cover of TVF

- elastic (wants to return to original resting position after moved)


- responsible for vibration for phonation


- moves bottom up, wavelike motion

minimum airflow pressure required to achieve TVF vibration

- 3-5 cm h20 flow

bernoulli effect

- given a constant flow of air, at a point of constriction there will be a decrease in air pressure perpendicular to the flow and an increase in speed of the flow

steps of TVF vibration

1) inhale


2) exhale & adduct TVF (causes constriction)


3) maintain adduction. Positive subglottal pressure blows open TVF from bottom->up


4) glottis is blown open. airflow increases & pressure decreases


5) negative pressrue causes the TVF to close again, from bottom->up


6) repeat process many times per second to achieve phonation. maintain adduction of TVF

3 phases of phonation

1) vocal attack: process of adducting TVF into airstream to begin


2) sustained phonation: vibration of TVF while maintained/sustained in adducted position during exhalation "ahhhhh"


3) termination of phonation: process of abducting TVF to open glottis to stop vibration in airstream; required for voiceless sounds and breathing (posterior cricoarytenoid)

3 types of vocal attack in normal speech

1) breathy vocal attack: onset of exhalation occurs before vocal attack (adduction), whisper & voicing


2) simultaneous vocal attack: onset of exhalation and vocal attack (adduction) occur at the same time


3) glottal attack: vocal attack (adduction) occurs before onset of exhalation

3 modes of of TVF vibration (vocal registers)

1) modal register/phonation: pattern of phonation used in conversation (speech); most efficient register

2) glottal fry: pattern of phonation extremely low in pitch; sounds rough or crackly; TVF are short/thick, mostly closed (90%)


3) falsetto: pattern of phonation extremely high in pitch; TVF are long/thin and don't contact each other as frequently (10% closed)

2 variations of modal phonation

1) pressed phonation: medial compression of TVF is increased; results in harsh-sounding voice


2) breathy phonation: inadequate TVF medialization to achieve vibration; results in breathy voice

how do we alter pitch?

- length of TVF: contraction of cricothyroid muscle lengthens TVF


- increased length --> increased pitch


- tension in TVF: contraction of vocalis muscle tenses TVF


- increased tension -> increased pitch

voice disorer

when an individual uses the phonatory mechanism in a manner that exceeds its anatomical/physiological capacities

acute laryngitis

- inflammation of TVF, due to infection or vocal misuse


- TVF red and thick


- leads to hoarse voice or aphona (no voice)

vocal fold nodules

- tissue growth on anterior 1/3 of TVF, due to vocal misuse


- leads to breathy or hoarse voice

vocal hyperfunction

- over adduction of TVF


- associated with increased laryngeal tension


- due to vocal misuse


- leads to harsh voice