Exam #2 (Ch 3.5-5.5) A&P for CSD

Paramby Spring 2025

voiceless sounds

sounds produced without the use of vocal folds; open vocal folds, sound based on breath; ex: /s/, /f/, /p/

voiced sounds

sounds produced by an action by the vocal folds; closed or partially closed vocal folds + airflow from lungs = vibration of vocal folds; ex: /z/, /v/, /b/

phonation

the shaping of vocal production into speech; the sounds heard; occurs within the larynx

respiration

What provides energy for phonation?

vocal folds

layers of tissue and muscle that vibrate as air passes between them, producing phonation

1) squamous epithelium

2) superficial lamina propria

3) intermediate lamina propria

4) deep lamina propria

5) thyroarytenoid muscle

What are the five layers of vocal folds?

glottis

the space between the vocal folds; the most important laryngeal space for speech

sphincter

a ring of muscle surrounding, guarding, or closing an opening or tube

subglottal

area below the vocal folds

larynx

a hollow tube forming an air passage that connects the pharynx and the trachea; produces phonation with the vocal cords, protects airway from food, and allows for holding of breath; located at the top of the last ring of the trachea and adjacent to cervical vertebrae 4-6; aka voice box

males

Do males or females have longer larynxs?

44 mm

What is the average length of the larynx in adult males?

36 mm

What is the average length of the larynx in adult females?

hyoid bone

u-shaped bone in the middle of the neck at the base of the mandible; supports the tongue muscles and anchors the larynx; loosely articulates with superior cornu of thyroid cartilage; only bone that does not articulate directly with any other bone

trachea

a large membranous tube reinforced by rings of cartilage, extending from the larynx to the bronchial tubes and conveying air to and from the lungs; aka the windpipe

cricoid cartilage

unbroken ring-shaped laryngeal cartilage that sits immediately on the trachea; forms the inferior border of the larynx

thyroid cartilage

laryngeal cartilage that sits above the trachea and articulates with the cricoid cartilage

arytenoid cartilage

tiny paired triangle-shaped cartilage that sits above the cricoid cartilage

vocal ligament

ligament that runs from the arytenoid to thyroid cartilage; functions to move the vocal folds

lateral cricoarytenoid muscle

intrinsic muscle that adducts the vocal fold towards the midline by rotating the arytenoid cartilages inward, narrowing the glottis and bringing the vocal folds together; also closes to protect the airway

laryngectomy

surgery in which the larynx is completely removed, usually in response to cancer; the last resort; results in a hole cut in the neck through which the patient breathes and sometimes speaks; requires much education before and after the surgery; infection is common and can no longer swim

stoma

hole in the neck and trachea as a result of a laryngectomy surgery; where they breathe through, and sometimes talk through

cricoidpharyngeus muscle

muscle responsible for burping and TEP speech

esophageal speech

speech done by injecting air into the esophagus (aka burp speech); possible by anyone but not intuitive; used by laryngectomy patients frequently

tracheo esophageal protists (TEP)

prosthetic inserted into stoma after laryngectomy that allows patient to speak mostly normally by rerouting the voice back through the mouth

false vocal cords

aka vestibular folds; layer immediately next to the true vocal folds that in normal function, do not vibrate; helps with swallowing and glottal noises

extrensic

a muscle, cartilage, or ligament that is attached to a different structure on each end

intrensic

a muscle, cartilage, or ligament that is attached within the same structure on each end

valleculae

small mucosa-lined depression at the base of the tongue and the epiglottis

pyriform sinus

space between the aryepiglottic fold and the thyroid cartilage on either side of the larynx

glottis

the space between the true vocal folds

rima vestibuli

the space between the false vocal folds

aditus

cavity that makes up the entry to the larynx from the superior pharynx; the entrance into the larynx

vestibule

cavity that makes up the space between the aditus and the false vocal cords

laryngeal ventricle

mucosa-lined space between the true and false vocal folds

laryngeal saccule

anterior portion of the laryngeal ventricle containing mucus glands to lubricate the vocal folds

conus elasticus

a funnel-shaped ligament in the larynx that helps with airflow and vocal fold vibration; stretches from true vocal fold to the cricoid cartilage, behind the cricothyroid muscle

adduction, abduction, tense, relax

What are the four movements of the vocal folds?

cricothyroid joint

synovial joint that allows the cricoid and thyroid to rotate and glide relative to each other; allows for changes in pitch

cricoarytenoid joint

synovial joint that allows rocking, gliding, and minimal rotation; connects to vocal ligaments; allows for vocal folds to make contact with one another

vagus nerve

cranial nerve responsible for sensation and motor control in the thorax, neck, and abdomen; responsible for most speech movements

recurrent laryngeal nerve (RLN)

Which branch of the vagus nerve innervates all the parts of the larynx (except one)?

superior laryngeal nerve (SLN)

Cricothyroid is the only part of the larynx not innervated by the recurrent laryngeal nerve (RLN) branch of the vagus nerve. What branch is is innervated by instead?

vocal fold paralysis

vocal condition where the vocal folds are not coming together all the way, likely because one side is not working properly; results in breathy voice

transverse arytenoid muscle

adductor muscle that functions to close the vocal folds; stretches between the arytenoid cartilages

adductor muscle

muscle that closes the vocal fold

abductor muscles

muscles that function to open the vocal folds

posterior cricoarytenoid

What is the one abductor muscle that open the vocal folds?

cricothyroid muscle

the primary muscle for pitch adjustment; functions to tense and relax the vocal folds; innervated by the SLN

thyrovocalis muscle

the inner, smaller part of the thyroarytenoid muscle; fine-tunes vocal pitch, shortening vocal folds and influencing voice quality; responsible for increasing vocal fold mass

thyromuscularis

the outer, broader part of the thyroarytenoid muscle; makes larger adjustments in vocal fold length, affecting pitch and voice quality; responsible for shortening and relaxing the vocal folds

the one relaxer muscle of the larynx

suprahyoid vs infrahyoid

What are the two types of extrinsic laryngeal muscles?

suprahyoid muscles

group of extrinsic laryngeal muscles that are found above the hyoid bone and function to elevate the bone

infrahyoid muscles

group of extrinsic laryngeal muscles that are found below the hyoid bone and function to depress the bone

anterior and posterior

When swallowing, the hyoid moves in which directions?

stylohyoid muscle

extrinsic suprahyoid muscle that stretches between the styloid process and the hyoid bone;

Function: elevate and retract hyoid bone

facial nerve (CN 7)

Which cranial nerve innervates the stylohyoid muscle?

mylohyoid muscle

extrinsic suprahyoid muscle that stretches between the mandible and the hyoid bone; makes up the floor of the oral cavity

Function: moves hyoid anteriorly during swallowing and depresses the mandible when opening the mouth

trigeminal nerve

Which cranial nerve innervates the mylohyoid muscle?

hyoglossus muscle

extrinsic suprahyoid muscle that functions to depress & retract the tongue and elevate the hyoid

Function: lingual depressor

hypoglossal nerve

Which cranial nerve innervates the hyoglossus muscle?

genioglossus muscle

extrinsic suprahyoid muscle; the main tongue muscle; forms most of the tongues mass and connects to the chin and hyoid

Function: tongue muscle and hyoid elevator

thyropharyngeus muscle

extrinsic suprahyoid muscle; part of the interior pharyngeal constrictor

Function: elevates the larynx and constricts pharynx to move food during swallowing

sternohyoid muscle

extrinsic infrahyoid muscle that stretches between the sternum and the hyoid bone

Function: depresses hyoid or (if suprahyoid muscles are contracted) fixes the hyoid & larynx in place

omohyoid muscle

extrinsic infrahyoid muscle that has two bellies, inferior and superior; Function: depresses the hyoid bone and the larynx

sternothyroid muscle

extrinsic infrahyoid muscle that stretches between the sternum and the oblique line of the thyroid cartilage

Function: depresses the thyroid cartilage

thyrohyoid muscle

extrinsic infrahyoid muscle that stretches between the oblique line of the thyroid cartilage and the hyoid bone

Function: depresses the hyoid or raises the larynx

vocal ligaments

aka intrisic laryngeal muscles; part of the vocal folds made of elastic tissue; make fine adjustments for phonation control quickly (ex: change 7 times in one second when saying “Mississippi”)

smoke and poluttants

The vocal folds are sensitive to the external environment. What are two common external things that damage them?

dehydration and excessive bile

The vocal folds are sensitive to the internal environment. What are two common internal things that damage them?

drinking water, humidification, medication

What are three common therapies to help with vocal fold damage?

contact ulcers (sores) and vocal nodules (growths)

What are two common damages to the vocal folds?

tracheastomy

incision between two trachial cartilages in the neck below the vocal folds to reroute air if there is an issue with the vocal folds (swelling, cancer, etc.); vocal folds remain, but patient’s inhalation is routed around them

speaking valve

device used with tracheastomy patients to allow them to breath in through the tube and out past the vocal folds

coughing, throat clearing, abdominal fixation

What are the three ways the larynx protects the lungs?

elasticity

the measure of the ability of a material to return to its original shape after displacement

stiffness

the strength of force within a material to maintain its elasticity and return to its original shape

inertia

principle that a body in motion tends to stay in motion

periodic waveform

waveform that repeats in a predictable fashion

cycle

the measurement between identical points on consecutive crests or troughs

period

the time it takes to complete one cycle of vibration

frequency

how many times the vocal folds vibrate in a second; cycles/second

f = 1/T

What is the formula for frequency if given period?

around 100 Hz

What is a good estimate of the average frequency for adult males?

around 200 Hz

What is a good estimate of the average frequency for adult females?

Hertz

the unit for frequency; represents VF/sec or cycles/sec

inversely proportional

Frequency is (directly/inversely) proportional to period.

pitch

the perception of Hertz

time

What is the horizontal measurement of a waveform diagram?

pressure

What is the vertical measurement of a waveform diagram?

intensity

increased amplitude of a waveform

amplitude

degree to which a waveform goes beyond the x-axis (it’s “height”)

P = F/A

What is the formula for sound pressure?

decibel (dB)

the measurement of intensity or amplitude; logarithmic unit used to express the ratio of sound intensity and reference intensity

loudness

the perception of decibel

sound level meter (SLM)

instrumentation that measures the intensity (dB) of the sound pressure coming from a source; used by SLPs to measure the loudness of speech

fundamental frequency

the lowest frequency which is produced by the vibrating of the vocal folds

vocal jitter

variations in vocal fold vibration (frequency) from cycle to cycle; normal in small quantities, concerning when more frequent

vocal shimmer

variations in vocal intensity from cycle to cycle; normal in small quantities, concerning when more frequent

phonetogram

a graph of a person's vocal intensity range over a range of fundamental frequencies (F0); used to assess vocal limits and detect potential voice problems

graph of the interaction between intensity and frequency in someones voice