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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?
cricoid, thyroid, epiglottis
What are the three unpaired cartilages of the larynx?
arytenoid, corniculate, cuneiform
What are the three paired cartilages of the larynx?
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
thyrohyoid, thyroepiglottic, hyoepiglottic, and cricotracheal ligaments
What are the four extrinsic ligaments of the laryngeal membrane?
the cricothyroid ligament (conus elasticus) and the quadrangular membrane
What are the two intrisic ligaments of the laryngeal membrane (aka vocal ligaments)?
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; cavity in the throat on either side of the larynx; the transition point for food and liquid
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 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
lateral cricoarytenoid, transverse arytenoid, oblique arytenoid
What are the three adductor muscles that close the vocal folds?
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 and thyrovocalis
What are the two tensor muscles in the larynx?
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
geniohyoid, mylohyoid, anterior digastric muscle (MADGE)
What are the three anterior elevators of the larynx?
anterior and posterior
When swallowing, the hyoid moves in which directions?
stylohyoid and posterior digastric muscle (SPED)
What are the two posterior elevators of the larynx?
stylohyoid muscle
suprahyoid muscle that is a posterior elevator of the larynx; attached between the styloid process and the hyoid bone; functions to move the hyoid up
facial nerve (CN 7)
Which cranial nerve innervates the stylohyoid muscle?
mylohyoid muscle
suprahyoid muscle that moves the hyoid anteriorly during swallowing and depresses the mandible when opening the mouth
trigeminal nerve
Which cranial nerve innervates the mylohyoid muscle?
hyoglossus muscle
suprahyoid muscle that functions to depress & retract the tongue and elevate the hyoid
hypoglossal nerve
Which cranial nerve innervates the hyoglossus muscle?
genioglossus muscle
suprahyoid muscle; the main tongue muscle; forms most of the tongues mass and functions to protrudes and depresses the tongue; connects to the chin and has a few fibers connected to the hyoid so assists in hyoid elevation
thyropharyngeus muscle
suprahyoid muscle that elevates the larynx; part of the interior pharyngeal constrictor (constricts the lower pharynx to propel the bolus downwards into the esophagus during swallowing)
sternohyoid, omohyoid, sternothyroid, throhyoid (STOS)
What are the four infrahyoid extrinsic muscles in the larynx?
sternohyoid muscle
infrahyoid muscle that depresses the hyoid or (if suprahyoid muscles are contracted) fixes the hyoid & larynx in place
omohyoid muscle
thin, long, infrahyoid muscle that has two bellies (inferior and superior); depresses the hyoid bone and the larynx; stabilizes the hyoid bone during swallowing, assists in respiration by widening the airway, and helps stimulate blood flow in veins in the neck
sternothyroid muscle
infrahyoid muscle that depresses the thyroid cartilage
thyrohyoid muscle
infrahyoid muscle that 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
