Phonatory System: Processes, Framework, Joints, Ligaments/Membranes, Internal Structures

PHONATION

Aka voicing, Product of the vibration of the vocal folds, Source of voice, Powerhouse of the voice

LARYNX

“Voice box”: MusculoCartilaginous tissue

Anatomical location: Cervical Region, Anterior to the esopahgus, Proximal, near the middle, or actually in the midline

Hyoid bone, Trachea

LARYNX: Superior border: \___ Inferior border: \___

Protection of the lower respiratory tract

PHONATION BIOLOGICAL FUNCTIONS: Prevents foreign materials (e.g., food and liquids) from entering the larynx, Forcefully expels foreign stuff

Allows thoracic fixation

PHONATION BIOLOGICAL FUNCTIONS: (aka holding of breath): Lifting of heavy objects, Childbirth, Bowel and bladder evacuation, if you hold breath, you’ll feel something closing sa throat

HYOID BONE

Serves as the origin and insertion of many muscles (22 or 23 muscles attached), including those important for speech, Not directly attached to any other bone; Upper region of the neck, third cervical vertebra, above adams apple a bit, u-shaped

thyroid cartilage

Hyoid Bone: Main attachment:

mobile

Hyoid Bone: because of the muscles, it make hyoid very \___ which helps in speech and swallowing

Hyoid sling muscles

muscles connected to hyoid bone

Corpus

Parts of Hyoid Bone: convex anterior surface and concave posterior surface

Greater cornua

Parts of Hyoid Bone: lateral border of corpus; project posteriorly and superiorly

Lesser cornua

Parts of Hyoid Bone: looks like “devil’s horns”; found at the connection between greater cornua and corpus

Hyaline

Types of Cartilage: Tendency of ossifying with older age: Eg. thyroid, cricoid, arytenoid

Elastic

Types of Cartilage: Eg. epiglottis, corniculate, cuneiform

Thyroid Cartilage

Largest of laryngeal cartilages, Shape: similar shape to hyoid bone, hyaline, Superior border: hyoid bone, Inferior border: cricoid cartilage

Lamina

Parts of Thyroid Cartilage: Made of 2 quadrilateral-shaped plates called

thyroid angle

Parts of Thyroid Cartilage: Fusing the Lamina would form the \___ \___ (midpoint of the fusion)

thyroid notch

Parts of Thyroid Cartilage: The fusion also makes thyroid notch \= v-shaped cut)

laryngeal prominence

Parts of Thyroid Cartilage: Below the thyroid notch is the \___ \___ (Addam’s apple)

oblique line

Parts of Thyroid Cartilage: On each thyroid lamina, there is an \___ __: prominent ridge running obliquely along the surface

Superior cornua

Parts of Thyroid Cartilage: 2 pairs of cornua \= longer, more slender, project posteriorly (back), superiorly (up), and medially (middle)

Inferior cornua

Parts of Thyroid Cartilage: 2 pairs of cornua \= shorter

Cricoid Cartilage

Lowermost border or base of the larynx, Smaller but more stout compared to the thyroid cartilage, Continuous; circular ring (like a signet ring), Superior Border: thyroid cartilage, Inferior Border: trachea

Anterior arch

Parts of Cricoid Cartilage: immediately below angle of thyroid;

Posterior quadrate lamina

Parts of Cricoid Cartilage: broad; occupies portion of open space in thyroid cartilage’s posterior side

Facets for arytenoid

Parts of Cricoid Cartilage: Along superior surface of the posterior quadrate, Point of articulation with 2 arytenoid cartilages

Facets for thyroid

Parts of Cricoid Cartilage: Point of articulation of cricoid cartilage with the inferior cornua of thyroid cartilage: Forms cricothyroid joints

Ridge

Parts of Cricoid Cartilage: Vertical, midline of posterior quadrate lamina (with 2 shallow depressions on either side),

esophagus

Parts of Cricoid Cartilage: Ridge: point of insertion of some fibers from __,

cricoarytenoid muscles

Parts of Cricoid Cartilage: posterior quadrate lamina: Shallow depressions \= point of insertion for \___ \___.

Epiglottis

immediately posterior to the root of tongue and corpus of hyoid bone; Shape: like a leaf, Vertical orientation

corpus

Epiglottis Parts: (leaf-like), convex anterior surface, smooth, concave posterior surface, pitted, smooth

petiolus

Epiglottis Parts: (stalk-like)

glossoepiglottic

Epiglottis Parts: Anterior surface of its corpus is connected to the root of the tongue through 1 medial and 2 lateral \____ folds

valleculae

Epiglottis Parts: Medial is separated from lateral glossoepiglottic fold by 2 pits called

hyoepiglottic ligament

Epiglottis Parts: Connection to hyoid bone: corpus connected through \____ \___: Adipose tissue making a fat pad between epiglottis and hyoid bone

thyroepiglottic ligament

Epiglottis Parts: Connection to thyroid cartilage: petiolus extend behind thyroid and anchored by

trap door

Epiglottis: Theories on its function: Acts like a “\___ \___” to seal the laryngeal opening -\> approximates with thyroid cartilage

Vestigial

Epiglottis: Theories on its function: \___ organ in humans: In animals, approximates with the soft palate, In humans, there is a space between soft palate and epiglottis; children magkadikit soft palate and epiglottis, sa adults may space kaya namomove when swallowing

Arytenoid Cartilages

Location: posterior sloping border of posterior quadrate lamina of the cricoid cartilage (forms cricoarytenoid joint), Shape: like a three-sided pyramid with an apex and base; 3 sides \= medial, posterior, and anterolateral surface, Posterior point of attachment of the vocal folds

Triangular fovea & Fovea oblonga

Parts of Arytenoid Cartilage: (anterolateral) Both are depressions

Arcuate ridge

Parts of Arytenoid Cartilage: (anterolateral): medial line between the foveas: Found towards the apex and fovea oblonga along the base

Muscular process

Parts of Arytenoid Cartilage: (meeting point of anterolateral and posterior): Lateral direction, more distal, where muscles are attached

Vocal process

Parts of Arytenoid Cartilage: (meeting point of anterolateral and medial), where the vocal folds are attached to

aryepiglottic

Cuneiform & Corniculate Cartilages: Found within the \___ folds

Cuneiform Cartilages

anterolateral (immediately) to corniculate; “Wedge form” provide stability to the folds; stiffen and support membranous laryngeal covering

Corniculate Cartilages

found on top of the apexes of the arytenoids, vestigial structures in humans: no function

Cricothyroid Joint

Joint: Connects the Cricoid and Thyroid cartilages

inferior horn

Cricothyroid Joint: Articulates at the \___ \__ of the thyroid cartilage and the thyroid

Synovial - Pivot

Cricothyroid Joint: Type of joint:

Rocking of the thyroid down and front, Slight gliding of thyroid forward and backward, relative to cricoid

Cricothyroid Joint: Movement

allows major adjustment for change in pitch

What will happen to the vocal folds: when the thyroid wraps down: Vocal folds

Cricoarytenoid Joint

Formed between the Cricoid and arytenoid cartilages of the Larynx

arytenoid, cricoid

Cricoarytenoid Joint: Articulates at the superior \___ facets and inferior \___ facets

Saddle (sinovial)

Cricoarytenoid Joint: Type of Joint:

Rocking (abduct \= out and up; adduct \= in and down), Gliding -\> anterior-posterior, Minimal rotation

Cricoarytenoid Joint: Movement

Posterior Cricoarytenoid Ligament

Types of Cricoarytenoid ligaments: Superior border of cricoid lamina to posterior border of arytenoid base, Limits forward movement of arytenoid cartilage

Anterior Cricoarytenoid Ligament

Types of Cricoarytenoid ligaments: Underdeveloped and often absent, May limit backward movement of arytenoid cartilage, Cricoid cartilage to anterolateral base of arytenoid cartilage

Extrinsic Laryngeal ligaments & Membranes

One attachment is binded to a laryngeal cartilage while the other attachment is connected to a structure outside the larynx

Extrinsic Laryngeal ligaments & Membranes

Extrinsic/Intrinsic: Hyothyroid membrane & ligament, Hyoepiglottic ligament, Thyroepiglottic ligament, Glossoepiglottic ligament, Cricotracheal membrane, Joint ligaments

Intrinsic Laryngeal ligaments & Membranes

Membranes with all of their attachments found only within the larynx

Intrinsic Laryngeal ligaments & Membranes

Extrinsic/Intrinsic: Conus elasticus, Quadrangular membranes, Aryepiglottic folds, Mucous membrane

Hyothyroid Membrane and ligament (Thyrohyoid)

Extrinsic Ligaments & Membranes: Location: space between greater cornu of hyoid and lateral hyoid

Medial Hyothyroid

Parts of Hyothyroid: Location: corpus hyoid to the upper border of the anterior thyroid

Lateral Hyothyroid

Parts of Hyothyroid: Location: posterior of medial; superior cornu of thyroid to the posterior tip of the greater cornu hyoid

Triticeal Cartilage (tritiate cartilage)

Parts of Hyothyroid: Not always present, Outside the structure

Hyoepiglottic ligament

Extrinsic Ligaments & Membranes: Binds epiglottis to the hyoid bone; Lingual surface of the corps of epiglottis to the upper, posterior surface of the corpus of the hyoid bone

Thyroepiglottic ligament

Extrinsic Ligaments & Membranes: The other ligament binding the epiglottis; Attaching the petiolus of epiglottis to the thyroid cartilage

Glossoepiglottic ligament

Extrinsic Ligaments & Membranes: Attachment of epiglottis to the tongue, Also called \____ folds

Lateral (2), Median (1)

Parts of Glossoepiglottic Ligament:

Valleculae (2)

Parts of Glossoepiglottic Ligament: Overlay of mucous membrane producing little valleys between the tongue and epiglottis, Separates the median glossoepiglottic ligament from the lateral ones

Cricotracheal membrane

Extrinsic Ligaments & Membranes: Attach trachea to larynx; inferior anchor of the larynx; Binds cricoid cartilage to the first tracheal ring; Location: from inferior border of the cricoid to the superior border of the first tracheal ring

Conus elasticus

Intrinsic Ligaments & Membranes: Connects thyroid, cricoid, and arytenoid cartilages; dominant membranous lining, Location: Situated below the vocal folds; attaching to the lower thyroid cartilage and upper surface of the cricoid cartilage and the tip of the vocal process of the arytenoid

cricovocal, cricothyroid

Intrinsic Ligaments & Membranes: Conus elasticus: Also referred to as the \___ membrane or \___ ligament

true vocal folds

Intrinsic Ligaments & Membranes: Conus elasticus: Their connection at the arytenoids is the point of attachment for the

Lateral

Intrinsic Ligaments & Membranes: Conus elasticus Parts (2): Location: superior lateral margins of the cricoid cartilage going to inferior of the larynx; terminating below the ventricular ligaments from the quadrangular membrane (no overlap?)

Median

Intrinsic Ligaments & Membranes: Conus elasticus Parts (1): Location: midline; superior border of the arch of the cricoid to the inferior border of the thyroid cartilage

Quadrangular membranes

Intrinsic Ligaments & Membranes: 2 separate membranes that converge and end as ventricular folds: Starts from angle of thyroid and stops at the connection of epiglottis and arytenoid cartilage at the triangular fovea; Location: starts at lateral borders of epiglottis, around the thyroid cartilage and end at corniculate cartilage and medial surface of arytenoid cartilages

Aryepiglottic folds

Intrinsic Ligaments & Membranes: Connects the sides of the epiglottis to the arytenoid cartilages, Superior portion of the quadrangular membrane, Lateral to the aryepiglottic folds

Mucous membrane

Intrinsic Ligaments & Membranes: Continuous with the mucous membrane of the oral cavity and trachea, Rich in mucous glands, especially in ventricular and vocal folds

Aditus Laryngis

Larynx Internal Structures: Entry into larynx from the pharynx, Door Frame between pharynx and larynx; Anterior - epiglottis, Lateral - aryepiglottic folds, Posterior - arytenoid cartilages, Landmarks: Cuneiform cartilages & Corniculate cartilages

Pyriform Sinus

Larynx Internal Structures: Fossae or indentations between aryepiglottic folds (medially) and mucous lining of thyroid cartilage; Position: Posterolateral - aditus laryngitis

Supraglottal

Larynx Internal Structures: Supraglottal and subglottal spaces:Above vocal folds

Subglottal

Larynx Internal Structures: Supraglottal and subglottal spaces:Below vocal folds

Vestibule

Larynx Internal Structures: Supraglottal and subglottal spaces:(entryway): Space between aditus and ventricular folds (false vocal folds), Wide at aditus; Narrow at ventricular folds; Position: Lateral - aryepiglottic fold, Posterior - membrane covering arytenoid cartilages (superior to false vocal chords)

Rima vestibule

Larynx Internal Structures: Supraglottal and subglottal spaces: Space between the false vocal folds

Laryngeal ventricle (laryngeal sinus)

Larynx Internal Structures: Supraglottal and subglottal spaces: Middle space between margin of false (superior) vocal cords true vocal cords (inferior), Anterior extension \= laryngeal saccule

Rima Glottidis

Larynx Internal Structures: Opening between the true vocal folds

Glottis

Larynx Internal Structures: Between supraglottis and subglottis; Position: Superior - vestibular folds, Inferior - conus elasticus, Lateral - vocal folds, arytenoid cartilage, Most important for speech

vocal folds and rima glottidis

Glottis: Larynx Internal Structures: Components:

Membranous glottis (anterior commissure)

Glottis: 2 different parts based on position: Soft tissue of vocal folds

Cartilaginous glottis (posterior commissure)

Glottis: 2 different parts based on position: Cartilage of arytenoids

Squamous Epithelium

Vocal Folds: Layers: most superficial; protective layer

Superficial lamina Propria (SLP)

Vocal Folds: Layers: fibrous and elastic; acts as cushion

Intermediate Lamina Propria (ILP)

Vocal Folds: Layers: similar to superficial lamina propria

Deep lamina Propria (DLP)

Vocal Folds: Layers: functions to prohibit extension

Thyrovocalis and thyromuscularis

Vocal Folds: Layers: Thyroarytenoid muscle: Divided into 2:

Mucosal lining of vocal folds

Squamous Epithelium + Superficial Lamina Propria \=

vocal ligament

Intermediate Lamina Propria + Deep Lamina Propria (elastin and collagen) \= \___ __: Stiffens and supports the vocal folds