Voice Disorders Exam 1

What are the three subsystems of voice production

• resonance

• phonation

• respiration

what sub system is known as the power source to supply energy

respiration

which subsystem is known as the sound source to produce sound

phonation

which subsystem is known for resonating filter to shape sound

resonance

What theory involved these subsystems

Sound Filter Theory

what is the Sound part of sound filter theory mean

• lungs give power

• larynx gives buzzing

What does the Filter part of the Sound Filter Theory mean

• moving cavities shape sound

The size and shape of the cavities of the vocal tract influence what ?

the final acoustic output

change in shape=

change in sound

the lartnx is ?

tube of cartilage and muscle

where does the larynx sit?

in front of the cervical spine

what is the top of the larynx

tip of epilglottis

what is the bottom of the larynx

inferior rim of cricoid cartilage

which subsite of the laryx is above true vocal folds

supraglottic

which subsite of the larynx is the true vocal folds

glottic

what subsite of the laryn is below the true vocal folds

subglottic

list organization of larynx from superior to inferior

1. Epiglottis

2. laryngeal inlet

3. false vocal folds

4. ventricles

5. true vocal folds

6. cricoid cartilage

7. trachea (not part of larynx)

What are laryngeal cartilages primarily made up of

hyaline

Which cartilage is prone to ossifcation (becomes stiff and bone like with age)

hyaline

what is the only free floating bone in the body

hyoid

What is the leaf shaped cartilage attached to the interior of the thyroid cartilage

epiglottis

What is the function of epiglottis

-protects the airway by directing food/liquid around the airway

during swallowing when larynx elevates, the epiglottis folds down

what does the epiglottis fold down to cover

laryngeal inlet

What are the laryngeal cartialges

• epiglottis

• thyroid

• cricoid

• arytenoids

• corniculate cartilages

• cuneiform cartilages

which laryngeal cartilage is two laminae 9plates) fuse anteriorly to form the laryngeal prominence of thyroid notch

thyroid cartialge

what articulates with the sides of the cricoid cartilage to form the cricothyroid joint

inferior cornu (horns)

What articualtes with hyoid born via the hypothyroid ligament

superior cornu (horns)

where do the true vocal folds attach to

internal angle of the thyroid cartilage

Which laryngeal; cartilage is thick, strong, ring-shaped, and taller posteriorly, forms the lower and posterior parts of the wall of the larynx, articulates with thyroid and arytenoid cartilages to form the cricothyroid joints and cricoarytenoid joints respectively

cricoid cartilage

which laryngeal cartialges are the paired, pyramd shaped cartialges that articulate with the posterior lamina (plates) of the cricoid cartilage at the cricoarytenoid joint

arytenoids cartilages

what allows the rocking and sliding motion of arytenoids

synovial joints

what part of arytenoids is attachemtn for vocal ligmaent and medial

vocal process

what part of arytenoids is lateral attachment for major intrinsic muscles of vocal fold movment

muscular process

what part of arytenoids is top of arytenoids

apex

what laryngeal cartilages are the paired cartilages that sit atop of the arytenoids (at the apex), unclear purpose

corniculate cartilages

what laryngeal cartilages are paired, small cartilages that sit superiorly to the corniculates, completely embedded with the aryepiglottic fold, unclear purpose (maybe provide additional stability to laryngeal complex)

cuneiform cartilages

what are all of the cartilages of the larynx except for epigltotis amde up of

hyaline cartilages

what cartialge is more prone to ossifcation 9become hard like bone)

hyaline cartialge

what cartilage is epiglottis made up of

elastin (LESS prone to ossifcation)

What has a true protective function in the larynx

epiglottis

what muscles have attachments within the larynx

intrinsic

what is the closing of the glottis

adduction

what is the opening of the glottis

abduction

what controls pitch

lengethenign and shortening of vocal folds

what are the functions of intrinsic msucles

• adduction

• abduction

• pitch modifiers (lengthening and shortening VF)

what are the muscles that have an attachment outisde the larynx

extrinsic motivation

what do the extrinsic muscles do

elevate and depress the larynx

which intrinsic musles are the adductors

• lateral cricoarytenoid (LCA)

• thyroarytenoid (TA)

• Interarytenoid IA

what intrinsic muscles are the abductors

posterior cricoarytenoid

which intrinsic laryngeal muscles are the pitch modifiers

cricothyroid

thyroarytenoid

what muscle primarily decreases pitch

thyroarytenoid

what muscle primarily increases pitch

cricothyroid

what is th eonly abductor of the VF

posterior cricoarytenoid

what is the attachment of the Posterior cricoarytenoid PCA

attacked to the posterior lamina of the cricoid and muscular process of the arytenoid

when and how much does the PCA abduct

abducts fully for respiration and partially for voiceless sounds

where is the lateral cricoarytenoid attached LCA

to the anterior muscular process and superior border of the cricoid

how does the LCA move things

moves muscular process anterolaterally making vocal process move medially

where does the interarytenoid attach

the left and right arytenoid cartilages

what are the 2 bellies of interarytenoid

transverse (horizontal)

oblique (X)

what pulls arytenoids together causing tighter closure of the of especially posterior

interarytenoid

what are the attachments of the thyroarytenoid

attaches anteriorly to the internal angle of the thyroid cartilage and posteriorly to the vocal processes of the arytenoid

what are the 2 bellies of the TA

• vocalis (medial)

• Thyromuscularis (lateral)

what is the body of the true vocal fold

thyroarytenoid

what muscle contribute to increases loudness and tighter glottic closure

TA thyroarytenoid

which msucle ahs two functions

thyroarytenoid

how does the TA contribute to pitch

thickens and rounds the vf (increase mass= lower frequency/pitch)

where does the cricothyroid CT attach

attaches to the anterior rim of thyroid

what are the 2 bellies of cricothyroid CT

pars recta (medial?)

pars oblique (lateral?)

what does the CT to contribute to pitch

• rocks thyroid over cricoid stretching and thinning the VF increasing pitch

What are the two classification systems of VF layer

• histological

• mechanical

what are the layers of the VF within the histological system

• epithelium

• superficial LP

• intermediate LP

• deep LP

• vocalis muscle

what are the VF layers using mechanical system

• cover

• transition

• body

in the histological classification what is the thin stiff capsule that maintains fold shape (skin)

epithelium

in the histological classification what is the loose fibrolus components (like a mass of soft gelatin)

superficial layer of lamina propria

what is the superficial layer also known as

reinke’s space

in the histological classification what is the elastic (like a bundle of soft rubber abends)

intermediate layer of lamina propria

in the histological classification what the collagenous fibers (like a bundle of cotton thread)

deep layer of lamina propria

what layers according to histological classification what makes up the vocal ligament

intermediate +deep layers of lamina propria

according to histological classification what is the main body of the vf (like a bundle of stiff rubber bands)

thyroarytenoid muscle

what happens as you go deeper into the vf

the layers get stiffer

whose discovery of the layered structure of vf led to a revolutionary change in voice care procedures

hirano’s

what structure is vibrating during phoantion

membranous structure

the integrity of vibration is dependent on what?

healthy mucous membrane

what are the mechanical classifications of VF

• cover

• transition

• body

what does the cover layer according to mechanical classification include?

epithelium and superficial layer of VF cover (passive)

what does the transition layer of mechanical classification consist of

intermediate and deep layers of the lamina propria (passive) *vocal ligament

what does the body of mechanical classification consist of

TA muscle (passive and active)

Look at VF Schemes chart

layered structure of vf contribute to what

complexity of human voice

differences in pitch, quality, and timbre arise from what

variation in flexibility, elasticity, and tension

what does VF do to reduce injury

distribute mechanical forces

varied cellular properties of vf influence what

healing, recovery, and interventions for voice care

what kind of control are the muscular layers under comaprd to other layers

muscular layers are under voluntary control while other layers are under passive control

can various pathologies affect specific layers of the VF

yes

What nerve innervates the larynx

cranial nerve X (vagus)

what function does CN X Vagus have

sensory and motor

what sensation does CN X give

sensation from the larynx and pharynx

what movement does CN X Vagus help with

movement for intrinsic laryngeal muscles and swallowing

what are the 2 branches of the laryngeal innervation

• recurrent laryngeal nerve (RLN)

• superior laryngeal nerve (SLN)

where is the RLN longer?

on the left to wrap around aorta