A&P Voice Exam

What are the 3 main subsystems involved in voice production?

Respiration, phonation, and resonance/vocal tract

What is the role of the respiratory system in voice production?

Provides the power/airflow and pressure for phonation

What is the role of the phonatory system in voice production

The vocal folds vibrate to create the sound source

What is the role of the vocal tract/resonatory system in voice production

Acts as a filter/resonator that shapes the sound.

What is the easiest way to remember the 3 voice subsystems?

Lungs power it → vocal folds make it → vocal tract shapes it.

What is checking action?

Continued contraction of inspiratory muscles during speech to control airflow.

What does checking action resist?

The passive elastic recoil of the respiratory system.

Why is checking action necessary for speech?

 To maintain controlled, relatively constant airflow and pressure while speaking

What is the typical subglottic (below vocal folds) pressure for normal voicing?

4–10 cm H₂O

What structures make up the basic laryngeal framework?

Hyoid bone

6 types of cartilages: epiglottis, thyroid, cricoid, arytenoid, corniculate, cuneiform

What are the 3 unpaired laryngeal cartilages?

Epiglottis, thyroid, cricoid.

What are the 3 paired laryngeal cartilages?

Arytenoid, corniculate, cuneiform.

What is the largest laryngeal cartilage?

Thyroid Cartilgage

What is the thyroid prominence?

The Adam's apple, where the two thyroid laminae meet anteriorly.

What does the cricoid cartilage form inferiorly?

The inferior boundary of the laryngeal skeleton.

What attaches to the vocal process of the arytenoid?

The vocal ligament/vocal fold.

What joint allows movement of the arytenoid cartilages?

Cricoarytenoid joint

What attaches to the muscular process of the arytenoid?

Muscles that move the arytenoid/vocal folds.

What joint allows the thyroid cartilage to rock forward to change VF length/tension?

Cricothyroid joint.

What are the 3 types of arytenoid movement?

Rocking, gliding, rotating

Which muscle rocks the arytenoid inward?

thyroarytenoid

Which muscle glides the arytenoids toward the midline?

Interarytenoid

Which muscle rotates the vocal process inward?

Lateral cricoarytenoid

Which muscle rotates the vocal process outward?

Posterior cricoarytenoid

What is the overall function of the intrinsic laryngeal muscles?

Directly manipulate the vocal folds/glottis.

What are the 5 paired intrinsic laryngeal muscles?

LCA, oblique IA, PCA, CT, TA

What is the single/unpaired intrinsic laryngeal muscle?

Transverse IA.

What is the primary action of the LCA?

Adducts/closes the vocal folds.

What is the primary action of the IA?

Adducts the vocal folds, especially the posterior glottis.

What are the two portions of the IA?

Transverse and oblique

What is the primary action of the PCA?

Abducts/opens the vocal folds.

What is special about the PCA?

It is the only VF abductor.

What does CT contraction do to the VFs?

Lengthens and tenses them.

What happens to pitch when the CT contracts?

Pitch increases.

What does TA contraction do to the VFs?

Shortens/thickens/relaxes them.

What happens to pitch with TA contraction?

Pitch decreases.

What is the vocalis?

The medial portion of the TA that provides fine control of VF tension/stiffness.

What makes a muscle “extrinsic” to the larynx?

It has at least one attachment outside the larynx.

What is the main function of the extrinsic laryngeal muscles?

Move/position the larynx as a whole.

What do the suprahyoid muscles generally do?

Elevate the hyoid/larynx.

Which suprahyoid muscles are in your notes?

Stylohyoid, mylohyoid, digastric, geniohyoid, hyoglossus.

What does the stylohyoid do?

Pulls the hyoid up and back.

What innervates the stylohyoid?

CN VII (facial).

What does the mylohyoid do?

Elevates the hyoid/floor of the mouth.

What innervates the mylohyoid?

third branch of CN V

What is an important structural function of the mylohyoid?

Forms/supports the floor of the mouth.

What are the 2 portions of the digastric?

Anterior belly + posterior belly

What does the anterior digastric do?

Can elevate the hyoid or depress the mandible.

What innervates the anterior digastric?

CN V

What does the posterior digastric do?

Draws the hyoid backward.

What innervates the posterior digastric?

CN VII

What does the geniohyoid do?

Pulls the hyoid forward and upward.

What innervates the geniohyoid?

branches of cervical plexus accompanied by CN XII.

 What does the hyoglossus do?

Can elevate the hyoid/larynx or depress the tongue.

 What innervates the hyoglossus?

CN XII (hypoglossal).

What do the infrahyoid muscles generally do?

Depress the hyoid/larynx.

What are the 4 infrahyoid muscles?

Sternohyoid, sternothyroid, omohyoid, thyrohyoid

What does the sternohyoid do?

Pulls the hyoid/laryngeal complex downward.

What does the sternothyroid do?

Pulls the thyroid cartilage/larynx downward.

Which infrahyoid does NOT directly attach to the hyoid?

Sternothyroid.

What does the omohyoid do?

Pulls the hyoid/laryngeal complex downward.

What are the two portions of the omohyoid?

Superior and inferior bellies.

What does the thyrohyoid do?

Shortens the distance between the hyoid and thyroid cartilage.

What is unusual about the thyrohyoid's action compared with the other infrahyoids?

It does not simply pull the entire laryngeal complex downward.

What innervates the external intercostal muscles?

Intercostal nerves (spinal nerves).

Which cranial nerve innervates the larynx?

CN X — vagus nerve

What are the 2 major laryngeal branches of CN X?

SLN and RLN

What does SLN stand for?

Superior laryngeal nerve

What does the internal SLN do?

Provides sensory information above the VFs.

What does the external SLN do?

Provides motor innervation to the CT.

What does RLN stand for?

Recurrent laryngeal nerve

Which intrinsic muscles receive motor innervation from the RLN?

PCA, LCA, IA, TA

 Where does the RLN provide sensory innervation?

Below the vocal folds.

What does the right RLN loop under?

Right subclavian artery

What does the left RLN loop under?

Aortic arch

Which RLN has the longer course?

Left RLN

Why is the left RLN especially vulnerable during heart surgery?

It travels near the heart/aortic arch.

What VF problem could occur after left RLN damage during heart surgery?

Left vocal fold paralysis.

External SLN damage primarily weakens which muscle?

CT

What happens to VF control with external SLN/CT damage?

Reduced ability to lengthen/tighten the VF.

What voice change would you expect with external SLN/CT damage?

Difficulty producing high pitches/reduced pitch range.

RLN damage affects which intrinsic muscles?

PCA, LCA, IA, TA

What can RLN damage do to VF movement?

Cause weakness/paralysis and impaired positioning.

What voice quality may result from inadequate VF closure following RLN injury?

Breathy/weak voice.

 What are the 5 histological VF layers from superficial → deep?

Epithelium → Superficial layer of lamina propria (SLLP) → intermediate layer of lamina propria (ILLP) → Deep layer of lamina propria (DLLP) → vocalis

What are the 3 tissue-type categories of the VF?

Mucosa, ligament, muscle

What VF layers make up the mucosa?

Epithelium + SLLP

What VF layers make up the vocal ligament?

 ILLP + DLLP

What makes up the muscle layer?

Thyrovocalis/vocalis

What are the 3 functional categories of the VF?

Cover, transition, body

What layers make up the cover?

Epithelium + SLLP

What layers make up the transition?

ILLP + DLLP

What makes up the body?

Vocalis muscle

Which portion of the VF is the most loose/flexible/pliable?

Cover

Which VF layer is especially loose and pliable?

 SLLP

Which LP layer is richer in elastic fibers?

 ILLP

Which LP layer is denser/stiffer and richer in collagen?

DLLP

What are the mechanical properties of the body?

Relatively firm, stiff, and stable.

What is the general mechanical trend from superficial → deep?

Increasing density/stiffness.

Which VF tissue is capable of actively contracting?

Vocalis/body.