Anat Exam 2

respiratory functions

tissue oxygenation; air conduction and filtration; airway protection (cough reflex)

non-respiratory functions

voicing and speech; introracic pressure regulation

intrathoracic pressure regulation

stabilizes thoracic cavity during high effort tasks

tidal breathing cycle

inspiratory phrase 40% expiratory phrase 60%

speech breathing

generating airflow to make sounds, but don’t use too much air to run out of breath; inspiratory 10% expiratory 90%

inspiratory checking action

counteracts the relaxation pressures and promotes steady lung pressure neccesary for phonation, which creates speech

swallowing breathing pattern

inhale exhale swallow exhale inhale

tachypnea

rapid breathing; over 20 brpm

bradypnea

reduced sedated breathing; less than 12 brpm

apnea

absence of spontaneous breathing; intubation and mechanical ventilation

hypopnea

decreased depth of breathing with or without decrease in rate

hypernea

increased depth of breathing with or without an increase in rate

paradoxical vocal fold movement

vocal folds close abnormally during inhalation and exhalation causing breathing difficulties and affecting speech production

normal pulse oximetry

95-100%

pulse oximetry

oxygen saturation level in the blood

biologic functions of the larynx

valve that opens and closes

nonbiological larynx function

phonation

hyoid

2 greater cornua- 2 lesser cornua; larynx is suspended from it

cricoid cartilage

2nd largest; encircles the larynx

thyroid cartilage

largest; adams apple; attaches vocal folds

epiglottis

attaches to the inner surface of the thyroid cartilage; peaks over; spine of a book

arytenoid cartilages

located on the top of the widest part of cricoid cartilage; vocal folds attach

cuneiform and corniculate cartilages

found within the aryepligottic folds

cricoid thyroid joint

infeiror horn of thyroid cartilages to the side of the cricoid

cricoiarytenoid joint

permit rocking gliding and rotation; cricoid to arytenoids

where do the vocal folds attach anteriorly?

thyroid cartilage

where do vocal folds attach posteriorly?

arytenoids

extrinsic laryngeal ligaments

larynx to outside the membrane

thyrohyoid membrane

membrane that connects thyroid and hyoid bone

cricotracheal ligament

connects trachea to the larynx

hypoepiglottic ligament

connects epiglottis to hyoid bone

thyrohyoid ligaments

ligament that connects the larynx to the hyoid bone

quadrangular membrane

broadsheet; courses upward from the arytenoids to epiglottis; covers and connects the laryngeal structures above the level of vocal folds WALLS

vestibule space

upper space; houses ventricular fold (fvf)

suprahyoid muscles

run from the hyoid bone and elevates the larynx

infrahyoid muscles

run from the hyoid bone down; lowers the larynx; strap muscles

stylohyoid

moves the larynx up and back (like a hook)

digastric muscle

2 bellied muscle

mylohyoid

floor of the mouth muscle; fan shaped

geniohyoid

thin bands muscle

sternohyoid

connects sternum to the hyoid bone; goes all the way up

sternothyroid muscle

sternum to thyroid cartilage; only goes halfway

thyrohyoid muscle

thryoid to hyoid bone; upper half

omohyoid muscle

scapula to hyoid bone; dog leg

loud speech

takes in greater lung volume and use a greater percentage of vital capacity. Think of graph

sequential swallows

“chugging” inhale exhale swallow swallow inhale

respiratory distress effects on speech

weak inhales affect vocal loudness and phonation

respiratory distress effects on swallowing

disruption of the norma swallowing pattern causing them to aspirate

nasal canula

Delivers low to moderate levels of supplemental oxygen. It consists of a lightweight tube with two prongs in the nostril  

mechanical ventilation

Used when a patients respiratory system is compromised.

where does the larynx sit anteriorly to

esophagus

what does the larynx attach to inferiorly

trachea

paired cartilages of the larynx

arytenoids, corniculate, and cuneiform

unpaired cartilages of the larynx

cricoid, thyroid, and epiglottis

what functions do the intrinsic muscles of the larynx do

open, close, tense, and relax the vocal folds

what do the extrinsic muscles of the larynx do

lift and pull down the larynx

name the parts of the thyroid

superior horns, knotch (adams apple), and inferior horns

cricothyroid membrane

connects cricoid and thyroid

how is the epiglottis attached to the arytenoids

aryepiglottic folds; upper rim of larynx

where does the epiglottis attach anteriorly

thyroid, hyoid bone, and tongue

vallecula

“little valleys” between the tongue and the epiglottis

cricothyroid joint

stretches and tenses the vocal cord

what does the cricoarytenoid joints permit

opening, closing, tensing, and relaxing the vocal folds

cricovocal membrane

membrane that covers the space below the level of the vocal folds

narrow anterior part of the cricoid cartilage

anterior arch

corniculate cartilages

small paired cartilages that sit atop the arytenoids

cuneiform cartilages

small cartilages found within the aryepiglottic folds

Thyroarytenoids muscles (vocalis and muscularis)

intrinsic layrngeal muscle that makes up the body of the vocal folds

cricothyroid muscle

decreases the anterior space between the cricoid and thyroid cartilage and lengthens vocal folds; can be split into pars recta and pars oblique (each head)

transverse interarytenoid muscle

causes arytenoids to be pulled towards each other (straight across)

what happens when the arytenoids are pulled towards each other

vocal folds adduct

posterior cricoarytenoid muscle

sole abductor of the vocal folds, pulls them apart

how does the contraction of the posterior cricoarytenoid muscle move tha arytenoids

pulls them apart, as well as the vocal folds

covering-musca layer

vocal fold layer 1; loose structure that is key to vocal fold vibration; epithelial tissue

vocal ligament

vocal fold layer 2; composed of immediate and deep lamina propria

vocal fold layer 3

thyroarytenoid muscle

medial compression

degree of force that may be applied by the vocal folds at their point of contact; lateral cricoarytenoids

how are valleculae formed

by the arytenoids and thyroid cartilages

thyroepiglottic ligament

attaches the thyroid to the epiglottis

functionally mobile joints

cricothyroid and cricoarytenoid joints

vocalis

medial muscle of the vocal folds; tenses and relaxes

glottis

space between the true vocal folds

lateral cricoarytenoid muscle

helps close and lengthen the vocal folds; arytenoids tilt forwards; medial compression

oblique interarytenoids muscle

criss cross; adductions

thyroarytenoid muscle

TA- maid vocal folds

neural innervation

nerve supply; intrinsic laryngeal muscles are innervated by the vagus

facial innervation

posterior belly of digastric, stylohyoid

hypoglossal innervation

geniohyoid, genioglossus, hyoglossus, sternohyoid, omohyoid, and thyrohyoid

trigeminal innervation

anterior belly of digastric; mylohyoid

3 phases of phonation

adduction, aerodynamic separation (blow apart), recoil

longitudinal tension

how long or short the vocal folds are (increases in tension) controls frequency

myoelastic

elasticity of the vocal folds allow them to be set in vibration by the aerodynamic forces; once it starts it keeps going

bernoulli effect

higher pressure- lower speed and visa versa

convergent shaped glottis

facilitates a relatively high lung bressure that forces the vocal folds laterally

pitch mechanism

directly correlates to frequency

loudness mechanism

directly correlates to amplitude

organic consideration of voice disorders

affecting in structure

neurogenic consideration of voice disorders

impairment to PNS or CNS

functional consideration of voice disorders

misuse of vocal mechanism

ventricular folds

fase vocal folds