Speech Systems Larynx anatomy and functions
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| Larynx is made of... | Cartilage (ability to change shape and flexibility)
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| Biological Functions of Larynx | Expelling foreign objects, bearing down, protection of airway
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| Epiglottis | attached to thyroid cartilage, does not function for phonation, highly important for swallowing
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| Thyroid Cartilage | attachment for many muscles, superior and inferior cornu, notch,
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| Cricoid Cartilage | Ring-shaped, sits just below thyroid cartilage, separates thyroid cartilage from tracheal rings, 2 facets for arytenoids
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| Arytenoid Cartilage | 2 pyramid-like structures at top of cricoid cartilage. Muscular process and vocal processes, attach to muscles (outside) and vocal folds (inside). Many degrees of freedom.
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| Cricothyroid Joint | Joint where cricoid and thyroid cartilages connect. Tilting forward motion, contstricts larynx anterior-posterior.
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| Hyoid Bone | only bone in body that does not articulate to another bone, helps connect tongue base to larynx, supports larynx in neck
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| Cavities of Larynx | Aditus laryngis, vestibule, valleculae, pyriform sinus, glottis
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| Aditus laryngis | textbook anatomy point, entry from larynx to pharynx
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| Vestibule | space between aditus and false vocal folds
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| Valleculae | space between tongue base and epiglottis
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| Pyriform Sinus | Space between aryepiglottic fold and thyroid cartilage
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| Glottis | Space between true vocal folds
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| False Vocal Folds | just superior to true VF, not meant to vibrate, help create the 3-D space of larynx.
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| Cricothyroid membrane | attach to cricoid and thyroid cartliages
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| Extrinsic Muscles of Larynx (Elevators) | innervated by Cranial Nerves. Digrastricus (anterior and posterior), Stylohyoid, Mylohyoid, Geniohyoid, Hyoglossus, Genioglossus, Inferior Pharyngeal Constrictor
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| Extrinsic Muscles of Larynx (Depressors) | innervated by Cervical Spinal Nerves, pull down on Hyoid bone. Sternohyoid, Omohyoid, Sternothyroid, Theyrohyoid
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| Extrinsic Muscles of Larynx | 1 pt of attachment in larynx, 1 point of attachment outside larynx, support larynx in cavity, but also helps move larynx as a whole system
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| Intrinsic Muslces | Refine the 3-D space of the larynx (tuning). Contralateral innervation by Vagus nerve, bilateral innervation of interarytenoid muscles. Innervated by CN X (Vagus)
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| Superior Laryngeal Nerve (SLN) | Internal branch: sensory from larynx - innervates supra-glottic space, sensory: swallowing
External branch: motor to cricothyroid muscle
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| RLN (Recurrent Laryngeal Nerve) | Motor to all intrinsic muscles except cricothyroid muscle. Left wraps around aorta, sensory detection in trachea, inferiorally enters larynx
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| Adductor Muscles | Lateral Cricothyroid, Transverse Arytenoid, Oblique Arytenoid
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| Abductor Muscles | Posterior Cricoarytenoid
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| Tensor Muscles | Slowtonic fibers, prolonged contraction that is very well defined. Thyrovocalis, Cricothyroid
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| Relaxer Muscles | Thyromuscularis (more outer), adjacent to thyrovocalis, when contracted, rocks arytenoid cartilages closer.
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| True Vocal Folds | 5 layers of tissue: Epithelium, Lamina Propria (3 layers), Vocal Ligament
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| 6 degrees of Arytenoid Cartilages | Rotate Medially and Laterally, Tilt Anteriorally and Posteriorly, Slide medially and laterally
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| Ventricular Folds | False Vocal Folds, made of aryepiglottic folds
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| Lamina Propria | Superficial (main vibrating portion, very flexible), Intermediate (allows anterior to posterior stretch, more dense), Deep (collagen fibers, very dense, protect VF from overstretching)
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| Vocal Ligament | ligament that goes from arytenoids to thyroid cartilages. Most innermediate ligament
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| Spectogram | Visual representation of the acoustic signal. Time (horiz axis in millisecs), Frequency (vertical axis in Hz), Intensity (darkness)
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| Fundamental Frequency | # cycles of vibration/second, measured in Hz, not a linear relationship with pitch.
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| Optimal Pitch vs Habitual Pitch | most comfortable pitch for VF based on height/age/makeup vs what we use. Optimal pitch should be habitual.
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| SPL | Sound Pressure Level: measured in dB. Reflects acoustic power of signal. Based on ability to build up subglottic pressure.
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| VRP: | Voice Range Profile: gives a Phonetogram: comprehensive data about frequency a person can produce.
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| MPT: | Maximum Phonation Time: maximum duration of a vowel, measured in seconds or millisecs based on the patient. Dependent on integrity of VF and buildup of Subglottic Pressure
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| S:Z Ratio | Measures ability to sustain voiceless phoneme vs a voiced phoneme. Ratio in healthy person should be 1 (15:15).
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| VHI | Voice Handicap Index: Survey for a patient regarding how their voice impacts their life
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| CAPE-V | Concensus Acoustic Perceptual Evaluation of Voice. Perception scales for strain, rough, loudness, etc.
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| GRBAS | Grade of roughness, Roughness based on irregularity, Breathiness, Aesthemia (weakness), Strain. Perceptual Scale.
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| Nasendoscopy | halogen light source tube through nasal cavity for a birds-eye view of larynx
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| Stroboscropy | Same as Nasendoscopy but with a strobe light to see VF movement
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| Electroglottography (EGG) | measuring how much VF make contact with each other. Often done with Nasendoscopy.
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| MAT | Myoelastic Aerodynamic Theory: subglottic pressure blows VF apart laterally, blowing the inferior border apart first (comes back together first). Needs Muscle contraction, Elasticity, and Airflow (aerodynamic)
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| Bernoulli Effect | FITS INTO MAT. Negative pressure caused by the narrow formation of larynx causes VF to be pulled together again. Because of the increase of velocity of airflow, pressure becomes negative, so the VF come back together.
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| Nonvocal Glottal Attacks | Cough, Throat clearing, grunt
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| Vocal Glottal Attacks | Simultaneous attack (breath during attack), Breathy attack (breath comes before stop), Glottal Attack (attack prior to airflow)
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| Register | Pattern of activity vocal folds undergo during vibration
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| Modal register | Optimal, habitual register
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| Pulse register | Glottal Fry, low rough, not much airflow, decreased tension of VF
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| Loft Register | Falsetto, VF lengthen to thin and reed-like, Vocal ligament is doing most of the vibrating
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| Whistle | Higher than falsetto. Think Mariah Carey and Christina Agulera.
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