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Voice Disorders

Voice Disorders Test 1

QuestionAnswer
Latin for knowledge; gaining knowledge about nature. Can be natural (math) or social (behavior), basic or applied Science
State hypothesis, define methods, collect data, analyze, report results, reject or accept hypothesis, predict, replicate Scientific Method
Cortical mechanisms, subcortical pathways, brainstem connections, vagal nuclei, cerebellum, vagus nerve X Laryngeal Neuroanatomy
Motor control, site for intelligence, last to develop, includes motor strip (precentral gyrus) Cortical Mechanism-Frontal Lobe
Separated from frontal lobe by central gyrus, somatosensory information, sensory strip (postcentral gyrus) Cortical Mechanism-Parietal Lobe
Auditory interpretation, separated from frontal and parietal lobe by lateral sulcus Cortical Mechanism-Temporal lobe
Visual processing Cortical Mechanism-Occipital lobe
Under the lobes and folds in on itself at birth Cortical Mechanism-Insular lobe
Little brain, posterior and inferior in the brain, connected to brain stem, coordinates movements. Patients may complain of coughing or lack of gag reflex Cortical Mechanism-Cerebellum
Includes midbrain, pons, and medulla Brainstem
Controls heart rate, digestion, and respiration Midbrain
Connects the midbrain and medulla, controls primitive actions Pons
Connects to the spinal cord and controls primitive actions Medulla
Runs from the medulla to the hips, reflexive Spinal cord
Includes grey matter (cortices and bell bodies) and white matter (subcortical pathways and axons) Subcortical pathways
Below the cortex inside of the brain, receives all motor and sensory activity will the exception of smell Thalamus
Produces dopamine Substantia Nigra
Major pathway that is connected to the heart Vagal nuclei
Controls speech and swallowing Cranial Nerve X
Consists of the brain and spinal cord Central Nervous System
Consists of the nerves and they exit points at the spinal cord Peripheral Nervous System
Consists of nerves that leave the brainstem to innervate the head and neck Cranial Nervous System
Contains cerebrospinal fluid, lateral ventricles, choroid plexus, and meninges Ventricular System
Drain into the inferior ventricles and the spinal cord Lateral ventricles
Primary site of blood filtering to create CSF Choroid Plexus
Dura mater, arachnoid layer, pia mater Meninges layers
Caused by cortical lesions Alzheimer's
Caused by lesion in the motor area Aphasia or apraxia
Caused by lesion to the motor pathways Dysarthria
Molecular layer, external granular layer, pryamidal layer, internal granular layer, ganglionic layer, fusiform layer Cortex layers
Includes the head (site for dopamine synthesis), tail, and amygdala Subcortical Nuclei/Basal Ganglia-Caudate Nucleus
Divided into the putamen and globus palidus. Involved in retrieving over-learned motor behaviors Subcortical Nuclei/Basal Ganglia-Lentricular nucleus
Processes incoming sensory input except smell Subcortical Nuclei/Basal Ganglia-Thalamus
Would cause resting (cerebral) or intentional tremors (basal ganglia) Subcortical nuclei lesion
Flow of air that is manipulated to make sounds, how well you manipulate the air determines how well sounds are produced Respiration
Amount we take in and release during quiet breathing Tidal volume
Volume that remains to keep the lungs from collapsing Residual volume
Take in as much oxygen as possible Inspiratory volume
Let out as much oxygen as possible Expiratory volume
Inspiratory to expiratory; varies as a function of aging, health, and smoking Vital capacity
Beyond normal breathing limits, used for shouting Reserve levels
Closed system with air and water WET spirometer
Normal quiet breathing Eupnea
Increased depth of breathing without increased rate of breathing Hypernea
Succession of breathing at the end of normal exhalation Apnea
Succession of breathing at the end of normal inhalation Apneusis
Increase in tidal volume followed by decrease in tidal volume, sign for cardiac arrest and meth abuse Cheyne-Stokes respiration
Repeated deep gasps followed by apnea, may have high CSF pressure, ALS, or Huntington's Biat's respiration
Helps maintain attention by screening out other stimuli Reticular Activating System
Connects the midbrain and cerebellum Superior Cerebellar Peduncle
Connects the pons and cerebellum Middle cerebellar peduncle
Most ventral portion of the midbrain Crus Cerebri
Includes the trapezoid bodies, superior olavary complex which are relay sites for audition Pons
Includes pyramids and ventral portions Medulla oblongata
Efferent motor system, major descending pathway. Begins in pyramidal layer of cortex at the precentral gyrus of frontal lobe and passes through midbrain Cortical spinal tract 1
Converges at the internal capsule. Descends through midbrain to the crus cerebri. Continues to pons and medulla to the pyramid. Cortical spinal tract 2
80% of fibers cross at the pyramid of the medulla and become lateral corticospinal tract. If they do not cross they become the anterior corticospinal tract. Fibers continue to the spinal tract Cortical spinal tract 3
Lesions in the internal capsule would cause this damage Contralateral
Lesions in the anterior cortical spinal tract would cause this damage Same side, less damage
Efferent motor system, begins in the cortex and goes to the bulbar area to supply cranial nerves. More on lateral side. Fibers descend through internal capsule into midbrain and crux cerebri. Cortical Bulbar Tract 1
Will exit to innervate head and neck, exits at the midbrain to innervate occulomotor nerve and some will exit in the pons or medulla for the vagus nerve Cortical Bulbar Tract, 2
Information coming into the brain will go to the postcentral gyrus of the parietal lobe Afferent sensory system
Responds to mechanical pressure and vibratory sensations Pacinian Corpuscle
Responds to light touch Meissners Corpuscle
Tells you the angles of your joints Joint receptors
located in the fingertips, gives kinesthetic feedback Golgi-Mazzoni Corpuscle
Fibers of the afferent sensory system will decussate in the medulla at the ____ Internal arcuate fibers
Ear, receives info from the pinna, involved in contact ulcers with a burning sensation behind the ear Aricular (sensory) vagus branch
Supplies the carotid sinus reflex and helps control blood pressure, palpitations will be a symptom Cardiac (motor) vagus branch
Goes to the pharynx and velum, tensor veli palatini is NOT innervated Pharyngeal (motor) vagus branch
sensory branch receives info from the mucous membranes of the larynx, epiglottis, esophagus, supraglottic walls, and pharyngeal walls. Motor branch innervates the cricothyroid and inferior pharyngeal constrictor Superior Laryngeal (sensory-motor) vagus branch
sensory branch receives info from below the vocal folds. Motor branch innervates larynx muscles Inferior/Recurrent Laryngeal (sensory-motor) vagus branch
Helps with autonomic and secretory functions within the abdomen and thorax Parasympathetic vagus branch
Hoarse voice, swallowing difficulties, mild to moderate breathing difficulties, nasality, loss of gag reflex on side of lesion Unilateral lesion of the vagus
complete paralysis of the pharynx and larynx, vocal fold adduction, paralysis of the esophagus, projectile vomiting, tachycardia Bilateral lesion of the vagus
Provides and airway, facilitates birthing, defecation, and lifting weights, maintains blood pressure Biological function of the larynx
Only bone in the larynx, free floating Hyoid bone
Independent movements of these allows us to change pitch and intensity. May rock, glide, or rotate Arytenoid cartilages
Theory based on anatomical model by Hirano states there are 2 layers of vocal folds that allow for mucosal wave Body-Cover Theory of Phonation
Do not vibrate, but oscillate. Cover and body contribute to phonation Vocal folds
Mucosal epithelium, stratified squamous epithelium, ciliated colunmar epithelium, superficial layer of the lamina propria Vocal fold cover
Intermediate and deep layers of the laminal propria Vocal fold transition layer
Vocalis muscle Vocal fold body
Originiate outside of the laryngeal framework but insert into the larynx Extrinsic muscles
Originate inside and insert inside of the laryngeal framework Intrinsic muscles
Pull the larynx upwards and shorten the vocal tract Laryngeal elevators/supraglottic
Pull the larynx down and lengthen the vocal tract to create a lower tone Laryngeal depressor/infraglottic
A function of time Amplitude
Movement during amplitude when it decreases and loses energy Dampening
Line on the graph Function
Simple harmonic motion Sine curve
Distance from a reference point Amplitude
Rate that the sine wave repeats itself Frequency
60-65dB Average of conversational speech
The time it takes to complete one cycle Period
cycles per second, lower hertz=lower pitch Hertz (Hz)
Average for men is 120Hz, average for women is 220Hz, children is 300Hz, crying is 600Hz in infants Average frequencies
distance between two successive events in simple harmonic motion Wavelength
Combining two sine waves Complex tone
Wave with the highest energy Fundamental frequency
Air, volume, length, and material Will affect sound and tone
Movement of air based on Bernoulli principle. As air flow increases internal pressure decreases. Air flows through vocal folds and is constricted, moving faster, causing internal pressure to drop and suck vocal folds together. Myoelastic and aerodynamic theory 1
Once the vocal folds are closed pressure will build up again and cause them to blow back open. The faster air moves the more pressure will drop Myoelastic and aerodynamic theory 2
the vocal folds will continue to come together after being moved apart Self sustaining oscillation
Amplitude as a function of frequency Spectrum
amplitude as a function of time Wavelength
the major concentration of energy Resonant frequencies/poles
next greatest concentration of energy, multiples of the fundamental frequency Formants/harmonics
How the input changes from pure sound to phonation and the dampening characteristics of the vocal tract that changes input to output by absorbing energy or resonating energy Transfer function
Where energy is being absorbed, valleys with decreased energy Anti-resonances/zeros
source is created at the glottal level by the vocal folds that create pure noise, its spectrum decreases at a uniform rate. Air passes through vocal tract some frequencies are dampened and some are resonated. Filter is the vocal tract Source filter theory
Two masses that are connected to muscles that make them elastic. the muscles move back and forth to change the shape of the vocal fold (vertical phasing). Biomechanical explanation for vertical phasing Two mass model of phonation
Superior and inferior levels of the vocal folds have phase relationship (bottom portions of the vocal folds open and close first to create the mucosal wave) Vertical phasing
8 masses represented the body, 8 masses represented the cover. Biomechanical explanation for longitudinal phasing 16 mass model of phonation
Anatomical, aerodynamic, biomechanical, and source filter Models of phonation
Origin: cricoid Insertion: thryoid Innervation: superior laryngeal nerve Action: elongates the vocal folds Cricothyroid-Intrinsic
Origin: cricoid Insertion: Arytenoid Innervation: recurrent laryngeal nerve Action: adducts the glottis Lateral cricoarytenoid-intrinsic
Origin: arytenoid Origin: Arytenoid Innervation: recurrent laryngeal branch Action: adducts the glottis Transverse arytenoids-intrinsic
Origin: muscular process of arytenoid Insertion: opposite arytenoid Innervation: recurrent laryngeal branch Action: closes the arytenoids Oblique arytenoid-intrinsic
Origin: thryoid Insertion:arytenoid Innervation: recurrent laryngeal nerve Action: adducts te thyroid and arytenoid Thyromuscularis-intrinsic
Origin: thyroid Insertion: vocal process of arytenoid Innervation: recurrent laryngeal branch Action: May tense vocal folds Thyrovocalis-Intrinsic
Origin: Cricoid Insertion: muscular process of the arytenoid Innervation: recurrent laryngeal branch Action: abducts the glottis Posterior cricoarytenoid-intrinsic
Origin: mandible Insertion: hyoid bone Innervation: trigeminal Action:draws hyoid up and forward Anterior belly of the digastric-Extrinsic
Origin: temporal bone Insertion: hyoid Innervation: facial nerve Action: draws the hyoid up and back Posterior belly of the digastric-Intrinsic
Origin: temporal Insertion: hyoid Innervation: facial nerve Action: draws hyoid up and back Stylohyoid-Extrinsic
Origin: mandible Insertion: hyoid Innervation: trigeminal nerve Action: Raises the hyoid Mylohyoid-Extrinsic
Origin: mandible Insertion: hyoid Innervation: hypoglossal nerve Action: draws hyoid up and forward Geniohyoid-extrinsic
Origin: sternum Insertion: hyoid Innervation: upper cervical spinal nerve Action: draws the hyoid down Sternohyoid-extrinsic
Origin: scapula Insertion: Hyoid bone Innervation: Upper cervical spinal nerve Action: draws the hyoid down Omohyoid-extrinsic
Origin: thryoid Insertion: hyoid Innervation: upper cervical spinal nerve Action: draws the hyoid down Thryohyoid-extrinsic
Origin: sternum Insertion: thryoid Innervation: upper cervical spinal nerve Action: draws the thryoid down Sternothryoid-extrinsic
Created by: rawlinan