Exam 2

1) protect the airway during & after swallowing

2) generate phonatory source for vowels & voiced sounds

3) build up abdominal pressure for support

consists of: 1 bone, 9 cartilage (3 unpaired, 3 paired), 2 joints, 2 membranes, and cavities (supraglottis space, subglottis space, laryngeal vestibule/ventricle)

- anterior to neck

- anterior to esophagus

- superior to trachea

- inferior to oral and nasal cavities

- abductor, adductors, tensors/relaxers

- laryngeal elevators

- laryngeal depressors

- only "free floating" bone: not connected to any other bone

- serves as attachment to many muscles

- 3 landmarks: corpus, greater horns, lesser horns

- largest cartilage of larynx

- made of hyaline cartilage

- shield like, open in posterior

- 3 landmarks: thyroid notch (laryngeal prominence, adams apple), superior horn, inferior horn

- made up hyaline cartilage

- only completely closed cartilage of airway (closed mostly posteriorly)

- 2 landmarks: facet for thyroid cartilage & facet for arytenoid cartilage

- there's 2, made up hyaline

- vocal folds attached to end, so it opens & closes vocal folds

- 2 processes: muscular process (posterior) and vocal process (anterior)

- sits atop cricoid cartilage

- theres 2, made up of hyaline

- used for structural support

- theres 2

- structural support

- embedded into aryepiglottic folds (skin, mucous lining)

- lateral to corniculate cartilage

- elastic cartilage

- helps protect airway during swallowing

- leaf like shape

- posterior to hyoid bone and thyroid cartilage

- allows thyroid cartilage to rock forward and down

- lengthens true vocal folds (stretches like rubberbands)

- alters pitch

- allows movement of arytenoids

- pulls artyenoids together (adducting) or aparting (abducting) -- how we open and close vocal folds

- changes position & tension of vocal folds to produce voice

- moves artyenoids in 3 dimensions

1) rocking: down & inward toward trachea

2) gliding: medial or lateral

3) rotation: clockwise or counter clockwise

- larynx = tube that connects upper & lower respiratory tracts

- quandrangular membrane holds bone and cartilage together (in upper)

- conus elasticus holds bone & cartilages (below)

- lined with epithelial tissue

- tube can constrict to produce disturbance in airflow by moving vocal cords into the air stream

laryngeal spaces above the true vocal folds

- aditus: entryway into larynx

- laryngeal vestibule: space between aditus & false vocal folds

- laryngeal ventricle: space between true and false vocal folds

laryngeal space between true vocal folds

- superior to true vocal folds

- can be used for screaming or forced holding breath (valsalva)

- not used for normal voicing

- protects airway

- more mobile, moves in bottom-up wavelike motion

- inferior to false vocal folds

- anterior attachment to the thyroid cartilage

- posterior attachment to the vocal process of arytenoid cartilages

- below true vocal folds

- above trachea

- contains conus elasticus membrane

1) Cover:

- thin outer epithelial layer

- superficial layer of lamina propria (gelatin)

- intermediate layer of lamina propria (soft rubberbands)

2) body:

- deep layer of lamina propria (cotton threads)

- thyroarytenoid (vocalis) muscle (stiff rubber bands)

- have both origin & insertion on a laryngeal structure

- make fine adjustments to larynx

- especially important for voice production

- include: 3 adductors, 1 abductor, 2 tensors, 1 relaxer

- especially important for swallowing (moves larynx out of harm's way)

- have one attachment on a laryngeal structure & other attachment on a distant structure

- make gross/large movements on larynx (raise or lower)

- 5 elevators (suprahyoid), 4 depressors (infrahyoid)

- transverse interarytenoid

- oblique interarytenoid

- lateral cricoarytenoid

- innervation: CN X Vagus, recurrent laryngeal branch

- action: adduct glottis

- posterior cricoarytenoid

- abducts glottis

- for termination of phonation or voiceless sounds

- origin: posterior of cricoid

- insertion: muscular process of arytenoid

- innervation: CN X, recurrent laryngeal branch

- cricothyroid - tenses & lengthens TVF

- vocalis (medial thryoarytenoid): tenses TVF

- lateral thyroartenoid

- relaxes TVF

- pulls arytenoid down & in

- origin: thyroid cartilage (near notch)

- insertion: muscular process of arytenoid

- innervation: CN X vagus, recurrent laryngeal

- mylohyoid, anterior belly of digastric, posterior belly of digastric, stylohyoid, geniohyoid

- all inserted at hyoid bone

- floor of mouth

- origin: inner surface of mandible

- insertion: hyoid bone

- innervation: CN 5, trigeminal

- moves hyoid up & forward (for swallowing)

- origin: inside midline of mandible

- insertion: hyoid bone

- innervation: CN 5 trigemnal

- moves hyoid up & forward

- origin: styloid process of temporal bone (toothpick)

- insertion: hyoid bone

- innervation: CN 7 facial

- moves hyoid up & back

- origin: inside, midline of mandible

- insertion: hyoid bone

- innervation: CN 5 trigeminal

- moves hyoid up & forward

- origin: mastoid process of temporal bone

- insertion: hyoid bone

- innervation: CN 7, facial

- moves hyoid up & back

- origin: inside midline of mandible

- insertion: hyoid bone

- innervation: CN 12, hypoglossal

- moves hyoid up & forward

- sternohyoid, sternothyroid, superior belly of omohyoid, inferior belly of omohyoid

- no innervation

- action: move larynx down

- beneath sternocleidomastoid

- origin: sternum

- insertion: hyoid bone

- move larynx down

- origin: sternum

- insertion: thyroid cartilage (oblique line)

- move larynx down

- origin: scapula

- insertion: hyoid bone

- move larynx down

geniohyoid -> mylohyoid -> anterior belly of digastric

sternothyroid -> sternohyoid -> omohyoid (next to sternohyoid) -> sternocleidomastoid

- "voicing"

- occurs when TVF are adducted and vibrate in the upper airway

- TVF are slightly adducted to create turbulence in airstream, but not so much as to achieve phonation (not vibrating)

- elastic (wants to return to original resting position after moved)

- responsible for vibration for phonation

- moves bottom up, wavelike motion

- 3-5 cm h20 flow

- given a constant flow of air, at a point of constriction there will be a decrease in air pressure perpendicular to the flow and an increase in speed of the flow

1) inhale

2) exhale & adduct TVF (causes constriction)

3) maintain adduction. Positive subglottal pressure blows open TVF from bottom->up

4) glottis is blown open. airflow increases & pressure decreases

5) negative pressrue causes the TVF to close again, from bottom->up

6) repeat process many times per second to achieve phonation. maintain adduction of TVF

1) vocal attack: process of adducting TVF into airstream to begin

2) sustained phonation: vibration of TVF while maintained/sustained in adducted position during exhalation "ahhhhh"

3) termination of phonation: process of abducting TVF to open glottis to stop vibration in airstream; required for voiceless sounds and breathing (posterior cricoarytenoid)

1) breathy vocal attack: onset of exhalation occurs before vocal attack (adduction), whisper & voicing

2) simultaneous vocal attack: onset of exhalation and vocal attack (adduction) occur at the same time

3) glottal attack: vocal attack (adduction) occurs before onset of exhalation

2) glottal fry: pattern of phonation extremely low in pitch; sounds rough or crackly; TVF are short/thick, mostly closed (90%)

3) falsetto: pattern of phonation extremely high in pitch; TVF are long/thin and don't contact each other as frequently (10% closed)

1) pressed phonation: medial compression of TVF is increased; results in harsh-sounding voice

2) breathy phonation: inadequate TVF medialization to achieve vibration; results in breathy voice

- length of TVF: contraction of cricothyroid muscle lengthens TVF

- increased length --> increased pitch

- tension in TVF: contraction of vocalis muscle tenses TVF

- increased tension -> increased pitch

when an individual uses the phonatory mechanism in a manner that exceeds its anatomical/physiological capacities

- inflammation of TVF, due to infection or vocal misuse

- TVF red and thick

- leads to hoarse voice or aphona (no voice)

- tissue growth on anterior 1/3 of TVF, due to vocal misuse

- leads to breathy or hoarse voice

- over adduction of TVF

- associated with increased laryngeal tension

- due to vocal misuse

- leads to harsh voice