02 - Respiratory II & III

Question 1

Volume is one way of measuring respiratory function. What are 3 other things we can measure?

Answer 1

Air Pressure
Airflow
Chest wall shape and movement

Question 2

What is respiratory air pressure, and what units is it measured in?

Answer 2

The forces generated by the respiratory process
-includes speech pressures (Palv, Ps, Ptrach, Poral, Pnasal)

Measured in cmH2O (centimeters of water)

Question 3

Air Pressure reflects the _____ for speech

Answer 3

Power Supply

Question 4

What is Palv?

Answer 4

Alveolar pressure - the pressure inside the lungs

Question 5

What is Ps?

Answer 5

Subglottal pressure - the pressure below the vocal folds

Question 6

What is Ptrach?

Answer 6

Tracheal pressure - the pressure below the vocal folds and inside the trachea

Question 7

What is Poral?

Answer 7

Oral pressure - the pressure inside the mouth

Question 8

What is Pnasal?

Answer 8

Nasal pressure - the pressure inside the nasal cavities

Question 9

When are the oral, subglottal, tracheal, and alveolar pressures all equal (i.e. what conditions must be met)?

Answer 9

When:

• the nose is plugged or velum elevated
• the vocal folds are open
• the mouth is closed

Question 10

What is one device that can be used to measure pressure?

Answer 10

Manometer (u-tube or pressure gauge)

Air Pressure Transducer

Question 11

What is the manometer useful for, and what is it not suitable for?

Answer 11

Useful for slow, continuous (static) pressures, like determining if a patient can hold a given pressure for a length of time

Not suitable for measuring most rapid dynamic speech pressures

Question 12

In patients with neurological damage, what rule has been found useful for estimating their ability to demonstrate the minimal air pressure requirements for speech?

Answer 12

The ‘5cmH2O for 5 seconds” rule

Can also be completed using a straw in a glass

Question 13

When using a(n) _______, pressure creates a continuous electrical signal for display on an oscilloscope or computer

Answer 13

Air Pressure Transducer

Question 14

Which device for pressure measurement involves a tube being placed on the end of the device and inserted into the mouth?

Answer 14

Air Pressure Transducer

Question 15

Which device uses a u-tube or pressure gauge?

Answer 15

Manometer

Question 16

Pressure obtained during /p/ in continuous speech provides an estimate of what pressure?

Answer 16

Speech Subglottal Pressures

Question 17

What is the range of pressure (in cmH2O) necessary for conversational speech?

Answer 17

5-10 cmH2O

Question 18

Air pressure and speech loudness are ______ (proportional/inversely proportional

Answer 18

Proportional - pressure increases fairly consistently with speech loudness (e.g. double air pressure and see 8-9 dB increase in loudness)

Question 19

When loudness is kept constant, the intraoral (subglottal) pressure _______ (remains consistent, is elevated, decreases)

Answer 19

Remains consistent

Question 20

Put the following populations in order, from lowest to highest, for average maximum effort air pressures:
children, young males, older females, older males, young females

Answer 20

Children: 35-50 cmH2O
Older Female: 87 cmH2O
Young Female: 121 cmH2O
Older Male: 123 cmH2O
Young Male: 166 cmH2O

Question 21

What is the average maximum effort air pressure that young males are capable of?

Answer 21

166 cmH2O

Question 22

What speech sounds have the highest intraoral air pressure:

voiced plosives, voiceless plosives, voiced fricatives, voiceless fricatives, glides/liquids, or nasals?

Answer 22

Voiceless plosives: 5-7 cmH2O

Question 23

What speech sounds have the lowest intraoral air pressure:

voiced plosives, voiceless plosives, voiced fricatives, voiceless fricatives, glides/liquids, or nasals?

Answer 23

Nasals: 0.2 - 0.4

Question 24

What is airflow? What are its units?

Answer 24

Change in volume of air over a certain period of time (also referred to as “volume velocity”

ml/sec (also ml/min & l/sec)

Question 25

Name one of the two devices used to measure airflow

Answer 25

Rotameter | Pneumotachograph

Question 26

Describe how a rotameter works

Answer 26

The amount of airflow blown into the base of the tube causes the ball inside to rise to different calibrated heights

Question 27

What is a rotameter used to measure?

Answer 27

Continuous static airflow (NOT rapid dynamic airflows found in continuous speech)

Question 28

Describe how a pneumotachograph works

Answer 28

It is an air flow transducer which provides a continuous electrical signal for oscilloscopic display or a computer, and is based on a change in pressure across a constant resistance -a pressure transducer is located on either side of a face mask, with a small wire mesh of a known resistance to flow Flow = (pressure 1 - pressure 2)/resistance

Question 29

Average air flow during conversation is largely related to the air flow during _______ (consonants/vowels)

Answer 29

Vowels | adult average air flow in conversation= 160-170 ml/sec

Question 30

What is the average air flow during a prolonged /a/ for men? Are women higher or lower?

Answer 30

112 ml/sec (women are lower at 94 ml/sec)

Question 31

What type of consonants produce the highest air flows, and what is the value?

Answer 31

Voiceless stops /ptk/ = 900 ml/sec

Question 32

What type of consonants produce the lowest air flows, and what is the value?

Answer 32

Glides/Liquids = 100-150

Question 33

What measures are used to estimate laryngeal resistance?

Answer 33

Oral air pressure and oral air flow

Question 34

What is the formula for resistance?

Answer 34

Resistance = Pressure / flow | Ohm's Law

Question 35

If we measured peak air pressure of /p/ and airflow during /i/ to find values of 5 cmH2O and 140 ml/sec, what would our laryngeal resistance be?

Answer 35

``` Resistance = pressure/flow Resistance = 5 cm H2O / 0.14 L/sec Resistance = 35.7 cmH2O/L/sec ``` Average normal adult laryngeal resistance = 35 cmH2O/L/sec

Question 36

Do breathy voices have a higher or lower laryngeal resistance?

Answer 36

Lower (20) Airflow = 250 mL/sec (as opposed to 170 ml/sec), so larger denominator = smaller resistance value (Resistance = pressure/flow)

Question 37

Do strained voices have a higher or lower laryngeal resistance?

Answer 37

Higher (60) Airflow = 83 mL/sec (as opposed to 170 ml/sec), so smaller denominator = larger resistance value (Resistance = pressure/flow)

Question 38

Lung volume changes are related to the movements of which 2 components of the chest wall?

Answer 38

Rib cage movements | Abdomen movements

Question 39

Measurements of the changes in diameter of the rib cage and abdomen during breathing will accurately measure changes in _______

Answer 39

Total lung volume

Question 40

Name one way that we can measure RC (rib cage) and ABD (abdomen) movements

Answer 40

Inductive Plethysmography Respitrace Instrument - 2 coiled wires wrap around RC and ABD - diameter changes of the coiled wires cause changes in the inductance (electromagnetic levels) RC and ABD is continuously obtained as an electrical signal Magnetometer - pairs of transmitter and receiver magnetic coils are placed on the front and back of the RC and ABD - changes in RC and ABD diameter cause changes in the magnetic forces between the coils, and this is detected as a continuous electrical signal

Question 41

How are chest wall movement displayed (describe the graph)?

Answer 41

ABD movements on x-axis and RC movements on y-axis - measure start, end, and total volumes for RC and ABD - can see patterns of movement (smooth vs variable, paradoxical vs parallel)

Question 42

Ideally, our Chest Wall Display should show ABD movements _____ (increasing/decreasing) as RC movements decrease

Answer 42

Increasing