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Flashcards in Anatomy Deck (48):
1

Respiration Structures

The Ribs & the Diaphragm

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Ribs

12 thoracic vertebrae: muscles play an impt. role in respiration
Ribcage wall: expands for inspiration & collapses for expiration

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Diaphragm

Base of thorax: separates the thoracic from the abdominal cavity
As it contracts, it descends & increases vertical dimension of thorax
As it relaxes, it ascends back to higher position

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Primary Muscle of Inspiration

Diaphragm

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Secondary Muscles of Inspiration

External intercostals, pectoralis major & minor, costal elevators, serratus posterior, neck accessory muscles primarily the sternocleidomastoid

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Primary Muscles of Expiration

4 abdominal muscles: Internal oblique abdominal, external oblique abdominal, transverse abdominal, rectus abdominal

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Air stream flows for inhalation thru the following passage:

nostrils, nasal cavity, nasopharynx, VP port, oropharynx, hypopharynx, larynx, b/t the ventricular fold (false VFs), b/t the true VFs, trachea, divides into the 2 bronchial tubes, branch into bronchioles, terminate in lungs @ alveolar sacs

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When the thorax enlarges

Lungs within the thorax enlarge
Air in the lungs becomes less dense than atmospheric air & inspiration begins

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Expiration

When the lung pressure exceeds atmospheric pressure by an amount sufficient to overcome resistance, air flows out of the lungs

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Speaking on residual air

Resulting lack of sufficient air flow & subglottal pressure usually produces an increase in glottal tension as 1 attempts to maintain phonation; voice lacks adequate intensity & resonance

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Phonating with Insufficient Loudness

Intensity of the voice is directly related to the amount of airflow & degree subglottal air pressure; individual should increase overall inspiration b/c as he/she increases his/her airflow, voice will be perceived as louder
Use diaphragmatic abdominal breathing

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Speaking with Shortness of Breath

Some pts w/ certain physical conditions (emphysema, TB, quadriplegia) have serious problems in inspiration-expiration

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Struggling to Take in a Breath

Pt uses clavicular rather than diaphragmatic-abdominal breathing

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Key Problem for Many Voice-Disordered Patients

Tendency to "squeeze" the glottis closed to produce "power" rather than using abdominal muscles
Excessive effort becomes basis of a hyperfunctional voice d/o which may lead to: nodules, contact ulcers, polyps, laryngitis, loss of voice

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Speaking & singing both require...

An outgoing air stream capable of activating vocal vibration

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When looking at respiration (& speaking/singing) we need to look at:

How many phrases can we sing
How much emphasis we can use on 1 expiration

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Laryngeal Functions & Respiration

Cough productions & valsalva maneuver

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Laryngeal Functions & Deglutition

Prevents aspiration

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Laryngeal Functions & Phonation

Develops subglottic air pressure; modifies air flow to vibrate VFs

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Cartilaginous Framework of Larynx

1 thyroid, 1 cricoid, 1 epiglottis, 2 arytenoids, 2 corniculates, 2 cuneiforms

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Extrinsic Laryngeal Muscles

Stylohyoid, posterior digastric belly, anterior digastric belly, geniohyoid, thyrohyoid, sternohyoid, sternothyroid, omohyoid

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Strap Muscles of Neck

Geniohyoid, thyrohyoid, sternohyoid, sternothyroid, omohyoid

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Intrinsic Laryngeal Muscles

Thyroarytenoid, Posterior cricoarytenoid, Lateral cricoarytenoid, interarytenoid, cricothyroid

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Thyroartyenoid/vocalis Function

Shorten the VFs
Relaxation

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Posterior cricoarytenoid Function

Abduction of the VFs

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Lateral cricoarytenoid Function

Adduction of the VFs

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Interarytenoids Function

Adduction of the VFs

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Cricothyroid Muscle

Anteriorly placed paired muscles that lie external to the laryngeal cartilage

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Cricothyroid Muscle Innervation

Superior laryngeal nerve

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VF Histology

Divided into 3 layers: Cover, Lamina Propria, Muscular layer

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Cover of VFs

Composed of epithelial layer & superficial connective tissue layer

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Lamina Propria of VFs

Superficial, Intermediate, and Deep layers

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Median Position of VFs

Position VFs take during phonation

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Paramedian Position of VFs

Position most VFs take when paralyzed

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Intermedian Position of VFs

Between the paramedian position and full adduction

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Full Abduction Position of VFs

Similar to breathing, VFs are wide open

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Myoelastic Aerodynamic Theory of Phonation

Phonation begins w/ expiration, setting the closed VFs in vibration as airflow passes b/t folds
Subglottal air pressure builds up, resulting in increased velocity of airflow
Subglottal increases & VFs are blown apart =izing supraglottic & subglottic pressure
B/c of mass of VFs & Bernoulli Effect, they come back together again

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Bernoulli Effect

Occurs when velocity of subglottal air is increased while approaching & passing thru the constricted glottis
Increased velocity of airflow creates a (-) pressure b/t medial edges of VFs
VFs will be "sucked" back together producing the repetitive vibratory cycle of folds blown apart & sucked back together 100s of times/sec.
Is the suction action that draws the folds together

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The Vibratory Cycle

Repeated approx. 100 times per second for an adult male and approximately 200 times per seconds for and adult female

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Fundamental Frequency

Directly related to how many vibratory closings & openings the VFs make in 1 sec.
Short, thick, lax fold vibrates at a slow rate producing a low pitch
Long, thin, tense fold vibrates at a fast rate producing a high pitch

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Falsetto

VFs can elongate/stretch only so far; extending range
Folds appear long, stiff, very thin along edges, & often somewhat bow-shaped
Gives the breathy quality of this
Often called "loft" register

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Glottal Fry

Pitch opposite falsetto in quality & airflow rate
Described as the pulse register, the lowest range of notes
Sounds like a sputter of a low-powered outboard motor
Produced when the folds are approximated tightly, particularly at the arytenoids

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Pulse/Chest Register

Lowest range of phonation

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Modal/Midvoice Register

Range of fundamental frequency

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Loft/Falsetto Register

Higher range of fundamental frequencies

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Modes of Attack

Hard, glottal, or stopped
Even or static
Breathy

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Short, thick, lax fold vibrates

at a slow rate producing a low pitch

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Long, thin, tense fold vibrates

at a fast rate producing a high pitch