Chapter 1-Anatomy, Neuroanatomy, And Physiology Of The speech Mechanism Flashcards
(211 cards)
1
Q
What is defined as: Voicing with the structures and processes that help produce voice
A
Phonation
2
Q
What is the modification of the voice produced at the laryngeal level called?
A
Resignation
3
Q
What is production of speech sounds in isolation as well as in connected speech called?
A
Articulation
4
Q
The lungs, brochi, trachea, spinal column, sternum, and rib cage are all important for what?
A
Respiration
5
Q
When an excessive amount of carbon dioxide in the blood cells creates a need for oxygen what part of the brain reacts?and what does it do?
A
The medulla oblongata in the brain stem fires impulses to the respiratory muscles.
6
Q
Pressure within the lungs,compared to that outside the lungs, is reduced when?
A
The lungs expand.
7
Q
When is the duration of an exhalation topically longer? During regular breathing or when speaking?
A
Speaking
8
Q
When compared to quiet breathing this type of breathing is more consciously monitored and adjusted to meet the demands of speech in various daily situations.
A
What is breathing for speech.
9
Q
What is the basic process of inhalation in order?
A
Inhalation-> chest and lungs expand -> diaphragm lowers-> air flows in through nose and mouth-> air goes down pharynx and between open vocal folds-> air continues downward through trachea and bronchial tubes-> air reaches final destination of lungs
10
Q
When are the lungs partially inflates to approximately 40% of their total capacity?
A
at rest.
11
Q
The spinal column consists of 32-33 individual vertebrae. These are divided into five categories. Name the categories and the number of vertebrae present.
A
7 cervical vertebrae (C1-C7)
12 thoracic vertebrae (T1-T12)
5 lumbar vertebrae (L1-L5)
5 sacral vertebrae (S1-S5) [these are fused in adults]
3-4 coccygeal vertebrae (fused and called the coccyx)
12
Q
Which type of vertebrae provide points of attachment to the ribs?
A
The thoracic vertebrae.
13
Q
Which type of vertebrae are long and suitable for weight bearing functions?
A
The lumbar vertebrae.
14
Q
The manubrium, corpus, and zip hid process are all parts of what structure?
A
The Sternum.
15
Q
The upper most part of the sternum which provides attachment for the clavicle and first rib is?
A
The manubrium.
16
Q
Another name for this is body. It is long and narrow. This is also know for being the connection point the cartilages if runs 2-7.
A
What is corpus.
17
Q
What is the small cartilaginous structure at the bottom of the sternum called?
A
Xiphoid process.
18
Q
How many pairs of ribs make up the thoracic cage/rib cage?
A
12 pairs of ribs
19
Q
The Sternum in the anterior surface, 12 thoracic vertebrae in the posterior surface, and 12 pairs of ribs that connect laterally from the vertebrae to their individual costal cartilage make up the?
A
Rib cage
20
Q
What are the muscles between the ribs called?
A
Intercostal muscles.
21
Q
What pulls downward to decrease the diameter of he thoracic cavity for exhalation?
A
The 11 paired internal intercostals.
22
Q
What raises the ribs up and out to increase the diameter of the thoracic cavity for inhalation?
A
The 11 paired external intercostals.
23
Q
The serrated posterior, Levantine costarum brevis, levator costarum longis, and external intercostal muscles are all involved in what?
A
Elevation of the rib cage.
24
Q
What distends the abdomen, enlarges the vertical dimension of the thorax, and depresses the central tendon of the diaphragm?
A
The diaphragm (innervation (C3-C5)
25
What muscles and innervations elevate the rib cage?
Serratus posterior superior (C7, T1-T4)
Levator costarum brevis (T2-T12)
Levator cosrarum longis (T2-T12)
External intercostal (T2-T11)
26
What key muscles of the neck are also involved in the process of respiration?
Sternocleidomastoid and the trapezius.
27
What muscle elevates the sternum and indirectly the rib cage?
Sternocleidimastoid
28
What muscle controls the head and elongates the neck indirectly influencing respiration?
The trapezius.
29
What muscles of the shoulder and upper arm work to move the rib cage and increase/decrease it’s dimensions?
Pectoralis major, pectoralis minor, serratus anterior, and levator scapulae.
30
What muscle increases transverse dimension of the rib cage through elevation of the sternum?
Pectoralis major (C4-T1)
31
What muscle increases transverse dimensions of the rib cage?
Pectoralis minor (C4-T1)
32
What muscle elevates robes 1-9?
Serratus anterior (C3-C5)
33
What muscle elevates scapula and supports the neck?
Levator scapulae (C3-C5)
34
What muscles stabilize shoulder girdle?
Rhomboideus major and minor (C5)
35
What muscles depress ribs 1-11?
The internal intercostals and the innermost intercostals.
36
What muscle depresses ribs 2-6?
Transversus thoracis (T2-T6)
37
What two posterior thoracic muscles are involved in respiration? (Both support exhalation)
Serratus posterior inferior muscle (pulls the rib cage down) and subcostal muscle (depresses the thorax).
38
What are the muscles of expiration (breathing out)?
Latissimus dorsi, rectus abdominis, transversus abdominals, internal oblique abdominis, and quadratus lumborum.
39
What muscle stabilizes the posterior abdominal wall for expiration?
Latissimus dorsi (C6-C8)
40
What muscle flexes the vertebral column?
Rectus abdominis (T7-T12)
41
What muscle compresses the abdomen?
Transversus abdominis (T7-T12)
42
What muscle compresses the abdomen, flexes and rotates trunk?
Internal oblique abdominis (T7-T12)
43
What muscle supports abdominal compression through bilateral contraction, which fixes abdominal walls?
Quadratus lumborum (T12, L1-L4)
44
Moving toward the midline is called?
Adduct
45
Moving away from the midline is called?
Abduct
46
Biological functions of the larynx:
- closure of the trachea so that food and other substances do not enter the lungs
- production of the cough reflex to expel foreign substances that accidentally enter the trachea
- closure of the vocal folds to build subglottic pressure necessary for physical tasks such as excretion and lifting of heavy items.
47
What does the hyoid bone do?
It suspends the larynx
48
Of the key cartilages if the larynx which one forms the anterior and lateral walls of the larynx and protects the larynx.
Thyroid cartilage
49
Of the key cartilages in the larynx: which one is viewed as he uppermost tracheal ring. This is linked to the thyroid cartilage and the paired arytenoid cartilages. It completely surrounds the trachea.
Cricoid cartilage.
50
Of the key cartilages of the larynx which one is small, pyramid-shaped cartilages connected to the cricoid through the cricoarytenoid joint, which permits sliding and circular movements?
Arytenoid cartilages
51
Of the cartilages in the throat what ones are small and cone-shaped. Sits on the apex of the arytenoids. They assist in reducing the laryngeal opening when a person is swallowing.
Corniculate cartilages
52
Of the cartilages in the throat what ones are tiny come-shaped that are located under the mucous membrane that covers the aryepiglotoc folds. Their role is to stiffen or tense the aryepiglottic folds.
Cuneiform cartilages
53
Intrinsic laryngeal muscles are primarily responsible for controlling sound production what are the 6 muscles that fall into this category?
- thyroarytenoid
- lateral cricoarytenoid
- transverse arytenoid
- oblique arytenoid
- cricothyroid
- posterior cricoarytenoid
54
What is the primary portion of the thyroarytenoid muscle, which vibrates and produces sound. Generally referred to as the vocalist muscle/ vocal folds.
Internal thyroarytenoid
55
Adductor muscles of the larynx includes:
- lateral cricoarytenoid
- transverse arytenoid
- oblique arytenoid
56
Abduction of the vocal folds is accomplished when..?
The posterior cricoarytenoid muscle contracts
57
Of the interinsic laryngeal muscles this one is the internal thyroarytenoid the primary portion of the thyroarytenoid muscle, which vibrates and produces sound?
Thyroarytenoid (innervation of Cranial nerve X [10-vagus nerve])
58
Of the interinsic laryngeal muscles which one addicted vocal folds, increases medical compression?
Lateral cricoarytenoid (innervation of Cranial nerve X [10-vagus nerve])
59
Of the interinsic laryngeal muscles which one addicted the vocal folds?
Transverse arytenoid (innervation of Cranial nerve X [10-vagus nerve])
60
Of the interinsic laryngeal muscles which pulls the apex of the arytenoids in a medial direction?
Oblique arytenoid (innervation of Cranial nerve X [10-vagus nerve])
61
Of the interinsic laryngeal muscles which one lengthens and tenses vocal folds?
Cricothyroid (innervation of Cranial nerve X [10-vagus nerve])
62
Of the interinsic laryngeal muscles which one abducts the vocal folds?
Posterior cricoarytenoid (innervation of Cranial nerve X [10-vagus nerve])
63
What muscles primary function is to support the larynx and fix its position? These muscles must have one attachment to a structure within the larynx and one attachment to a structure outside the larynx.
Extrinsic laryngeal muscles
64
The elevators or suprhyoid muscles lie above the hyoid bone and consist of..?
- digastric (innervates CN- V[trigeminal] ,VII [facial]
- geniohyoid (innervates CN-XII[hypoglossal] and C1)
- mylohyoid (innervates CN-V)
- stylohyoid (innervates CN-VII)
- hyoglossus (innervates CN-XII)
- genioglossus (innervates CN-XII)
65
The depressors or infrahyoid muscles lie below the hyoid bone and consist of...?
- throhyoid (innervates CN-XII [hypoglossal] and C1)
- omohyoid (innervates C1-C3)
- sternothyroid (innervates C1-C3)
- sternohyoid (innervates C1-C3)
66
What are the three layers of the vocal folds?
A) the epithelium or outer cover
B) the lamina propria or middle layer
C) vocalis muscle or body (this provides stability and mass to the vocal fold)
67
What are the other pair of folds around the vocal folds?
- Aryepiglottic folds: composed of a ring of connective tissue and muscle extending from the tips of the arytenoids to the larynx
- ventricular or false vocal folds. (Compress during coughing or lifting of heavy objects).
68
What is caused by he increased speed of air passing between the vocal folds. It’s the “sucking” motion of the vocal folds toward one another.
Bernoulli effect
69
This movement is vital to to the vibration of the vocal folds. During this movement the cover and the transient over the vocalis muscle slide and produce a wave.
Mucosal wave
70
That cortical areas (places in the brain) are the primary areas involved in speech-motor control, including phonation are what?
- area 4 (primary motor cortex)
- area 44 (Brock’s area)
- area 3,1,2 (somatosensory cortex)
- area 6 (supplementary motor cortex)
71
What is the function of the cerebellum?
Regulating motor movements. (Critical in the control of speech movement)
Note: It is key to the coordination of the laryngeal muscles for adequate phonation. It’s also key to the effective functioning of other speech systems like respiration.
72
Which cranial nerve innervates the posterior belly of the digastric muscle?
CN- VII (the facial nerve)
73
Which cranial nerve has the following primary branches (superior laryngeal nerve [SLN] and recurrent laryngeal nerve [RLN])
CN-X (the vagus nerve)
74
Which primary branch of CN-X has internal and external branches. With internal branches that provide all sensory information to the larynx, and an external branch supplies motor innervation solely to the cricothyroid muscle.
Superior laryngeal nerve (SNL)
75
Of CN-X’s primary branches which one supplies all motor innervation to the inter arytenoid, posterior cricoarytenoid, and lateral cricoarytenoid muscles. It also supplies all sensory information below the vocal folds.
Recurrent laryngeal nerve (RLN)
76
What are the structure involved in articulation?
- Pharynx
- soft palate
- hard palate
- mandible
- teeth
- tongue
- lips
- cheek
77
What is the modification of laryngeal tone by selective dampening or enhancement of specific frequencies.
Resignation
78
What does the velum do for speech?
The velum elevates and retracts to produce all other (oral) sounds in the English language
79
The _______ depicts the vocal tract as a series of linked tunes: the oral cavity, or mouth; the pharynx; and the nasal cavity.
Source-filter theory
80
What is the connection of moveable parts or the joining of two elements? Refers to the movement of joined an atomic parts, as well as the production of speech sounds that result from such movements.
Articulation
81
The pharyngeal cavity is divided into three segments:
- laryngopharynx: which begins immediately superior to the larynx and ends at the base of the tongue, is connected to the oropharynx
- oropharynx: which extends up to the soft palate and is connected to the nasopharynx
- nasopharynx: which ends where the two nasal cavities begin.
82
Most pharyngeal muscles are innervates by what two CNs?
CN-X (the vagus nerve) and CN-XI (spinal accessory nerve)
83
Of the pharyngeal muscles which one elevates the lateral pharyngeal wall?
Salpingopharyngeus (innervates CN-X (the vagus nerve) and CN-XI (the spinal accessory nerve).
84
Of the pharyngeal muscles which one elevates and opens the pharynx.
Stylopharyngeus (innervates CN-XI (the spinal accessory nerve))
85
Of the pharyngeal muscles which one constricts the pharyngeal diameter and pulls the pharyngeal wall forward
Superior pharyngeal constrictor (CN-X (cause) and CN-XI(spinal accessory nerve))
86
Of the pharyngeal muscles which one narrows the diameter of he pharynx?
Middle pharyngeal constrictor (innervates CN-X (vagus) and CN-XI (spinal accessory nerve))
87
Of the pharyngeal muscles which one constricts the superior orifice of esophagus?
Inferior pharyngeal constrictor, cricopharyngeus (innervates CN-X (vagus) and CN-XI (spinal accessory nerve))
88
Of the pharyngeal muscles which one reduces the diameter of the lower pharynx?
Inferior pharyngeal constrictor, thyropharyngeus (innervates CN-X (vagus) and CN-XI (spinal accessory nerve))
89
Muscles that make up the soft palate and their functions.
- Levator veil palatine (innervates CN- X,XI). Function: primary elevator of velum
- Tensor velum palatini (innervates CN-V). Function: tenses velum, dilates Eustachian tube
- Palaoglossus (innervates CN-X,XI). Function: elevates and depresses velum
- Palatipharyngeus (innervates CN-X,XI). Function: narrows pharyngeal cavity, lowers velum, may help elevate the larynx.
90
What is the frontal portion of the maxillary bone called? It houses the four upper front teeth (incisors).
Premaxilla
91
What is the portion of the maxillary bone that forms the hard palate called?
Palatine process
92
What are the outer edges of the maxillary bone called?
Alveolar process
93
What is the medical name for the lower jaw? It is formed by the fusion of two bones in the midpoint of the chin (considered to be one bone in adults)
Mandible
94
The alveolar arch is the part of the mandible that houses what?
Teeth
95
The mandible is attached to the temporal bone of the skull by what joint?
Temporomandibular joint
96
The muscles of the mandible serve two major functions:
A) opening and closing the mouth
B) chewing food
97
The muscles of the mandible may be categorized as either elevators or depressors. They arise from branches of which 3 CNs?
- V (trigeminal nerve)
- VII (facial nerve)
- XII (hypoglossal nerve)
98
Elevators of the mandible and their functions. All elevators innervate CN -V
- Masseter: elevates mandible
- Temporalis: elevates mandible, draws mandible back of protruded.
- Medial (internal) pterygoid: elevates mandible
- Lateral (external) pterygoid: protrudes mandible
99
Depressors is the mandible and their function.
- Anterior belly of digastric (innervates CN-V): depresses mandible in conjunction with posterior belly of digastric; pulls hyoid forward
- Posterior belly of digastric (innervates CN-VII): depresses mandible in conjunction with anterior belly of digastric; pulls hyoid back
- Geniohyoid (innervates CN-XII, and C1): depresses mandible
- Mylohyoid (innervates CN-V): depresses mandible
100
How many teeth total do adults have?
32 teeth with 16 in each arch
101
The tongue is divided into four parts what are they and what is their function? (The tongue connects to the mandible at the inferior portion of the tongue. This connection is called the lingual frenulum.)
- Tip: thinnest and most flexible part of the tongue and plays an important part in articulation
- Blade: small region adjacent to the tip; in a resting position, it is the portion of the tongue that lies just inferior to the alveolar ridge
- Dorsum: the large area of he tongue that lies in contact with both the hard and soft palate
- Root: the very back and bottom portion of the tongue
102
What are the intrinsic muscles of the tongue? And their functions. (All intrinsic muscles innervate CN- XII)
- Superior longitudinal muscle: shortens tongue, turns tip upward, assists in turning lateral margins upward
- Inferior longitudinal muscle: shortens tongue, pulls tip downward, assists in retraction
- Transverse muscles: narrow and elongate tongue
- Vertical muscles: flatten tongue
103
What are the extrinsic muscles of the tongue? And their function (all but the Plataglossus innovative CN-XII) the Palatiglossus muscles doesn’t innervate.
- Genioglossus: forms bulk of tongue; is able to retract tongue,draw tongue downward, draw entire tongue anteriorly to protrude tip or press tip against alveolar ridges and teeth /th/ sound.
- Styloglissus: draws tongue up and back, may draw sides of tongue upward to help make dorsum concave
- hyoglossus: retracts and depresses tongue
- Chondroglossus: depresses tongue
- Palatoglossus: sometimes considered a muscle of the velum, helps elevate tongue (but depresses velum)
104
What is the primary muscle of he lips called?
Orbicularis oris muscle
105
The cheeks are primary composed of what muscle?
Buccinator muscle (a large flat muscle whose inner surface is covered with mucous membrane).
106
Facial muscles innervate CN-VII. What are the muscles? And their functions.
- Mentalis: pulls lower lip out, wrinkles and elevates chin
- Platysma: depresses mandible
- Risorius: retracts lips at corners
- Buccinator: retracts lips at corners
- Depressor labor inferioris: pulls lips down and out to dilate orifice
- Depressor anguli oris (triangularis): helps to press lower and upper lips together; depresses corners of mouth
- Orbicularis oris inferioris and superioris: pulls lips together, seals lips, serves as point of insertion for other muscles, interacts with other muscles to produce facial expression
- Levator anguli oris: draws corner of mouth upward and toward medial
- Levator labor superioris: elevates upper lip
- Levator labor superioris alaeque nasi: elevates upper lip
107
The study of neurological disorders and diseases and their diagnosis and treatment_____.
Neurology
108
A branch of neurology concerned with the study of structures of the nervous system _____.
Neuroanatomy
109
Concerned with the study of the function of the nervous system_____.
Neurophysiology
110
The central nervous system (CNS) is made up of different types of cells.
Glial cells (or neuroglia) include: astrocytes, oligodendroglia, ependymal cells, and microglia.
111
Glia cells of the peripheral nervous system (PNS) are called...
Schwann cells and satellite cells.
112
What is the function of the neuroglia or simple glia cells?
They do not transmit nerve impulses; they maintain support and protect the nerve cells.
113
What is the most important type of nerve cell?
Neurons
114
What are the two parts of a neuron or nerve cell?
A) nerve fibers
| B) soma or cell body
115
These are short fibers that extend from the cell body____. They receive neural impulses generated from the axons of other cells, and they transmit those impulses to the cell body.
Dendrites
116
The wrapping that’s on axons is called?
Myelin sheath
117
The junctions through which neurons communicate____
Synapses
118
What are two important neurotransmitters (chemical contained within the terminal buttons) in the motor system?
Dopamine and acetylcholine
119
What are the three basic types of neurons?
Motor neurons/ efferent neurons: transmit impulses away from the central nervous system
Sensory neurons/Afferent neurons: carry sensory impulses from the peripheral sense organs toward the brain
Interneurons (most common type of neuron): link neurons with other neurons and, therefore play an important role in controlling movement
120
What composes the peripheral nervous system (PNS)?
12 pairs of crimson nerves (CN)
Nerves outside of the spinal column and skull that carries sensory and motor impulses back and forth from the brain to various body parts.
Part of he peripheral nervous system is the autonomic nervous system, with its sympathetic and parasympathetic branches
121
What are the 3 type of nerves within the PNS?
Cranial, spinal and autonomic
12 pairs of CN
31 pairs of spinal nerves
122
The CNs emerge from the brain stem and are attached to the base of the brain. They are part of what system?
Lower motor system
123
Sensory nerves are also called?
Afferent nerves
124
Motor nerves are also called?
Efferent
125
Which cranial nerves are not connected to speech, language, or hearing?
I (olfactory nerve): sensory nerve for smelling
II (optic nerve): sensory nerve for vision
III (oculomotor nerve) and IV (trochlear nerve): motor nerves that corresponds with eye movement
VI (abducens nerve): motor nerve for eye movement
126
Cranial nerves 1-12, names, function and sensory/motor or both.
I (olfactory): sense of smell [S]
II (optic): vision [S]
III (oculomotor): eye movement [M]
IV (Trochlear): eye movement [M]
V (Trigeminal): face [S], jaw [M] [both]
VI (Abducens): eye movement [M]
VII (Facial): tongue [S], face [M] [both]
VIII (Acoustic): hearing and balance [S]
IX (Glossopharyngeal): tongue and pharynx [S], pharynx only [M] [both]
X (vagus): larynx, respiratory, cardiac, and gastrointestinal systems [S/M] [both]
XI (spinal accessory): shoulder, arm, and throat movements [M]
XII (Hypoglossal): mostly tongue movements [M]
127
The Trigeminal CN-V has sensory fibers that are composed of three branches.
- ophthalmic branch: sensory branches to the nose, eyes, and forehead
- maxillary branch: sensory branches to the upper lip, maxilla, upper cheek area, upper teeth, maxillary sinus, and palate
- mandibles branch: sensory branches to the mandible, lower teeth, lower lip, tongue, part of the check, and part of the external ear
128
The Trigeminal CN-V has motor fibers that innervate various jaw muscles including:
- temporalis
- lateral and medial pterygoids
- masseter
- tensor velum palatini
- tensor tympani
- mylohyoid
- anterior belly of the digastric muscle
129
Damage to The Trigeminal CN-V May result in:
- inability to close the mouth
- difficulty in chewing
- Trigeminal neuralgia (sharp pain in the facial area)
130
Facial Nerve CN-VII is a mixed nerve describe he various parts.
Sensory: responsible for taste sensations on the anterior two hires of the tongue
Motor: innervates muscles important to facial expression and speech. (Muscles include the buccinator, zygomatic, orbicularis oris, orbicularis oculomotor, platysma, stapedius, stylohyoid, frontalis, proverbs, nasalis, depressor labor inferioris, depressor anguli oris, auricular muscles, various labial muscles, and the posterior belly of the digastric muscle.
131
Damage to the facial nerve results in...
Damage often results in a mask-like appearance with minimal or no facial expression
132
Acoustic/vestibulocochlear nerve is a sensory nerve what does it do?
- vestibular branch is primarily responsible for maintenance of equilibrium, or balance
- acoustic branch transmits sensory information from the cochlea of the inner ear to the primary auditory cortex of the brain, where it is interpreted
133
Damage to the vestibular branch of the acoustic nerve results in?
Damage results in hearing loss, problems with balance, or both.
134
Glossopharyngeal nerve is a mixed nerve what does it do?
Sensory: assist in processing taste sensations from the posterior third of the tongue. This component also provides general sensation for the tympanic cavity, ear canal, Eustachian tube, faucial pillars, tonsils, soft palate, and pharynx.
Motor: innervate the stylopharyngeus, a muscle that raises and dilated the pharynx
Opinions differ on whether the motor fibers innervate the superior pharyngeal constrictor. The vagus nerve is the other nerve that is suspected to innervate the upper pharyngeal constrictor muscles
135
Damage to the Glossopharyngeal nerve may result in...
Lessons of this nerve may create difficulty in swallowing, unilateral loss of the gag reflex, and loss of taste and sensation from the posterior third of the tongue.
136
Vagus nerve CN-X is a mixed nerve wing motor, sensory, and autonomic fibers. What does it do?
Motor: supply the digestive system, heart, and lungs.
Sensory: convey information from the digestive system, heart, trachea, pharynx, and larynx.
Recurrent laryngeal nerve (RLN): regulates the intrinsic muscles of the larynx, excluding the cricothyroid, which is supplied by the superior laryngeal nerve branch. The RLN May be damaged during thyroid surgery, resulting in total or partial paralysis of the vocal folds.
Pharyngeal branch: supplies the pharyngeal constrictors. It also supplies all the muscles of the velum expect the tensor tympani, which is innervated by the trigeminal nerve.
137
Damage to the vagus nerve results in...
Damage includes a variety of sequels, such as difficulty swollowing paralysis of the velum, and voice problems if the RLN is damaged.
138
Spinal accessory nerve is a motor nerve. It is both a cranial and spinal nerve. What does it do?
The spinal root supplies the trapezius and sternoclidomastoid muscles, which assist in head and shoulder movements.
In concert with the vagus nerve, the cranial fibers of the accessory nerve innervate the uvula and levator veli palatini muscles of the soft palate.
139
Damage to the spinal accessory nerve results in?
Lesions to this nerve may result in neck weakness, paralysis of the sternocleidomastoid, and consequent inability to turn the head, as well as an inability to shrug the shoulders or raise the arm above shoulder level.
140
Hypoglossal nerve is a motor nerve the runs under the tongue. What does it do?
It supplies 3 extrinsic tongue muscles: the styloglossus, hyoglossus, and genioglossus.
This nerve also supplies all the intrinsic muscles of he tongue.
141
Damage to the hypoglossal nerve results in?
Lesions can result in tongue paralysis, diminished intelligibility, and swallowing problems.
142
These nerves of the PNS are closely related to the autonomic nervous system.
The spinal nerves
143
Spinal nerves can be motor, sensory, or mixed. What are they involved in?
Not all the spinal nerves are directly involved with speech production; some nerves contribute to speech though innervation of the respiratory musculature.
144
There are 32 pairs of spinal nerves that are divided into segments. What are the segments and how meany pairs are in each section?
8 pairs of cervical spinal nerves (C1-C8)
12 pairs of thoracic spinal nerves (T1-T12)
5 pairs of lumbar spinal nerves (L1-L5)
5 pairs of sacral spinal nerves (S1-S5)
1 pair of coccygeal spinal nerves (Col)
145
Autonomic nervous system (ANS) is viewed as part of the peripheral nervous system. What does it do?
The ANS controls and regulates the internal environment of our bodies with its two branches: the sympathetic and the parasympathetic.
Sympathetic: mobilized he body for “fight or flight” situations. (Accelerated the heart rate, dilated the pupils, raised the blood pressure, and increases blood flow to the peripheral body structures)
Parasympathetic: helps bring the body back to a state of relaxation. (After the body has mobilized for highly charged situations, the parasympathetic branch lowers blood pressure, slows the heart rate, increases activity within the stomach, and generally relaxes the body. This will make the person feel relaxed and calm during activation.)
146
The central nervous system (CNS) is composed of the spinal cord and the brain. What does it do?
Acts as a motor command center for planning, originating, and carrying out the transmission messages.
Key structures of the brain include: the brain stem, the reticular activating system, the diencephalon, the basal ganglia, the cerebellum, and the cerebrum.
Other key structures and systems include the pyramidal and extrapyrimidal systems, connecting fibers within the brain, the cerebral ventricles, the protective layers of the brain, and structures that provide the cerebral blood supply.
147
Brain stem:
Said to be the oldest part of the brain
Connects the spinal cord with the brain via the diencephalon.
Serves as a bridge between the cerebellum and all other CNS structures (spinal cord, thalamus, basal ganglia, and the cerebrum)
The brainstem itself consists of: longitudinal fiber tracts, cranial nerve nuclei, and the reticular formation
148
Midbrain/mesencephalon (contains CN- IV [trochlear] and III [oculomotor]):
It’s a narrow structure that lies superior to the pond and inferior to the diencephalon
Helps to connect the brainstem and the cerebellum
(The substantia nigra runs the vertical length of the midbrain at the level of the peduncles).
The midbrain controls many motor and sensory functions such as postural, reflexes, visual reflexes, eye movements, and coordination of vestibular-generated eye and head movements.
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Pons/metencephalon (houses CN-V [trigeminal] and VII [facial]):
Roundish, bulging structure that bridges the two halves of the cerebellum.
Located directly inferior to the midbrain.
Serves as a connection point between the cerebellum and various cerebral structures.
It transmits information relative to movement from the cerebral hemispheres to the cerebellum.
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Nebula/mylencephalon:
| Houses CN VIII [vestibulocochlear], IX [glossopharyngeal], X [vagus], XI [Accessory], and XIII [hypoglossal]
Contains all the fibers that originate in their cerebellum and cerebrum and moves downward to form the spinal cord.
Has several centers that control vital, automatic bodily functions, such as breathing, digestion, heart rate, and blood pressure.
Very important for speech production because it contains descending fibers that transmit motor information to several cranial nerve nuclei.
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Reticular activating system (RAS)
A structure within the midbrain, brain stem, and upper portion of the spinal cord. It integrates motor impulses flowing out of the brain with sensory impulses flowing into it.
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Diencephalon
His lies above the midbrain and between the brainstem and the cerebral hemisphere. The thalamus and hypothalamus are the two main structures of the diencephalon.
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Basal ganglia
Structures deep within the brain, near the thalamus and lateral ventricles. Primarily composed of gray matter. Highly complex system of neural pathways that have connections with many subcritical and cortical areas. They receive input primarily from the frontal lobe and relay information back to the higher centers of the brain via the thalamus. It is part of the extrapyramidal system.
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Lessons in the basal ganglia:
Lesions can result in unusual body postures, dysarthria, changes in body tone, and involuntary and uncontrolled movements (dyskinesia) that interfere with a person’s voluntary attempts to walk, speak, or do many other activities.
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The Cerebellum has 3 primary fiber bundles that serve as connections between the brainstem and the cerebellum. They include:
The superior, middle, and inferior cerebellar peduncles. These connect the midbrain, the pins and the medulla, respectively. All efferent and afferent fibers going to and from the cerebellum pass through these peduncles.
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The cerebellums afferent and efferent fibers.
Afferent fibers travel through the inferior and middle cerebellar peduncles. These fibers mediate almost all sensorimotor information to the cerebellum.
Efferent fibers travel through the superior cerebellar peduncles. These fibers transmit information from the cerebellum to the brainstem; from there, the information is transmitted to the thalamus, motor cortex, and spinal cord.
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The cerebellum is not a primary motor integration or initiation center. Instead it:
Receives natural impulses from the other brain centers and helps coordinate and regulate those impulses. Therefore, it acts as a “modulator” of neuronal activity through its efferent and afferent circuits.
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The cerebellums regulates:
Regulates equilibrium (balance), body posture, and coordinated fine motor movements.
Note: Because these movements are necessary for rapid speech, cerebellar intactness is very important to speech production.
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Damage to the cerebellum results in:
A neurological disorder called ataxia
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The cerebrum is the biggest and most important CNS structure for what?
Language, speech, and hearing.
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Gurus and sulcus what are they
Gyrus:the ridges on the cortex. (Plural of gyrus is gyri)
Sulcus: the shallow valleys (plural is sulci)
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The 3 fissures if the Cerebrum.
Longitudinal fissure: Course’s along the middle of the brain from front to back and divides the cerebrum into the left and right hemisphere.
Fissure if Rolando, or central sulcus: is a major fissure that runs laterally, downward, and forward, and arbitrarily divides the anterior from the posterior half of the brain.
The Sylvia’s fissure, or lateral cerebral fissure (sulcus): starts at the inferior portion of the frontal lobe at the base of the brain and moves laterally and upward. (Note: the areas surrounding the Sylvia’s fissure are especially critical in language, speech, and hearing)
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How much of the cerebrum is made up of the frontal lobe?
1/3 of the surface area of the cerebrum is frontal lobe.
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What is the role of the frontal lobe?
Deliberates formation of plans and intentions the dictate a person’s conscious behavior.
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Where is the primary motor cortex or motor strip located?
It is located on the precentral gyrus, a large ridge that lies anterior to the central sulcus. This area controls voluntary movements of skeletal muscles in the opposite side of the body.
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Brock’s area:
Located in the third convolution of the left cerebral hemisphere. It is anterior to the portion of the primary motor cortex hat controls lip, tongue, jaw, and laryngeal movements.
It is also called the motor speech area because it controls motor movements involved in speech production.
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The 3 different gyri if the parietal lobe:
Postcentral gyrus: also called the sensory cortex or sensory strip, lies just behind the central sulcus. It is the primary sensory area that integrates and controls somesthetic sensory impulses.
Supramarginal gurus: lies superior to the lateral fissure in the inferior portion of the parietal lobe. It’s posterior portion curves around the lateral fissure. Damage to the supramarginal gyrus can cause condition aphasia and agraphia, a writing disorder.
Angular gyrus: lies posterior to the supramarginal gyrus. Damage to this area can cause writing, reading, and naming difficulties and, in some cases, transcortical sensory aphasia.
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Occipital lobe primary function is for...
Vision
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Alveolar pressure is found inside or outside of the lungs?
Within the lungs
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Atmospheric pressure is found inside or outside the lungs?
Outside the lungs
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Expiration to inspiration ration for normal tidal breathing vs. speech breathing.
Normal tidal breathing: expiration is 60% and inspiration is 40%
Speech breathing: expiration is 90% and inspiration is 10%
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This is critical to speech production. The fibers of this tract control all the voluntary movements of the speech muscles.
Coricobulbar tract
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Motor neurons (efferent nerves) in the spinal and cranial nerves. Activity of these neurons eventually results in muscular movement.
Lower motor neurons
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Motor fibers (efferent nerves) within the CNS.
Upper motor neurons
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This system is responsible for carrying the impulses that control voluntary fine motor movements. It has a direct connection with the lower motor neurons.
Pyramidal system
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This system transmits impulses hat control the postural support needed by those fine motor movements. Considered a more indirect activation system that interacts with various motor systems in the nervous system.
Extrapyramidal system
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Structures of the Brian are connected with one another through?
Specialized bundles of nerve fibers.
These fibers vary in length. Adjacent areas use short fibers and distant areas have long fibers called fasciculi.
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What fibers allows for areas of hemisphere to communicate with each other?
Intrahemispheric fibers
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What type of fiber permits communication between hemispheres and are composed mostly of myelinated axons fibers, or white matter?
Interhemispheric fibers
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What type of fibers connects the cortex and subcritical structures like the cerebellum, basal ganglia, brainstem, and spinal cord?
Projection fibers
The motor projection fibers originate primarily in the ore motor and primary motor areas in the frontal lobe.
Afferent projection fibers relay sensory information (such as smell) from the peripheral sense organs to the Brian
Efferent projection fibers come together in the internal capsule and pass through the thalamus and basal ganglia.
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What fibers connect areas within the same hemisphere and assist in maintaining communication between the structures in a hemisphere?
Association fibers
The most important of these fibers is the bundle of superior longitudinal fibers and the actuate fasciculus, that lies below the surface of the cortex (connects Broca’s and Wernicke’s areas)
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What types of fibers are interhemispheric connectors that run horizontally and connect the corresponding areas of the two hemispheres.
Commissural fibers
The most important of commissural fibers is the corpus callosum, is a thick, broad band of myelinated fibers that connects the two hemispheres at their base. (Damage results in disconnection syndrome)
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Cerebral ventricles are?
A system of cavities deep within the brain. This interconnected cavities are filled with CSF(this fluid is produced by the chorus plexus, which is composed of vascular membranous materials.
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There are 4 cerebral ventricles they are?
The largest of the 4 are the 2 lateral ventricles (one in each hemisphere- located immediately inferior to the corpus callosum)
The third ventricle is behind the lateral ventricle at the top of the brainstem
The fourth ventricle is located between the cerebellum and the pond and is continuous with the central canal of the spinal cord.
(The cerebral aqueduct connects the fourth and third ventricles)
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The brain is protected by three layers they are?
A layer of skin
The skull bones
Meninges (3 layers):
dura mater-outer most
Arachnoid- thin, delicate, and weblike
Pia matter-delicate, thin, transparent (many blood vessels penetrate the pia matter to enter the brain
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Brains blood supply?
The brain takes 25% of the bodies oxygen and 20% of its blood
Vertebral arteries enter the skull and then branch out to supply the spinal cord and many organs of the body as they move up to the lower level of the pond, and the two vertebral arteries join to form the basilar artery.
The basil artery divides into the two posterior cerebral arteries.
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Carotid Arteries and what they supply?
Carotid arteries (one on each side) enter the neck, each branch me out into an internal carotid artery and an external artery.
External carotid artery: moves toward the face and branches into smaller arteries. It supplies blood to the muscles of the mouth, nose, forehead, and face.
Internal carotid artery: major supplier of blood to the brain
Middle cerebral artery: biggest branch of the internal carotid artery, and it supplies the entire lateral surface of the cortex, including the major regions of the frontal lobe.
Supplies blood to major areas involved with
motor and sensory functions and language,
speech, and hearing functions. This includes
Precenteal gyrus, Broca’s area, Wernicke’s area
Supramarginal gyrus, primary auditory cortex,
Angular gyrus, and somatisensory cortex.
Damage: stroke, Aphasia, reading/writing problems contralateral hemiplegia, and impaired sense of pain, temperature, touch, and position.
Anterior cerebral artery: supplies primarily the middle portion of the parietal and frontal lobes.
Damage: cognitive deficits or paralysis in the feet and legs.
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Circle of Willis (circulus arteriosus) is?
A sequence of anastomoses (connections between arteries), is formed at the base of the brain where the two carotid and two vertebral arteries join.
Provides a common blood supply to various cerebral branches. If an artery is blocked above the circle, brain damage will occur because the brain has no alternate source of blood.
If an artery is blocked below the circle of Willis, brain damage may be minimal because alternate channels of blood flow may be maintained to compensate.
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What are the 3 main gyrus of the temporal lobe?
The superior (upper) temporal gyrus, the middle temporal gyrus, and the inferior (lower) temporal gyrus.
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The temporal lobe contains two general areas that are critical to adequate hearing and speech they are...
1) the primary auditory cortex (located on the superior temporal gyrus)
2) the auditory association area (lies posterior to the primary auditory cortex)
Note: Heschl's gyri is a term used in reference to the transverse convolutions that make up the auditory association cortex and the primary auditory cortex.
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Where does the auditory cortex receive sound stimuli from?
The acoustic nerve ( CN VIII) bilaterally. Once it is received the auditory association area then synthesizes the information so that it can be recognized as whole units.
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How does the auditory association area differ in the dominant vs nondominant sides of the brain?
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Dominant hemisphere (left in most individuals) does the general analysis of speech sounds so that the person recognizes words and sentences.
The nondominant hemisphere analyzes nonverbal sound stimuli, such as environmental noises and music.
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Wernicke's area
Located: posterior two-thirds of the superior temporal gyrus in the left hemisphere. It is close to the intersection of the parietal, occipital, and temporal lobes.
Critical function: important for comprehension of spoken and written language. It is connected to the Broca's area through the arcuate fasciculus.
Lesion: on the posterior portion of the superior temporal gyrus causes Wernicke's Aphasia, in which the patient produces fluent but meaningless speech and experiences significant language comprehension problems.
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Pyramidal Systems basic functions:
The pyramidal systems is the direct motor activation pathway that is primarily responsible for facilitating voluntary muscle movements. This system is composed of the corticobulbar and the corticospinal tracts.
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What is the Corticospinal Tract?
It has nerve fibers that descend from the motor cortex of each hemisphere through the internal capsule. The fibers course vertically through the midbrain and the pons.
Note: Because of the decussation of fibers at the medullary level, the right side of the body is generally controlled by nerve fibers that originate in the left cerebral cortex, and vice versa. Left-hemisphere strokes, for example, result in weakness on the right side of the body.
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What is the Corticobulbar Tract?
It is critical to speech production. The fibers of this control all the voluntary movements of the speech muscles (except the respiratory muscles).
Originates primarily in the motor cortex.
Lower motor neurons are the motor neurons in the spinal and cranial nerves.
Upper motor neurons are the motor fibers within the central nervous system. They are thought of as all the descending motor fibers that course through the central nervous system.
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Extrapyramidal System basic facts:
This system transmits impulses that control the postural support needed by those fine motor movements.
It is important for speech production!
Composed of different subcortical nuclei, including the red nucleus, the substantia nigra, the subthalamus, the basal ganglia, and the pathways that connect these structures to one another.
Considered to be a more indirect activation system that interacts with the various motor systems of the nervous system.
Damage to the extrapyramidal system creates motor disturbances that fall under the rubric of " involuntary movement disorders". Patients may show unusual movement patterns of various muscles (including facial muscles) and bizarre postures.
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Respiration relies on the muscles of inspiration and expiration. The thick, dome-shaped muscle that separates the abdomen from the thorax is called the?
Diaphragm
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Which branch of the vagus nerve (CN X) innervates the cricothyroid muscle?
Superior laryngeal nerve
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The primary muscle of the lips is the?
Obicularis oris
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The neurons that transmit information away from the brain are called?
Efferent neurons
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An important structure adjacent to the brainstem that contains the hypothalamus (which controls emotions) and the thalamus (which relays sensory impulses to various portions of the cerebral cortex) is called the?
Diencephalon
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The corpus striatum is composed of three nuclear masses, which are the?
Gloves pallidus, caudate nucleus, and putamen
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The structure that regulates body posture, equilibrium, and coordinated fine motor movements is the?
Cerebellum
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The anterior cerebral artery supplies blood to the?
Corpus callosum and basal ganglia
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The laryngopharynx and oropharynx add resonance to sound produced by the larynx. The nasopharyngeal adds noticeable resonance to which sounds?
M,n, ng
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These are composed of a ring of connective tissue and muscle extending from the tips of the arytenoid cartilage of the larynx. They separate the laryngeal vestibule from the pharynx and help preserve the airway.
Aryepiglottic folds
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The cranial nerve that innervates the larynx and also innervates the levator veil palatine, palatiglissus, and palatipharyngeus muscles is?
CN X, the vagus nerve
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Muscles hat contribute to velipharyngeal closure through tensing or elevating the velum are the?
Palatoglossus, tensor veli palatini, and levator veli palatini
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The structure at the inferior portion of the tongue that connects the tongue with the mandible is called the?
Lingual frenum
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When a person is producing voiced and voiceless /th/, the muscle that is most involved is the?
Genioglossus
