Chapter 4

Question 1

Define speech breathing.

Answer 1

The regulation of breathing for voice and speech production

Question 2

Define inhalation.

Answer 2

Air moving into the upper and lower airways

Question 3

Define exhalation.

Answer 3

Air moving out of the upper and lower airways

Question 4

What is respiration?

Answer 4

Respiration is the process of gas exchange, specifically at the cellular level. It refers to the process of the cells taking in oxygen and releasing carbon dioxide

Question 5

Define Boyle’s Law.

Answer 5

Boyle’s Law states that pressure and volume are inversely related. So as volume increases, given a constant temperature, pressure decreases, and if volume decreases, pressure increases.

Question 6

What is the difference between the mechanics of blowing up a balloon and how we breathe?

Answer 6

In blowing up a balloon, you apply air by force to increase the pressure, causing the balloon to stretch, and increasing the volume of the balloon. Breathing is not like blowing up a balloon because instead of forcing expansion of the lungs, the biomechanics of breathing follow so that as lung size increases, the pressure inside of them drops, causing an inward rush of air (Bernoulli effect).

Question 7

Identify the structures through which air passes as we breathe.

Answer 7

Oral/nasal cavities, pharynx, larynx, trachea, bronchi, bronchioles, alveoli

Question 8

How does gas exchange occur?

Answer 8

Gas exchange occurs when oxygen from the air passes through the alveolar membrane into the blood, and carbon dioxide from the blood is then sent back into the alveoli to be exhaled. It occurs by diffusion, which is the movement of gases from the area of higher concentration to the area of lower concentration.

Question 9

What are the three things necessary for diffusion to happen quickly and efficiently?

Answer 9

A large surface area, a thin and permeable membrane, and a high-concentration gradient

Question 10

What active movement can a muscle perform?

Answer 10

Contraction

Question 11

What is muscle contraction?

Answer 11

Shortening of a muscle

Question 12

What is muscle relaxation?

Answer 12

Lengthening of a muscle

Question 13

What are the types of muscle contractions?

Answer 13

• Isometric: when the tension in the muscle is equal to the load of the muscle, and the muscle length doesn’t change
• Isotonic: when the muscle length changes
  - Concentric: occurs when the tension is greater than the load, and the muscle shortens
  - Eccentric: occurs when the tension in the muscle is less than the load, and the muscle lengthens

Question 14

What are agonists and antagonists?

Answer 14

The agonist muscle is the muscle that contracts to achieve a movement, and the antagonist is the muscle that opposes the contraction (antagonist stretches as agonist contracts)

Question 15

What are the two categories of agonist muscles, and what do they do?

Answer 15

Prime movers are the muscles that do the most work in achieving a given movement, and synergists are muscles that assist the prime mover and are helpful for providing additional control of a movement

Question 16

How does a lever system facilitate efficiency of muscle contraction?

Answer 16

The lever system of muscle contraction allows for muscles to exert more force on a load with less effort than a muscle would be able to generate on its own. It helps to maximize either the velocity or force created by the muscular effort.

Question 17

Identify the major muscles of inhalation and exhalation and their effect on the rib cage upon contraction.

Answer 17

The major muscles of inhalation are the diaphragm (the main muscle of inspiration) and the external intercostals. Both of these muscles aid in the expansion of the thoracic cavity and rib cage, allowing ample space for the lungs to expand. The diaphragm exerts a downward pull, while the external intercostals exert an anterior pull (rather than superior). The major muscles of exhalation are the internal intercostals. These muscles cause an inward and downward pull on the ribs, decreasing volume.

Question 18

Define motor equivalence.

Answer 18

Motor equivalence describes the idea that different people respond/react with different motor behaviors to the same stimulus

Question 19

Define tidal breathing.

Answer 19

Tidal breathing is quiet breathing in which the diaphragm is the only active muscle, and exhalation is done passively. It’s basically the passive breathing we do when we are not physically exerting ourselves beyond a regular resting point.

Question 20

What are the pleural linings and what is their critical contribution to breathing mechanics?

Answer 20

The pleural linings (parietal and visceral) are membranes covering the lungs that contain fluid, allowing them to adhere to each other. They are of critical importance because they reduce the amount of friction caused by inhalation and exhalation (allowing for an increased ease of movement). The linkage between the lungs and the thoracic cavity is the pleural linings and their fluid, which is one of the necessary components for lung volume changes.

Question 21

What is the significance of resting lung volume?

Answer 21

Resting lung volume is the point at which the elastic recoil forces of the lungs are balanced by the tendency for the chest wall to spring outward. It is the point of equilibrium in the lungs, and the point at which a cycle of tidal breathing begins and ends (at roughly 38% of vital capacity).

Question 22

Identify and define the four lung volumes.

Answer 22

• Tidal volume, which is the volume of air that we breathe in and out during a regular cycle of tidal, quiet breathing
• Inspiratory reserve volume, which is the maximum amount of air that can be inspired after a tidal inspiration
• Expiratory reserve volume, which is the maximum amount of air that can be expired following a tidal expiration
• Residual volume, which is the amount of air that remains in the lungs even after maximal expiration (it cannot be exhaled)

Question 23

Identify and define the four lung capacities.

Answer 23

• Total lung capacity, which is the sum of all the volumes of air in the lungs
• Vital capacity, which is the sum of the volumes of air that can be used in inhalation and exhalation (so TV, IRV, and ERV, but not RV)
• Inspiratory capacity, which is the volume of air that can be inhaled after a tidal expiration
• Functional residual capacity, which is the amount of air remaining in the lungs after a normal tidal exhalation

Question 24

Define forced inhalation and exhalation.

Answer 24

Forced inhalation is inspiring additional air beyond that inspired during tidal breathing (this occurs at volumes above 60% of vital capacity). Forced exhalation is expiring beyond the level of tidal expiration. Both forced inhalation and exhalation are active processes, unlike tidal breathing.

Question 25

Define relaxation pressure.

Answer 25

Relaxation pressure is the pressure caused by three passive forces that act to return the body to equilibrium after taking a breath.

Question 26

Explain the three passive forces that comprise relaxation pressure.

Answer 26

The three passive forces that comprise relaxation pressure are the surface tension of the alveoli, gravity, and the elastic recoil forces of the lungs and the rib cage. These three things help return the entire breathing system back to the resting expiratory level.

Question 27

Define inspiratory checking action and explain when it would be used.

Answer 27

The inspiratory checking action is the action of muscle engagement of the thoracic inspiratory muscles that prevents the elastic recoil forces from decreasing lung pressure too quickly. It counteracts the relaxation pressures and allows for consistent and steady phonation. It is used when the pressure of the lung volume is more than necessary to sustain phonation. So the greater the relaxation pressure above what is necessary, the greater the inspiratory checking action will be, so that it can control the pressure.

Question 28

How is the cycle of inhalation/exhalation altered for running speech, as compared to tidal breathing?

Answer 28

In tidal breathing, inspiration makes up 40% of the breathing cycle, and expiration 60%. Only 10% of running speech is used on inspiring, and the other 90% is exhalation.

Question 29

Define phase breath group.

Answer 29

Phase breath group is the number of words or syllables that are spoken on one exhalation

Question 30

What are the four important concepts to be learned from the Hixon et al. study?

Answer 30

- Speech breathing is never managed solely by passive relaxation pressure. Throughout all phases of speech breathing, there is an active force aiding in lung volume management. - At the beginning of an utterance, the diaphragm, rib cage inspiratory muscles, and abdominal muscles are all active to varying degrees. - Lung volume and the magnitude of the inspiratory force are directly related, and lung volume and the magnitude of the expiratory muscle force are inversely related. - In speech breathing, the abdomen replaces the diaphragmatic force and stabilizes the chest wall and provides a force against which the thoracic muscles can exert their pull.

Question 31

How might carrying excess weight influence speech breathing?

Answer 31

The excess weight coming from the adipose tissue can affect the biomechanics of breathing, as it could be pulling on the diaphragm, inhibiting its ability to make the rapid changes in lung volume that are necessary for speaking (especially during inspiration)

Question 32

How do linguistic factors influence speech breathing?

Answer 32

Linguistic factors, while they do not alter the actual biomechanics of breathing, do affect the timing of inspiration and expiration. For example, we only take inspiratory pauses at certain times during speaking, and if we were to deviate from this usual pattern, it would call attention to itself.

Question 33

How does cognitive load influence speech breathing?

Answer 33

Cognitive load can bring alterations in the pattern or timing of speech breathing. An example is creating silences during the expiratory part of speech to formulate thoughts while speaking, or having a slower breathing rate. You may also take shorter breaths or have fewer pauses when speaking very quickly, expressively, or loudly.

Question 34

Define speech-breathing personality.

Answer 34

Speech breathing personality is the unique breathing pattern of an individual (also called ventilatory or respiratory personality)

Question 35

Provide two examples of different styles of speech breathing and describe how they differ.

Answer 35

- Clavicular breathing is one kind of speech breathing that involves overactivity of the pectoral muscles, as seen during breathing when the clavicle and shoulders move upward. It’s an inefficient method of breathing as it requires more muscle force than is necessary for breathing, causing unnecessary fatigue. - Diaphragmatic breathing, on the other hand, is referred to as the optimal breathing technique because there is minimal effort required to breathe. The diaphragm is the main active muscle in this speech breathing style, and it relies on more passive forces so that the body does not tire itself out with breathing.

Question 36

What is the effect of increased respiratory demands on phrase breath group length, expiratory time, lung volume, and rate of speech?

Answer 36

Increased respiratory demands cause a shortening of phrase breath groups (as more effort needs to be dedicated to breathing), expiratory time decreases, lung volume increases, and the rate of speech is unchanged.

Question 37

Define airway resistance.

Answer 37

Resistance to the flow of air

Question 38

How does the structural design of the airway system affect resistance?

Answer 38

The more narrow a tube, the more resistance offered to the airflow by it. As lung volume increases, airway resistance decreases (due to the larger radii of the internal structures). Almost half of the resistance faced by airflow is in the upper airways (the nose, pharynx, and larynx). The nose has a smaller radius and therefore offers more airflow resistance. Of the resistance found in the lower airways, roughly 80% is due to the trachea and bronchi (with little resistance offered by the bronchioles and alveoli).

Question 39

How does the nervous system regulate airway resistance?

Answer 39

The autonomic nervous system controls airway constriction: the sympathetic nervous system widens the airways, and the parasympathetic nervous system constricts the airways.

Question 40

Define turbulent airflow.

Answer 40

A disorganized, high-velocity airflow in an airway with irregular walls (so the airflow has a tendency to form eddies)

Question 41

Define laminar airflow.

Answer 41

Smooth, straight, uninterrupted airflow

Question 42

What is the relationship of airway resistance and type of airflow?

Answer 42

It is a complex relationship with many factors influencing airflow and its resistance, such as airway size, airflow velocity, and the airflow nature.

Question 43

Define elastic resistance.

Answer 43

Resistance to the tissue returning to its original shape once deformed (resisting the elasticity of the lungs)

Question 44

Define viscosity.

Answer 44

A measure of the internal friction of a fluid

Question 45

Define friction.

Answer 45

The force that causes drag on an object, slowing it down

Question 46

What is electromyography (EMG)?

Answer 46

The study of the electrical activity of muscles

Question 47

What are the three electrodes that can be used with EMG?

Answer 47

- Surface electrodes: detect changes in muscle electrical activity on the surface of the skin surrounding the muscle, but when the muscle is not close to the skin or is surrounded by other active muscles, it can be hard to determine accurate results - Needle electrodes: placed directly into smaller muscles, and will therefore receive more accurate readings than surface electrodes, but larger muscle movement may still displace the needle - Hooked wire electrodes: placed securely into the muscle they are measuring, and are less likely to be displaced by large movements.

Question 48

What are the advantages and disadvantages of using EMG?

Answer 48

The biggest advantage of EMG is the ability to measure muscle activity quantitatively, and more specifically to measure the activity of different muscles for the same event. The disadvantages of EMG are physical discomfort, difficulties in making sure the muscle being measured is the target muscle, and the specificity of placement of a needle or hooked wire for precise measurement.

Question 49

What does inductance plethysmography measure, and how does it work?

Answer 49

Inductance plethysmography measures changes in lung volume during breathing and the contributions of the abdomen and rib cage. A zig-zig-shaped wire coil is attached to a band that is wrapped around the chest. A second band is wrapped around the abdomen, and as the chest wall and abdomen expand during breathing, the coils also expand and contract, and as the wire stretches with lung volume changes, the inductance (inductance: opposition to change in the flow of an electrical current) properties change. Tools measure the inductance changes proportional to the lung volume changes during breathing.

Question 50

What are the three common respiratory diseases of COPD?

Answer 50

- Chronic bronchitis: a longstanding inflammation of the respiratory passageways and increased mucus production - Asthma: swelling and inflammation of the linings of the airway and increased mucus production - Emphysema: damage to the alveoli that causes them to lose their elasticity

Question 51

What are the common symptoms experienced by many individuals with respiratory disorders?

Answer 51

The four common symptoms of breathing disorders are dyspnea, which is the sensation of shortness of breath, fatigue, stridor (noisy breathing), and voice changes (loudness, pitch, quality, etc.)

Question 52

Give an example of a maladaptive compensatory strategy of an individual with a breathing disorder and explain why it is not a good strategy.

Answer 52

An example of a maladaptive compensatory strategy used by an individual with a breathing disorder could be inhaling too much air before talking, causing the muscles to have to use the inspiratory checking action. This will tire out the muscles unnecessarily.

Question 53

How does knowledge of the physiology of speech breathing inform clinical practice for SLPs?

Answer 53

It allows SLPs to form accurate diagnoses, which allows for the formation of adequate intervention plans. It also helps with the recognition of issues (you have to know what right looks like before you can diagnose wrong). Knowledge of the physiology of speech breathing helps clinicians to properly assess and treat their patients.