Lecture 1 Anat Flashcards
(84 cards)
1
Q
4 biological functions of the larynx.
A
- connects trachea and pharynx
- valving
- thoracic fixation
- sound production
2
Q
Give examples of when you use thoracic fixation.
A
lifting objects, fighting, jumping, defecating…etc.
3
Q
What is the “second heartbeat”?
A
when someone is breathing, their VFs open during inhalation and come close together when exhaling
4
Q
Deep Inhalation muscles
A
Sternocleidomastoid
Scalene
External intercostals
Diaphragm
Inter-cartilaginous part
5
Q
Forced exhalation muscles
A
Latissimus dorsi
Internal intercostals
Transversus abdominis
Internal oblique
External oblique
Rectus abdominis
6
Q
What does the diaphragm do during inhalation?
A
lower
7
Q
What does the diaphragm do during exhalation?
A
rise
8
Q
At what % of vital capacity does expiratory muscle activity begin?
A
55% VC
9
Q
Tidal volume (TV)
A
Inhalation and expiration during a typical cycle (adults: 0.5L at rest)
10
Q
Inspiratory reserve volume (IRV)
A
Maximum air that can be inhaled beyond a tidal cycle (male 3.3L, female 1.9L)
11
Q
Expiratory reserve volume (ERV)
A
Maximum air that can be exhaled beyond a tidal cycle (male 1.1L; female 0.7L)
12
Q
Vital capacity (VC)
A
TV + IRV + ERV (male 4.8L, female 3.1L)
13
Q
Residual volume (RV)
A
Air remaining in lungs, cannot be expired (male 1.2L, female 1.1L)
14
Q
Total lung capacity (TLC)
A
Total capacity of lungs. Measured by plethysmography (volume displacement testing; male 6.0L, female 4.2L)
15
Q
What do SLPs use vital capacity for?
A
SLPs use breathalyzer to see if the patient has sufficient air for speech
16
Q
Five breathing types
A
- Clavicular - felt in shoulders
- Thoracic - felt in chest
- Costal - feel in sides of ribs
- Abdominal - feel in belly
- Costo-abdominal
17
Q
What is costo-abdominal breathing?
A
A mix of costal and abdominal breathing. Considered to be desirable for singers.
18
Q
Nine laryngeal cartilages
A
Unpaired:
1. epiglottis
2. thyroid
2. cricoid
Paired:
1. aryrtenoid
2. cuneiform (accessory)
3. corniculate (accessory)
19
Q
4 features of cartilage
A
- no blood supply
- composed of live cells
- perichondrium is a fibrous, dense connective tissue surrounding the cartilage (except articular surfaces)
- chondrocyte (tissue cells)
20
Q
Three types of cartilage
A
- hyaline: sturdy, ossifying cartilages, found in respiratory tract; calcify at 25.
- elastic: less sturdy, non-ossifying
- fibrous: found in tendon attachments
21
Q
5 roles of laryngeal cartilages
A
- provide laryngeal framework
- support tissue
- protect soft tissue
- nearly as strong as steel
- provide attachment for muscles
22
Q
Name of the space in larynx above thyroid notch?
A
thryo-hyoid space
23
Q
Which is more narrow, the cricoid cartilage or the thyroid cartilate?
A
cricoid cartilage
24
Q
5 features of hyoid bone
A
- U-shaped sesamoid bone
- Only bone in the body that does not articulate with another bone
- articulation with the superior horn of the thyroid cartilage
- two greater and two lesser horns
- situated at the level of the third cervical vertebra in adults
25
3 features of epiglottis
1. First level of the three-tiered laryngeal protection mechanism with ventricular and vocal folds
2. Base attached to the anterior rim of the thyroid cartilage
3. Composed of elastic, non-ossifying cartilage to keep its pliability throughout the life span
26
7 features of the thyroid cartilage
1. saddle-shaped
2. open at back
3. two inferior and two superior horns
4. composed of hyaline cartilage
5. largest cartilage in larynx
6. protects the airway like a "thyrus-shield"
7. anterior midline prominence (notch) and two lateral laminae (Newborn: 130°, Adult female: 110°, Adult male: 90°)
27
4 features of the cricoid cartilage
1. Composed of hyaline cartilage
2. Signet-ring shaped
3. Two sets of paired facets for articulation with the arytenoids and the thyroid
4. Joints are lined with a synovial membrane*
*Synovia: viscid lubricating fluid secreted by the membrane lining joints and tendon sheaths
28
In which two directions does the cricoarytenoid joint move?
Anteriorly/posteriorly
Laterally
29
2 features of the arytenoid cartilages
1. Pyramid-shaped hyaline cartilages
2. Four surfaces
30
4 surfaces of arytenoid cartilages
1. Anterior angle forms the vocal process
2. Lateral angle forms muscular process
3. Medial angle faces its arytenoid pair
4. Base has the shape of a concave cylinder and forms the arytenoid portion of the cricoarytenoid joint
31
3 Arytenoid processes
1. Vocal process: provides the posterior attachments for the vocal ligament and the thyroarytenoid
2. Muscular process: provides attachments for the lateral parts of the thyroarytenoid and the lateral and posterior cricoarytenoids
3. Apex process: pointed top, posterior part of the laryngeal sphincter mechanism
32
6 features of the Corniculates of Santorini
1. Horn-shaped
2. Paired and small
3. Synovial joint attachment to the superior tips of the arytenoids
4. May fuse with arytenoids
5. May be absent
6. Support the posterior portion of aryepiglottic fold
33
4 features of cuneiform cartilages
1. Submucosally in free margin of aryepiglottic folds
2. Rod-shaped
3. Function: Reinforcement of the aryepiglottic fold
4. Commonly absent
34
What can cause vocal webs?
conus elasticus overgrowth (from genetics, surgery, intubation, injury...etc.)
35
The conus elasticus
1. A soft membrane between the arch of the cricoid, the vocal process of the arytenoid and the junction of the thyroid laminae.
2. The free thickened upper border of this membrane is the vocal ligament - when covered with mucous membrane, this edge is known as the true vocal fold.
3. Not cone-shaped
36
3 laryngeal compartments
1. laryngeal vestibule
2. laryngeal ventricle (space between true and false folds)
3. inferior laryngeal ventricle
* lesions/tumors can form in these compartments
37
The three groups of laryngeal muscles
1. Suprahyoid muscles: raise the larynx
2. Infrahyoid muscles: lower the larynx
3. Intrinsic muscles: determine the intrinsic muscle configuration
38
Does swallowing raise or lower the larynx?
raise
39
Does yawning raise or lower the larynx?
lower
40
Stylohyoid attachment and function
attachment: Temporal bone (styloid process) to hyoid
function: Raises hyoid bone posteriorly
41
Mylohyoid attachment and function
attachment: Mandible to hyoid
function: Raises hyoid bone anteriorly
42
Anterior digastricus attachment and function
attachment: Mandible to hyoid
function: Raises hyoid bone anteriorly
43
Posterior digastricus attachment and function
attachment: Temporal bone (mastoid process) to hyoid
function: Raises hyoid bone posteriorly
44
Geniohyoid attachment and function
attachment: Mandible to hyoid
function: Raises hyoid bone anteriorly
45
Thyrohyoid attachment and function
attachment: Thyroid to hyoid
function: Brings thyroid and hyoid bone closer
46
Sternothyroid attachment and function
attachment: Sternum to thyroid
function: Lowers thyroid cartilage
47
Sternohyoid attachment and function
attachment: Sternum to hyoid
function: Lowers hyoid bone
48
Omohyoid attachment and function
attachment: Scapula to hyoid
function: Lowers hyoid bone (& turns head w help of sternocleidomastoid)
49
Implications of laryngeal muscle tension
too much force in voice
raising the larynx
harder to recover from injury
50
Suprahyoid extrinsic larygeal muscles
stylohyoid
mylohyoid
anterior & posterior digastricus
geniohyoid
51
infrahyoid extrinsic laryngeal muscles
thyrohyoid
sternothyroid
sternohyoid
omohyoid
52
Intrinsic laryngeal muscles
cricothyroid - pars recta & oblique m.
thyroarytenoid - vocalis m. thyromuscularis m.
interarytenoid m. - transverse m. & oblique m.
lateral cricoarytenoid m. (LCA)
posterior cricoarytenoid m. (PCA)
53
attachment of pars recta fibers
cricoid to inferior border of the thyroid lamina
*works with pars oblique
54
attachment of pars oblique fibers
cricoid to inferior cornu of the thyroid
*works with pars recta
55
Purpose of cricothyroid muscles
Join the cricoid to the thyroid
56
Where is the thyroarytenoid muscle? (what is it attached to?)
Between the thyroid and the arytenoid vocal process
57
Where is the vocalis m.
medial portion of the thyroarytenoid muscle
58
where is the thyromuscularis?
on the lateral portion of the thyroarytenoid muscle
59
Purpose of interarytenoid muscles
Join the muscular processes of the arytenoids
60
attachment of transverse interarytenoid muscle
single muscle layer, horizontally between the lateral laminae of the arytenoids
61
attachment of oblique interarytenoid muscle
Paired muscles forming an X- configuration between the one arytenoid base and the other arytenoid apex
62
attachment of lateral cricoarytenoid muscle
Lateral cricoid to arytenoid muscular process
63
attachment of Posterior cricoarytenoid muscle
Posterior aspect of the cricoid to the arytenoids
64
Functions of the criocothyroid muscle
1. Decreases distance between cricoid and thyroid by raising cricoid and/or lowering thyroid
2. Lengthens the vocal fold and contributes to controlling pitch (especially in the higher frequencies)
3. Consists of pars recta and pars oblique
65
Components and functions of the thyroarytenoid muscle
1. Lateral component: thyromuscularis
2. Medial component: thyrovocalis (vocalis)
3. On contraction, shortens the vocal fold length by drawing the arytenoids forward, and increases mass of the vocal fold edge
4. Contributes directly to lowering fundamental frequency, increasing loudness and tightening glottic closure
66
Function of the the lateral cricoarytenoid muscle (LCA)
Rocks the arytenoids anteriorly and slides them laterally, thereby bringing the vocal processes medially and adducting the vocal folds
67
Function of the interarytenoid muscles
Transverse interarytenoid: the only unpaired laryngeal muscle, runs between the arytenoids
Oblique interarytenoid: X-shaped paired muscles
Shortens the interarytenoid distance and contributes to forceful closure of the posterior glottis
68
Function of the posterior cricoarytenoid (PCA)
- Sole vocal fold abductor
- Rocks the arytenoids posteriorly and redirects the vocal processes laterally, thereby separating the vocal folds
- Important for breathing and voiceless sounds
69
What is the benefit of a dense vocal fold?
stability and protection
70
3 Histologic layers of the vocal folds
1. epithelium (pliable, thin layer of squamous cells)
2. lamina propria:
a. superficial layer/Reinke's space
b. intermediate
c. deep
3. vocalis muscle
71
3 features of the vocalis muscle
1. Only active component of the vocal folds
2. Main body of VF
3. Gives tone, stability, & mass
72
Superficial layer
(Reinke’s space)
- soft, slippery, gelatinous mass
- strong vibration during phonation
- delicate layer prone to injury
73
Intermediate layer
elastic fibers, which have more mass but still contribute to vibration
74
Deep layer
collagen fiber
75
what is the vocal ligament?
the intermediate and the deep layer.
not present in newborns, develops between 1-4
76
Theories of vocal fold vibration
1. Aerodynamic-Myoelastic Theory (van den Berg)
2. Body-Cover Theory (Hirano)
3. Flow-Induced Self-Oscillation Theory (Titze)
77
Flow-Induced Self-Oscillation Theory (Titze)
- explains VFs as triple-mass oscillator - VFs working as an oscillator (like pistons)
- Air pressure increases, blowing VFs apart, air rises upwards, and blows apart the upper edge of the VFs (zipper-like)
78
Body-Cover Theory (Hirano)
Three vibratory divisions:
1. Cover (epithelium and superficial layer of the lamina propria): compliant and fluid oscillation
2. Transition (intermediate and deep layer of the lamina propria): coupling between mucosa and muscle tissue
3. Body (vocalis muscle): stiffer underlying mass provides fundament
79
what is a mucosal wave?
when the vocal folds move in a wave-like movement.
80
three components (directions) of a mucosal wave
1. Horizontal (medial to lateral movements)
2. Longitudinal (anterior-posterior ‘zipperlike’ wave)
3. Vertical (inferior to superior movement)
81
Superior Laryngeal Nerve
internal branch of the SLN - sensory
external branch of SLN - motor
external branch innervates the cricothyroid m.
Controls pitch
82
Recurrent Laryngeal Nerve
main motor nerve
innervates 4 muscles (PCA, LCA, interarytenoid m., thyroarytenoid m.)
right side: around sternum, through thyroid gland, into cricothyroid space
left side: around heart, longer than right side, more prone to injury
83
Three "all except" rules
1. All muscles are paired except the transverse interarytenoid m. (adduct VFs)
2. All of the intrinsic muscles serve as adductors except the posterior cricoarytenoid, the sole abductor
3. All of the muscles are innervated by the recurrent laryngeal nerve execept the cricothyroid muscle, which is innervated by the external branch of the superior laryngeal nerve
84
How does height affect f0?
taller person has a bigger larynx with a lower f0
