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Flashcards in Muscles of the Larynx Deck (59):
1

Intrinsic Muscles of the Larynx:
Adductors:
1.
2.
3.

1. LCA (lateral Cricoarytenoid
2. Transverse Arytenoid
3. Oblique Arytenoid

2

Intrinsic Laryngeal Muscle Functions:
1.
2.
3 .
4.

1. Adductors
2. Abductors
3. Tensors
4. Relaxers

3

Intrinsic Muscles of the Larynx:
Abductors:
1.

1. PCA (Posterior Cricoarytenoid)

4

Intrinsic Muscles of the Larynx:
Tensors:
1.
2.

1. Thyrovocalis (medial thyroarytenoid)
2. Cricothyroid

5

Intrinsic Muscles of the Larynx:
Relaxers:
1.

1. Thyromuscularis (lateral thyroarytenoid)

6

Lateral Cricoarytenoid (LCA):
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Adductors
Origin: superior and lateral surface of cricoid
Insertion: muscular process of arytenoid
Course: superior and posterior
Function: Adduct vocal folds *rotates arytenoids*

7

Transverse Arytenoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Adductors
Origin: lateral margin of posterior surface of one arytenoid
Insertion: lateral margin of posterior surface of opposite arytenoid
Course: Transverse
Function: Adduct; Brings arytenoids closer together *glides* arytenoids

8

Oblique Arytenoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Adductors
Origin: muscular process of arytenoid
Insertion: apex of opposite arytenoid
Course: oblique
Function: adduct vocal folds; *glides* arytenoids

9

Posterior Cricoarytenoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Abductors
Origin: cricoid lamina
Insertion: muscular process of each arytenoid
Course: oblique, fan-like
Function: Abduct vocal folds (open to breathe) *rocking* movement of Cricoarytenoid joint

10

Thyrovocalis (medial thyroarytenoid):
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Tensors
Origin: inner surface of thyroid cartilage near angle at notch
Insertion: vocal process of arytenoid
Course: posterior
Function: Tense (lengthen) vocal folds

11

Cricothyroid: Pars Recta
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Tensors
Origin: cricoid arch
Insertion: thyroid lamina
Course: oblique and Superior
Function: Tense (lengthen) vocal folds

12

Cricothyroid: Pars Oblique
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Tensors
Origin: Lateral surface of cricoid
Insertion: Juncture of thyroid lamina and inferior horn
Course: oblique and superior
Function: Tense (lengthen) vocal folds

13

Thyromuscularis (lateral thyroarytenoid):
Group:
Origin:
Insertion:
Course:
Function:

Group: Intrinsic Relaxers
Origin: inner surface of thyroid cartilage at notch
Insertion: muscular process and base of arytenoid
Course: posterior
Function: Relax (shorten) vocal folds

14

Auxilliary Intrinsic Laryngeal Muscles:
Function:
1.

1. Auxiliary (supplementary) function for voicing

15

Auxilliary Intrinsic Laryngeal Muscles:
1.
2.
3.

1. Thyroepiglottis
2. Superior Thyroarytenoid
3. Aryepiglotticus

16

Styloid Process vs Mastoid Process

Styloid Process: close to ear canal, pointed projection
Mastoid Process: posterior to styloid process, rounded projection

17

Extrinsic Laryngeal Muscles:
Functions:
1.
2.

1. Elevators
2. Depressors

18

Extrinsic Laryngeal Muscles, Elevators:
1.
2.
3.
4.
5.
6.
7.
8.

1. Stylohyoid
2. Mylohyoid
3. Geniohyoid
4. Hyoglossus
5. Genioglossus
6. Thyropharyngeus
7. Digastricus Anterior
8. Digastricus Posterior

*** 2 of each, 16 total***

19

Stylohyoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: styloid process of temporal bone
Insertion: corpus of hyoid
Course: medial and inferior
Function: elevate and retract hyoid

20

Mylohyoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: underside of mandible
Insertion: corpus of hyoid
Course: medial and inferior "fan-like"
Function: elevate hyoid

21

Geniohyoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: inner surface of mandible near midline
Insertion: corpus of hyoid
Course: posterior
Function: elevate hyoid

22

Hyoglossus:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: corpus and greater horns of hyoid
Insertion: posterior and lateral tongue
Course: superior
Function: elevate hyoid

23

Genioglossus:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: inner surface of mandible at midline
Insertion: corpus of hyoid and tongue
Course: posterior
Function: elevate hyoid

24

Thyropharyngeus:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: thyroid cartilage
Insertion: posterior pharynx
Course: lateral
Function: elevate hyoid

25

Digastricus Anterior (Anterior Belly):
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: inner surface of mandible at midline
Insertion: intermediate tendon attached to hyoid
Course: posterior, inferior
Function: elevate hyoid (pull up and forward)

26

Digastricus Posterior (Posterior Belly):
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Elevators
Origin: mastoid process of temporal bone
Insertion: intermediate tendon
Course: anterior and inferior
Function: elevate hyoid (pull up and back)

27

Extrinsic Laryngeal Muscles, Depressors:
1.
2.
3.
4.

1. Sternohyoid
2. Omohyoid, superior and inferior bellies
3. Sternothyroid
4. Thyrohyoid

**2 of each, 8 total**

28

Sternohyoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: Extrinsic Depressors
Origin: manubrium of sternum, medial end of clavicle
Insertion: hyoid
Course: superior
Function: depress (lower) hyoid

29

Omohyoid Superior Belly:
Group:
Origin:
Insertion:
Course:
Function:

Group: extrinsic depressors
Origin: hyoid
Insertion: intermediate tendon
Course: down, inferior
Function: depress hyoid

30

Sternothyroid:
Group:
Origin:
Insertion:
Course:
Function:

Group: extrinsic depressors
Origin: manubrium and rib 1
Insertion: thyroid lamina
Course: superior
Function: depress hyoid

31

Omohyoid Inferior Belly:
Group:
Origin:
Insertion:
Course:
Function:

Group: extrinsic depressors
Origin: scapula
Insertion: intermediate tendon
Course: anterior and superior
Function: depress hyoid

32

Thyrohyoid:
Group:
Origin:
Insertion:
Course:
Function:

Group: extrinsic depressors
Origin: oblique line of thyroid cartilage
Insertion: greater cornua of hyoid
Course: superior
Function: depress hyoid

33

Biologic Functions of Larynx:
1.
2.
3.

1. Coughing
2. Throat Clearing
3. Abdominal Fixation

34

Biologic Functions of Larynx:
Coughing:

deep inhalation
followed by tensing and tight adduction of vocal folds and laryngeal elevation
in response to an irritant or foreign object

35

Biologic Functions of Larynx:
Throat Clearing:

less severe than cough, clears airway

36

Biologic Functions of Larynx:
Abdominal Fixation:

capture air in thorax, transfers force to muscles
ex: lifting

37

Non-Biologic Function of the Larynx:
1.

1. Sound and voice production

38

Myoelastic Aerodynamic Theory of Vocal Fold Vibration:
For vocal folds to vibrate, there must be sufficient:
1.
2.
3.

1. subglottal air pressure
2. tissue elasticity
3. air flow at constriction

39

Bernoulli's Principle/Effect:

Given a constant flow of air at a point of constriction, there will be a decrease in air pressure perpendicular to the flow and an increase in the speed of the flow

Pressure at the vocal folds drops, resulting in air flow speed increasing which leads to vocal fold vibration when adducted.

40

Phases of Phonation
1.
2.
3.

1. Vocal Attack (initiate)
2. Sustained Phonation (continue)
3. Terminate Phonation (terminate)

41

Vocal Attack Types:
1.
2.
3.

1. Simultaneous Vocal Attack
2. Breathy Vocal Attack
3. Glottal Attack

42

Simultaneous Vocal Attack:

subglottal air pressure and vocal fold adduction occur at the same time
Gives good, clear quality

43

Breathy Vocal Attack:

exhaling through glottis before vocal fold adduction

44

Glottal Attack:

Exhalation after vocal fold adduction
**vocal folds adducted and are forced open**

45

Vertical Phase Difference:

Vocal folds open inferior to superior
Vocal folds close inferior to superior

46

A-P Phase Difference:

Vocal folds open posterior to anterior OPA
Vocal folds close anterior to posterior CAP

47

Medial Compression:

Force with which the vocal folds come together

48

Pitch/Fundamental Frequency:
Optimal:
Habitual:
Pitch changes:

Optimal: vocal folds vibrate at optimal frequency, no strain no tenstion

Ideally, habitual pitch = optimal pitch, but doesn't always occur

Pitch changes: voice cracking, not consistent

49

Pitch/Fundamental Frequency:
Range:

how high and how low voice will go, determined by the length and weight of vocal folds

50

Fundamental Frequency for Adults
Males:
Females:

Males: 130 Hz
Females: 220 Hz (females have shorter, thinner vocal folds)

51

Frequency
Perceptual vs Objective

Perceptual: pitch (we measure pitch loudness and quality to determine if voice is working properly)
Objective: frequency

52

Intensty and Loudness
Perceptual vs Objective

Perceptual: loudness
Objective: Intensity, measured in dB

53

Intensity and loudness affected by:
1.
2.

1. subglottal air pressure: must have atleast 3-5mm subglottal air pressure , higher = louder sound

2. Medial Compression: greater = more subglottal air pressure require to speak
(vocal folds come together more tightly, more pressure needed to vibrate them)

54

Quality
Objective vs Perceptual

Only perceptual, too many factors to give one objective measurement
Can be breathy, rough, harsh, strained, etc.

55

What can the quality of the voice tell you about how it is functioning?

Age, gender, health status

56

Quality based on:

1. longitudinal tension : how tense are vocal folds
2. Mass per Unit Length (MLU): weight of vocal folds
3. Medial Compression
4. Subglottal Air Pressure
5. Symmetry of vocal folds: will vibrate at different rates if not symmetrical, leading to voice disorder

57

Vocal Registers:
1. Highest:
2. Mid-High:
3. Mid-Low:
4. Lowest:

1. Highest: Whistle( air flowing with high resistance)
Whisper (air flowing with low resistance)
2. Mid-High: Falsetto (most often used when laughing)
3. Mid-Low: Modal (everyday register)
4. Lowest: Glottal Fry : low subglottal air pressure, low tension, low frequency

58

What are the two unvoiced vocal registers?

Whistel and whisper, the highest registers

59

What is a vocal register?

The mode of vocal fold vibration