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SPPA 2050 Speeech Anatomy & Physiology Tasko
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The Phonatory System
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Outline ANATOMY OF THE PHONATORY SYSTEM
Bones, Cartilages & Joints Ligaments and membranes Innervation of the larynx Muscles of the Larynx Laryngoscopic, coronal and dorsal views of larynx and associated
structures Vocal Fold Structure
PHYSIOLOGY OF PHONATORY SYSTEM Laryngeal function Description of vocal fold vibration Necessary & sufficient conditions for phonation
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The Larynx: Key Functions Airway Protection Intrathoracic pressure generation Valving for speech
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trachea
thyroid gland
larynx
The larynx: in situ
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Midsagittal section
Figure 37.3
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Spin 180º
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Superior view
ventral
dorsalVocal folds
glottis
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Bones, Cartilages & Joints
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Skeletal Structure
Hyoid Bone Thyroid Cartilage Cricoid Cartilage Epiglottis Arytenoid Cartilage
Figure 37.21
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Hyoid Bone, Thyroid Cartilage & Epiglottis
Figure 37.21 Figure 37.17
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Cricoid Cartilage
Figure 37.19
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Arytenoid Cartilages (paired)
Figure 37.20
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Laryngeal JointsMovement Basics 6 degrees of freedom possible Translation – 3 degrees Rotation – 3 degrees
Pitch Roll Yaw
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Figure 37.21
Laryngeal Joints
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Joint Articulation Thyroepiglottic joint
pitch Cricothyroid joint
Pitch Translation
Cricoarytenoid joint Pitch and roll – rocking Translation – sliding or
gliding
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Ligaments & Membranes: Epiglottis
Hyoepiglottic l. Thyroepiglottic l. Glossoepiglottic folds
(median and lateral) Aryepiglottic fold
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Ligaments & Membranes: Epiglottis
Hyoepiglottic l. Thyroepiglottic l. Glossoepiglottic folds
(median and lateral) Aryepiglottic fold
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Ligaments & Membranes: Thyroid & Cricoid cartilages
Thyrohyoid m. Ceratocricoid l. Conus elasticus Vocal l. Cricotracheal m. Posterior Cricoarytenoid l.
Figure 37.21
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Conus Elasticus & Vocal Ligament
Figure 37.21
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Laryngeal Anatomy: “Surface Geography” – Superior view
Dorsal/Posterior
Ventral/Anterior
True vocal fold
False (ventricular) fold
esophagusarytenoid
aryepiglottic fold
epiglottis
glottis Pyriform sinus
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Anterior View of Larynx
Figure 37.31
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Interior view of larynx
Figure 37.23
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Coronal View
Rostral (superior)
Caudal (inferior)
Ventricular(false) folds
ventricle
True vocal foldsglottis
Subglottal area
Supraglottal cavity(aditus)
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Coronal section
Figure 37.23
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Laryngeal Anatomy Posterior view
Pyriform Recess (fossa)
Laryngeal Vestibule (aditus)
Figure 36.28
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Nerve supply to larynx Cranial Nerve X (Vagus N.)
provide motor supply to all intrinsic muscles major nerve communicating sensory information
to the CNS 2 branches important for larynx
Superior laryngeal nerve Internal branch – provides sensory supply External branch – supplies cricothyroid m.
Recurrent laryngeal nerve Motor to all other intrinsic muscles
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Nerve supply to Larynx
Figure 36.33Figure 37.26
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Nerve supply to Larynx
Figure 37.28
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Laryngeal Anatomy: The muscles1. Intrinsic muscles Both origin and insertion are within the larynx
2. Extrinsic muscles An origin or insertion is within the larynx
3. Supplemental muscles No origin/insertion within the larynx, but affects the location
of larynx in the neck
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Key ActionsPosition Adduct AbductTension Tense SlackenLength Lengthen Shorten
Intrinsic Laryngeal muscles
ADDUCTION
ABDUCTION
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Lateral cricoarytenoid (LCA)
Origin:
Superior edge of
lateral border of cricoid
cartilage
Insertion:
muscular process of
arytenoid
Action: adducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
Figure 37.22
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Lateral cricoarytenoid (LCA) Action
From Netter
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Posterior cricoarytenoid (PCA)
Origin: Posterior (dorsal) surface of cricoid cartilage
Insertion:
muscular process of
arytenoid
Action: abducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
Figure 37.22
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Posterior cricoarytenoid (PCA)
Figure 37.22
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Posterior cricoarytenoid (PCA) Action
From Netter
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Thyroarytenoid (TA)Often considered to have 2 parts Vocalis Thyromuscularis
Origin: Internal surface of the thyroidangle Insertion: Vocal and muscular process ofarytenoid Action: shorten & adducts VF Motor Supply: CN X(recurrent laryngeal nerve)
From Netter
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Thyroarytenoid (TA)
Figure 37.22
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Thyroarytenoid (TA) Action
From Netter
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(Inter)arytenoid (IA)Often considered to have 2 fiber types Oblique Transverse
Origin: Posterior (dorsal) surface of arytenoid surface
Insertion:
Posterior (dorsal) surface of
opposite arytenoid
Action: adducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
Figure 37.22
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Interarytenoid (IA) Action
From Netter
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Cricothyroid (CT)
Often considered to have 2 fiber types Oblique VerticalOrigin: ventral and lateral surfaces of arch of cricoid cartilage Insertion: Caudal border of the thyroidcartilage and anterior surface ofinferior horn Action: lengthens and tenses VF Motor Supply: CN X(external branch of superior laryngeal
nerve)
Figure 37.22
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Cricothyroid (CT) Action
From Netter
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Summary of Key actions
Box 37.20
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Extrinsic laryngeal muscles refers to muscles with a single attachment to a
laryngeal cartilage
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Extrinsic muscles: Sternothyroid
Origin:superior and posteriorportion of the sternum andfirst costal cartilageInsertion: oblique line of thyroidAction: depresses thyroidcartilageMotor Supply: C1-C3Ansa cervicalis
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Extrinsic muscles: Thyrohyoid
Origin:
oblique line of thyroid
Insertion:
hyoid bone
Action: depresses hyoid or
elevates thyroid cartilage
Motor Supply: C1
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Ansa Cervicalis
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Ansa Cervicalis
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Supplemental laryngeal muscles no direct attachments to laryngeal cartilages attach on/near the hyoid bone “Suspends” larynx in the neck may elevate or depress hyo-laryngeal complex Suprahyoid muscles: muscles that attach to sites
rostral to the hyoid bone Infrahyoid (aka ‘strap’) muscles: muscles that
attach to sites caudal to the hyoid bone
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Supra and infra hyoid muscles
Figure 37.7
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Geniohyoid
Figure 37.15 Figure 37.8
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Mylohyoid
Figure 37.8
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Digastric and Stylohyoid
Figure 37.8 Figure 37.7
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Hyoglossus
Figure 36.23
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Sternohyoid & Omohyoid
Figure 37.8Figure 37.15
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Sternohyoid & Omohyoid
Figure 37.7
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Flex.mpg
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Vocal Fold paralysis video
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Superior view
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“Layered” structure of vocal fold
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Basic Structure of the vocal fold
epithelium
connective tissue
superficial layer
tissue loosely connected to the other layers
intermediate layer
elastic fibers (stretchy)
deep layer
collagen fibers (not stretchy)
muscle (TA)
Vocal ligament
Laminapropria
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Vocal Fold Lesions
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Laryngeal Physiology
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What is the function of the larynx?
Protection Pressure generation Valving for speech
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Laryngeal function during SwallowingWithin the SLP scope of practice
Role of larynx in swallowing protect the airway from
food/liquids. Levels of protection
True vocal folds Ventricular folds (false folds) Adduction and anterior motion
of arytenoids “Retroflexion” of the epiglottis
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Anterior (ventral)
Posterior (dorsal)
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Videofluoroscopy tape
Figure 37.3
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What is the function of the larynx?
Protection Pressure generation Valving for speech
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What did we see?
Alternate opening and closing of the glottis There are some distinct phases
Opening phase (glottis is getting bigger) Closing phase (glottis is getting smaller) Closed phase (glottal opening is absent)
Different parts of the glottis opens and closes at different times
“wave like” action along length of vocal folds If we could see it, the bottom of the fold opens first and closes
first (vertical phase difference)
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What did we see?
Different parts of the glottis opens and closes at different times
“wave like” action along length of vocal folds If we could see it, the bottom of the fold
opens first and closes first (vertical phase difference)
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Why does phonation occur?
Aerodynamic-myoelastic theory of phonation Glottal vibration is the result of an interaction between aerodynamic
forces and vocal fold muscular forces Three things are necessary and sufficient for phonation to occur
1. Adduction (often termed medial compression)
2. Longitudinal tension (the vocal fold must have an appropriate amount of tension along its length)
3. Aerodynamic forces (pushing and pulling by air flow and pressure)
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Do we need a larynx to phonate? Insufflation test