Unit 2 respiration phonation
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UNIT 2 RESPIRATION & PHONATION. Structure and Mechanics of Respiratory System. Pulmonary system Lungs and airways Upper respiratory system Lower respiratory system Chest wall system Necessary for normal vegetative and speech breathing. Pulmonary system: lower respiratory tract.

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UNIT 2 RESPIRATION & PHONATION

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Unit 2 respiration phonation

UNIT 2 RESPIRATION & PHONATION

SPPA 4030 Speech Science


Structure and mechanics of respiratory system

Structure and Mechanics of Respiratory System

  • Pulmonary system

    • Lungs and airways

      • Upper respiratory system

      • Lower respiratory system

  • Chest wall system

    • Necessary for normal vegetative and speech breathing

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Pulmonary system lower respiratory tract

Pulmonary system: lower respiratory tract

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Pulmonary system lower respiratory tract1

Pulmonary system: lower respiratory tract

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Chest wall system

Chest wall system

  • Rib cage

  • Abdomen

  • Diaphragm

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Chest wall lung relation

Chest wall-Lung relation

  • Lungs not physically attached to the thoracic walls

  • Lungs: visceral pleura

  • Thoracic wall: parietal pleura

  • Filled with Pleural fluid

  • Ppleural < Patm - “pleural linkage” allows the lungs to move with the thoracic wall

  • Breaking pleural linkage Ppleural = Patm - pneumothorax

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Thorax

Thorax

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Abdomen

Abdomen

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Unit 2 respiration phonation

Diaphragm

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Respiratory muscles

Respiratory muscles

  • Diaphragm

  • External intercostals

  • Internal intercostals

    (interosseus & intercartilaginous)

  • Costal elevators

  • Serratus posterior superior

  • Serratus posterior inferior

  • Sternocleidomastoid

  • Scalenes

  • Trapezius

  • Pectoralis major

  • Pectoralis minor

  • Serratus anterior

  • Transverse throacis

  • Rectus abdominis

  • External obliques

  • Internal obliques

  • Transversus abdominis

  • Quadratus lumborum

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Moving air

 Vt = Palv

Palv < Patm (- Palv)

P differential = density differential  air molecules flowing into lungs = inspiration

 Vt = Palv

Palv > Patmos(+ Palv)

P differential = density differential  air molecules flow out of lungs = expiration

Moving Air

Patm: atmospheric pressure

Palv: alveolar pressure

Vt: thoracic volume

P = k/V: Boyle’s Law

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Changing lung volume v lung

Changing lung volume ( Vlung)

  • pleural linkage:Vlung = Vthoracic

  •  Vthoracic is

    • raising/lowering the ribs (circumference)

      • Raising:  Vthoracic = inspiration

      • Lowering:  Vthoracic =expiration

    • Raising/lowering the diaphragm (vertical dimension)

      • Raising: Vthoracic =expiration

      • Lowering: Vthoracic =inspiration

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Rest breathing vs speech breathing

Rest breathing vs. speech breathing

  • What are the goals?

  • Rest breathing

    • ventilation

  • Speech breathing

    • communication

    • ventilation

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Quantifying respiratory function

Quantifying respiratory function

  • What measures would be useful?

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Measuring respiratory function

Measuring respiratory function

Volume

  • Spirometer

    • “wet” and “dry” varieties

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Measuring respiratory function1

Measuring respiratory function

Pressure

  • Manometer

  • Specialized pressure transducers

    • measures pressure at specific locations

    • For example,

      • When swallowed, thoracic and abdominal pressures

      • “inserted” into the trachea for tracheal pressure

      • placed strategically along the vocal tract

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Measuring respiratory function2

Measuring respiratory function

Flow Rate

  • Spirometer

    • nonspeech

  • Pneumotachograph

    • Airflow during speech and nonspeech

    • Vented mask the covers mouth and nose

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Spirometry

Spirometry

Lung Volume

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Lung volumes

Lung Volumes

REL

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A review of volumes and capacities

A Review of volumes and capacities

Tidal Volume (TV)

  • Volume of air inspired/expired during rest breathing.

    Expiratory Reserve Volume (ERV)

  • Volume of air that can be forcefully exhaled, “below” tidal volume.

    Inspiratory Reserve Volume (IRV)

  • Volume of air that can be inhaled, “above” tidal volume.

    Residual Volume (RV)

  • Volume of air left after maximal expiration. Measurable, but not easily so.

    Total Lung Capacity (TLC)

  • Volume of air enclosed in the respiratory system (i.e. TLC=RV+ERV+TV+IRV)

    Functional Residual Capacity (FRC)

  • Volume of air in the respiratory system at the REL (i.e. FRC=RV+ERV)

    Inspiratory capacity (IC)

  • TV + IRV

    Vital Capacity (VC)

  • Volume of air that can be inhaled/exhaled (i.e. VC=IRV +TV+ERV)

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Unit 2 respiration phonation

NOTE

  • Some authors use the term FRC (functional residual capacity) instead of REL (resting end-expiratory level)

  • Behrman uses resting lung volume (RLV)

  • Refers to equivalent “place” in the lung volume space

SPPA 4030 Speech Science


Some typical adult values

Typical Volumes & Capacities

Vital Capacity (VC)

4-5 liters

Total Lung Capacity (TLC)

~ one liter more than VC

Resting Tidal Volume (TV)

~ 10 % VC

Resting expiratory end level (REL)

~ 35-40% VC when upright

Typical Rest Breathing Values

Respiratory rate

12-15 breaths/minute

Alveolar Pressure Palv

+/- 2 cm H20

Airflow

~ 200 ml/sec

Some typical adult values

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Respitrace

Respitrace

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Unit 2 respiration phonation

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Speech vs life breathing

Rest Breathing

Volume

10 % VC at rest

Alveolar Pressure Palv

+/- 2 cm H20

Average Airflow

100-200 ml/sec

Ratio of inhalation to exhalation

~40/60 to 50/50

Speech Breathing

Volume

20-25 % VC @ normal loudness

(note Kent reports lower values)

40 % loud speech

Alveolar Pressure Palv

+ 8-10 cm H20 on expiration

Average Airflow

100-200 ml/sec

Ratio of inhalation to exhalation

~ 10/90

Speech vs. Life Breathing

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Respiratory system mechanics

Respiratory System Mechanics

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Respiratory system mechanics1

Respiratory System Mechanics

  • It is spring-like (elastic)

  • Elastic systems have an equilibrium point (rest position)

  • What happens when you displace it from equilibrium?

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Unit 2 respiration phonation

Displacement away from equilibrium

Restoring force back to equilibrium

Longer than

equilibrium

equilibrium

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Unit 2 respiration phonation

Displacement away from equilibrium

Restoring force back to equilibrium

Shorter than

equilibrium

equilibrium

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Unit 2 respiration phonation

Displacement away from equilibrium

Restoring force back to equilibrium

Shorter than

equilibrium

Longer than

equilibrium

equilibrium

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Equilibrium point rel

Equilibrium point ~ REL

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Unit 2 respiration phonation

Displacement away from REL

Restoring force back to REL

Lung Volume

Below REL

Lung Volume

Above REL

REL

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Is the respiratory system heavily or lightly damped

Is the respiratory system heavily or lightly damped?

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Respiratory mechanics bellow s analogy

Respiratory Mechanics: Bellow’s Analogy

  • Bellows volume = lung volume

  • Handles = respiratory muscles

  • Spring = elasticity of the respiratory system – recoil or relaxation pressure

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Unit 2 respiration phonation

  • No pushing or pulling on the handles ~ no exp. or insp. muscle activity

  • Volume ~ REL

  • Patmos = Palv, no airflow

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At rel

At REL

muscle force

elastic force

muscle force

  • pull handles outward from rest

  • V increases ~ Palv decreases

  • Inward air flow

  • INSPIRATION

SPPA 4030 Speech Science


Unit 2 respiration phonation

At REL

muscle force

elastic force

muscle force

  • push handles inward from rest

  • V decreases ~ Palv increases

  • outward air flow

  • EXPIRATION

SPPA 4030 Speech Science


Respiratory mechanics bellow s analogy1

Respiratory Mechanics: Bellow’s Analogy

Forces acting on the bellows/lungs are due to

  • Elastic properties of the system

    • Passive

    • Always present

  • Muscle activity

    • Active

    • Under nervous system control (automatic or voluntary)

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Forces due to elasticity of system no active muscle activity

Forces due to elasticity of system(no active muscle activity)

  • Recoil forces are proportionate to the amount of displacement from rest

  • Recoil forces ~ Palv

  • Relaxation pressure curve

    • Plots Palv due to recoil force against lung volume

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Relaxation pressure curve as in behrman

Relaxation Pressure Curve (as in Behrman)

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Relaxation pressure curve our version

Relaxation Pressure Curve(Our version)

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Unit 2 respiration phonation

60

40

relaxation pressure

20

REL

Alveolar Pressure (cm H20)

0

-20

-40

-60

80

60

40

20

0

100

% Vital Capacity


Unit 2 respiration phonation

Breathing for Life: Inspiration

  • pulling handles outward with net inspiratory muscle activity

SPPA 4030 Speech Science


Unit 2 respiration phonation

Breathing for Life: Expiration

  • No muscle activity

  • Recoil forces alone returns volume to REL

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Unit 2 respiration phonation

60

40

20

relaxation pressure

Alveolar Pressure (cm H20)

0

-20

-40

-60

80

60

40

20

0

100

% Vital Capacity

Breathing for Life

~ 2 cm

10 %


Respiratory demands of speech

Respiratory demands of speech

  • Conversational speech requires

    • “constant” tracheal pressure for driving vocal fold oscillation

    • brief, “pulsatile” changes in pressure to meet particular linguistic demands

      • emphatic and syllabic stress

      • phonetic requirements

SPPA 4030 Speech Science


Respiratory demands of speech1

Conversational speech

Volume solution

Constant tracheal pressure 8-10 cm H20

Pulsatile solution

Brief increases above/below constant tracheal pressure

Driving analogy

Volume solution

Maintain a relatively constant speed

Pulsatile solution

Brief increases/decreases in speed due to moment to moment traffic conditions

Respiratory demands of speech

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Example

Example

10

5

Pressure wrt atmosphere

0

-5

Time

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Unit 2 respiration phonation

Breathing for Speech: Inspiration

  • pulling handles outward with net inspiratory muscle activity

  • Rate of volume change is greater than rest breathing


Unit 2 respiration phonation

Breathing for Speech

60

40

20

relaxation pressure

~ 8-10 cm

Alveolar Pressure (cm H20)

0

-20

-40

20 %

-60

80

60

40

20

0

100

% Vital Capacity


Unit 2 respiration phonation

Breathing for Speech

60

40

20

relaxation pressure

~ 8-10 cm

Alveolar Pressure (cm H20)

0

-20

-40

20 %

-60

80

60

40

20

0

100

% Vital Capacity


Unit 2 respiration phonation

Breathing for Speech: Expiration

  • Expiratory muscle activity & recoil

    forces returns volume to REL

  • Pressure is net effect of expiratory muscles (assisting) and recoil forces (assisting)


Unit 2 respiration phonation

Breathing for Speech

60

40

20

relaxation pressure

~ 8-10 cm

Alveolar Pressure (cm H20)

0

-20

-40

20 %

-60

80

60

40

20

0

100

% Vital Capacity


Summary to this point

Summary to this point

Muscle activity for Inhalation

  • Life

    • Active inspiration to overcome elastic recoil

  • Speech

    • Active inspiration to overcome elastic recoil

    • Greater lung volume excursion

      • Longer and greater amount of muscle activity

    • Rate of lung volume change greater

      • Greater amount of muscle activity

SPPA 4030 Speech Science


Summary to this point1

Summary to this point

Muscle activity for exhalation

  • Life

    • No active expiration (i.e. no muscle activity)

    • Elastic recoil force only

  • Speech

    • Active use of expiratory muscles to maintain airway pressures necessary for speech (8-10 cm water)

    • Degree of muscle activity must increase to offset reductions in relaxation pressure

SPPA 4030 Speech Science


Unit 2 respiration phonation

  • This meets our needs to provide ‘constant’ pressure of 8-10 cm H20

  • What about meeting our ‘pulsatile’ pressure demands?

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What is required to provide these pressure pulses

What is required to provide these pressure ‘pulses’?

  • Brief, robust expiratory muscle activity

  • We need a ‘well-tuned’ system

    • Chest wall must be ‘optimized’ so that rapid changes can be made

    • Optimal environment created by active muscle activity

  • A ‘modern’ view of speech breathing

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What we know now vs then

What we know now vs. then

  • “Classic” studies of speech breathing

    • University of Edinburgh

    • Draper, Ladefoged & Witteridge (1959, 1960)

  • “Contemporary” studies of speech breathing

    • Harvard University

    • Hixon, Goldman and Mead (1973)

    • Hixon, Mead and Goldman (1976)

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What we know then and now

Then

Inspiratory muscles only

Now

Coactivation of

Rib cage (insp)

Abdomen (exp)

‘net’ inspiration

What we know then and now

Net Inspiratory Muscle Pressure

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What we know then and now1

Then

All muscles are silent

Now

Coactivation of

Rib cage (insp)

Abdomen (exp)

System ‘balanced’

What we know then and now

Net Zero Muscle Pressure

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What we know then and now2

Then

RC muscles

Now

Rib cage (exp)

Abdomen (exp)

What we know then and now

Net Expiratory Muscle Pressure

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Interpretation of information

Interpretation of information

  • Constant muscle activity may serve to “optimize” the system in various ways

    For example,

  • Abdominal activity during inspiration

  • pushes on, and stretches the diaphragm

  • Optimal length-tension region of diaphragm

  • Increase ability for rapid contraction which is needed for speech breathing

SPPA 4030 Speech Science


Interpretation of information1

Interpretation of information

  • Constant muscle activity may serve to “optimize” the system in various ways

    For example,

  • Abdominal activity during expiration

  • Provides a platform for rapid changes in ribcage volume (pulsatile)

  • Without constant activity, abdomen would ‘absorb’ the forces produced by the ribcage

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So what

So what?

  • Suggests speech breathing is more ‘active’ than originally thought

  • Passive pressures (recoil forces) of the system is heavily exploited in life breathing

  • speech breathing requires an efficient pressure regulator and therefore relies less on passive pressures

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Summary muscle activity

Inspiration

Life

Active inspiratory muscles

Speech

COACTIVATION OF

inspiratory muscles

expiratory muscles (specifically abdominal)

INS > EXP = net inspiration

System ‘tuned’ for quick inhalation

Expiration

Life

No active expiration (i.e. no muscle activity)

Speech

Active use of rib cage expiratory muscles

Active use of abdominal expiratory muscles

System “Tuned” for quick brief changes in pressure to meet linguistic demands of speech

Summary: Muscle activity

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Summary muscle activity1

Summary: Muscle activity

No Airflow

Life

  • Minimal muscle activity

    Speech

  • Coactivation of

    • Rib cage (inspiratory)

    • Abdomen (expiratory)

    • System ‘balanced’

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Lifespan considerations kent 1997

Lifespan considerations (Kent, 1997)

  • Respiratory volumes and capacities

    •  until young adulthood

    •  young adulthood to middle age

    •  during old age

      •  stature

      •  elastic properties

      •  muscle mass

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Lifespan considerations kent 19971

Lifespan considerations (Kent, 1997)

  • Maximum Phonation Time (MPT)

    • Longest time you can sustain a vowel

    • Function of

      • Air volume

      • Efficiency of laryngeal valving

    • Follows a similar pattern to respiratory volume and capacities

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Lifespan considerations kent 19972

Lifespan considerations (Kent, 1997)

  • Birth

    • Respiration rate 30-80 breaths/minute

    • Evidence of ‘paradoxing’

    • Limited number of alveoli for oxygen exchange

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Lifespan considerations kent 19973

Lifespan considerations (Kent, 1997)

  • 3 years

    • Respiration rate 20-30 breaths/minute

    • Speech breathing characteristics developing

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Lifespan considerations kent 19974

Lifespan considerations (Kent, 1997)

  • 7 years

    • Adult-like patterns

    • > subglottal pressure than adults

    • Number of alveoli reaching adult value of 300,000

  • 10 years

    • Functional maturation achieved

  • 12-18 years

    • Increases in lung capacities and volume

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Clinical considerations

Clinical considerations

  • Parkinson’s Disease

  • Cerebellar Disease

  • Spinal cord Injury

  • Mechanical Ventilation

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Parkinson s disease pd

Parkinson’s Disease (PD)

  • Rigidity, hypo (small) & brady (slow) kinesia

    Speech breathing features

  •  muscular rigidity   stiffness of rib cage

  •  abdominal involvement relative to rib cage

  •  ability to generate Ptrach

  •  modulation Ptrach

  • Speech is soft and monotonous

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Cerebellar disease

Cerebellar Disease

  • dyscoordination, inappropriate scaling and timing of movements

    Speech breathing features

  • Chest wall movements w/o changes in LV (paradoxical movements)

  •  fine control of Ptrach

  • Abnormal start and end LV (below REL)

  • speech has a robotic quality

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Spinal cord injury

Spinal cord injury

  • Remember those spinal nerves…

  • Paralysis of many muscles of respiration

    Speech breathing features

  • variable depending on specific damage

  •  abdominal size during speech

  •  control during expiration resulting in difficulty generating consistent Ptrach and modulating Ptrach

  • Treatment: Support the abdomen (truss)

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Mechanical ventilation

Mechanical Ventilation

  • Breaths are provided by a machine

    Speech breathing features

  •  control over all aspects of breath support

  • Length of inspiratory/expiratory phase

  • Large, but inconsistent Ptrach

  • Inspiration at linguistically inappropriate places

  • Speech breathing often occurs on inspiration

  • Treatment: “speaking valves”, ventilator adjustment, behavioral training

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Other disorders that may affect speech breathing

Other disorders that may affect speech breathing

  • Voice disorders

  • Hearing impairment

  • Fluency disorders

  • Motoneuron disease (ALS)

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