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The Phonatory System. 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

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the phonatory system
The Phonatory System

SPPA 2050 Speeech Anatomy & Physiology Tasko

outline
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
The Larynx: Key Functions
  • Airway Protection
  • Intrathoracic pressure generation
  • Valving for speech

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the larynx in situ
The larynx: in situ

larynx

thyroid gland

trachea

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midsagittal section
Midsagittal section

Figure 37.3

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slide7

Spin 180º

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superior view
Superior view

dorsal

Vocal folds

glottis

ventral

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bones cartilages joints

Bones, Cartilages & Joints

SPPA 2050 Speeech Anatomy & Physiology Tasko

skeletal structure
Hyoid Bone

Thyroid Cartilage

Cricoid Cartilage

Epiglottis

Arytenoid Cartilage

Skeletal Structure

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Figure 37.21

hyoid bone thyroid cartilage epiglottis
Hyoid Bone, Thyroid Cartilage & Epiglottis

Figure 37.17

Figure 37.21

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cricoid cartilage
Cricoid Cartilage

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.19

arytenoid cartilages paired
Arytenoid Cartilages (paired)

Figure 37.20

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laryngeal joints
Laryngeal Joints

Movement Basics

  • 6 degrees of freedom possible
  • Translation – 3 degrees
  • Rotation – 3 degrees
    • Pitch
    • Roll
    • Yaw

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laryngeal joints15
Laryngeal Joints

Figure 37.21

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joint articulation
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

Ligaments & Membranes: Epiglottis

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ligaments membranes epiglottis18
Hyoepiglottic l.

Thyroepiglottic l.

Glossoepiglottic folds (median and lateral)

Aryepiglottic fold

Ligaments & Membranes: Epiglottis

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ligaments membranes thyroid cricoid cartilages
Thyrohyoid m.

Ceratocricoid l.

Conus elasticus

Vocal l.

Cricotracheal m.

Posterior Cricoarytenoid l.

Ligaments & Membranes: Thyroid & Cricoid cartilages

Figure 37.21

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conus elasticus vocal ligament
Conus Elasticus & Vocal Ligament

Figure 37.21

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laryngeal anatomy surface geography superior view
Laryngeal Anatomy: “Surface Geography” – Superior view

esophagus

Dorsal/Posterior

arytenoid

glottis

Pyriform sinus

True vocal fold

aryepiglottic fold

False (ventricular) fold

epiglottis

Ventral/Anterior

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anterior view of larynx
Anterior View of Larynx

Figure 37.31

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interior view of larynx
Interior view of larynx

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Figure 37.23

coronal view

Rostral (superior)

Ventricular

(false) folds

Supraglottal cavity

(aditus)

ventricle

True vocal folds

glottis

Subglottal area

Caudal (inferior)

Coronal View

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coronal section
Coronal section

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Figure 37.23

laryngeal anatomy posterior view
Laryngeal Anatomy Posterior view

Laryngeal Vestibule (aditus)

Pyriform Recess (fossa)

Figure 36.28

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nerve supply to larynx
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 larynx29
Nerve supply to Larynx

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Figure 37.26

Figure 36.33

nerve supply to larynx30
Nerve supply to Larynx

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Figure 37.28

laryngeal anatomy the muscles
Laryngeal Anatomy: The muscles

1. 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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intrinsic laryngeal muscles
Intrinsic Laryngeal muscles

Key Actions

Position

  • Adduct
  • Abduct

Tension

  • Tense
  • Slacken

Length

  • Lengthen
  • Shorten

ADDUCTION

ABDUCTION

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lateral cricoarytenoid lca
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)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

lateral cricoarytenoid lca action
Lateral cricoarytenoid (LCA) Action

From Netter

SPPA 2050 Speeech Anatomy & Physiology Tasko

posterior cricoarytenoid pca
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)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

posterior cricoarytenoid pca36
Posterior cricoarytenoid (PCA)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

posterior cricoarytenoid pca action
Posterior cricoarytenoid (PCA) Action

From Netter

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thyroarytenoid ta
Thyroarytenoid (TA)

Often considered to have 2 parts

  • Vocalis
  • Thyromuscularis

Origin:

Internal surface of the thyroid

angle

Insertion:

Vocal and muscular process of

arytenoid

Action: shorten & adducts VF

Motor Supply:CN X

(recurrent laryngeal nerve)

From Netter

SPPA 2050 Speeech Anatomy & Physiology Tasko

thyroarytenoid ta39
Thyroarytenoid (TA)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

thyroarytenoid ta action
Thyroarytenoid (TA) Action

From Netter

SPPA 2050 Speeech Anatomy & Physiology Tasko

inter arytenoid ia
(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)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

interarytenoid ia action
Interarytenoid (IA) Action

From Netter

SPPA 2050 Speeech Anatomy & Physiology Tasko

cricothyroid ct
Cricothyroid (CT)

Often considered to have 2 fiber types

  • Oblique
  • Vertical

Origin:

ventral and lateral surfaces of

arch of cricoid cartilage

Insertion:

Caudal border of the thyroid

cartilage and anterior surface of

inferior horn

Action: lengthens and tenses VF

Motor Supply:CN X

(external branch of superior laryngeal nerve)

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.22

cricothyroid ct action
Cricothyroid (CT) Action

From Netter

SPPA 2050 Speeech Anatomy & Physiology Tasko

summary of key actions
Summary of Key actions

Box 37.20

SPPA 2050 Speeech Anatomy & Physiology Tasko

extrinsic laryngeal muscles
Extrinsic laryngeal muscles
  • refers to muscles with a single attachment to a laryngeal cartilage

SPPA 2050 Speeech Anatomy & Physiology Tasko

extrinsic muscles sternothyroid
Extrinsic muscles: Sternothyroid

Origin:

superior and posterior

portion of the sternum and

first costal cartilage

Insertion:

oblique line of thyroid

Action: depresses thyroid

cartilage

Motor Supply: C1-C3

Ansa cervicalis

SPPA 2050 Speeech Anatomy & Physiology Tasko

extrinsic muscles thyrohyoid
Extrinsic muscles: Thyrohyoid

Origin:

oblique line of thyroid

Insertion:

hyoid bone

Action: depresses hyoid or

elevates thyroid cartilage

Motor Supply: C1

SPPA 2050 Speeech Anatomy & Physiology Tasko

ansa cervicalis
Ansa Cervicalis

SPPA 2050 Speeech Anatomy & Physiology Tasko

ansa cervicalis50
Ansa Cervicalis

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supplemental laryngeal muscles
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
Supra and infra hyoid muscles

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.7

geniohyoid
Geniohyoid

Figure 37.8

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Figure 37.15

mylohyoid
Mylohyoid

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Figure 37.8

digastric and stylohyoid
Digastric and Stylohyoid

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.7

Figure 37.8

hyoglossus
Hyoglossus

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 36.23

sternohyoid omohyoid
Sternohyoid & Omohyoid

SPPA 2050 Speeech Anatomy & Physiology Tasko

Figure 37.8

Figure 37.15

sternohyoid omohyoid58
Sternohyoid & Omohyoid

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Figure 37.7

flex mpg
Flex.mpg

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vocal fold paralysis video
Vocal Fold paralysis video

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superior view61
Superior view

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layered structure of vocal fold
“Layered” structure of vocal fold

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basic structure of the vocal fold
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)

Lamina

propria

Vocal ligament

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vocal fold lesions

Vocal Fold Lesions

SPPA 2050 Speeech Anatomy & Physiology Tasko

laryngeal physiology

Laryngeal Physiology

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what is the function of the larynx
What is the function of the larynx?
  • Protection
  • Pressure generation
  • Valving for speech

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laryngeal function during swallowing
Within 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

Laryngeal function during Swallowing

SPPA 2050 Speeech Anatomy & Physiology Tasko

slide68

Posterior (dorsal)

Anterior (ventral)

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videofluoroscopy tape
Videofluoroscopy tape

Figure 37.3

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what is the function of the larynx70
What is the function of the larynx?
  • Protection
  • Pressure generation
  • Valving for speech

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what did we see
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)

SPPA 2050 Speeech Anatomy & Physiology Tasko

what did we see73
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)

SPPA 2050 Speeech Anatomy & Physiology Tasko

why does phonation occur
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
  • Adduction (often termed medial compression)
  • Longitudinal tension (the vocal fold must have an appropriate amount of tension along its length)
  • Aerodynamic forces (pushing and pulling by air flow and pressure)

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do we need a larynx to phonate
Do we need a larynx to phonate?
  • Insufflation test

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