sppa 2050 speeech anatomy & physiology tasko 1 the phonatory system

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


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


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



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Mylohyoid

Figure 37.8


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Digastric and Stylohyoid



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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

sppa 2050 speeech anatomy & physiology tasko 1 the phonatory system

Documents

laryngeal anatomy

outline anatomy

speech slide

phonation slide

situ slide

gliding slide

phonatory system slide

degrees pitch roll yaw