SPPA 2050 Speeech Anatomy & Physiology Tasko The Phonatory System SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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 SPPA 2050 Speeech Anatomy & Physiology Tasko
The Larynx: Key Functions Airway Protection Intrathoracic pressure generation Valving for speech SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko The larynx: in situ larynx thyroid gland trachea SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Midsagittal section Figure 37.3 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Spin 180º SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Superior view dorsal Vocal folds glottis ventral SPPA 2050 Speeech Anatomy & Physiology Tasko
Bones, Cartilages & Joints SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Skeletal Structure Hyoid Bone Thyroid Cartilage Cricoid Cartilage Epiglottis Arytenoid Cartilage SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.21
Hyoid Bone, Thyroid Cartilage & Epiglottis Figure 37.21 Figure 37.17 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Cricoid Cartilage SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.19
Arytenoid Cartilages (paired) Figure 37.20 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Laryngeal Joints Movement Basics 6 degrees of freedom possible Translation – 3 degrees Rotation – 3 degrees Pitch Roll Yaw SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Laryngeal Joints Figure 37.21 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Joint Articulation Thyroepiglottic joint pitch Cricothyroid joint Pitch Translation Cricoarytenoid joint Pitch and roll – rocking Translation – sliding or gliding SPPA 2050 Speeech Anatomy & Physiology Tasko
Ligaments & Membranes: Epiglottis Hyoepiglottic l. Thyroepiglottic l. Glossoepiglottic folds (median and lateral) Aryepiglottic fold SPPA 2050 Speeech Anatomy & Physiology Tasko
Ligaments & Membranes: Epiglottis Hyoepiglottic l. Thyroepiglottic l. Glossoepiglottic folds (median and lateral) Aryepiglottic fold SPPA 2050 Speeech Anatomy & Physiology Tasko
Ligaments & Membranes: Thyroid & Cricoid cartilages Thyrohyoid m. Ceratocricoid l. Conus elasticus Vocal l. Cricotracheal m. Posterior Cricoarytenoid l. Figure 37.21 SPPA 2050 Speeech Anatomy & Physiology Tasko
Conus Elasticus & Vocal Ligament Figure 37.21 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko
Laryngeal Anatomy: “Surface Geography” – Superior view esophagus Dorsal/Posterior arytenoid glottis Pyriform sinus True vocal fold aryepiglottic fold False (ventricular) fold epiglottis Ventral/Anterior SPPA 2050 Speeech Anatomy & Physiology Tasko
Anterior View of Larynx Figure 37.31 SPPA 2050 Speeech Anatomy & Physiology Tasko
Interior view of larynx SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.23
SPPA 2050 Speeech Anatomy & Physiology Tasko Coronal View Rostral (superior) Caudal (inferior) Ventricular (false) folds ventricle True vocal folds glottis Subglottal area Supraglottal cavity (aditus) SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Coronal section SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.23
Laryngeal Anatomy Posterior view Laryngeal Vestibule (aditus) Pyriform Recess (fossa) Figure 36.28 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Nerve supply to Larynx SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.26 Figure 36.33
SPPA 2050 Speeech Anatomy & Physiology Tasko Nerve supply to Larynx SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.28
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 SPPA 2050 Speeech Anatomy & Physiology Tasko
Intrinsic Laryngeal muscles Key Actions Position Adduct Abduct Tension Tense Slacken Length Lengthen Shorten ADDUCTION ABDUCTION SPPA 2050 Speeech Anatomy & Physiology Tasko
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 From Netter SPPA 2050 Speeech Anatomy & Physiology Tasko
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 (PCA) SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.22
Posterior cricoarytenoid (PCA) Action From Netter SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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
SPPA 2050 Speeech Anatomy & Physiology Tasko Thyroarytenoid (TA) SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.22
Thyroarytenoid (TA) Action From Netter SPPA 2050 Speeech Anatomy & Physiology Tasko
(Inter)arytenoid (IA) Often considered to have 2 fiber types Oblique Transverse Origin: Posterior (dorsal) surface of arytenoid surface Insertion: opposite arytenoid Action: adducts VF Motor Supply: CN X (recurrent laryngeal nerve) SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.22
Interarytenoid (IA) Action From Netter SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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 From Netter SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Summary of Key actions Box 37.20 SPPA 2050 Speeech Anatomy & Physiology Tasko
Extrinsic laryngeal muscles refers to muscles with a single attachment to a laryngeal cartilage SPPA 2050 Speeech Anatomy & Physiology Tasko
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 Origin: oblique line of thyroid Insertion: hyoid bone Action: depresses hyoid or elevates thyroid cartilage Motor Supply: C1 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Ansa Cervicalis SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Ansa Cervicalis SPPA 2050 Speeech Anatomy & Physiology Tasko
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 SPPA 2050 Speeech Anatomy & Physiology Tasko
Supra and infra hyoid muscles Figure 37.7 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Geniohyoid Figure 37.8 Figure 37.15 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Mylohyoid Figure 37.8 SPPA 2050 Speeech Anatomy & Physiology Tasko
Digastric and Stylohyoid Figure 37.8 SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.7
SPPA 2050 Speeech Anatomy & Physiology Tasko Hyoglossus Figure 36.23 SPPA 2050 Speeech Anatomy & Physiology Tasko
Sternohyoid & Omohyoid Figure 37.15 SPPA 2050 Speeech Anatomy & Physiology Tasko Figure 37.8
Sternohyoid & Omohyoid Figure 37.7 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Flex.mpg SPPA 2050 Speeech Anatomy & Physiology Tasko
Vocal Fold paralysis video SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Superior view SPPA 2050 Speeech Anatomy & Physiology Tasko
“Layered” structure of vocal fold SPPA 2050 Speeech Anatomy & Physiology Tasko
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 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Vocal Fold Lesions SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Laryngeal Physiology SPPA 2050 Speeech Anatomy & Physiology Tasko
What is the function of the larynx? Protection Pressure generation Valving for speech SPPA 2050 Speeech Anatomy & Physiology Tasko
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 SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko Posterior (dorsal) Anterior (ventral) SPPA 2050 Speeech Anatomy & Physiology Tasko
Videofluoroscopy tape Figure 37.3 SPPA 2050 Speeech Anatomy & Physiology Tasko
What is the function of the larynx? Protection Pressure generation Valving for speech SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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
SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko 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
SPPA 2050 Speeech Anatomy & Physiology Tasko
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) SPPA 2050 Speeech Anatomy & Physiology Tasko
SPPA 2050 Speeech Anatomy & Physiology Tasko
Do we need a larynx to phonate? Insufflation test SPPA 2050 Speeech Anatomy & Physiology Tasko