Anatomy of phonation practice sets

the cuneiform cartilages are especially functional in:

closing and opening the larynx during swallowing (by providing shape and support to quadrangular membrane, not by actively changing shape)

What is the only bone associated with the larynx (although not part of the larynx) ?

hyoid bone

The superior horn of the thyroid cartilage extends toward the _____.

hyoid bone.

The hyoid bone is held in position by the ____ _____.

hyoid sling (extrinsic muscles)

the epiglottis is a ______ structure that will cover the ____ of the larynx during swallowing.

protective; orifice.

Cricothyroid joint

• Between lateral cricoid surface and inferior horn of the thyroid • 3 capsular ligaments (anterior, lateral, and posterior ceratocricoid ligaments)

cricothyroid (CT)

• Fan-shaped muscle located between cricoid and thyroid • 2 divisions: Pars oblique and pars recta • Originates on arch of cricoid • Insertion on inner inferior margin of thyroid

The larynx is composed primarily of:

• Muscles • Cartilages • Ligaments • Mucous membranes

Which muscles is know as THE ABDUCTOR muscle

Posterior cricoaryntenoid (PCA)

when Lateral crocoarytenoid (LCA) Rotates the arytenoid cartilage on its vertical axis it can be described as a _____ motion.

Rocking

INTRINSIC muscles (5)

These muscles have their points of attachment entirely within the boundaries of the laryngeal cartilages. They are functionally classified with respect to their potential action on the vocal folds.

thyroarytenoid (TA)

This vocalis makes up the main mass of what is referred to as the true focal folds. runs from the anterior commissure on the deep surface of the thyroid cartilage (just below the thyroid notch) back to the vocal process of the arytenoid cartilage.

what are the four possible actions distinguished by the intrinsic muslces?

adduction (drawing the vocal folds together) abduction (drawing the folds apart) tensor action (making the folds more tense and stiff) relaxer action (making the holds less stiff)

muscles attached to the arytenoids provide both ______ and _____ functions.

adductory and abductory.

The __________________ folds course from the side of the epiglottis to the arytenoid apex.

aeroepiglottic

extrinsic superhyoid muscles (6) (5 connect to hyoid bone , 2 connect to the tonuge)

all elevate the larynx: digastric stylohyoid mylohyoid geniohyoid hyoglossus genioglossus

What part of the thyroid is associated wit the adam's apple?

angle of the thyroid cartilage more acute in males-- palpable notch at the midline of the thyroid.

genioglossus

another tongue muscle-- from mental symphysis primarily to the lower surface of the tongue, but some inferior fibers insert into the body of the hyoid-- protrudes tongue and elevates larynx.

extrinsic superhyoid digastric muscle has two bellies which are the ______ and ______ bellies.

anterior and posterior

Aryepiglottic ligament

aryepiglottic folds

the paired ______ Cartilages ride on the high-backed upper surface of the cricoid cartilage, forming the posterior point of attachment for the vocal folds.

arytenoid

the vocal folds are bands of mucous membrane, connective tissue, and thyrovocalis muscle that are slung between the _________and the ________so that they may be moved into and out of the air stream.

arytenoid cartilages ; thyroid cartilages

Thyroepiglottic ligament

attaches petiolus and inferior part of the cartilage to the internal thyroid surface-- allows considerable movement.

The arytenoid cartilage has 1 _____ and 3______ (like a pyramid shape)

base ; sides on either side of the process something different is connected (muscular process and vocal process). muscle contraction moves the cartilages.

The true vocal folds lie _______ the false vocal folds

beneath

thyrohyoid/hyothyroid membranes & ligaments fill the space:

between the hyoid bone and the thyroid. outer boundary of the larynx.

Bundle of muscle fibers making up much of the true vocal folds

thyroarytenoid (TA)

why do we need to understand the the role of the intrinsic muscles?

in order to understand the production of voice and the control of its various parameters.

The principal structure for producing a vibrating air stream is the

layrnx

the _______ surface of the arytenoid cartilage faces the other aryentoid across midline --- provides a point of attachment for the arytenoid muscles.

medial

The combined action of the oblique interarytenoids and transverse interarytenoids causes the cartilages to glide together in a stable manner and causes the vocal folds to:

move closer together (adduct)

What is the function of the mucous membrane in the inner larynx?

mucous membranes keep tissue moist and flexible.

the ______ process of the arytenoid cartilage extends out to the side and provides a point of attachment for the PCA and LCA muscles.

muscle

The______ muscle is a fan-shaped muscle that makes up the floor of the mouth. It meets midline at a raphe.

mylohyoid

The hyoid bone is the only bone in the body that is:

not attached to another bone.

what are the 5 intrinsic muscles?

thyroarytenoid (TA) Posterior cricoaryntenoid (PCA) Lateral crocoarytenoid (LCA) arytenoids (or interarytenoids -IA) cricothyroid (CT)

The __________________ membrane and ligaments cover the space between the hyoid and thyroid.

thyrohyoid/ hyoithyroid

The hyoid bone articulates loosely with the superior cornu of the ____ cartilage.

thyroid

the cricothyroid joint allows anterior-inferior movement of the?

thyroid cartilage.

The approximate anterior attachment of the vocal folds is indicated by the ____________

thyroid notch

The ______ cartilage is the largest of the laryngeal cartilages.

thyroid.

thyroarytenoid (TA) is separated into ________(medial) (attaches to vocal process) and __________muscles (attaches to muscular process)

thyrovocalis and thyromuscularis

Although not part of the lyrnx, the hyoid bone form the union between the _____ and the ______ ______.

tongue; laryngeal structure.

The lyrnx attaches to the _____ inferiorly and the _____bone superiorly

trachea; hyoid

The lyrnx includes Includes 3 ______ and 3 _____ cartilages

unpaired; paired.

The epiglottic attachment to the tongue is made by means of lateral and median glossoepiglottic ligaments, and they overlay of of the mucous membrane on these ligaments produces the "little valleys" or _______ between the tongue and the epiglottis.

valleculae

the pars recta course _______, and the pars oblique courses ______ and ________.

vertically superiorly and posteriorly

Its vibrating elements are the _______________.

vocal folds

The thyroid cartilage is the anterior (front) point of attachment for the _________, which are below the thyroid notch.

vocal folds.

extrinsic laryngeal muscles have _____ point of attachment to the lyarnx.

one

the thyroid cartilage is able to articulate with the cricoid cartilage by means of a _________ that let it rock forward and back.

paired process.

laryngeal cartilages (3 paired and 3 unpaired)

paired: • Arytenoid (2) Corniculate (2) Cuneiform (2) Unpaired: Thyroid (1) • Cricoid (1) • Epiglottis (1)

superior cricoid notch

posterior-superior landmark between arytenoids.

The laryngeal cavity Contains:

• A deep structure of cartilages • Ligaments and membrane that connect these cartilages • A lining of wet smooth mucous membrane

The ______________________ is an intrinsic membrane that runs internally from the aryepiglottic folds to the false vocal folds, where it is called the ventricular ligament.

quadrangular membrane.

the cricoid cartilage sits at a _____ angle.

slope; its back is arching up relative to the front.

Biological functions of the larynx

• Airway protection • Valving to shut off airflow for behaviors in which fixation of the thorax is necessary (e.g., coughing, effortful lifting, defecation, childbirth)

landmarks of the cricoid cartilage:

• Anterior arch • Posterior quadrate lamina • Lateral articular facets • Cricothyroid joint • Superior-posterior articular facets • Cricoarytenoid joint • Superior cricoid notch

Movement of the cricothyroid (CT)

• Causes movement about the cricothyroid joint • Downward tilting of the thyroid cartilage or upward tilting of the cricoid • Elongation of vocal folds • Anterior-posterior sliding • PRIMARY PITCH CHANGER

Laryngeal joints

• Cricothyroid joint • Cricoarytenoid joint

Rima glottidis (glottis)

space between the true vocal folds

False glottis/ventricle

space between ventricular (false) vocal folds

Ventricle

space between ventricular folds and the rima glottidis (glottis)

inferior pharyngeal constrictor

sphincter arising from the thyroid and cricoid cartilages; sphincter is contiguous with the espophagus

Aryepiglottic folds Form a:

sphincter to protect the airway

the two external infrahyoid muscles are:

sternohyoid omohyoid

extrinsic laryngeal muscles

sternohyoid (depresses layrnx) thyrohyoid (elevates larynx) inferior pharyngeal constrictor

Hyoepiglottic ligament

strand running from anterior surface of the broad part of the epiglottis to the posterior, midline surface of the hyoid.

sternohyoid is _______ to sternothyroid.

superfisical

(intrinsic ) Quadrangular membrane:

superior margin is the aryepiglottic folds, which include the cuneiform cartilages - terminates inferiorly as the ventricular ligaments (in the false vocal folds).

The VFs include ______distinct layers that work together to promote VF vibration.

three (5 with Hirano's Body Cover Theory)

Cricoarytenoid joint

Between superior surface of cricoid ring and the inferior surface of arytenoid cartilages (saddle joint) • Complex motion of rocking (antero-posteriorly) and rotating (in the horizontal plane) and gliding (laterally-medially)

Vocal fold layers

1. Epithelium 2. Superficial lamina propria (fibrous matrix) 3. Intermediate lamina propria (elastic fibers) 4. Deep lamina propria (collagenous fibers) 5. Vocalis muscle

The corpus of the hyoid bone is the point of attachment for ___ muscles.

6.

Laryngeal cavity:

A constricted tube with a smooth and aerodynamic surface.

True or False: The cuneiform cartilages are enclosed within the aryepiglottic folds.

TRUE

Extrinsic membranes of the inner larynx (3)

Thyrohyoid/hyothyroid membranes & ligament hyoeppligottic membrane & ligament Cricotracheal membrane

the stylohyoid is just _____ the diagastric muscle

above.

Lateral crocoarytenoid (LCA)

an adductor. runs from lateral surface of the cricoid cartilage to the muscular process of the arytenoid cartilage (same as PCA but in opposite direction) rotates the arytenoid cartilage on its vertical axis, but causes rotation in the opposite direction, so that the vocal folds are moved closer together. (adducted)

At the ____ of the arytenoid cartilage sits the corniculate cartilages and where the aryepiglottic folds attach.

apex

Glossoepiglottic ligament

base back of your tongue connected to epiglottis

Extrinsic Infrahyoid muscles are _____ the hyoid bone, there function is to _______ the larynx.

below, depress.

on top of the cricoid cartilage there is ________articular facet, where the arytenoid cartilage sits.

cricoarytenoid

The ______ cartilage is a complete ring resting atop the trachea and is the most inferior of the laryngeal cartilages.

cricoid.

The inferior horn of the thyroid cartilage extends toward the _____.

cricoid.

mylohyoid is deep to the __________ and ________muscles.

digastric and stylohyoid

both parts of cricothyroid causes movement about the cricothyroid joint. This movement can be _____tiling of thyroid or _____ tiling of cricoid

downward ; upward.

the extrinsic superhyoid muscles function is to _____ the layrnx

elevate

the affect cricothyroid has on the vocal folds is

elongation

mylohyiod

forms most of the floor of the mouth- runs from the inner surface of the jaw (from the mylohyoid line) to a midline tendon (the midline raphe) and the body of the hyoid.

the digastric muscle is a major ______ muscle.

jaw

The anterior 2/3 of the vocal folds is________; the posterior 1/3 _______.

membranous; cartilaginous.

Posterior quadrate lamina of the cricoid cartilage

surface; between lateral articular facets for cricothyroid joint. superior-posterioir articulatory facets for cricoarytenoid joint.

Vocalis is a VF ________ Thyromuscularis is a VF ______

tensor; relaxer.

Posterior cricoaryntenoid (PCA)

the abductor muscle from posterior surface of the cricoid cartilage to the muscular process of the arytenoid cartilage-- rotates, or pivots, the arytenoid cartilage on its vertical axis casing the vocal folds to be drawn apart at their posterior end (the anterior end is fixed at the anterior commissure)

Aditus larynges

the opening formed by the epiglottis & aryepiglottic folds

anterior arch of the cricoid cartilage

thin arch, the "bottom" of the ring shape.

Location of the larynx: immediately superior to the _____________; immediately inferior to the ____________.

trachea; hyoid bone.

the cornicule cartilages are also known as

vestigial cartilages

the _____ process of the arytenoid cartilage extends anteriorly near the midline and provides a point of attachment for the vocal folds and the vocal ligament.

vocal

landmarks of the thyroid cartilage:

• Superior cornu (horn) • Inferior cornu (horn) • Superior tubercle • Angle of the thyroid/thyroid notch

what are the 4 Epiglottis ligaments (connecting cartilage to cartilage)

• Thyroepiglottic ligament • Aryepiglottic ligament • glosseoepiglottic ligament hyoeppiglotic ligament

Laryngeal folds (3)

• True vocal folds • False vocal folds (also: ventricular or vestibular folds) • Aryepiglottic folds

what helps give shape and to the quadrangular membrane?

cuneiform cartilages

geniohyoid is ____ to mylohyoid

deep

geniohyoid

deep to mylohyoid; runs from mental symphysis to midline of the hyoid bone.

medial to the hyoid bone and thyroid cartilage is the ______, a leaf-like cartilage.

epiglottis.

hyoglossus

from body of hyoid to the under surface of the tongue (may have a more significant function as a tongue muscle, rather than as a laryngeal muscle).

thyrohyoid (extrinsic)

from greater horn of hyoid bone to oblique line of thyroid elevates layrnx.

sternohyoid (extrinsic)

from manubrium of sternum to oblique line of thyroid depresses larynx

Vestibule

from the aditus to the ventricular (false) vocal folds

sternohyoid

from the manubrium of sternum to the body of the hyoid

the stalk of the epiglottis extends down to the larynx which

functionally closes off the layrnx when necessary

The __________________ ligament attaches the epiglottis to the hyoid and the __________________ ligament attaches the epiglottis to the inner thyroid.

hyoeepiglottic; thyroepiglottic

which joint Allows folds to be adducted and abducted?

Cricoarytenoid joint

clinical note about the vallueculae

During the normal swallow, the larynx elevates and the epiglottis folds down to protect the airway. Food and liquid then pass over the back of the tongue, through the valleculae, into the pyriform sinuses, and into the esophagus. • When the swallow is compromised due to disease or stroke, food/liquid can accumulate in the valleculae or pyriform sinuses, allowing particles to drop into the airway after the person has swallowed, increasing the probability of pneumonia.

arytenoids (or interarytenoids -IA) 2 parts:

Oblique interarytenoids Transverse interarytenoids

2 divisions of cricothyroid:

Pars oblique and pars recta

Non-biologic function of the larynx:

Phonantion!

Thyroarytenoid (TA) muscle: • ___ mm membranous glottis (anterior 2/3) • ___mm cartilaginous glottis (posterior 1/3) • About ___ mm wide opening at rest

15, 8, 8

omohyoid

2 bellies from the upper border of the scapula by the way of an intermediate tendon at the sternum to the greater horn of the hyoid.

Movement of the interarytenoids

Adduct arytenoids, closing the cartilaginous glottis

(intrinsic) Cricothyroid membrane (conus elasticus):

cone-shaped - connects thyroid, cricoid, and arytenoid Divided into medial cricothyroid ligament and 2 lateral cricothyroid membranes Extends from superior border of arch of cricoid to upper limits of VFs (ends are the vocal ligaments within the VFs)

cricotracheal membrane

connects inferior surface of the cricoid with the superior surface of the first tracheal ring.

The ______________________ is an intrinsic membrane that runs internally from the cricoid to the upper edge of the vocal folds, where it is called the vocal ligament.

conus elasticus

The paired _______ cartilages ride on the superior surface of each aryntenoid and are prominent landmarks of the aryepiglottic folds.

corniculate

three major elements of the hyoid bone

corpus/body greater cornu & lesser cornu (major and minor horns)

Transverse interarytenoids

course horizontally

stylohyoid

courses from a projection deep in the skull, the styloid process of the temporal bone, to the body of the hyiod.

location of digastric

courses from the mastoid process (on the temporal bone) - to the lesser horn of the hyoid- to the internal surface of the mental symphysis.

Which muslcle is the primary pitch changer?

cricothyroid

cricothyroid Originates on ____ of cricoid

cricothyroid

What joint is considered the Primary pitch changer?

cricothyroid joint

The cricoid and thyroid cartilages articulate at the ________ joint.

cricothyroid joint.

intrinsic membranes and ligaments

cricothyroid membrane (conus elasticus) Quadrangular membrane

The __________________ ligament attaches the trachea to the larynx.

cricotracheal

Oblique interarytenoids

cross from the muscular process of one arytenoid cartilage to the opposite apex

the paired ______ cartilages reside with in the aryepiglottic folds and provides a degree of rigidy to the folds.

cuneiform