LARYNGEAL JOINTS AND INNERVATIONS LARYNGEAL INNERVATIONS Classified or supplied by 2 particular 2 IMPORTANT LARYNGEAL JOINTS branches of the Cranial nerve 10 (vagus that functionally makes the larynx mobile nerve) in the junctions or attachments Superior Laryngeal Nerve Cricothyroid Joint Courses inferiorly and is called Junction of cricoid cartilage and “superior” because it is coming from inferior cornua of the thyroid cartilage the superior portion of the larynx Synovial or a diarthrodial joint that Supplies sensory to the structures permits the cricoid and the thyroid above the vocal folds and only has rotate and glide relative to each other one motor innervation (cricothyroid Rotation at the cricothyroid joint muscle) permits the thyroid cartilage to rock Internal Branch (sensory branch) down anteriorly Provides sensory supply above the (forms a similar movement when vocal folds you flex your neck when you bow External Branch (innervation branch) down) Supplies innervation to the Permits the thyroid to glide anteriorly cricothyroid muscle and slightly posteriorly relative to the cricoid cartilage Recurrent Laryngeal Nerve Provides the major adjustment for the “Recurrent” because it courses through change in vocal pitch inferiorly but comes back superiorly to innervate the lower structures Cricoarytenoid Joint Supplies efferent nerve fibers to all Joint formed between the cricoid and other intrinsic laryngeal muscles arytenoid cartilages except for the cricothyroid muscle Synovial or a diarthrodial joint that Supplies sensory innervations to the permits the rocking, the minimal structures inferior to the vocal folds rotating, and gliding of the arytenoid cartilages totosusummmmaarirzize:e: The arytenoid facet of the cricoid is a convex, oblong-like surface, and the The laryngeal cartilages have a number of axis of the motion is round important landmarks to which muscles are Rocking action brings the two vocal attached. processes together permitting the The cricoid cartilage is shaped like a signet vocal folds to do adduction ring, higher in back. Combinations of these movements, The arytenoid cartilages ride on the superior which are the adduction and surface of the cricoid, with the cricoarytenoid abduction, provide the mechanism for joint permitting rotation, rocking, and gliding. the vocal fold approximation The muscular and vocal processes provide attachment for the thyromuscularis and thyrovocalis muscles. Understanding the role of each of these muscles in producing vocal fold movement is necessary for better understanding of laryngeal biomechanics as well as the development of new treatments for neuromotor laryngeal disorders. When contracted with muscles that shorten the vocal folds, the intrinsic laryngeal muscles can be classified as adductors for vocal fold closing, abductors for vocal fold opening, or lengtheners for increasing vocal fold length or tension. (Poletto et al., 2004)
MUSCLES OF THE PHONATORY SYSTEM oblique arytenoid INTRINSIC MUSCLES modifies phonation the adduction and abduction functions are provided by muscles linked to the arytenoids, which allow us to adjust the amount of airflow through muscular contraction. ADDUCTORS Lateral cricoarytenoid, transverse transverse arytenoid arytenoid, oblique arytenoid Put the vocal folds in the midline. MUSCLE: LATERAL CRICOARYTENOID posterior lateral ORIGIN: Superior-lateral surface of the cricoid cricoarytenoid cricoarytenoid cartilage COURSE: Superior-posteriorly INSERTION: Muscular process of the ABDUCTORS arytenoids Pulls away from midline (opens) INNERVATION: CNX (10 - vagus nerve), Only one muscle abductor recurrent laryngeal nerve branch Posterior cricoarytenoid FUNCTION: Adducts vocal folds; increase Since arytenoids are capable of gliding medial compression on the long axis of the facet, the INTERARYTENOIDS abduction will also be permitted because of the posterior MUSCLE: TRANSVERSE ARYTENOID cricoarytenoid muscle. ORIGIN: Lateral margin of the posterior arytenoid surface MUSCLE: POSTERIOR CRICOARYTENOID COURSE: Laterally ORIGIN: Posterior cricoid lamina (specifically INSERTION: Lateral margin of the posterior the posterior quadrate lamina of the cricoid) surface; opposite arytenoid COURSE: Superiorly INNERVATION: CNX (10 - vagus nerve), INSERTION: Posterior aspect of the arytenoids recurrent laryngeal nerve branch INNERVATION: CNX (10 - vagus nerve), FUNCTION: Adducts vocal folds recurrent laryngeal nerve branch FUNCTION: Rocks arytenoids cartilage MUSCLE: OBLIQUE ARYTENOID laterally which then abducts the vocal folds ORIGIN: Posterior base of the muscular when it contracts process * Vocal folds must be adducted, and abducted at a COURSE: Superiorly and obliquely full range of laryngeal adjustment is possible INSERTION: Apex of the opposite arytenoids INNERVATION: CNX (10 - vagus nerve), * From completely abducted to tightly adducted: use recurrent laryngeal nerve branch of range during phonation and bulk of voice complaints FUNCTION: Pulls the apex medially will arise from inadequate control of this musculature.
MUSCLES OF THE PHONATORY SYSTEM Thyrovocalis INTRINSIC MUSCLES modifies phonation Tensors, Relaxers, and Auxiliaries TENSORS Tenses the vocal fold 2 types: Thyrovocalis and Cricothyroids (cricothyroids have 2 subtypes) Cricothyroid MUSCLE: THYROVOCALIS Thyromuscularis ORIGIN: Inner surface, Thyroid cartilage near notch RELAXERS COURSE: Posteriorly MUSCLE: THYROMUSCULARIS INSERTION: Lateral surface of the arytenoid ORIGIN: Inner surface of the thyroid cartilage vocal process near the notch INNERVATION: Recurrent laryngeal nerve COURSE: Posteriorly branch, CN X Vagus INSERTION: Base and muscular process of FUNCTION: Tenses vocal folds arytenoid cartilage INNERVATION: Recurrent laryngeal nerve, CN INTERARYTENOIDS X - Vagus nerve FUNCTION: Relaxes vocal folds MUSCLE: CRICOTHYROID - PARS RECTA ORIGIN: Anterior surface of the cricoids Pars Recta cartilage beneath the arch Part COURSE: Superior, externally INSERTION: Lower surface of the thyroid Oblique Part lamina INNERVATION: External branch of the superior REMEMBER: Thyroarytenoid Muscles are two muscles, laryngeal nerve of CN X - Vagus nerve which are the medial-tensor and lateral-relaxer) FUNCTION: Depresses thyroid relative to cricoid; tenses vocal folds MUSCLE: CRICOTHYROID - PARS OBLIQUE ORIGIN: Cricoids cartilage lateral to Pars Recta COURSE: Superiorly and obliquely INSERTION: Thyroid cartilage between laminae and inferior horns INNERVATION: External branch of the superior laryngeal nerve of CN X - Vagus nerve FUNCTION: Depresses thyroid relative to cricoid; tenses vocal folds
MUSCLES OF THE PHONATORY SYSTEM EXTRINSIC MUSCLES consists of muscles with one attachment INTRINSIC MUSCLES to a laryngeal cartilage. modifies phonation Tensors, Relaxers, and Auxiliaries LARYNGEAL ELEVATORS AUXILIARIES MUSCLE: DIGASTRICUS MUSCLES (ANTERIOR) Help in relaxation, abduction and ORIGIN: Inner surface of the mandible, near adduction of the vocal folds symphysis (around the chin area) Constriction of airway COURSE: Medially and inferiorly INSERTION: Into Hyoid, by means of MUSCLE: SUPERIOR THYROARYTENOID intermediate tendon ORIGIN: Inner angle of thyroid cartilage INNERVATION: CN V - trigeminal nerve, COURSE: Posteriorly mandibular branch, via the mylohyoid INSERTION: Muscular process of arytenoid branch of the inferior alveolar nerve INNERVATION: Recurrent laryngeal nerve, X FUNCTION: Elevate hyoid; draws hyoid Vagus superiorly and anteriorly FUNCTION: Relaxes vocal folds MUSCLE: DIGASTRICUS MUSCLES (POSTERIOR) MUSCLE: THYROEPIGLOTTIC MUSCLE ORIGIN: Mastoid process of temporal bone ORIGIN: Inner surface of thyroid at angle COURSE: Medial and inferior COURSE: Posteriorly-Superiorly INSERTION: Into lesser cornu of Hyoid, by INSERTION: Lateral Epiglottis (sides) means of intermediate tendon INNERVATION: Recurrent laryngeal nerve, X INNERVATION: VII facial nerve, digastric Vagus branch FUNCTION: Dilates airway; makes the FUNCTION: Elevate hyoid as well, but draws epiglottis instead of deflecting downward, it hyoid a little bit more posteriorly keeps it in place for it not to be in obstruction MUSCLE: STYLOHYOID MUSCLE MUSCLE: ARYEPIGLOTTIC MUSCLE ORIGIN: Styloid process of temporal bone ORIGIN: Continuation of oblique arytenoid COURSE: Medially and inferiorly muscle from arytenoid apex INSERTION: Corpus of Hyoid COURSE: Posteriorly-Superiorly as muscular INNERVATION: CN VII - Facial nerve component of Aryepiglottic fold FUNCTION: Move hyoid posteriorly INSERTION: Lateral Epiglottis (sides) INNERVATION: Recurrent laryngeal nerve, X MUSCLE: MYLOHYOID Vagus ORIGIN: Mylohyoid line, inner surface of FUNCTION: Constricts laryngeal opening; mandible closes/deflects epiglottis downward COURSE: Fan-like arrangement to median fibrous raphe and hyoid * Thyroepiglottic muscle has no apparent function INSERTION: Corpus of Hyoid in speech but is active in the pharyngeal phase of INNERVATION: Alveolar nerve, CN V - swallowing. Keeps either the epiglottis at its resting trigeminal nerve, mandibular branch position, or relaxes to give way to the aryepiglottic FUNCTION: Elevates hyoid or depresses muscle. mandible (if hyoid is in fixed position)
MUSCLES OF THE PHONATORY SYSTEM LARYNGEAL DEPRESSORS Infrahyoid Muscles EXTRINSIC MUSCLES AKA laryngeal depressors Muscles that come from the hyoid to LARYNGEAL ELEVATORS structures below the hyoid MUSCLE: GENIOHYOID MUSCLE: OMOHYOIDS, SUPERIOR BELLY ORIGIN: Mental spines, inner surface of ORIGIN: Intermediate Tendon mandible COURSE: Inferiorly COURSE: Posteriorly and inferiorly INSERTION: Lower border, hyoid INSERTION: Corpus of Hyoid INNERVATION: Superior ramus of ansa INNERVATION: CN XII - hypoglossal nerve cervicalis from C1 (mostly) and C1 spinal nerve FUNCTION: Depresses hyoid FUNCTION: Elevates hyoid or depresses mandible MUSCLE: OMOHYOIDS, INFERIOR BELLY ORIGIN: Upper border, scapula MUSCLE: HYOGLOSSUS COURSE: Superiorly and medially ORIGIN: Hyoid bone, particularly greater INSERTION: Intermediate tendon cornu, and corpus INNERVATION: Ansa cervicalis, spinal C2-C3 COURSE: Inferiorly FUNCTION: Depresses hyoid INSERTION: Sides of tongue INNERVATION: Motor branch of the CN XII - MUSCLE: STERNOTHYROID hypoglossal nerve ORIGIN: Manubrium sterni and first costal FUNCTION: Elevates hyoid when tongue is cartilage fixed; when hyoid is fixed, it depresses tongue COURSE: Superiorly and externally INSERTION: Oblique line, thyroid cartilage MUSCLE: GENIOGLOSSUS INNERVATION: XII hypoglossal and spinal ORIGIN: Inner surface of mandible at nerves C1 and C2 symphysis FUNCTION: Depresses thyroid cartilage COURSE: Superiorly, posteriorly, and inferiorly INSERTION: Tongue and corpus hyoid MUSCLE: THYROHYOID INNERVATION: Motor branch of the CN XII - ORIGIN: Oblique line, thyroid cartilage hypoglossal nerve COURSE: Superiorly FUNCTION: Elevates hyoid although it may INSERTION: Greater cornu, hyoid also have an effect to the tongue depending INNERVATION: XII hypoglossal nerve and on which structure is fixed fibers from spinal C1 FUNCTION: Depresses hyoid or elevates larynx MUSCLE: THYROPHARYNGEUS ORIGIN: Thyroid lamina and inferior cornu * When the larynx is elevated, this could help COURSE: Superiorly, medially elevate the sternum and the clavicle. INSERTION: Posterior pharyngeal raphe * When the sternum is fixed, it could pull both the (meeting point of pharyngeal constrictors) thyroid and the hyoid downward or inferiorly. INNERVATION: CN X - vagus, recurrent * The extrinsic muscles enable, with the nature of laryngeal nerve (external laryngeal) the hyoid bone, makes the larynx suspended with the FUNCTION: Constricts Pharynx and it may muscles acting as the sling of that suspended elevate the larynx bcos of constriction structure
musclesMaUssSocCiaLtEeSd OwFithTHlEarLyAnRgYeaNl Xfunction INTRINSIC EXTRINSIC Adductors Hyoid and Laryngeal Elevators Lateral cricoarytenoid Stylohyoid Transverse arytenoid Mylohyoid Oblique arytenoid Geniohyoid Genioglossus Abductor Hyoglossus Posterior cricoarytenoid Inferior pharyngeal constrictor Digastricus anterior and posterior Tensors Thyrovocalis (medial thyroarytenoid) Hyoid and Laryngeal Depressors Cricothyroid, pars recta, and pars oblique Sternothyroid Omohyoid Relaxers Thyrohyoid Thyromuscularis (lateral thyroarytenoid) Auxiliary Musculature larungeaLlAUmGuHscINleG activuty Superior thyroarytenoid Thyroarytenoid Aryepiglotticus Understanding the structure and function of the laryngeal mechanism is necessary for assessing phonatory function, analyzing the larynx and vocal folds, and determining the effects of aberrant changes or adaptations on voice production. According to Scott (2015), When it comes to the human voice, an individual has abilities like vocal impersonation, singing, beatboxing, and so on. However, a separate vocal behavior, like laughter, can effectively disrupt these voluntary motor movements. This was further supported by a journal article of Citardi, et al. (1996), the vocal folds were discovered to undergo rhythmic abduction and adduction during laughter. This was viewed through a telescopic and fiberscopic videolaryngoscopy which was used on five people who laughed in various vowels, at various frequencies, and with diverse voice characteristics to assess laryngeal function during laughter. All subjects were able to establish voluntary control of paramedian vocal fold location by the completion of these specific phonation trials. The laryngeal function during laughter was better defined in their study. Moreover, this means that when individuals laugh loudly, they begin to emit sounds that we would never hear in any other situation. If we are speaking, or attempting to speak, the effect of the laughter will be instantly obvious, as we begin to lose control over the muscles in our rib cage that normally work so precisely during speech. We don't do much extra to alter the sound of laughter – it's a really fundamental sound to make.
PROPERTIES OF VOICE VOCAL PITCH Perceptual correlate of frequency ( Hz ) VOCAL REGISTER Fundamental frequency or pitch is range of tones in the human voice determined by the mass, tension, and produced by a particular vibratory pattern length of vocal folds of the vocal folds. The higher the mass the lower the frequency and vice versa. DIFFERENTS TYPES OF REGISTERS: The greater the length of the vocal folds, Modal the higher the frequency The more tensed the vocal folds are, the register for regular speech higher fundamental frequency and vice Should match a person's age, gender, versa built or size of the speaker The more relaxed it is, the lower the fundamental frequency is (That’s why Falsetto pitch when we are stressed has a Increase in length and tension of the vocal tendency to be higher) folds Male has lower fundamental frequency Maintain longitudinal gap than females High pitch voice Commonly used in singing Vocal Pitch Issues A person with bigger built will have low Vocal/Glottal Fry sounding pitch voice Happens when there is a decrease in A person who is petite will have a high length of vocal folds sounding pitch voice Increased tension in lateral borders of the Reduced Pitch range - vocal fatigue vocal folds Experienced by singer Relaxed medial border of vocal folds Misuse of voice when they cannot Because of differences of tension and reach the higher pitches or notes. relaxation between the borders, Variable Pitch - the pitch variations is too unnaturally low pitched voice can be varied without patterns produced Monopitch - a person without changing Not normal for singing and speech the tone which may be caused by pathologies Whistle Register High-pitched sound squeaky, bird-like, The extrinsic laryngeal muscles also come and adds at least a half octave and often into play slightly during production of higher and much more to the upper range lower pitches (especially in untrained singers) The highest register in the female voice Conversely, if one can lower pitch similarly the and is rarely found in the male voice. larynx will lower. A good speaking voice does not Singers utilize this technique to sing in the apparently require much active muscle 5th, 6th, and 7th octaves involvement of the extrinsic laryngeal muscles. The posterior cricoarytenoid helps in the Trained singers keep the height of the larynx abduction of vocal folds and thyrovocalis nearly constant while singing a range of high cricothyroid which tenses the vocal folds and low notes (Sataloff, 1981). meant to increase the pitch
PROPERTIES OF VOICE VOCAL QUALITY Also known as harmonicity VOCAL LOUDNESS How voiced is produced smoothly Perceptual correlate of Intensity (dB) Clear and smooth voice In order for sound to be generated in Vocal folds should have symmetrical vocal folds, there should be pressure in mass, length and tension the vocal folds. If not symmetrical, one vocal fold will The higher the subglottal pressure, the vibrate differently and would produce higher the intensity and vice versa. different fundamental frequencies. People with low voices may have problems building up subglottal pressure. Diplophonia - wherein a person is generating There is a limit to how much pressure we two different fundamental frequencies or can generate normally. having two voices. Amplification devices are needed like megaphones to produce more pressure. Vocal folds should not come together too loosely because it will produce a breathy Primary Biomechanical Determinants voice. 1.subglottal pressure Person who speaks very tightly because 2.medial compression of the vocal folds the tension is very tensed and cannot 3.the duration, speed, and degree of vocal produced the normal vibratory pattern fold closure The vocal folds cover should move in 50 percent of the cycles. Vocal Loudness Issues The vocal folds should mirror each other's Cases where voices would be too soft like moverement. If does not happen, there whispering will be an increased gap and causes Cases where voices would be too loud or breathiness using loudness higher than the usual Monoloudness Vocal Quality Issues wherein a person talks in a consistent Hoarseness loudness Variable loudness can be characterized by breathiness no patterns which may be caused by Rough sounding voice pathologies Not smooth Sounds like it is breaking Hixon and Abbs (1980) have written: “Sound Strain pressure level, the primary factor contributing to Can be characterized by too much our perception of the loudness of the voice, is tension governed mainly by the pressure supplied to the suffocated larynx by the respiratory pump” Breathiness Too much air Great gap within the vocal fold covers The principles of changing voice quality are less well known than those of changing pitch or volume. The laryngeal articulator mechanism reconciles the concepts of voice quality as long-term, habitual postural settings in an accent and voice quality as the vibratory, phonatory portion of speech. It explains how multiple configurational adjustments and vibratory elements are achieved in the lower vocal tract. (Benner et. al, (2019)
UNIT FOUR: PHONATION ACTIVITY The creation of vocal sound and speaking is referred to as phonation. Although vocal expression appears to be effortless and simple, it is actually the result of a delicate and sophisticated system of laryngeal muscles and ligaments. The larynx is sustained in mid-air by a large sling of muscles that must work together to perform the complicated motions required for speech and non-speech functions. The larynx and its cartilages require both coarse and subtle adjustments to move. (Dumwright, King & Seikel, ., 2010) larySnPgEeaElCHvocAalNDfolNd OmNovSemPeEnEtCaHndGEmSuTscUleREaSctivity The activation of each of the laryngeal muscles was connected with laryngeal movement during diverse tasks such as sniffing, coughing, or clearing the throat, as well as speech syllable production, in order to better understand their involvement in causing vocal fold movement. Poletto et al. (2004) has stated in their journal that with bipolar hooked wire electrodes implanted bilaterally in four normal patients, the posterior cricoarytenoid, lateral cricoarytenoid, cricothyroid, and thyroarytenoid muscles were monitored through the nasoendoscope to record vocal fold movement and muscle activity at the same time. The posterior cricoarytenoid recordings all had a significant relationship with vocal opening, whereas cricothyroid activity only had a significant relationship with opening during sniffing. The thyroarytenoid and lateral cricoarytenoid activity were found to be significantly linked to the closure of the vocal folds during coughing. The patterning of laryngeal muscles that create vocal fold movement varied depending on the task; reciprocal muscle activity occurred during coughing, but speech and sniffing frequently featured simultaneous contractions of muscular antagonists. All that said, during respiratory, airway protection, and speaking duties, distinct combinations of muscle activation are used for biomechanical control of vocal fold opening and closing movements.
UNIT FOUR E-PORTFOLIO reflection PHONATION As human individuals, it is part of our daily life to talk, laugh, sneeze, yawn and so much more, all of which go through the process of phonation. It's not that complicated as I expected it to be and every single session I've had with the course has made me much more curious. Basically, the cricoid, thyroid, and epiglottis cartilages, as well as the paired arytenoid, corniculate, and cuneiform cartilages, make up the larynx. The cricothyroid joint connects the thyroid and cricoid cartilages, allowing the two cartilages to move closer together in front. A joint connects the arytenoid and cricoid cartilages, allowing for a wide range of arytenoid motion. The cartilages are then connected by ligament sheets and cords, and the medial-most surface of the larynx is covered with a smooth mucous membrane. Additionally, the vocal folds are made up of five layers of tissue, with the muscle of the vocal folds being the deepest. The intrinsic muscles of the larynx must work together to bring the vocal folds into and out of approximation. Increased tension, a function of the thyrovocalis and cricothyroid, raises vocal fundamental frequency. From that point, I've realised that as a singer the fact that I get to study this ideas, concepts and muscle activities make me more conscious. The principles of changing voice quality are less well known than those of changing pitch or volume. The laryngeal articulator mechanism reconciles the concepts of voice quality as long-term, habitual postural settings in an accent and voice quality as the vibratory, phonatory portion of speech. It explains how multiple configurational adjustments and vibratory elements are achieved in the lower vocal tract. Moreover, as a not-so professional singer, I've dealt with the paos, malat and hoarse voice because I kept on abusing my vocal folds. I've experienced having to rest my voice for almost two months after a solid fundraising concert, back then and the concept of the abuse of our voices made me much aware of how delicate this structures are. Phonation concerns more than how we view our voice and the larynx in terms of the individual's structures and capabilities as a tool for emotional expression, as well as its complex and wide-ranging function in spoken human communication.
ANATOMY AND PHYSIOLOGY OF RESONANCE AND ARTICULATION 5
ANATOMY AND PHYSIOLOGY OF SWALLOWING 6
HEAD AND NECK EMBRYOLOGY 7
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