SLP1043_3rdShifting_E-Portfolio_MacaraegTanyaPoleen

ANATOMY AND E-PortfolioPHYSIOLOGY FOR SLP SUBMITTED BY: MACARAEG, TANYA POLEEN B.

table of 1 CONTENTS 2 3 This e-portfolio is designed to 4 enable individuals to understand the anatomy and physiology of 5 hearing, respiration, phonation, 6 resonation and articulation 7 systems that are necessary for speech production and vegetative purposes like swallowing. The e-portfolio focuses on normal function and development of the structures for speech, hearing, and swallowing. The individuals should be able to exhibit understanding of the different structures and functions of the human body that enables production of speech, the ability to hear, and the ability to perform swallowing.

INTRODUCTION TO ANATOMY AND PHYSIOLOGY ANATOMY AND PHYSIOLOGY OF HEARING ANATOMY AND PHYSIOLOGY OF RESPIRATION ANATOMY AND PHYSIOLOGY OF PHONATION ANATOMY AND PHYSIOLOGY OF RESONANCE AND ARTICULATION ANATOMY AND PHYSIOLOGY SWALLOWING HEAD AND NECK EMBRYOLOGY

INTRODUCTION TO ANATOMY AND PHYSIOLOGY 1

BASICS OF ANAPHY ANATOMICAL POSITION Understand how the human body works Point of reference when studying the Which parts are affected when there is a human body condition or disease Why study Anatomy and Physiology? PLANES OF REFERENCE Anatomy comes from the Greek word 1.Coronal Plane 'anatomia' and 'anatemnein' meaning to Vertical plane of reference cut up or cut open Allows us the identify the anterior and Physiology is the function in relation to the posterior sides (forward and anatomy backward) Pathology is the study of disease; focused 2.Sagittal Plane on the structural and functional changes Vertical plane of reference as a result of the disease. Separates left and right portion Named in reference to the sagittal *good understanding cannot be achieved without good suture that runs lengthwise the center understanding of the anatomy and physiology of the organism of the top of the skull Midsagittal - If body or body part is SPEECH PROCESSES divided down the middle so that there is an equal left and right portion Motions and events that enable us to Parasagittal - section that is parallel to communicate or produce speech the midsagittal plane RESPIRATION 3.Transverse Plane Power behind speech Horizontal plane of reference Breath is turned into energy via the Separates body into the superior and vibration of the vocal cords. Control over inferior portion (upper and lower) breath influences pitch, loudness, and timing of speech Saggital Plane Coronal PHONATION Plane Enables to produce voice; Sound source. The respiratory system is its power generator via the breath passing through the larynx from the lungs. RESONATION & ARTICULATION Modify the sounds in the larynx that are heard and perceived as speech sounds. Configuration of the vocal tract i.e. lengthening / constriction of the pharynx, the elevation of the tongue, closure of the lips, the elevation of velum, closure of the oral, nasal, and cavities. *Resonance is the most affected when the person has Transverse colds as passageways are congested. Plane *Articulation changes in the structure of our oral extremities affect how we produce speech sounds.

terms of ABDUCTION Separation of structures SPATIAL ORIENTATION ADDUCTION Bring together structures ANTERIOR Posterior (front - back) CIRCUMDUCTION Circular motion CENTRAL Centrally (middle or source) DEGLUTITION Process of swallowing PERIPHERAL Outside MASTICATION Process of chewing CONTRA Opposite side (one-another) ex. Turn foot IPSI Same side (one-Structure in the EVERSION Turning outward outward or same side) lateral DEEP Away from the surface INVERSION Turning inward ex. Turn foot SUPERFICIAL On the surface sole medially DISTAL Away PROTRACTION Sliding/moving forward PROXIMAL Toward (near to point of origin) RETRACTION Sliding/moving backward DORSAL Back side EXTENSION Stretching out VENTRAL Front (toward the belly) FLEXION Bending of a structure EXTERNAL Structures outside ex. particular muscle contracts INTERNAL Structures inside DORSIFLEXION Moving foot superiorly EXTRINSIC Structure into another ex. Flexing INTRINSIC Muscles within structure PLANTARFLEXION Moving foot inferiorly INFERIOR Lower than reference point ex. Tiptoe SUPERIOR Higher than reference point DEPRESSOR Lowering a structure LATERAL Towards the side ex. Depressor anguli oris - muscle lowering corner of mouth MEDIAL Center most portion LEVATOR Raising a structure PRONE Face down ex. Levator veli palatini - muscle raising soft palate SUPINE Face up TENSOR Tensing a structure ex. Tensor veli palatini - muscle tensing soft palate OPPOSITION Move structure to another ex. Contacting the thumb and index finger AGONIST Help move the muscle ex. Quadriceps for muscle extension ANTAGONIST Opposite motion ex. Hamstring to the opposite direction terms of MOTION

JOINTS AND CAVITIES Pivot Joint JOINTS Connection of one structure to another particularly one bone to another; enables motion Hinge Joint Types of Joints Condyloid Joint 1.Pivot Joint Enables rotation C1 and C2 vertebrae (Atlas and Axis) Enables to move/rotate your head Saddle Joint Ball and Socket 2.Hinge Joint Joint Enables to do flexion and extension Ex. Elbow Plane Joint 3.Saddle Joint Enables you to move laterally just like waving your hand without moving the arm 4.Plane Joint Joints between the tarsal bones 3. Abdominal Cavity Enables to do eversion and inversion, Houses the stomach, liver, pancreas, dorsiflexion and plantar flexion kidneys, parts of small intestine, and 5.Condyloid Joint parts needed for digestion Joints between radius and carpal Separated from the thoracic cavity via bones DIAPHRAGM Enables to twist your hand moving from one side then navigating to 4. Pelvic Cavity another Houses muscles; some abdominal, spine 6.Ball-and-socket Joint and leg muscles Enables you to do circumduction Allows movement for the excretory, Hip joint urinary, and reproductive systems CAVITIES Cranial Cavity 1.Cranial Cavity Superior Pleural Cavity Mediastinum Houses brain and parts of the spinal cord Main protection of the brain Thoracic Cavity 2.Thoracic Cavity Houses the heart, lungs, and trachea Divided into three parts: Mediastinum - space in between Pericardial Cavity the pleural cavity Abdominal Cavity Pleural Cavity - is the space for the lungs Pericardial Cavity - space that houses the heart Pelvic Cavity

TISSUES Development: Epithelial Types of Tissues Develops from Epithelial Tissue - covers all body endoderm/mesoderm/ectoderm from surfaces embryological germ layer Simple Squamous Epithelium Connective Simple Cuboidal Epithelium Develops from mesoderm (embryonic Simple Columnar Epithelium mesoderm origin) Stratified Squamous Epithelium Stratified Cuboidal Epithelium Arrangement: Stratified Columnar Epithelium Epithelial Pseudostratified Columnar Epithelium Arranged in layers which can be either Connective Tissue - found within the single/multi layer body Connective Areolar Tissue Cells are in scattered form in the matrix Dense Fibrous and doesn’t show arrangement Cartilage Adipose Tissue Surrounding: Blood Epithelial Bone Not surrounded by blood capillaries Connective Composition: Surrounded by blood capillaries Epithelial - made up of cells and SMALL amount of intercellular matrix Location: Connective - made up of cells and HUGE Epithelial amount of intercellular matrix Above the basement membrane Connective Role: Below the basement membrane called Epithelial lamina propia Covering of the organs both internally and externally Nutrition: Helps in transcellular and intercellular Epithelial absorption (chemicals, ions) Gains nutrition from cellular membrane Selective absorption for protection of Connective cells Gains nutrition from blood capillaries Connective Supports other tissues and organs Bounded Tissues that make up the frame of the Epithelial body Special proteins, desmosomes, Helps muscle and bone formation hemidesomes Helps in working of blood and lymph Connective Site of blood and lymph production Blood capillaries and elastic or collagen Bone marrow is the center for RBC fibres production Found: Epithelial Lungs, kidneys, skin, mucus membrane Covering of a surface Connective Bones, nerves, ligaments, tendons, blood Connects a structure to another (skeletal, ligaments, tendons, or even blood)

HUMAN ORGAN Main divisions of the body that has specific major functions. Each system contributes to different functions and the sustenance SYSTEMS and maintenance of the body The network of organs and tissues that help humans RESPI breathe is known as the respiratory system. This system RATORY SYSTEM assists your body in absorbing oxygen from the air so that your organs can function properly. It also removes waste gases from your blood, such as carbon dioxide. Parts of the Respiratory System maintain PH levels Lungs Bronchioles Trachea Alveoli Sacs Primary and Secondary Bronchi *every second of life begins with oxygen NERVOU S SYSTEM The nervous system is the control center of the body. It manages ones motions, thoughts, and automatic responses to the world. It also plays an essential role in the things that the body does without thinking. Other body functions and processes, such as digestion, respiration, and sexual development. *controls all the functions of the body Parts of the Nervous System Brain Nerves Spinal Cord DIGESTIVE SYSTEM The digestive system is designed specifically to convert food into the nutrients and energy humans require to live. When it's completed, it properly stores solid waste, or stool, for disposal the next time one has a bowel movement. Parts of the Digestive System Teeth Stomach *breaks down and absorbs nutrients for Mouth Intestines energy, cell growth, and repair Esophagus Pancreas

URINARY S YSTEM The urinary system functions as a filter, eliminating toxins and wastes from the body via urine. This waste is transported through a system of tubes and ducts. *maintain body’s water and electrolyte balance. Parts of the Urinary System Kidney Ureter Bladder Urethra INTEGUMENTARY SYSTEM The skin and accessory structures protect the body from pathogens, chemicals, and other external elements, prevent dehydration, operate as a sensory organ, modulate body temperature and electrolyte balance, and synthesize vitamin D, among other things. Parts of the Integumentary System Hair Sweat Glands protects the rest of the body Nails Sebaceous Glands like a barrier Skin The skeletal system works as a support structure for the body. It gives the body its shape, allows movement, makes blood cells, provides protection for organs and stores minerals. SKELETAL *framework of the body!! SYSTEM Parts of the Skeletal System Bones Ligaments Cartilages The muscular system's primary role is to aid with movement. This works in pairs and are hostile to each other. The other muscle relaxes while one muscle contracts. This contraction helps with mobility by pulling on the bones. Muscles also help to maintain body posture. MUSCULAR SYSTEM Parts of the Muscular System Muscles Cardiac Smooth Skeletal

REPRODUCTIVE SYSTEM In both males and females, the reproductive system is a collection of internal and external organs that work together to procreate. Parts of the Female System Parts of the Male System Fallopian Tubes Sperm Duct Ovaries Penis Uterus Testis Vagina CIRCULATORY SYSTEM The circulatory system pumps blood through a system of blood vessels as the heart beats. The vessels are elastomeric tubes that transport blood throughout the body. Blood is required for survival. It transports oxygen and nutrients to the tissues of the body. It is necessary to maintain life and the health of all body tissues. Parts of the Circulatory System Heart Blood cells Blood vessels ENDOCRINE The glands that make up your endocrine SYSTEM system are made up of various organs. Hormones are created and secreted by these glands, which are found all over the body. Hormones are substances that transmit information from the blood to your organs, skin, muscles, and other tissues, allowing them to coordinate various tasks in one's body. *instruct your body on Parts of the Endocrine System what to do and where Composed of the ductless glands

UNIT ONE: Main divisions of the body that has specific major functions. Each system contributes to different functions and the sustenance ACTIVITY and maintenance of the body ANATOMICAL POSITION AND TERMS OF DIRECTION It is essential to situate the body in anatomical posture when studying the human body. Anatomical position is defined as having the body facing itself, feet together, and feet flat on the floor. The arms are straight at the side, palms facing ahead, and the head is held erect. All references to the body are made as though it is in this posture, thus when we say something is higher than anything else, we're referring to the body's anatomical position. Anatomy has served as the educational foundation for all medical and health professions throughout history, as a thorough understanding of the structure and function of the human body is required for safe and effective clinical practice. Similarly, anatomical terminology, which is as complicated as anatomy itself, serves as the foundation for successful communication in all medical areas. (Goran et. al., 2018) REGIONS OF THE ABDOMEN Individuals believe that cross-sectional, dynamic, and other types of abdominal imaging can now replace physical examinations, but the latter should always come first. Physical findings, in combination with the patient's history, can help determine which imaging to use and how to interpret it, as well as provide some positive and/or negative diagnostic clues that ultrasonography, computed tomography, magnetic resonance imaging, and nuclear isotopic scanning cannot. (Reuben, 2016)

UNIT ONE: BODY REGIONS ACTIVITY The human body is divided into regions and organ systems. The organ system approach is used in this work, in which particular organs are grouped into a broader organ system. Physical structures and places make up the human body. In metabolic activities, these physiological gaps are crucial. These areas were frequently overlooked in earlier scientific studies. The study of their role in the body can aid in the scientific understanding of some of the most difficult medical issues we face today. (Zhang, K., 2020)

UNIT ONE: BODY REGIONS ACTIVITY The human body is divided into regions and organ systems. The organ system approach is used in this work, in which particular organs are grouped into a broader organ system. It may also aid in the detection and prevention of disease, particularly sickness caused by drugs. The scientific knowledge of the principles of acupuncture and moxibustion may be improved by properly interpreting the essence of meridians from the perspective of these places. (Zhang, K., 2020)

UNIT ONE: BODY REGIONS ACTIVITY The human body is divided into regions and organ systems. The organ system approach is used in this work, in which particular organs are grouped into a broader organ system. Focused on the physical structures that can be dissected and are made of tangible things and quantifiable, such as organs, tissues, cells, and molecules, in our knowledge of the human body's creation. However, another crucial component was entirely overlooked: the physiological gaps that exist in the body. In a study of Zhang, K. (2020) it was mentioned that space occurs widely in the human body, such as the nasal cavity, ear canal, mouth cavity, digestive tract, and lung, which are filled with gases and connect with the natural space outside the human body, from the perspective of a human body structure. These areas are critical for appropriate metabolism and function.

UNIT ONE E-PORTFOLIO reflection INTRODUCTION This section of the e-portfolio have discussed the basic systems of one's body. I've actually enjoyed the part where we would make a paragraph of a daily thing, using phrases of anatomical terms. We've also made it fun in the sense that each one of us would make paunahan to remembering the anatomical terms, as my sister is a fourth year nursing student, my cousin is a second year nursing student, and my 'ex' now friend is a first year nursing student. A battle of the minds if you must say. Anyway, the terms were confusing at first, but eventually I got the hang of it and learned how to remember it in a not so hard way becuase I enjoyed it. Moreover, running back and getting to swift throught the topics on body systems was a refresher, although I still know their functions.

ANATOMY AND PHYSIOLOGY OF HEARING 2

ALL ABOUT HEARING ANATOMY: THE OUTER EAR AUDITION Collect Sound curves, cartilages The process of hearing Localization sound source identification Hearing is an essential element of Resonator creates a distinctive imprint on the verbal communication and survival Protection acoustic wave traveling into the ear canal Audiologists Foreign Body for Assistive Devices experts that deal with the screening, assessments, hearing aids to lounge unto intervention of hearing and balance disorders t he pinna Helix Communication specialists take care of hearing skill/sensation prevents things that would make Darwin's tubercle Cymba Concha hearing less effective Tragus Antihelix 4 MAJOR COMPONENTS OF THE EAR: 1.The outer ear Concha Cavum 2.The middle ear 3.The inner ear Lobule External 4.The neural pathway Auditory Meatus PINNA LOBULE HELIX General term for the outer Composed of connective The outermost portion of the ear. May also be called the tissues lacking the firmness auricular cartilage. Forms the auricale and is based of and elasticity of the other shape of the pinna and has a several muscles and parts of the auricle. It also has landmark called the “Darwin’s auricular cartilages. a large blood supply, serving a Tubercle”. warming mechanism. ANTIHELIX inherited from genetic line TRAGUS The opposite curve. It is INTERTRAGIC NOTCH another prominent ridge Flap of cartilage on the and ends inferiorly to anterior wall of the ear canal. Located in the middle of the form the antitragus. Pressing on the tragus serves tragus and the antitragus. nicely to close off the canal Serves the purpose of being EXTERNAL AUDITORY MEATUS to dampen unwanted sound. like a funnel that drains cerumen. The ear canal. It is a CYMBA CONCHA continuous tube that is CONCHA CAVUM made up of cartilage, an The anterior extension of the extension of the auricle. helix in the anterior entrance The one that is more of the concha, which is the superior to the concha. It depressions inside the auricle. directs sound into the external acoustic meatus.

MARKERS OF ANATOMICAL VARIATION Part of Tympanic Membrane Variation in size Annula macrotia; microtia, anotia Space/depression between the annular ligament and EAM Variation in position Pars Flaccida Translucency is caused by sparseness low-set ears; posterior angulation of the ear of fibers in the superior region of TM Flaccida Variations of the individual anatomical flaccid; soft; not tense or not rigid Pars Tensa parts: Remaining fibrous portion antihelix, antitragus; concha; helix; lobe; scapha; tragus; triangular fossa. Named ear anomalies crumpled ear; cryptoia; cupped ear; lop ear; preauricular and auricular tags; preauricular ectopias; prominent ear; question mark detachment Manubrium: Long handle of the of ascending helix; satyr ear; shell ear; Stahl ear. malleus Composed of 3 layers: ANATOMY: THE MIDDLE EAR Central fibrous layer; sturdiness Central intermediate layer; circular fibers by connective tissues Air-filled cavity; more internal compared Outermost layer; thin epithelium that is to the outer ear continuous with the lining of EAM Typanum: Timpani or kettledrums Innermost layer (medial layer); Type of drum, consists of a skin called a mucosa that is continuous with the head stretched over a large bowl lining of the middle ear commonly made of copper. You have approximately effective Played by striking the head with a special vibrating area of 55mm drum stick called a timpani stick. Outer ring of TM is fixed to the tympanic sulcus; only the 55mm2 area is effectively Tympanic Membrane eardrums vibrating Separates the outer ear from the middle Outer ring of TM does not vibrate at all. ear Otoscopy Creates a barrier protecting the middle Small scope magnified with a light source and inner areas from foreign objects (penlight) Vibrates in response to sound pressure pars flaccida waves. Cone-shaped in appearance which lateral reflects light posterior process of About 17.5mm in diameter malleor fold malleus Little as one-billionth of a cm Cone of light anterior 5 o’clock - normal right tympanic membrane malleor fold 7 o'clock position - normal left tympanic membrane manubrium Detecting the cone of light of malleus Reflection of light due to the cone of light shape of the TM. umbo TM is circular and concave; a little bit depressed internally.

OSSICULAR CHAIN / OSSICLES Stapes Tiny bones that forms into a chain to Also known as the stirrup transmit mechanical energy Smallest bone of the ossicular chain Approximately 4mg and 3.5mm2 Tympanic Membrane Head articulates with the lenticular Translucent; Defines the border between process of the incus outer and middle ear Incudostapedial Joint Articulation of the incus and stapes Manubrium Ball and socket joint Opaque but the color depends on the Anterior and Posterior Crus temperature; has tendency to turn One of them is attached to a muscle yellowish Footplate Attached to the tympanic membrane the shape of it fits exactly the oval Draws the tympanic membrane inward window within the temporal bone towards the middle ear giving its concave Oval Window shape (manubrium of the malleus) Separation of middle ear to the inner ear Malleus Composed of the handle, neck, head, and *Sizes play a role in the amplification of the processes sound Anterior Process site of anterior malleolar ligament. This *Ossicles starts motion and with that there is a ligament attaches bones to another pressure generated by the movement of bone or muscle. Same goes for the stapes pressing against the oval window lateral process so that it will also have an attachment MUSCLES Head/Caput Serves as protection Biggest part of the malleus Stapedius Protrudes to the epitympanic recess of Tensor Tympani the middle ear 9mm long and 25mg Tensor Tympani 25 mm in length and nearly 6 mm^2 in Incus cross-sectional area Anvil; Middleman Arising from the anterior wall of the Provides the intermediate link between middle ear space, superior to the orifice of the ossicular chain the Eustachian tube. Articulates with head of the malleus by Cartilaginous part of the Eustachian tube means of malleolar facet and greater wing of the sphenoid Long process is nearly parallel with the Coursing through the canal for the tensor manubrium of the malleus tympani in the anterior wall of the middle 30mg and the long process is ear approximately 7mm The tendon for the tensor tympani emerges from the canal, courses around *Malleus and incus articulate by means of the a bony outcropping called the saddle joint trochleariform process Function: stiffen the middle ear *Although it looks like there is a limited movement, transmission system, thereby reducing both malleus and incus move transmission of acoustical information in pass one unit upon the vibration/motion the lower frequencies.

Acoustic Reflex CAVITIES The acoustic reflex (also known as the Landmarks in the ear. stapedial reflex) is a staple of the Epitympanic recess audiologist’s diagnostic toolkit. Area of the temporal lobe that passes The stapedius muscle applies a force on the middle ear, where your heads of the footplate of the stapes that reduces the malleus and incus will be located. the amplitude of excursion of the The oval window (fenestra vestibuli; footplate, thereby reducing the sound fenestra ovalis), in which the footplate of pressure level reaching the cochlea. the stapes is embedded. A basic protective mechanism for the Triggering the acoustic reflex will rotate cochlea, as it is triggered by loud sounds, the footplate. The footplate won’t fit the typically greater than 85 dB SPL. oval window The acoustic reflex may also include Auditory tube (Eustachian tube or response by the tensor tympani muscle. pharyngotympanic tube) - starts from the middle ear particularly in the portion of Stapedius temporal bone, terminates to the nasal Approximately 6 mm long and 5 mm2 in pharynx (when you yawn, you remove cross-sectional area pressure from ears). Embedded in the bone of the posterior Canal of tensor tympani-where tensor wall of the middle ear. tympani originates from Its tendon emerges from the pyramidal Tympanic nerve within the middle ear eminence in the middle ear space. cavity. Inserts into the posterior neck of the stapes, so that when it contracts, the ANATOMY: THE INNER EAR stapes is rotated posteriorly Muscle spindles have been found in the 1.Vestibular system - regulates balance. stapedius muscle SEMICIRCULAR CANAL & VESTIBULE stapedius 2.Auditory system- our hearing mechanism. COCHLEA tensor tympani VESTIBULE Central egg shaped cavity of inner ear. Space is continuous with both vestibular mechanism (semicircular canal and the cochlea) Marked by 3 prominent recesses. Spherical recess Elliptical recess Cochlear recess *Spherical recess- the medial wall contains perforation in macula cribrosa media. 2 end organs within membranous labyrinth Utricle - located superiorly. Larger. Cont to semicircular canal. Saccule - lies on the medial wall cont to cochlea.

SEMICIRCULAR CANALS Has the sense organ for the movement of PHYSIOLOGY: THE OUTER EAR the body space Peripheral Auditory System includes: Outer Ear Ability to maintain balance Middle Ear Inner Ear Composed of anterior vertical/superior, Auditory Nerve posterior vertical, horizontal/lateral OUTER EAR FUNCTIONS Several parts that compose the outer ear semicircular canal. Pinna or auricle Concha Each ring is in the right angle to each Auditory canal, or more specifically, external auditory meatus other so that the interaction of the 3 Tympanic membrane, or the border The external ear is responsible for field- permits the brain to code 3-d space. to-eardrum transfer that provides 10 – 15 dB gain from 2500 – 5000 Hz. X, Y, Z axis (int/pos,inf/sup,L/R) *This are sounds that cover part of speech sounds, Semicircular canal all open to the and some of the environmental sounds as well. vestibule by means of apertures although the vertical canals, the anterior and PINNA OR AURICLE posterior semicircle share an aperture Funnel acoustic vibration to the concha Vestibule technically has five openings and external auditory meatus. even if we only have three semicircular Aids in the localization of sounds, canals. meaning sounds that come from one direction, or the opposite direction will be COCHLEA easily heard/received by the ear closer to Resemble the shape of snail it. *the ears are more concave rather than flat. Spirals about 2-3 turns Sound localization is important to 3 canals understand speech better, especially in scala tympani isolating speech sounds to background scala vestibular noise. scala media The bony part where the cochlea spin is CONCHA the MODIOLUS and within that is where primarily for amplification of sound cranial nerve 7, particularly the acoustic because of its shape. branch of cranial nerve a, passes through funnel-like, where the bigger part of other structures that it innervates. the funnel would be the pinna, and The branch of the acoustic nerve goes to then the one that is closest to the the different spaces where it is now called external auditory meatus is the concha the spiral ganglion. Spiral ganglion *the narrower it becomes, more amplitude it will have, Covered by a sheath of membrane hence why it amplifies sound called the spiral lamina and it terminates to the organ of corti. Resonant frequency Organ of corti dependent on size; thus varies for each Find hair cells; Tectorial membrane individual and other support structures. amplifies 5000 Hz frequencies Stria vascularis Structure responsible for maintaining/supplying blood to the whole cochlea.

EXTERNAL AUDITORY MEATUS PHYSIOLOGY: THE MIDDLE EAR Narrowest point of the external ear For amplification. The whole external MIDDLE EAR FUNCTIONS ear is for amplifying sounds you To protect against loud sounds receive or sense from the environment. To provide a means of pressure Resonant frequency is around 2500 Hz. equalization Sizes still vary for each individual, but To act as impedance-matching device the difference will be more minimal Compressed of the ossicular chain compared to the shape and size of the Acoustic reflex activates the stapedius concha. muscle and tensor tympani because Amplifies 2500 Hz frequencies and these muscles serve as protection from slightly above very loud and strong sound Has oil glands in the outer 1/3, which is If there’s an intense sound, the muscles called earwax or cerumen Protects the contract so the ossicular chain stiffens external auditory meatus from insects or Since reflex lang siya, it happens very fast other debris that can go inside the meatus It serves to lubricate *Minute movements allowed Cilia (EAM cilia) – hair follicles that help *Reflex happens very fast reduce dust and wax build-up The best way to clean the ears is to let EUSTACHIAN TUBE them be. Do not use Q-tips. Pushing of the Connection between middle ear and Q-tips into the canal would also push the nasopharynx or opening towards nasal cerumen closer to the tympanic cavity membrane, which can build-up over time. Helps equalize pressure between middle Do not clean your ears because they are ear cavity and surrounding environment self-cleaning. The shape of the external auditory meatus *air-filled is slightly curved downward, because it helps the cerumen slide down and go IMPEDANCE MISMATCHING external from the EAM. 99% of the sound energy is reflected by the tympanic membrane because of the TYMPANIC MEMBRANE AIR TO WATER IMPEDANCE leaving only 1% Round-like shape, opaque for most of its to be transmitted surface, and has a concave shape Outer ear - Air *atmospheric surrounding (bulging inwards or medially towards the Middle ear - Air ; link between tympanic middle ear) membrane and oval window is mostly the Airtight because of the annular ligament. ossicular chain Drum-like structure because it is Inner ear - Fluid-filled stretched from all of its sides from the When air pressure goes to fluid filled center cavity, it negates/disperses the energy Pars Tensa (75%) is tightly stretched, Sound is reduced to 30dB (the 1% sound which is called the pars tensa energy transmitted) Pars Flaccida (25%) is the superior one; Sound travels first through air then to the loose and floppy liquid in the inner ear (cochlea) Air is less dense and has resistance in water The use of a tympanometer to determine the state of the tympanic membrane and middle ear is crucial information for audiologists. According to Shanks & Shohet (n.d.), the same pathology can cause multiple tympanogram patterns, and the same tympanogram pattern can be caused by multiple middle-ear pathologies.

3 WAYS THAT COMPENSATES THE MISMATCH PHYSIOLOGY: THE INNER EAR 1.Area Difference Difference of the area of the tympanic INNER EAR LABYRINTHS membrane and the footplate of the Osseous Labyrinth (Bony Labyrinth) stapes. Walls made of temporal bone 2.Lever Action Contains Perilymph fluid Between malleus and incus Membranous Labyrinth 3.Buckling Action Tissue structure within the bone Tympanic membrane PARS TENSA structure Area is 55mm2 Contains Endolymph fluid Effective area of vibration STAPES FOOTPLATE VESTIBULAR PORTIONS (BALANCE) Area is 3mm2 Vestibule + Semicircular Canals Tympanic membrane is 18 times bigger Vestibule (18:1) space joining the semicircular Use of one thing to move another thing canals and the cochlea Lever action amplifies the force exerted responsible for linear acceleration from one force to another Semicircular Canals has three parts: the lateral, RATIO OF MALLEUS TO INCUS posterior and superior/ Inferior 1.3:1 Cochlear Portion (Transduction) Malleus is 1.3 times longer than incus Transducing mechanical energy to RATIO OF AMPLIFICATION electrical energy 2:1 coiled tube, roughly 35mm coils 2¾ to Buckling action of tympanic membrane itself, it is a labyrinth Peak displacement will be up to 1500 Hz 2 Windows of the Cochlea then a more complex action will happen due to the curve shape of the tympanic Oval Window - opens into the scala membrane vestibuli and is covered by the stapes membrane Helicotrema Round Window - opens into the scala tympani medially modiolus apex Helicotrema Area where the perilymph flows from vestibular vestibular the scala vestibuli to scala tympani nerve membrane Cochlear partition is also called Membranous labyrinth scala media scala spiral * Scala refers to the locations of vestibuli ganglion which canal is referred to the Scala Vestibuli, Scala Media, and Scala basilar scala organ of Tympani membrane tympani Corti * Basilar Membrane where organ of corti rests cochlear * Vestibular Membrane separates nerve scala media from scala vestibuli * Spiral Lamina covers the spiral ganglion

ORGAN OF CORTI STEREOCILIA Sits on top of basilar membrane Projections that go outside Within the scala media Each stereocilia bundle contains Runs longitudinal to the basilar approximately 60 stereocilia per inner membrane hair cell The stereocilia of the outer hair cell SPIRAL ORGAN follow a 'W' pattern Composed of the osseous spiral lamina Heights of the stereocilia varies with Spiral lamina the shortest on the inner hair cell protects the spiral ganglion or the nerves innervating the organ TECTORIAL MEMBRANE Basilar membrane Lays on top of the outer hair cell and inner Tough membrane which extends from hair cells (stereocilia) the osseous spiral lamina to the outer Comes from the spiral limbus. The inner wall of the cochlear edge is firmly connected to the spiral Spiral Ligament limbus Thick fibrous membrane located on The outer edge is connected to the the outer wall of the cochlea which supporting cells of the organ of corti holds the basilar membrane in place The longest stereocilia of the outer hair Stria Vascularis cell is embedded in the undersurface of Vascular layer of tissue that lines the the tectorial membrane outer wall of the scala media Secretes ENDOLYMPH *Gelatinous membrane that is composed of 99% Scala Media water. It is also almost transparent and is fibrous Contains endolymph Supplies blood to the cochlea According to Alberti, P. (n.d.), when the outer hair Spiral Limbus cells are injured, they lose their ability to contract in Base of the tectorial membrane response to minor sounds, and the inner hair cells are not activated. If the sound is louder, the inner hair cells HAIR CELLS are directly stimulated and respond appropriately, Considered as receptor cells of hearing allowing the ability to perceive louder sounds to be preserved. Loudness recruiting is a rather regular *When sound is amplified then impedance mismatched occurrence. Because inner hair cells are significantly and transmitted to the cochlea, the disturbance in the \"tougher\" than outer hair cells. Additionally, the ear is pressure middle ear most responsive to noises between 3000 and 4000 Hz, in part due to the amplifying mechanism of the ear Run longitudinally across the basilar canal, as previously stated. Once hair cells degenerate membrane they do not recover and a permanent hearing loss Nerve fibers pass through the inner tunnel develops. As a result, these frequencies create the most of corti to innervate to the outer hair cells strong stimulus, and the outer hair cells that respond to OUTER HAIR CELLS (OHC) these frequencies are the most vulnerable to injury. More than yung nerves here TRAVELLING WAVE Approximately 12 500 located further The basilar membrane serves as the base away from the modiolus of the organ of corti. It has the stiffest INNER HAIR CELLS (IHC) gradient. Change in stiffness is gradual Closer to the middle portion/modiolus along the length of the basilar membrane Approximately 3 500 lie on the side of Propagation of mechanical energy to a the organ of corti specific frequency-dependent point along the basilar membrane

Compression Wave: TONOTOPIC ORGANIZATION Fluid is displaced and it pushes the The variation between stiffness of the basilar membrane towards the scala basilar membrane places the different tympani frequencies depending on the stiffness of Fluid gets displaced and the round the basilar membrane window bulges out the middle ear Vibrations of different frequencies will cavity maximally displace the basilar membrane at different locations specific to the Rarefaction Wave: different frequencies Once the force reaches the maximum point, it will revert back to the opposite TONOTOPIC ARRANGEMENT OF THE BASILAR motion MEMBRANE It will bounce back a little more towards the middle ear cavity so once High frequency tone displaces the basilar the energy dissipates it will go back to membrane at the basal end (end near the resting position the base of the cochlea) and where the membrane is narrowest and stiffest * Fluids are displaced (incompressible) Low frequency tone displaces the basilar membrane at the apical end (end near compression rarefraction compression the apex of the cochlea) where the membrane is widest and most flaccid wavelength cochlea auditory nerve Helicotrema Enables the relief of additional low pressure generated by the frequency displacement of fluid and oval window Oval window pushes in, the round oval window bulges out window high frequency Will undergo rarefaction at rest (go to its resting position) round window The basal end is narrower meaning it is stiffer This organization penetrates all levels of the central The apical end or apex is wide and flacid auditory system, including the auditory nerve, The stiffer it is, the more vibrations it will subcortical nuclei, and auditory cortex, and serves as have basilar membrane one of the most distinctive functional concepts to guide our knowledge of auditory processing. (Langers & van oval Dijk (2011) analyzed that in this way, it's similar to how round retinotopy affects the visual system and how somatotopy affects the somatosensory and motor high-frequency waves 1,500-20,000 Hz systems. The tonotopic arrangement of the human apex auditory cortex, however, remains little known in comparison to various other topographic cortical mappings. Moreover, Moerel et al.(2012) mentioned that medium-frequency waves 600-1500 Hz the auditory cortex also contains representations of additional acoustic characteristics such as stimulus bandwidth, sweep direction, and lateralization, in base addition to tonotopic frequency maps. low-frequency waves 200-600 Hz

UNIT TWO: TONOTOPIC ORGANIZATION ACTIVITY Vibrations of different frequency will move the BM maximum in different areas unique to those frequencies because to the stiffness variation, Organization tonotopic. Looking for sounds using the sound 9. Whisper level meter. oLoudness – 43.6 dB oFrequency – 218 Hz 1.Leaves rustling oDisplacement – Displaced BM at the apex Loudness – 43.7 dB Frequency – 1041 Hz 10. Noise (i.e. people chatting in the background, tv Displacement – Displaced BM at oLoudness – 68.0 dB the middle of the apex and base oFrequency – 783 Hz oDisplacement – Displaced BM at the middle of the apex 2. Moderate rain/ Heels of a shoe and base Loudness – 73.3 dB Frequency – 946 Hz 11. Water droplets from faucet Displacement – Displaced BM at oLoudness – 42.7 dB the middle of the apex and base oFrequency – 711 Hz oDisplacement – Displaced BM at the middle of the apex 3. Conversational voice and base Loudness – 67.6 dB Frequency – 210 Hz 12. Shrilling Laughter Displacement – Displaced BM at oLoudness – 72.4 dB the apex oFrequency – 2012 Hz oDisplacement – Displaced BM at the base 4. Construction (hammer and nail) oLoudness – 83.8 dB (95.2) 13. Base Drum/ Knocking oFrequency – 1168 Hz oLoudness – 64.2 dB oDisplacement – Displaced BM at the middle of oFrequency – 465 Hz the apex and base Displacement – Displaced BM at the apex 5. Car Honking oLoudness – 84.3 dB oFrequency – 2376 Hz oDisplacement – Displaced BM at the base 6. Clapping oLoudness – 70.6 dB oFrequency – 975 Hz oDisplacement – Displaced BM at the middle of the apex and base 7. Bell Ringing oLoudness – 81.2 dB oFrequency – 8291 Hz oDisplacement – Displaced BM at the base 8. Cellphone Alarm oLoudness – 80.5 dB oFrequency – 2540 Hz oDisplacement – Displaced BM at the base The conversion of tonotopic representations of incoming acoustic waveforms into higher-level sound representations is required for auditory cortex processing of complicated meaningful sounds. An orderly succession of neuronal characteristic frequencies over the cortical surface is defined as tonotopic gradients. The characteristic frequency, on the other hand, is defined as the frequency at which a neuron's lowest response threshold is reached. (Langers & van Dijk, 2011)

UNIT TWO E-PORTFOLIO reflection HEARING This section of the e-portfolio have discussed the systems and depth elaborated the sections of the ear. The activity, I've liked the most is the part where we first had to check a person's ear. My mother's clan had the genes of having the so called ear tags that were excessive tissues. It was honestly cool to have it really discussed during the synchronous lessons. Moreover, as a teen I've developed the liking to ear piercings, and must I say that making kabisado of the parts of the outer ear was one of the easiest for me. Just because, I had the idea of the piercings. Moreover, the frequencies had me interested as it concerns the degree upon what and which we hear. Which I can connect to our 1041 course topic, all about hearing loss. It's nice having to integrate subjects so that it's easier to get a grasp of.

ANATOMY AND PHYSIOLOGY OF RESPIRATION 3

ANATOMY FOR RESPIRATION transverse process vertebral disc THE VERTEBRAE AND THE VERTEBRAL COLUMN The Vertebral Column spinous composed of 32 or 33 individual bones. process Vertebra (stacked upon each other vertically) body Intervertebral Discs Cervical Vertebrae cartilaginous discs in between the spinous and transverse processes adjacent vertebrae throughout the length Superior and inferior articular facets of the vertebral column except in the fused vertebral structures ( sacrum & Thoracic Vertebrae coccyx ) in the lowermost regions. Provide the basis for the respiratory framework because they form the The Vertebral Foramen posterior point of attachment for the ribs serves as a passageway from base of the of the bony thorax. skull to the lower back neural arch Relatively larger spinous and transverse Neural Arch processes formed by joining of two lamina The 9 ribs (specifically ribs 2 to 9) attaches to the transverse processes and Intervertebral Foramina corpus of the same vertebra which means permits a passageway for spinal nerves to Rib 2 attaches to T-2 exit and enter the spinal cord. Rib 3 attaches to T-3 Rib 4 attaches to T-4 body cervical Lumbo-Sacro-Coxal Vertebrae Lumbar: L1-L5 vertebral ars carry all of the upper body's foramen weight while providing flexibility and movement to the trunk spinous process thoracic region. protect the delicate spinal cord body and nerves within their vertebral canal. vertebral lamina Sacrum: 5 Fused Vertebrae foramen large, flat triangular shaped bone nested between the hip tprraoncsevsesrse transverse lumbar bones and positioned below process the last lumbar vertebra. vertebral 4 pairs of sacral foramina and foramen spinous process sacrum Coccyx: Terminal Vertebrae (3-4) body commonly known as the tailbone, is below the sacrum. lamina transverse transverse * sacrum and coccyx are composed of smaller process process bones that fuse (grow into a solid bone mass) together by age 30 articular articular sacrum * weight-bearing and integral to functions such as process process walking, standing and sitting coccyx spinous process

THE RIB CAGE AND GIRDLES vertebral bone Bones of the Thorax and Pelvis sternum Vertebrosternal Vertebrochondral The Rib Cage floating ribs Protects the lungs and heart by providing skeletal protection for these crucial THE DIAPHRAGM organs. Muscle Name: Diaphragm A total of 12 ribs Origin: Sternal, Costal, and Vertebral All have differences with regards to how Insertion: Central Tendon they attach to the sternum and if Innervation: Phrenic Nerve by arising from attached to the sternum at all. cervical plexus of spinal nerves C3-C5 Three parts of Rib Cage: Action: Increases the longitudinal volume of Vertebrosternal (True Ribs) the thoracic cavity and compresses the Directly attached to the sternum abdominal viscera Vertebrochondral (False Ribs) Attached to the costal cartilage then to the sternum Vertebral (Floating Ribs) Ribs 11 to 12 do not have any attachments to transverse processes because it is known as our “floating ribs” Does not attach to the sternum Sternum Also known as the breastbone Short bone that that only reaches up to somewhere in the level of the rib 6 or 7 Pectoral Girdle Main Inspiratory Muscle Refers to the bony structure in the chest The Diaphragm region that provides support for the upper extremities. A single muscle that separates the thorax Give frame/structures to your shoulders from the abdomen and is bi-domed. Primary and largest inspiratory muscle Pelvic Girdle Refers to the bony structure in the lumbar Interior View of Diaphragm region that provides support for the Aortic hiatus - holes nearest to thoracic thoracic lumbar regions and the vertebrae, allows the aorta coming from attachments of the upper extremities. the heart to pass through towards the Supports the whole weight of the lumbar, abdomen thoracic, and cervical regions along with Foramen Vena cava - allows vena cava to the head. pass through to abdomen going back to the main branch of the vena cava to the * Respiration is a key life-sustaining and voice-enabling heart process that occurs when the musculoskeletal system's Esophageal Hiatus - passageway of support structures move. esophagus from the superior portion down to the stomach

MUSCLE NAME STERNOCLEIDOMASTOID muscles ORIGIN Mastoid process of Temporal bone FOR INSPIRATION INSERTION Sternal Head (superior manubrium sterni) Clavicular Head (superior surface of clavicle) INNERVATION XI accessory, spinal branch arising from spinal cord in the regions of C2-C4 or C5 ACTION Elevates sternum and by association, rib cage MUSCLE NAME ANTERIOR SCALENES ORIGIN Transverse processes of C3-C6 INSERTION Inner border of upper surface of R1 INNERVATION Spinal C4-C6 ACTION Elevates R1 MUSCLE NAME SCALENEUS MEDIUS ORIGIN Transverse processes of C2-C7 INSERTION Superior surface of R1 INNERVATION Cervical plexus derived from C3 and C4 and spinal nerves C5-C8 ACTION Elevates R1 MUSCLE NAME SCALENEUS POSTERIOR ORIGIN Posterior tubercles of C6-C7, and in some cases C5 INSERTION Outer surface of R2 INNERVATION Spinal nerves C5-C8 ACTION Elevates R2 and fixes the upper rib MUSCLE NAME EXTERNAL INTERCOSTALS ORIGIN Lower border of R1-R11 INSERTION Upper surface of the rib immediately below. INNERVATION Thoracic intercostal nerves arising from T1 through T6 and thoracoabdominal intercostal nerves from T7 through T11. ACTION Elevate ribs, thus increasing width of thoracic cavity MUSCLE NAME INTERCHONDRAL INTERNAL INTERCOSTALS ORIGIN Lower border of R1-R11 INSERTION Upper surface of the rib immediately below INNERVATION Thoracic intercostal nerves arising from T2 through T6 and thoracoabdominal intercostal nerves from T7 through T11 ACTION Elevate ribs, thus increasing width of thoracic cavity

muscles MUSCLE NAME INTERNAL INTERCOSTALS FOR EXPIRATION ORIGIN Inferior margin of R1-R11 INSERTION Superior surface of the rib below INNERVATION Thoracic intercostal nerve: T2 - T6 and Thoracoabdominal intercostal nerve: T7 - T11 ACTION Depress R1-R11 MUSCLE NAME SUBCOSTALS ORIGIN Inferior margin of R1-R1 INSERTION Superior surface of the rib below INNERVATION intercostal nerves of thorax, from the ventral rami of the spinal nerves ACTION Elevates R1 MUSCLE NAME RECTUS ABDOMINIS ORIGIN Crest of the pubis INSERTION Cartilages of R5-R7 and xiphoid process INNERVATION T7-T11 intercostal nerves, subcostal nerve from T12 ACTION Pulls down the sternum and lower ribs MUSCLE NAME EXTERNAL OBLIQUE ORIGIN Posterior surfaces and lower borders of R5-R12 INSERTION Anterior half of iliac crest, abdominal aponeurosis INNERVATION Thoracoabdominal nerve from T7 - T11 and subcostal nerve from T12 ACTION Elevates R2 and fixes the upper rib MUSCLE NAME INTERNAL OBLIQUE ORIGIN Lower border of R1-R11 INSERTION Upper surface of the rib immediately below. INNERVATION Thoracic intercostal nerves arising from T1 - T6 and thoracoabdominal intercostal nerves from T7 through T11. ACTION Compresses anterior and lateral walls of abdomen MUSCLE NAME TRANSVERSUS ABDOMINIS ORIGIN Inner surfaces of R6-R12, diaphragm, and transversus thoracis INSERTION Deepest layer of abdominal aponeurosis and pubis INNERVATION Thoracic and lumbar nerves and first lumbar nerve, iliohypogastric and ilioinguinal branches ACTION Compress anterior and lateral walls of abdomen

INSinPsIpRiAraTtOorRyY MmuUsScCleLsES MUSCLE: PECTORALIS MINOR ORIGIN: anterior surface of R2-5 chondral margin MUSCLE: LEVATORES COSTARUM BREVIS INSERTION: coracoid process of scapula ORIGIN: Transverse processes of C7 and T1-11 INNERVATION: superior branch of brachial plexus INSERTION: Tubercle and angle of the rib ACTION: increase transverse dimension rib cage immediately below INNERVATION: dorsal rami of the intercostal MUSCLE: SERRATUS ANTERIOR nerves arising from spinal nerves T2-T12 ORIGIN: Ribs 1-9, lateral surface of thorax ACTION: elevates the posterior rib cage INSERTION: inner vertebral border of scapula INNERVATION: brachial plexus, long thoracic MUSCLE: LEVATORES COSTARUM LONGUS nerve from C5 through C7 ORIGIN: fasciculi of lower four brevis muscles ACTION: elevates ribs 1-9 INSERTION: second rib below their origin INNERVATION: dorsal rami of the intercostal MUSCLE: SUBCLAVIUS nerves arising from spinal nerves T2-T12 ORIGIN: junction of R1 and its cartilage ACTION: elevates the posterior rib cage INSERTION: inferior surface of the clavicle near the acromion of the scapula MUSCLE: TRAPEZIUS INNERVATION: brachial plexus, lateral branch, ORIGIN: spinous processes of C2 to T12 from spinal nerves 5 and 6 INSERTION: acromion of scapula and superior ACTION: elevates ribs 1 surface of clavicle INNERVATION: XI accessory, spinal branch EXePxIpRiAraTtOorRyY MmuUsScCleLsES arising from spinal cord in the regions of C2- C4 or C5 MUSCLE: TRANSVERSUS THORACIS ACTION: elongates neck; controls head ORIGIN: posterior surface of sternum, xiphoid process, and R5-R7 MUSCLE: LEVATOR SCAPULAE INSERTION: lower border and inner surface R2-R6 ORIGIN: transverse processes of C1-C4 INNERVATION: thoracic intercostal nerves, INSERTION: medial border of scapula thoracoabdominal intercostal nerves, and INNERVATION: C3-C5 of cervical plexus subcostal nerves derived T2-T12 spinal nerves ACTION: elevates scapula ACTION: depress R2-R6 MUSCLE: RHOMBOIDEUS MAJOR MUSCLE: SERRATUS POSTERIOR INFERIOR ORIGIN: spinous processes of T2-T5 ORIGIN: spinous processes of T11, T12, L1-L3 INSERTION: scapula INSERTION: inferior border of R8-R12 INNERVATION: Spinal C5 from dorsal scapular INNERVATION: intercostal nerves from T9-T11 and nerve of upper root of brachial plexus subcostal nerve from T12 ACTION: stabilizes shoulder girdle ACTION: depress R8-R12 MUSCLE: RHOMBOIDEUS MINOR MUSCLE: LATISSIMUS DORSI ORIGIN: spinous processes of C7 to T1 ORIGIN: spines of lower thoracic vertebrae, INSERTION: medial border of scapula lumbar vertebrae, sacrum, and R10-R12 INNERVATION: Spinal C5 from dorsal scapular INSERTION: upper humerus nerve of upper root of brachial plexus INNERVATION: brachial plexus, posterior branch; ACTION: stabilizes shoulder girdle fibers from the regions C6-C8 ACTION: compress lower portion of rib cage wall MUSCLE: PECTORALIS MAJOR ORIGIN: medical clavicle; sternum entire length MUSCLE: QUADRATUS LUMBORUM INSERTION: greater tubercle of the humerus ORIGIN: iliac crest and iliolumbar ligament INNERVATION: superior brachial plexus INSERTION: tranvers proces L1-L4; lower border R12 ACTION: elevates the sternum and anterior ribs INNERVATION: thoraic nerve T12; L1-L4 lumbar nerves ACTION: depress R12

MmUSuCscLlEeSs OofF RreEsPpIiRrAatTiIoOnN INSPIRATION EXPIRATION Muscles of Trunk Muscles of Trunk Primary Thorax Primary Thorax Diaphragm Diaphragm Accessory of Thorax Anterior Muscles of Thorax, Back, and Upper Limb External intercostal Anterior Interchondral portion Internal intercostal Internal intercostal (interosseous Posterior portion) Levatores costarum (brevis and Transversus thoracis longis) Posterior Serratus posterior superior Subcostal Serratus posterior inferior Muscles of Neck Innermost intercostal Sternocleidomastoid (superfi cial Latissimus dorsi neck) Scalenus (anterior, middle, posterior) Abdominal Muscles Trapezius Anterolateral Transversus abdominis Muscles of Thorax, Back, and Upper Internal oblique Limb abdominis Pectoralis major External oblique Pectoralis minor abdominis Serratus anterior Rectus abdominis Subclavius Posterior Levator scapulae Quadratus lumborum Rhomboideus major Rhomboideus minor summaryreasnpdirajoutironnal article When considering these muscles, it's beneficial to conceive of them in three categories: rib cage muscles, diaphragm muscles, and abdominal wall muscles. Thinking of the respiratory muscles in this way makes it easier to describe the movements that occur as a result of the passive and active forces addressed later in the unit, as well as the respiratory system's voice adjustment capabilities. Caruso, et. al. (2015) describe how the advantages, disadvantages, procedures, and clinical applicability of the main tests used in the assessment of respiratory muscle strength. Among individuals with neuromuscular disease, as well as those with primary lung parenchymal or airway disease, impairment of (inspiratory and expiratory) respiratory muscles is a typical clinical finding. As the diagnostic procedures used to assess the muscle strength are not commonly known and available, this delayed detection, or even absence thereof, happens. The strength of respiratory muscle during the inspiratory and expiratory phases can be measured in a variety of ways, such as volitional, non-volitional tests and ultrasound imaging.

TRACHEA CONDUCTING ZONE LUNGS Primary respiratory organ It is a flexible tube, which is known as the RESPIRATORY ZONEDivided into two sides wind pipe. Each lung is divided into lobes 11cm in length 16 to 20 hyaline cartilage rings The Tertiary Divisions Open in the posterior aspect Third level of branching serves segments Runs from inferior border of larynx for of lobes about 11 cm Bronchi divide repeatedly into smaller Bifurcates in the carina tubes, with final tube being terminal Splits to left and right bronchi or bronchial bronchiole tubes which serve the lungs 28 generations of subdivisions in respiratory tree Angle relative to the Trachea Right side or bronchi is 20-30 degrees Zones of Respiration Left side or bronchi is 45-55 degrees This angle is for the pericardial space or Name of Branches the heart trachea * angles give space for the pericardial space or our heart bronchi Positions relative to the Trachea Posterior to the trachea is the esophagus bronchioles It is adjacent to one another Runs parallel to each other terminal bronchioles The Trachea Rings Cartilaginous 2 to 2.5cm diameter: 0.4 to 0.5 cm wide Transport gasses from the outside body and Mucous membrane lining provides vice versa continuity and flexibility Terminate at the terminal bronchioles The cartilage provides support, while the Dead air volume- unable to do gas exchange. membrane permits freedom of movement respiratory bronchioles The Bronchial Tree Increasingly smaller tubes as one alveolar ducts progresses into the depths of lungs 14 generations in the left lungs alveolar sacs 28 generations in the right lungs Cellular respiration occurs The Lobar Division Respiratory bronchioles- 1mm in diameter Serve lobes of the lungs: Alveolar ducts serves as passageway Right lung - Superior, Middle, and Alveoli- 300 million in a immature lungs, where Inferior) the actual respiration occurs. Left lung - Superior and Inferior Lobes separated by fissures Space on the left taken up by the heart and mediastinal structures

Alveolar Lining RESPIRATORY PROTECTION Extraordinary thin ( 0.35 to 2.5 microns) A red blood cell is 7 microns in diameter Airway Protection This quality promotes rapid transfer of Nasal Cilia or nasal hair: can catch gas across the membrane objects greater than 10 microns. The alveolar lining is made up of two Mucous membrane: moistens the mouth types of cells: to the rest of the pharynx, provides Type I Pneumocytes receptacle for foreign matter where they (membranous pneumocytes) stick to. flat cells involved in gas exchange Goblet Cells: traps pollutants in the Type II Cells mucosal lining. (cuboidal cells) Tall Columnar Epithelium: lining of the source of surfactant, a substance respiratory passageway of the nose to the that reduces surface tension, keep bronchi that beats more than 1000 times alveoli from collapsing; per minute. maintaining the structure of the Warm and Humid Air: very difficult to alveolus breathe in very cold and non-humid environments because the respiratory terminal deoxygenated passageway protects the lungs by bronchiole oxygenated warming and humidifying the air alveolar pores respiratory PLEURA, INNERVATIONS, AND AIR MOVEMENT alveolar bronchiole sac Diaphragm contract alveolus Contracts and enlarges the vertical dimensions alveolar duct Rib cage elevate Enlarge transverse dimension Diffusion Closed system: only opening is the oral Exchange of carbon dioxide and nasal cavities Alveolar Capillaries where carbon dioxide pass through Pleural Lining It is being passed through from the Covering of lungs and inner thoracic wall capillaries or the other opposite side of Lungs are encased in linings the alveolus to the inside of the alveolus. Visceral Pleura: closest to the lungs Oxygen is moving/being diffused toward Thoracic Pleura: the ribs the capillaries to the RBCs Parietal Pleura: roughly more for your posterior-lateral end Blood Supply Mediastinal Pleura: covers the The capillaries are dense Mediastinum Small size permit 100 to 300 ml of blood to Diaphragmatic Pleura: covers the be spread over 70 M2 of surface Diaphragm Each alveolus richly supplied with blood Costal Pleura: covers the Inner surface for gas exchange from more than 2000 of Rib Cage capillaries/alveolus Apical Pleura: covers Superior-most The lungs have an intricate lacework of region of rib cage cartilage, its supportive tissue

Pleural Membranes THE BASICS OF RESPIRATION Elastic and Fibrous tissues Venules and Lymphocytes: provide Respiration protection and immune system level of Exchange of gas between an organism protection, starts at the root of the lung or and its environment main bronchus, provides an air tight seals Active process Visceral and Parietal are continuous at Inspiration: oxygen brought to the the Hilum cells of the body Hilum: root of the lung where main Expiration: eliminates waste products stem bronchioles are going into the by breathing out lungs roughly at the level of your T4 or All body cells use oxygen for metabolism T5 vertebrae Cuboidal cells along the pleural lining Concepts about Respiration Cuboidal Cells: produce surfactant Air Pressure: force exerted on the walls of that is released in the pleural space a chamber particularly the walls of the (reduces surface tension) between the lungs. lungs and thoracic wall Pressure: force exerted to a given area Boyle’s Law: pressure is inversely Mediastinum proportional to volume Most protected region of the body Occupied by heart, trachea, major blood Respiratory Cycle vessels, lymph nodes, nerves, and the 1 Inspiration = 1 Expiration esophagus 12 - 18 breaths per minute 500 ml of air Thymus Glands: one of the major each cycle 6000-8000 ml of air every glands of the endocrine system minute Heart is located deep within thick muscle and bone Breathing Rate Rate determined by factors like lung size Phrenic and Vagus nerves Smaller lungs = Shorter breathing rate Left and right Phrenic nerves pass Your respiratory rate changes depending anteriorly to the root structures of the on activity lungs (Hilum) and courses along the Active: respiratory rate goes up as the lateral surface of the Pericardium ( demand of the body to release carbon membranous sac enclosing the heart) to dioxide during activity goes up innervate the diaphragm Resting: respiratory rate goes down as Left and right Vagus nerves enter there is no need to get as much posteriorly to the mediastinum to oxygen to sustain body functions innervate the heart Vagal pulmonary branches provide the *Older = respiratory rate decreases because muscles parasympathetic nerves supply for the become more efficient if we use it more, structures lungs with the nerve fibers found in the grow larger smallest bronchioles Vasovagal reflex: severe coughing which AGE BREATHS PER MINUTE creates an increase in blood pressure due Newborn 60 breaths per minute to the decrease in diameter of not only 1 year old 30 breaths per minute the airway, but other surrounding 5 year old 20 breaths per minute structures. 10 year old 18 breaths per minute 20 year old 17 breaths per minute

BREATHING PATTERNS PHYSIOLOGY OF RESPIRATION 1.Diaphragmatic Breathing Diaphragm as the primary muscle Boyle’s Law Abdominal region expands during Temperature is constant inhalation and contracts during Volume and Pressure is inversely exhalation proportional Can be determined by palpation Volume Increase, Pressure decrease (hand on diaphragm area) Pressure dictates where the air flows 2.Clavicular Breathing “Shoulder breathing” Pulmonary and Atmospheric Pressure Additional movement of the clavicular Pulmonary: Pressure within the lungs region after a full inhalation; forward Atmospheric: Pressure outside the body motion after full inhalation Can be determined by palpating No Flow shoulders (shoulders move up and There is no flow if pulmonary pressure = down) atmospheric pressure 3.Thoracic Breathing You only do inhalation up until a certain Side of ribs point because the maximum amount of Thoracic region moves superiorly air that can go inside will depend on the during inhalation and then moves volume of lungs during inhalation and inferiorly during exhalation. when the lungs is completely filled and Can be determined by palpating ribs the pressure has equalized, there is no (expands laterally and partially movement of air until there is expiration anteriorly) Once you do this, there will be no more air going back until you do another cycle of *breathing types can occur simultaneously if you inhalation want to increase lung volume (like when tired) so we use more muscles Volume and Capacities Amount of air can be brought to the lungs PRESSURES OF RESPIRATION Volume = estimate of the amount of air Atmospheric pressure - pressure outside each lung section can hold the body; Amount of air Intraoral/mouth pressure - within the Capacities = combinations of volumes mouth that express physiological limits Subglottal pressure - pressure below the Human individual limits vocal folds so the pressure between two structures are the same RESPIRATORY VOLUME Alveolar pulmonary- lung pressure; Tidal Volume - air normally exchanged internal thus, lower during inspiration during a complete respiratory cycle Intrapleural pressure - negative Male = 600 cubic centimeters or throughout respiration milliliters Female = 450 cubic centimeters FORCES OF BREATHING Inspiratory Reserve Volume - volume that Passive: the natural recoil of muscles, can be inhaled after a tidal inspiration cartilages, ligaments, and lung tissue Amount of air after normal inspiration Active: actions of muscles of the chest 2475 CC wall; sign and magnitude of this force depend on which muscles are active and in what combinations.

Expiratory Reserve Volume - volume that PATHOLOGIES OF RESPIRATION can be exhaled after a tidal exhalation Obstructions Resting lung volume Allergies 1000 CC Asthma - difficulty in breathing Residual Volume - volume that cannot be Respiratory Diseases eliminated; It remains in a person's lungs Tuberculosis (Pulmonary) after fully exhaling. Emphysema - reduction in the 1100 CC diameter/size of the bronchioles Dead Space Air - volume that cannot be Chronic Bronchitis - swelling of the eliminated bronchioles 1100 CC Pneumonia - infections caused by bacteria in the lungs Tv TIDAL VOLUME Pulmonary Embolism - blood vessels that supply the lungs for it to work is IRv INSPIRATORY RESERVE VOLUME being blocked by an embolus or a block of plaque that cuts off the blood ERv EXPIRATORY RESERVE VOLUME supply Rv RESIDUAL VOLUME Musculoskeletal Pathologies Deviations of structure of spine RESPIRATORY CAPACITY Dystrophy - abnormal weakening of Vital Capacity - total volume of air that muscles can be inspired after a maximal expiration Scoliosis - sideways curve of the (how much can you inhale after exhaling backbone actively) Kyphosis - spine curves outward more VC = IRV + ERV + TV than it should 4000CC Functional Residual Capacity - volume Neurological Etiologies of air remaining in the body after a Parkinson’s Disease - caused by (quiet) passive exhalation infections in nerves FRC = ERV + RV Spinal Cord Injury - insult to the spinal 2100CC cord causing temporary or permanent Inspiratory Capacity - maximum function inspiratory volume possible after tidal Amyotrophic Lateral Sclerosis (ALS) expiration (after deep exhalation) Dystonia - abnormality in the muscle IC = TV + IRV tone due to damage in the cerebellum Total Lung Capacity - maximum of air Stroke - occurrences of tremors that the lungs can contain (all of your Tremors - contracting and relaxing of volumes) muscles in a rapid and cyclic manner TLC = TV + IRV + ERV + RV - 5100CC Trauma Pneumothorax - pressure within the Vc VITAL CAPACITY thorax is higher within the lungs. The pressure makes the lungs collapse FRc FUNCTIONAL RESIDUAL CAPACITY Laryngeal Trauma - swelling of laryngeal structures will result in restrictions in the Ic INSPIRATORY CAPACITY airways. TLc TOTAL LUNG CAPACITY

UNIT THREE: RESPIRATION ACTIVITY Respiration involves muscular effort, and an individual's ability to successfully control that musculature determines, in great part, the effectiveness of respiration. Given its centrality in speaking, it's no surprise that communication suffers when the respiratory system fails. Respiratory rate and tidal volume change in response to metabolic demand, and they rise with physical activity or in illness conditions like infection. Importantly, the respiratory rate reflects the amount of the metabolic demand, and individuals with an increased respiratory rate frequently have a more serious disease. (Yuan, et. al., 2013) JOUjoRurNnAalL AarRtiTcIlCesLES Voice function appears to be influenced by the vertical location of the larynx. Because a hyperfunctional and strained voice generally has a high vertical larynx position, lowering a habitually elevated larynx is sometimes a specific goal in clinical voice therapy, and several larynx-lowering exercises are utilized to attain this goal. Pitch and, to a lesser extent, vocal loudness, have been linked to vertical larynx position in previous studies. A study regarding the effects of lung volume on vertical larynx position during phonation of Iwarsson and Sundberg (1998) showed that the larynx position was evaluated using a multi-channel electroglottograph in 29 healthy, vocally untrained volunteers who phonated at varying lung volumes, pitches, and degrees of vocal loudness. The primary findings were that, when compared to low lung volume, high lung volume was definitely associated with a lower larynx position. In addition, pitch was substantially linked with vertical larynx position. Males have been demonstrated to have higher levels of both of these dependencies than females.

UNIT THREE: RESPIRATION ACTIVITY Respiration involves muscular effort, and an individual's ability to successfully control that musculature determines, in great part, the effectiveness of respiration. Given its centrality in speaking, it's no surprise that communication suffers when the respiratory system fails. Respiratory rate and tidal volume change in response to metabolic demand, and they rise with physical activity or in illness conditions like infection. Importantly, the respiratory rate reflects the amount of the metabolic demand, and individuals with an increased respiratory rate frequently have a more serious disease. (Yuan, et. al., 2013) JOUjoRurNnAalL AarRtiTcIlCesLES Understanding sex variations is important because they may have an impact on exercise rehabilitation programs for patients, exercise prescription for disease prevention in healthy people, and athlete training tactics. According to Foster, et. al. (2004), resting pulmonary function has been found to differ between men and women, which could affect the respiratory response to exercise. Even when height is taken into account, women have smaller lung capacities and maximal expiratory flow rates than men. Differences in resting and exercising ventilation have also been found over the menstrual cycle and in comparison to males, though the functional significance of these findings is unknown. In women, there is a restriction in their respiratory flow and a high work of breathing. Both males and women have been documented to have pulmonary system limitations, particularly exercise-induced arterial hypoxia; however, the frequency in women is unknown.

UNIT THREE E-PORTFOLIO reflection RESPIRATION Early parts of this e-portfolio have discussed the basic idea of the human body's anatomy. It was mentioned in unit one that the network of organs and tissues that help humans breathe is known as the respiratory system. This system assists your body in absorbing oxygen from the air so that your organs can function properly. It also removes waste gases from your blood, such as carbon dioxide. With that said, understanding the actual process, muscles, anatomy, physiology, and pathologies of respiration has urged me to be more curious about it, especially because I come from an asthmatic and heart- problematic family. Coming across the new terms and abbreviations like MOINA felt so overwhelming at first, simply because I wasn't a STEM or Health Allied graduate. However, the respiratory system isn't just about the unseen activity of exchange of air inside our system but also the fact of how the volumes and pressures can simply be of a big effect on an individual. Moreover, I realized how people can still be different from each other depending on their breathing patterns, and honestly, after our session, I became really observant of what mine is and those of who are around me. Since if you think about it, I am already too conscious of how I'll be breathing and so that can be a factor to get an accurate analysis. To put things into a simpler perspective, unit three discusses the 12 ribs in the rib cage, specifically 7 actual ribs, 3 false ribs, and 2 floating ribs. During breathing, the cartilaginous connection of the ribs to the sternum allows the ribs to rotate slightly, allowing the rib cage to rise. So when the lungs expand as the diaphragm contracts, sucking air into them through the bronchial pathway. Personally, I've always been corrected to sing from the stomach, and after the discussion of respiration, diaphragmatic breathing is an optimal pattern since we can maximize the length of the air we use for speaking and singing. It's much easier to be heard and have your voice carry when we sing with the stomach; hence, a better sound and louder one as the sound will be louder the more air we have in our lungs. The idea of respiration beforehand was just as simple as the exchange of air from the nasal cavity to the trachea to the lungs to the alveolar sacs, but after the unit's discussion, it became clearer that it's much complicated than what we think, in the sense that it's just simple. Like the na-add lang is the muscle activities, interventions, and functions. Muscle energy is then used to bring air into the lungs; thus, respiration.

ANATOMY AND PHYSIOLOGY OF PHONATION 4

PHONATION (VOICING) BASIC LARYNGEAL FUNCTIONS Product of vibrating vocal folds that occur 1. Phonation within the larynx. production of voice Larynx: source of the voice for speech. Respiration is the energy source for the 2.Protection from foreign body phonation to occur. during swallowing so food won’t go into trachea Voiceless sounds bolus passing through pharyngeal produced without the use of vocal folds cavity into esophageal cavity will not to airway or trachea Voiced sounds produced by the action of vocal folds 3.Pressure maintenance mechanism relatively louder and has greater intensity In subglottal area compared to voiceless sounds Valsalva Maneuver Once vocal folds are adducted the VOCAL FOLDS airway is closed thereby creating Made up of 5 layers of tissue which enable pressure subglottally the vibrations of the vocal folds Important for the function of the Located in course of air stream larynx: That’s why they vibrate; these Allows pregnant women to push vibrations result in phonation baby out of the uterus Allows stool to be pushed out 1.Thyrovocalis Muscle Adds force when lifting weights Deepest layer of the vocal folds 4.Deglutition or swallowing 2. Glottis protection of airway ‘rima glottidis’ ensures minimal to no entry of food Space between the vocal folds into the airway 3.Subglottal Tissue 5. Respiration Area below the vocal folds larynx increases pressure during respiration, can also decrease 4.Vestibule/Rima Vestibuli pressure in inspiratory cycle Space between the fake/false folds (non-moving vocal folds) bbrreeaakkddowown nofoftthhee llaarryynnxx LARYNX The larynx is a musculocartilaginous structure Located on top of the trachea located at th upper end of the trachea. It is Opens up the entrance to the esophagus, comprised of the cricoid, thyroid and epiglottis known as the upper esophageal sphincter cartilages, as well as the paired arytenoid Open posteriorly and close anteriorly corniculate, and cuneiform cartilages. The thyroid and cricoid cartilages articulate by Larynx means of the cricothyroid joint that lets the two cartilages come closer together in front. Trachea The arytenoid and cricoid cartilages also articulate with a joint that permits a wide range of arytenoid motion. The corniculate cartilages rest on the upper surface of the arytenoids, while the cuneiform cartilages reside within the aryepiglottic folds.

LARYNGEAL FRAMEWORK PALPATING LARYNGEAL STRUCTURE Hyoid - two fingers, posterior part of chin, Larynx move inferiorly. It is suspended Musculo Cartilaginous structure Thyroid- move anteriorly when swallowing Located at the top of trachea (attaches to Cricoid - the hard cartilage above the the cricoid cartilage - cricotracheal trachea junction) Mostly cartilage with some muscle with no RELATIONSHIPS OF THE STRUCTURES bones (though there is one bone that holds it in its position) LARYNX-TRACHEA CONNECTION Trachea Paired cartilages Cartilages that come in pairs. (Left & Composed of a series of cartilage rings Right) Connected and separated by annular 3 types: ligament (fibroelastic membrane) Arytenoid cartilage Larynx Corniculate cartilage Sits as an oddly shaped box atop the last Cuneiform cartilage (most superior) ring of trachea Level is adjacent to the cervical vertebra 4 Unpaired cartilages (C4-C6 for adults; higher for infants) Larger cartilages that span from one side to another. UNPAIRED CARTILAGES 3 types: 1.Cricoid Cartilage Cricoid Thyroid complete ring resting on top tracheal ring Epiglottis Most inferior of all Looks like a signet/class ring Cricothyroid Structures Thick and tapers thinner towards the Connects cricoid and thyroid inferior side Posterior to the larynx is the hypopharynx which goes into the esophagus and 2.Thyroid Cartilage superiorly goes into the oropharynx largest cartilage of the framework Articulates with cricoids inferiorly via Epiglottis the inferior cornum which enables the leaf-like cartilage rocking motion of the thyroid cartilage Located in the middle (can move anteriorly) Covers he opening of larynx especially during swallowing PAIRED CARTILAGES Protects the airway. 1. Arytenoid Cartilage epiglottis corniculate arytenoid located at the posterior-superior of cricoid cartilage cartilage cartilage cuneiform triticial cartilage Posterior point of attachment of vocal cartilage folds 2. Corniculate Cartilage located at the superior surface of each arytenoid cartilage Smaller than arytenoids Prominent landmarks in the aryepiglottic vocal folds (cuneiform cartilage is within the aryepiglottic folds that give it rigidity) cricoid cartilage thyroid cartilage

notes to remember: EXTRINSIC LIGAMENTS meaning it goes outside of the larynx and Average Length of the Larnyx provides attachment to the external 44mm - size of larynx for males (also structures particularly the hyoid fold wider than females that’s why their voice external structures aka hyoid bone is deeper) THYROHYOID MEMBRANE 36mm - size of larynx for females connect the larynx and hyoid bone stretches across the space between Infant vs Adult Larynx the greater cornu of the hyoid and Infants would have higher position lateral thyroid cartilage (roughly at the level of C1-C4) LATERAL THYROID LIGAMENT Infants can do concurrent breathing and runs from the superior of the cartilage deglutition to the posterior tip of the hyoid By 2 years of age, larynx will start to TRITICEAL CARTILAGE descend/move inferiorly found from the median thyroid By age 6, it reaches the adult position ligament (between level C4 and C6) runs anteriorly from the corpus of the hyoid to the superior border of the LARYNGEAL FRAMEWORK anterior border of the anterior thyroid cartilage MEMBRANES, LIGAMENTS, REGIONS, AND SPACES HYOEPIGLOTTIC LIGAMENT attachment of epiglottis to the corpus INNER LARYNX of the hyoid Tube-like space caused by constriction of THYROEPIGLOTTIC LIGAMENT cartilages inferior attachment of the epiglottis Construction is unique because it is attaches the epiglottis to the inner capable of adjustable constriction surface of the thyroid cartilage just Vocal folds bands of mucous membranes below the thyroid notch attached to the arytenoid posteriorly that LATERAL AND MEDIAL GLOSSOEPIGLOTTIC enable adduction and abduction to cover LIGAMENTS the airway and control the flow of airflow epiglottis is attached to the tongue of the air covered by a mucous membrane that forms vallecula LARYNGEAL MEMBRANES CRICOTRACHEAL LIGAMENTS Coverings externally and serves as attaches the larynx to the trachea attachments of one structure to the other Because of the attachments, the air goes thyrohyoid lateral to the medial point instead of escaping membrane thyrohyoid elsewhere hyoepiglottic ligament The internal membrane is smooth and ligament reasonable aerodynamic surface cricotracheal The mucous membrane that covers the cricothyroid ligaments larynx is wet and smooth and lines the ligament entire structure of the internal surface of the larynx median cricothyroid ligament

INTRINSIC LIGAMENTS isnutperermfiecdiiaaltdeeepmuscularis Ligaments that connect the cartilages of the larynx to each other or to the epithelium structures within the larynx lamina propria QUADRANGULAR MEMBRANE Connective tissue running from the 4. DEEP LAMINA PROPRIA (DLP) arytenoid to the epiglottis and thyroid Another layer deeper cartilage 1-2 mm thick Form the false vocal folds or the Primarily a supportive structure that is ventricular folds made up of collagen fibers that Originates at the inner thyroid angle prohibit extension (gives a more rigid and sides of the epiglottis structure and less flexible one compared to ILP and SLP ARYEPIGLOTTIC MUSCLE Forms the upper margin and lateral 5. THYROARYTENOID MUSCLE margin of aryepiglottic folds Deepest layer of vocal fold Thyrovocalis and thyromuscularis CONUS ELASTICUS muscles makes up the bulk of the Also known as the cricothyroid vocal fold and is the innermost layer membrane Lower margin is the attachment of the FINE STRUCTURES OF THE VOCAL FOLDS vocal ligament anteriorly and for Mucosal lining posteriorly, it is the vocal process of the arytenoids Squamous epithelium + Superficial lamina propria STRUCTURES OF THE FOLDS Vocal ligament (gives degree of stiffness and support to vocal folds) 1.EPITHELIAL LAYER Intermediate lamina propria + Deep Most superficial layer lamina propria Made of squamous epithelium Cover of the vocal folds (more superficial Approximately 0.1mm thick layers) Gives a glistening white appearance Squamous epithelium + Superficial Assists in fluid retention lamina propria + Intermediate lamina propria 2. SUPERFICIAL LAMINA PROPIA (SLP) Body of the vocal folds Reinke’s space Deep lamina propria + Thyroarytenoid Made up of elastic fibers; allows muscles stretching Cushion the vocal folds when adduction Elastic fibers of this are cross layered with the intermediate lamina propria 3.INTERMEDIATE LAMINA PROPRIA (ILP) 1-2 mm thick ILP is more composed of elastin fibers than the SLP Combination of SLP and ILP provides both elasticity and strength to the vocal folds

totosusummmmaarirzize:e: CAVITIES OF THE LARYNX The cavity of the larynx is a constricted tube. ADITUS LARYNGIS Sheets and cords of ligaments connect the entry to larynx from the pharyngeal area cartilages, while a mucous membrane covers that is superior to it the medial-most surface of the larynx. Anterior boundary is epiglottis and lateral The thyrohyoid membrane, lateral thyrohyoid boundary is aryepiglottic folds ligament, and median thyrohyoid ligament cover the space between the hyoid bone and VESTIBULE the thyroid. Entry or space between aditus laryngis The hyoepiglottic and thyroepiglottic and ventricular folds ligaments attach the epiglottis to the corpus Ventricular folds are not used for hyoid and the inner thyroid cartilage, phonation but there are conditions that respectively. move the ventricular folds during The valleculae are found between the tongue phonation (not normal physiology) and the epiglottis, within folds arising from the lateral and median glossoepiglottic ligaments. LARYNGEAL VENTRICLE The cricotracheal ligament attaches the Middle space of the larynx that lies trachea to the larynx. between the margins of the ventricular The fibroelastic membrane is composed of the folds and the true vocal folds upper quadrangular membranes and Where you can locate the saccule aryepiglottic folds; the lower conus elasticus and the vocal ligament, which is actually the SACCULE upward free extension of the conus elasticus. Pouch that is endowed with more than 60 The aryepiglottic folds course from the side of mucus glands the epiglottis to the arytenoid apex. Responsible for secreting the music that lubricates the laryngeal cavity REGIONS OF THE LARYNX Has muscles to squeeze mucus for lubrication 1. SUPRAGLOTTIS As mucus covers the mucosa, it also Anything superior to glottis assists it eliminating foreign bodies in the Where we can find false vocal airway, trapping them to be expelled folds/ventricle during coughing Laryngeal surface of epiglottis or surface of epiglottis facing the vocal GLOTTIS folds Space between vocal folds; important space for speech because the size of 2. GLOTTIS glottis determines the voicing of the Level where you can find your true speech production / phoneme production vocal folds Length of glottis is approx. 20mm for adults from the anterior comissior to the 3. SUBGLOTTIS posterior comissior Inferior of the glottis Adult males’ free margin of vocal folds is Begins 5mm below the free margins of roughly 15mm in length the vocal folds Females it is roughly 12mm Where pressure builds up

CAVITIES OF THE LARYNX PHONATION 1.Aditus Laryngis Phonation AKA entry to larynx from the According to ASHA, t is the generation of pharyngeal area that is superior to it sound by ay of vocal fold vibration Anterior boundary is epiglottis and Occurs within the larynx and the source of lateral boundary is aryepiglottic folds voice for speech Normal expiratory airflow, vocal fold 2. Vestibule structure and function, supraglottic Entry or space between aditus laryngis structure and function, and nervous and ventricular folds system control all contribute to normal Ventricular folds are not used for phonation (voice production). phonation but there are conditions that move the ventricular folds during Functions of Laryngeal Structures phonation Phonation Protection 3.Laryngeal Ventricle Pressure maintenance Middle space of the larynx that lies Respiration between the margins of the ventricular Swallowing folds and the true vocal folds Where you can locate the saccule Hydration of Vocal Folds Smoother flow 4. Saccule Less effort in producing the sound Pouch that is endowed with more than To avoid disorders 60 mucus glands Responsible for secreting the music Vocal Fold Vibration that lubricates the laryngeal cavity the vocal folds are located within a fixed Has muscles to squeeze mucus for laryngeal framework lubrication muscles within the larynx (intrinsic laryngeal muscles) facilitate vocal fold 5. Glottis abduction and adduction Space between vocal folds some of these intrinsic laryngeal Most important space for speech bcos musclescause changes in the elastic the size of glottis determines the properties of the vocal folds, thus voicing of the speech production / affecting their rate of vibration phoneme production an outgoing airstream also affects vocal Length of glottis is approx. 20mm for fold vibration adults from the anterior comissior to the posterior comissior breathing speaking/singing Area of glottis is variable bcos it is dependent of movement and (abducted vocal folds) (abducted and vibrating configuration of vocal folds vocal folds) At rest, the posterior glottis is approximately 8mm wide Doubles during forced inspiration and expiration Adult males’ free margin of vocal folds is roughly 15mm in length Females it is roughly 12mm