Muscles of Respiration
What are the three subsystems of voice?
resonance, phonation, resonance
What are the 9 cartilages?
epiglottis, thyroid, cricoid, arytenoid, corniculates, cuneiforms
cricothyroid
1. what is it? (adductor, abductor, tensor)
2. function
3. innervated by?
1. tensor
2. lengthens VFs to raise pitch
3. SLN
Types of voice disorders and what are they
functional = vocal quality compromised, but no anatomical/neurological factors
organic = problem with structure that affects vocal mechanism
neurogenic = results from problems with PNS and CNS innervation of larynx
psychogenic = problems with voice related to psychological factors
what is a malignant VF lesion called and what are the risk factors?
laryngeal carcinoma
1. smoking
2. alcohol
3. LPR
What are the 3 basic functions of the laryngeal valve?
1. airway preservation for ventilation
2. airway protection
3. phonation
What do the suprahyoid muscles do and what are they?
RAISE the larynx - mylohyoid, stylohyoid, digastrics, geniohyoid
thyroarytenoid
1. what is it? (adductor, abductor, tensor)
2. function
3. innervated by?
1. adductor
2. essentially the VFs, shortens the VFs to lower pitch
3. RLN
indirect = intubation
direct = head/neck surgery, laryngectomy, tracheotomy, etc.
nodules
1. describe
2. etiology
3. treatment
1. bilateral/symmetrical, anterior 1/3 posterior 2/3, SLLP, edema/inflammatory lesion, acute or chronic
2. phonotrauma
3. voice therapy, surgery in severe cases
What is the function of the intercostals?
elevate/contract the rib cage
What do the infrahyoid muscles do and what are they?
LOWER hyoid/larynx - thyrohyoid, sternothyroid, omohyoid, sternohyoid, sternocleidomastoid
lateral cricoarytenoid
1. what is it? (adductor, abductor, tensor)
2. function
3. innervated by?
1. adductor
2. strongest adductor - rocks arytenoids in/out to close VFs
3. RLN
3 categories of voice disorder etiologies - what are they and give an example
1. medical - LPR, indirect/direct surgical trauma, endocrine changes
2. personality - environmental/life stress, identity conflict
3. phono trauma - screaming, throat clearing, hard glottal attack, coughing, etc.
polyps
1. describe
2. etiology
3. treatment
1. bilateral (can be unilateral), SLLP, fluid-filled gelatinous lesions, sessile or pedunculated
2. phonotrauma
3. surgery
What are the 5 muscles of expiration?
internal intercostals, rectus abdominis, transverse abdominis, internal obliques, external obliques
What are the 2 types of extrinsic muscles?
suprahyoid and infrahyoid
interarytenoid
1. what is it? (adductor, abductor, tensor)
2. function
3. innervated by?
2. stabilizes VFs
3. RLN
changes in structure can lead to VF changes in...? (5 characteristics)
mass, size, stiffness, flexibility, tension
cysts
1. describe
2. etiology
3. treatment
1. fluid-filled lesions, congenital or acquired, SLLP (can extend into ILLP/DLLP)
2. mucous gland blockage, phonotrauma
3. surgery
What are the 5 muscles of inspiration?
diaphragm, external intercostals, sternocleidomastoids, scales, pectorals (major & minor)
What are the intrinsic laryngeal muscles?
cricothyroid, thyroarytenoid, lateral cricoarytenoid, interarytenoid, posterior cricoarytenoid
posterior cricoarytenoid
1. what is it? (adductor, abductor, tensor)
2. function
3. innervated by?
1. abductor (only one!!)
2. pushes arytenoids open
3. RLN
-no alcohol
-no caffeine
-more rest
-more water
-exercise/good nutrition
-avoid irritants (e.g., second hand smoke)
-avoid throat clearing/coughing/whispering
-avoid reflux (diet/behavior/medicine)
1. leukoplakia - white and patchy
2. hyperkeratosis - excessive keratin
3. erythroplasia - thickened and red