Laryngeal Mechanics Quiz
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Questions and Answers

What are the two main purposes of the larynx?

The larynx serves two main purposes: to protect the airway and to produce voice.

The posterior cricoarytenoid muscles are the only abductor muscles in the larynx.

True (A)

Which of the following is NOT an intrinsic muscle of the larynx?

  • Cricothyroid
  • Sternothyroid (correct)
  • Lateral cricoarytenoid
  • Posterior cricoarytenoid

    • What is the function of the cricothyroid muscle?

    <p>The cricothyroid muscle increases the pitch of the voice by stretching and tensing the vocal folds.</p> Signup and view all the answers

    What are the three dimensions of sound?

    <p>The three dimensions of sound are pitch, loudness, and quality.</p> Signup and view all the answers

    Which of the following is the physical correlate of pitch?

    <p>Frequency (C)</p> Signup and view all the answers

    An octave is an interval between two notes where the higher note has twice the frequency of the lower note.

    <p>True (A)</p> Signup and view all the answers

    What is the difference between periodic and aperiodic sounds?

    <p>Periodic sounds are produced with harmonics or overtones that are pleasant and less dissonant, while aperiodic sounds lack this harmonic relationship and can have components at all frequencies.</p> Signup and view all the answers

    Normal speaking voice is primarily aperiodic in nature.

    <p>False (B)</p> Signup and view all the answers

    What is the Myoelastic Aerodynamic Theory, and what does each word stand for?

    <p>The Myoelastic Aerodynamic Theory explains how voice production occurs. It involves the interaction of muscular forces (Myo), elastic properties of the vocal folds (Elastic), and airflow (Aero) which generate the dynamic movement and change (Dynamic) needed for phonation.</p> Signup and view all the answers

    The length and thickness of the vocal folds are the primary determinants of the fundamental frequency of a voice.

    <p>True (A)</p> Signup and view all the answers

    What is the difference between habitual pitch and best pitch?

    <p>Habitual pitch refers to the frequency at which a person speaks most often, while best pitch is the pitch that is most optimal for their vocal mechanism, producing a clear and loud voice with minimal effort.</p> Signup and view all the answers

    What are some of the factors that contribute to voice changes in older adults?

    <p>Older adults often experience voice changes due to factors such as muscular atrophy, thinning of the vocal fold mucosa, loss of ligament elasticity, calcification of cartilages, and vocal fold bowing.</p> Signup and view all the answers

    Which of the following is NOT a characteristic of a voice with a breathy quality?

    <p>Increased vocal effort (D)</p> Signup and view all the answers

    What is the difference between a vocal nodule and a vocal polyp?

    <p>Vocal nodules are typically bilateral and develop gradually from chronic vocal misuse, while vocal polyps are usually unilateral and often result from a single traumatic vocal event.</p> Signup and view all the answers

    What is the difference between primary and secondary muscle tension dysphonia?

    <p>Primary muscle tension dysphonia involves subtle vocal changes with no visible pathology on laryngeal examination, while secondary muscle tension dysphonia involves more significant vocal changes with visible tissue changes related to chronic misuse.</p> Signup and view all the answers

    Ventricular phonation is a characteristic of primary muscle tension dysphonia.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is a possible etiology of contact ulcers?

    <p>GERD (B)</p> Signup and view all the answers

    What are the two main etiologies of functional voice disorders?

    <p>The two main etiologies of functional voice disorders are muscle tension dysphonia and psychogenic disorders.</p> Signup and view all the answers

    Conversion aphonia is a type of muscle tension dysphonia.

    <p>False (B)</p> Signup and view all the answers

    What is paradoxical vocal fold movement (PVFM)?

    <p>Paradoxical vocal fold movement (PVFM) is a voice disorder that involves the inappropriate adduction of the vocal folds during inhalation, leading to respiratory difficulties and often resulting in a wheezing sound.</p> Signup and view all the answers

    Organic voice disorders are caused by physiological abnormalities in the structure or function of various sites along the vocal tract.

    <p>True (A)</p> Signup and view all the answers

    What is the difference between sulcus vocalis and Reinke's edema?

    <p>Sulcus vocalis is a congenital or acquired indentation in the vocal folds, while Reinke's edema is a thickening of the vocal fold cover due to fluid buildup.</p> Signup and view all the answers

    Laryngitis is always caused by a viral infection.

    <p>False (B)</p> Signup and view all the answers

    What are some of the potential consequences of laryngectomy?

    <p>A laryngectomy can have significant consequences for a patient, including loss of voice, difficulty swallowing, and changes in breathing.</p> Signup and view all the answers

    What are the three major categories of voice disorders?

    <p>The three major categories of voice disorders are functional, psychogenic, and organic.</p> Signup and view all the answers

    The CAPE-V is used to assess the functional impact of a voice disorder on a patient's life.

    <p>False (B)</p> Signup and view all the answers

    What does the VHI measure?

    <p>The VHI measures the functional, emotional, and physical impact of a voice disorder on a patient's daily life.</p> Signup and view all the answers

    Jitter and shimmer are perturbation measures that are highly correlated with the severity of voice disorders.

    <p>False (B)</p> Signup and view all the answers

    What is the purpose of the s/z ratio?

    <p>The s/z ratio is a screening tool used to measure a patient's ability to sustain a prolonged /s/ sound compared to a /z/ sound, which can indicate potential problems with phonatory expiration.</p> Signup and view all the answers

    Study Notes

    Normal Phonation Mechanics

    • Normal phonation involves vocal fold (VF) approximation along the entire anterior-posterior dimension, termed phonatory expiration.
    • Slight posterior glottal chink is more common in females and considered a normal variance, not pathology.

    Non-Phonatory Expiration

    • VF are abducted but not at extremes during non-phonatory exhalation. There is no voice production, only exhalation.

    Forced Inspiration

    • VF are widely abducted during forced inhalation.

    Whisper Phonation

    • Anterior two-thirds of VF approximate, but not firmly. Posterior glottal chink and turbulence produce the whisper. Whispering is not good for the vocal mechanism.

    Intrinsic Laryngeal Muscles

    • There are six intrinsic laryngeal muscles responsible for VF position and condition.
      • Posterior cricoarytenoid (2): The only abductor muscles, opening the glottis.
      • Lateral cricoarytenoids (2): Adductors, approximating and slightly tensing the folds.
      • Cricothyroids (2): Stretch and tense the VF, increasing pitch.
      • Transverse arytenoid (1): ADductor, approximating the vocal folds.
      • Oblique arytenoids (2): Adductors, pulling the arytenoids medially.
      • Thyroarytenoids (2): Lower pitch, shorten and thicken folds.

    Sound Characteristics

    • Any sound is described by pitch, loudness (intensity), and quality (timbre).
      • Pitch relates to frequency (vibrations per second).
      • Loudness relates to amplitude (energy).
      • Quality relates to harmonic constitution/waveform (combination of sounds).

    Frequency (Pitch)

    • Measured in Hertz (Hz). Higher frequency = higher pitch, lower frequency = lower pitch. Frequency is related to the size, material, shape, and movement of the sound source.

    Octave

    • The interval between two notes where the frequency ratio is 2:1.

    Intensity (Loudness)

    • Measured in decibels (dB); greater energy = louder sound.

    Quality/Harmonic Constitution/Waveform

    • Describes the combination of sounds to give the voice distinct characteristics.
      • Pure tone: One frequency, like a tuning fork.
      • Complex tone: Fundamental frequency plus component frequencies.

    Periodic vs. Aperiodic

    • Periodic sounds: Repeated patterns, pleasant/less dissonant, like vowels (harmonics/overtones).
    • Aperiodic sounds: Random vibrations, harsh/unpleasant, like consonants (lack harmonics).

    Voice Production Theories

    • Myoelastic-Aerodynamic Theory is the most accurate model, combining muscular action, elastic properties of the VF, and airflow for voice production.

    Vocal Fold Length and Pitch

    • Short, thick, lax folds vibrate slower = lower pitch.
    • Long, thin, tense folds vibrate faster = higher pitch. Amplitude and height of the mucosal wave change with altered pitch.
      • Higher pitches require lengthening folds, increased tension, and higher sub-glottal pressure.
      • Lower pitches require relaxation of cricothyroids, shortening and thickening of the folds.

    Larynx

    • Larynx primary function: Protect airway, support lifting and pushing, cough for foreign matter expulsion. Secondary = voice production. A valve for temporary closing to prevent air passage, can open to allow air passage.

    Older Adult Voice Changes

    • Older adults (69+) face muscular atrophy, mucosal thinning/dehydration, ligament loss, cartilage calcification, and vocal fold flaccidity and bowing.

    Presbyphonia

    • Natural aging changes in the voice.

    Voice Quality Descriptors

    • Harshness: Rough, unmusical sound.
    • Hoarseness: Unmusical quality, breathiness, rough; occurs at the phonatory level.
    • Stridence: Pharyngeal tension, sounds tight and hard.
    • Thinness: Oral tension, childish quality.
    • Breathiness: Insufficient VF closure, audible air escape.
    • Hypernasality: Excessive nasality.
    • Hyponasality: Lack of nasality.
    • Cul-de-sac resonance: Posterior focus, hollow sound.

    Additional Voice Assessment Tools

    • S/Z ratio: Screening for glottis pathology.
    • CAPE-V: Standardized perceptual voice evaluation. Assess severity, roughness, breathiness, strain, pitch, and loudness.
    • Voice Handicap Index (VHI): Quality of life assessment for patients (functional, emotional, physical impact).

    Voice Registers

    • Glotal
    • Modal
    • Mid-vocal
    • Falsetto

    Vocal Quality Measures

    • Best pitch: Optimal pitch for clarity and loudness.
    • Habitual pitch: Most frequently used.

    Voice Disorders (Functional)

    • Muscle Tension Dysphonia: Misuse of the vocal mechanism, often with vocal nodules or polyps. Common in those with over-excessive vocal activities which can create pressure on structures.
    • Psychogenic Voice Disorders: Related to emotional stress or trauma, including aphonia or dysphonia.
    • Ventricular Phonation: False vocal folds adduct, causing a lower pitch.
    • Vocal Nodules: Bilateral bulges at the junction of anterior and posterior VF thirds, often caused by chronic misuse.
    • Vocal Polyps: Unilateral growths often caused by traumatic events.
    • Reinke's Edema: Vocal fold thickening due to chronic misuse, often related to smoking.
    • Traumatic Laryngitis: Swelling of the vocal folds due to forceful use.
    • Contact Ulcers/Granulomas: Lesions often related to reflux, chronic throat clearing, or coughing.
    • Vocal Fold Thickening: Vocal fold thickening as a result of excessive muscle tension dysphonia.
    • Falsetto: Increased pitch due to muscle tension.
    • Phonation Break: Temporary loss of voicing.
    • Pitch Break: Sudden shift in speaking pitch.
    • Diplophonia: Two distinct voice frequencies.

    Voice Disorders (Organic)

    • Sulcus Vocalis: Indentation in the vocal folds.
    • Cancer: Tumors in the larynx
    • Leukoplakia: Whitish patch, needs monitoring.
    • Endocrine Changes: Issues with hormone production relating to the VF.
    • Hypothyroidism: Insufficient thyroid hormone, relates to increased vocal fold mass.
    • Granuloma: Protective tissue.
    • Hemangioma: Blood-filled sac.
    • Hyperkeratosis: Reactive lesion to irritation.
    • Infectious Laryngitis: Viral infection of the vocal folds.
    • Laryngectomy: Larynx removal.

    Other

    • Paradoxical Vocal Fold Movement (PVFM): Abduction of the vocal folds during inhaling.
    • Aphonia/Dysphonia (Functional): Inability to produce sound at different degrees. Different types with varying degrees based on patient responses.
    • Functional Dysphonia: No physiological cause, but vocal disorder persists.
    • Conversion Aphonia: Inability/ inadequate VF approximation due to atypical vocal posture.
    • Mutational Falsetto: Continuing use of higher pitch during puberty despite lower pitch.

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    Description

    Test your knowledge on normal phonation mechanics, non-phonatory expiration, forced inspiration, and whisper phonation. This quiz also covers the intrinsic laryngeal muscles and their functions in voice production. Perfect for students of voice and speech sciences.

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