SLPM 6066 - Speech Science PDF

Speech Science Introduction: Speech Science – Sep 10, 2024 What will be covered? ​ Understand normal physiology to better treat individuals with disorders ​ Are the parameters within normal limits? (wnl) ​ Increase awareness of wide range of variability in “normal” speakers – cultural consid...

Speech Science Introduction: Speech Science – Sep 10, 2024 What will be covered? ​ Understand normal physiology to better treat individuals with disorders ​ Are the parameters within normal limits? (wnl) ​ Increase awareness of wide range of variability in “normal” speakers – cultural considerations ​ Use real life analytical skills Instrumentation ​ Auditory perceptual judgment is initial, but using objective instrumentation helps to support those subjective findings ​ Equipment allows a clinician to acquire and analyze physiological or acoustic data objectively ​ Advantages: Give good pre and post therapy data ​ Disadvantages: However, it can be costly initially & time consuming when it comes to analyzing the data you collect. The data we expect is not always the data we receive ​ Go with your perceptual judgment and hopefully the instrument backs it up Physiological Systems ​ Speech production relies on a series of subsystems, every system effects it ​ The systems can be affected individually The Source Respiratory ​ We need air to have our vocal cords vibrate ​ The driving source for speech ​ Produce voiceless sounds as well Laryngeal system ​ Responsible for voicing ​ Active when sound is voiced, inactive when voiceless  The Filter Velopharyngeal ​ Velum + back of throat (pharynx) ​ Active and functioning when not producing nasals (m,n,ŋ) Articulatory System ​ The tongue, teeth, lips ​ Apparently… a neutral sound like ə or h… nothing is moving… so articulatory system is not moving LET’S PRACTICE Which of the following is not a function of the respiratory system? A.​ Driving force for voicing - airflow vibrates the vocal folds B.​ Ventilation for life - duh you need to breath C.​ Velopharyngeal closure D.​ Blood gas exchange – cardiopulmonary interaction Which of the following is not a muscle? A.​ Diaphragm B.​ Internal intercostals C.​ External intercostals D.​ Lungs – they can’t contract or do anything on their own, the diaphragm is what moves them, they are a passive organ E.​ Vocal folds What is the primary function of the laryngeal system? A.​ Voicing - primary function for laryngeal system in speech production B.​ Airway protection - physiological primary function → prevents aspiration C.​ Articulation D.​ Respiratory valving Which of the following is not a part of the velo-pharyngeal system? A.​ Soft palate B.​ Levator veli palitini C.​ Lateral and posterior pharyngeal walls D.​ Nasal cavity - you're actually blocking this part What is the function of the VP system? A.​ Voicing B.​ Open for non-nasals, closed for nasals C.​ Open for nasals, closed for non-nasals What is the best description of the articulatory system? A.​ Makes speech intelligible B.​ Adds prosodic variability C.​ Provides the source for speech production  D.​ Useful in speaker recognition Which physiological systems are active (contracting) during /p/ production? A.​ All B.​ Respiratory, laryngeal, vp C.​ Respiratory, vp, articulatory D.​ Respiratory and vp Which physiological systems are active during /m/ production? A.​ All B.​ Respiratory, laryngeal, articulatory C.​ Respiratory, laryngeal, vp D.​ Respiratory and vp Which physiological systems are active during "sh" production? A.​ All B.​ Respiratory, laryngeal, vp C.​ Respiratory and vp D.​ Respiratory, vp, articulatory Which physiological systems are active during /h/ production? A.​ All B.​ Respiratory and vp C.​ Respiratory, laryngeal, vp D.​ Respiratory, vp, articulatory Which physiological systems are active during /z/ production? A.​ All B.​ Respiratory and vp C.​ Respiratory, laryngeal, vp D.​ Respiratory, vp, articulatory The Lungs & Thorax: Foundations – Sep 10, 2024 Respiration ​ Respirations starts internally and works outward using the basic components: ○​ Lungs ○​ Bronchial tree ○​ Thoracic cavity Lungs ​ Big surface area, open cavity ​ The next part is the bronchiole ​ Starts at trachea → next goes in to two bronchi → separates in to lungs with continual branching that becomes shorter into alveoli  ​ Narrow tubes have more resistance and shorter for easier air flow to reach various parts of the lung to be able to disperse oxygen Alveoli ​ The most interior part are the alveoli -​ Alveoli are very small and surrounded by blood vessels, they are irregular shapes at the end of the bronchioles ​ Because of the alveoli, the surface area of a human lung is extremely large! ​ You are able to exchange oxygen and carbon dioxide more easily ​ There are a network of blood vessels surrounding the alveoli, this combined with the thin layer of the alveoli allows for that gas exchange to occur Purpose of successive bifurcations ○​ Keeps narrow tubes short ○​ Total cross sectional area of passages is increased ○​ All designed for easy efficient breathing Bronchi ○​ Right mainstem is straighter than the left and more susceptible to aspiration as a result ○​ Entrance to the bronchi is the trachea ○​ Primary bronchi separate into secondary bronchi Bronchial tube ​ Combination of smooth muscle & cartilage ​ Compliant tubes lined by respiratory mucosa ​ Contain variable amounts of muscle and/or cartilage in their wall ​ Conduct air and clear and filter foreign particles ​ Go through approx 10,000 liters of inspired air per day Tracheal rings ○​ Tracheal rings are c shaped and open in the back ○​ They are separated from the esophagus by the trachealis muscle Potential problems →​ Food can block the airway →​ Trachea can be blocked by large item passing through esophagus – it bulges out through trachealis muscularis by pushing the trachealis muscle inwards The Lungs & Thorax: The Mechanisms Sep 17, 2024 Henry’s Law ​ Gasses diffuse from high pressure to low pressure areas ​ This is also known as the pressure gradient ○​ This is a force that acts in a direction from higher toward lower pressure Gaseous exchange ​ Alveoli provide huge surface area for diffusion of gas ​ They inflate during inhalation and deflate during exhalation  ​ Every cell in the body needs oxygen to perform its function and keep us alive Oxygen and the bloodstream ○​ You first inhale oxygen and it gets filled in to the alveoli, where gas exchange will occur ○​ Pressure of oxygen in alveoli is much greater than the pressure of oxygen in the blood that enters the pulmonary capillaries, therefore the oxygen in the alveoli pushes out in to the surrounding blood vessels ○​ Due to pressure difference, oxygen leaves alveoli and enters the blood vessels to be circulated to supply tissues CO2 and the Bloodstream ○​ Pressure of carbon dioxide in blood stream is greater than the pressure of carbon dioxide in the alveoli ○​ therefore carbon dioxide enters the alveoli → goes back up the lungs → exhaled Pulmonary Hilium ​ Where pulmonary vessels enter and exit the lungs ​ Lungs are the spongy tissue but the gas exchange occurs in the alveoli which is lead in to by the bronchial tubes Lung anatomy ​ Left lung – two lobes, cardiac notch (lingula) on this side to give space for the heart ​ Right lung – three lobes, liver pushes up against the diaphragm making it higher and the right lung short and wider Knowledge Check 1.​ Compared to wider tubes, narrow bronchial tubes have greater resistance to airflow 2.​ Why does a large bolus in the esophagus block breathing? It pushes on the trachea 3.​ Gasses always move from areas of high pressure to areas of low pressure 4.​ Alveoli are best described as air sacs surrounded by capillaries 5.​ Compared to the left lung, the right lung is shorter, wider and heavier with 3 lobes 6.​ The lung has huge surface area for its size – due to the alveoli Healthy Lungs vs Diseased lungs ​ Blackening in lungs can happen with any toxins or particulate carbon being breathed in (ex. smoking or pollution) ○​ This is because of macrophages: protective mechanism that engulf toxins (no good way to dispose of them) so you end up with several macrophages on the surface of the lungs keeping it from entering the rest of the body ​ Smoker lungs are blacker because they’ve inhaled more toxins, you end up losing elasticity in the lungs making it harder to breathe Laryngectomy ○​ Combination of smoking & alcohol fume, can deal with these patients in SLP ○​ Need supports for breathing and sometimes even speaking →​ electrolarynx to cause mechanical vibration for speech →​ tracheoesophageal prosthesis – puncture in the trachealis where a hollow tube is placed which can be used for esophageal speech Components of pleural linkage ​ Pleura are single celled membrane linings ○​ Visceral pleura – encloses the lungs, lining the lungs themselves, look like a thin layer holding muscle fibers together ○​ Parietal pleura – lines inside of chest wall/thoracic cavity/rib cage, follows along the diaphragm and leaves space for heart ​ Interpleural space – space between the parietal and visceral pleura ○​ Pleura produce a small amount of fluid, creating a smooth surface to facilitate the lungs to expand and get smaller within the rib cage ○​ Ziplock bag w/ oil – represents this relationship keeping the pleura sucked together ​ Pleural linkage forces lung and rib cage away from their natural resting position Negative pressure ○​ Pleural membranes constantly absorbing the fluid and gasses that exist in the space between them causing negative pressure ○​ As a result, visceral and parietal pleura are sucked together ○​ This is referred to as pleural cavity pressure and is always negative Lung thorax unit ​ Lungs are naturally in a collapsed state – will recoil to ⅓ of their size when thorax is opened ​ Thorax is naturally expanded  ​ Plural linkage pulls them to be bigger than they would naturally be & ribs want to be further apart but they are pulled in to the lungs – this is resting expiratory level ​ With plural linkage there is always air in the lungs Resting Expiratory level (REL) ○​ The point in the respiratory system where the opposing forces of the lungs and ribcage are IN balance ○​ It is always the same ○​ At rest, this is the level you go down to, it is the balance point that we always return to after a quiet exhalation ○​ Moving above and below this determines how much and what type of effort is required (like in speech) Issues in the Lungs Pleurisy ​ A disease/disorder that causes inflammation of the visceral and parietal pleura → causing irritation and keeping it from sliding as smoothly ​ As a result, breathing becomes extremely painful ○​ Can be associated with pleural effusion: excess fluid fills the area between the membrane’s layers Pneumothorax ​ This is also known as a collapsed lung ​ There is a penetrating wound (accidental or surgical) , causing a loss of negative pressure, moving away from the inside of the rib cage ○​ Tends to be mostly traumatic causes (bullet, stabbing, injuries.) ○​ Can be for other reasons: lung diseases, spontaneous (usually in tall men) ​ Pleural linkage is disrupted because air gets into the intrapleural space, increasing the pressure in the lung becomes ​ Ex. bullet punctures thoracic wall and parietal pleura → air enters → negative pressure becomes positive with the increase → lung collapse ​ Ex. Tyrod taylor → sports doctors tried to insert a needle through skin around the intercostal nerves, to numb them and ease pain from previous rib injury. Since they are so close to lung, they went too deep puncturing the lung, causing pneumothorax Knowledge check  ​ Pleural linkage is created by negative pressure due to absorption of fluid and gases ​ The visceral pleura surrounds the lungs ​ The parietal pleura lines the ribcage Muscles of the lungs Diaphragm ​ Sheet of muscle and tendon ​ It is below the lungs and heart and above the abdomen, attached by the pleural linkage ​ Contraction is not intuitive ○​ At peak inspiration, diaphragm contracts and flattens, it is lower pushing organs down and allowing the lungs take up more space in the thoracic cavity ○​ At peak exhalation, it relaxes and pushes up to help release air from the lungs, getting smaller ​ Movement can be as much as 10cm ○​ Descent of the diaphragm accounts for half or more of the resting inspired volume ○​ This is for mechanical efficiency External intercostals ​ They are at an angel and allow for easier contraction, they are responsible for inspiration ​ They raise the ribs for inspiration in quiet breathing or maximal respiration Internal intercostals ​ They are located between the ribs and move diagonally inward ​ Diagonal muscles are longer and can become shooter on contraction, doing more work ​ Contraction: responsible for forced exhalation, not needed for quiet breathing Abdominal muscles -​ Assist in active or forced expiration -​ -there are foru major abdominal muscles and all support and compress viscera Other muscles -​ Don't really need or want the pectoral muscles involved, this will create unnecessary tension  Knowledge check ​ Muscles of inspiration are external intercostals and diaphragm ​ In quiet breathing, expiration is accomplished by relaxation of inspiratory muscle, stop contracting internal intercostal muscle BUT in forced expiration we use internal intercostal to push more air out ​ A common characteristic of a pneumothorax (air) and hemothorax (blood) is disruption of pleural linkage ​ REL is the point to which system returns after a quiet exhalation Forces in respiratory function ​ Passive forces – no muscle activity, these forces are determined by natural physiological structures ​ Active forces – these forces are applied when muscles are active, contracted Passive forces ​ Elasticity & gravity – main relaxation forces Air pressure ​ Air always moves from regions of hugger pressure to regions of lower pressure pressure/volume relationship ​ In general, there is an inverse relationship between pressure and volume ​ As volume goes up, pressure goes down + volume goes down, pressure goes up ​ Making the space smaller (volume go down) forces molecules to come together (pressure go up) ○​ Molecules feel “suffocated” need more space and move to a higher volume area because the it is a lower pressure area Pressure during respiration ​ Compare pressure inside lungs to atmospheric pressure (outside of lungs) ​ Is air always moving in and out of lungs? There is a small moment between inspiration and expiration where there is no air moving ○​ No airflow at peak inspiration and at end expiration (pressure inside lung = to atmospheric pressure)  ○​ The relative pressure (difference in pressure inside lungs compared to atmospheric pressure) is very small or nonexistent so airflow stops -​ No pressure differential = no movement ​ During inhalation, contract external intercostal and diaphragm, as a result, they increase lung volume bigger, now the pressure in the lungs decreases (less than atmospheric) and air moves in ​ During exhalation: the inspiratory muscles relax, diaphragm moves back up and ribcage relaxes, making the lungs smaller decreasing the lung – the pressure is getting greater (compared to atmospheric) so you breath out Test Yourself What makes air go into the lungs? -​ The inspiratory muscles of the external intercostals and diaphragm contract, increasing lung volume, this increase of volume creates a decreased lung pressure compared to that of the atmosphere and as a result air rushes into the lungs for inspiration 9/24 – Passive & active forces ​ Lung pressure, high lung volume is above REL ○​ High pressure in lungs relative to atmosphere ○​ Lungs get smaller ○​ Relaxation will be in an expiratory direction ​ Vital capacity: maximum amount of air exchanged in the lungs ○​ 0% VC is when maximal expiration ​ REL occurs at 38% of VC ○​ Lung pressure and atmospheric pressure are equal no air flow ○​ Opposing forces of lungs and thorax are equal ​ When below REL blow out aa much air as you possibly can, then relax ○​ The lung pressure is negative relative to atmosphere ○​ Relaxation recoil will be in an inspiratory direction What happens when we talk? ​ We have to work around the natural relaxation forces ​ must control the descent of the rib cage when exhaling and talking at the same time ​ Checking action: result of muscle activation, keep the ribcage from getting smaller, helps maintain a constant subglottal pressure -​ Actively contract external intercostal and diaphragm, regulates descent ​ Above REL (when expiration) → inspiratory muscle force used to stay above Subglottal pressure ​ Subglottal pressure positively correlated with intensity ​ Without constant subglottal pressure, it is ____ Relaxation pressure curve for speech -​ Muscle effort required depends where within the vital capacity curve you are speaking -​ Muscle activity is counteracting passive forces to maintain a constant subglottal pressure -​ IF above REL need active inspiratory muscle forces to counteract passive expiratory relaxation pressures -​ If below REL, need active expiratory 9/24 – Measurement and lung volumes ​ How to get objective information on how someone is breathing ​ Tough to do clinically because we don't want exaggerated breaths Device Measuring Unit Calibrated Pressure Transducer Pressure cm of H₂O Monometer (u-tube) Pneumotachograph Airflow cc/second Rotometer Respiratory Inductive Lung volume liters 1L spyrobag (know value of air) Plethysmography (Respitrace) Magnetometers Lung volume liters 1L spyrobag (know value of air) Calibration ​ Converts output voltage signal into a reference standard measurement ​ Need to calibrate to get a valid measurement ​ Without calibration to real world value, changes in voltage mean knowing ​ Voltage to pressure measured in cm of H20 ​ Voltage to airflow in cc/sec ​ Voltage to liters  How its done ​ Relate electrical signal to known value,s something that is meaningful to the phenomena you are trying to measure Pressure Transducer Air pressure ​ Accumulation of air particles in a closed space acting upon something ​ Force per unit area acting perpendicular to a surface Measure in speech ​ Alveolar pressure measured in the lungs ​ Subglottal pressure measured below the vocal folds – want constant ​ Intraoral pressure: pressure in the mouth, plosives and fricatives have high intraoral pressure, also voiceless sounds in general have more oral pressure Pressure measurement ​ In cm H20 – unit of measure for pressure ​ To calibrate, put known values in to transducer and see what change in voltage they lead to Flow ​ Movement of quantity of air through a given area in a unit of time ​ What structures matter? Vocal folds! ○​ If paralyzed, lots of air will be allowed to flow more than usual ○​ Laryngeal system ○​ VF paramedian position, medialization can occur, ENT place hard plastic implant to shove vocal fold to middle ○​ Good prepost measure for better closure of VF Pneumotachograph ​ Pneumo = air ​ Measures airflow by looking at pressure with electrical signal ​ Calibrated using rotometer getting it to 200 cc/sec with air tank, then attach to pneumotachograph Special problems measuring speech and singing -​ Physical attachment of mask to airway alters breathing pattern  -​ Problem led to the quest for non invasive ways to measure lung volume -​ Borrowed concepts from respiratory physiologists Respiratory inductive plethysmography ​ Stretchy elastic bands ​ One over ribcage ​ Other over abdomen ​ Circumferential – measure all around ​ Provides only an estimate of lung volume ​ Respitrace! -​ Typically calibrated with one liter bag of air that is breathed MAGNETOMETER ​ Measured anterior -posterior ​ Closer transmitter and receiver stronger the voltage ​ Corresponds to person breathing Subglottal pressure -​ Pressure generated below the level of the vocal cords -​ Direct measurement can be done with tracheal puncture -​ Indirect measurement of subglottal pressure -​ Generated intraoral pressure is similar to the subglottal pressure -​ less invasive -​ Intraoral pressure IS good estimate except in cases of very breathy or very strained pressed voices Knowledge check ​ After an individual breathe sin as much as possible, the passive forces are expiratory ​ After an individual breathes out as much as possible the passive forces are inspiratory ​ Resting expiratory level occurs at 40% vital capacity ​ The purpose of the checking action during speech is to maintain a constant subglottal pressure & control descent of ribcage ​ If a speaker is above REL (breathing in as much as possible & relax) which muscles are active to control expiration for speech? Inspiratory ​ If the speaker is below REL (breathing out as much as possible & relax), which muscles are active to control expiration for speech? Expiratory force it lower ​ A pressure transducer is calibrated with a manometer  ​ A pneumotachograph is calibrated with a rotameter ​ He respitrace is calibrated with a known volume of air (1L spyrobag) -​ Works on the principle of – resistance to flow of current ​ Magnetometers work on the principle of transmitter/receiver Pulmonary subdivisions Basic measurements ○​ Volume – measured in liters ○​ 1000cc = 1L Pulmonary function testing ○​ Can use a wet spirometer -​ Hollow inverted tube with water, gets pushed up and down as air enters/exits -​ Measured manually in mm then converted to lung volume using chimograph ○​ Today we use a pneumotachograph ○​ All basic pulmonary measures come from one single maneuver – the vital capacity maneuver -​ Must first breath quietly in as much as you possibly can -​ Blow out as quickly and completely as you can Factors that affect lung volume ​ We measure lung volume based off of an equation ○​ Subdivisions are considered in the equation to predict values ​ Critical to understand that there are variations in vital capacity depending on factors like: ○​ Biological sex: males have larger vital capacity than females, they just are bigger ○​ Age: vital capacity increases as children grow, cna go down when you get even older or as a result of illness ○​ Height ○​ Ethnicity ​ We care about the percent of what was predicted Reporting value ​ Values are reported as percent of predicted  ​ Concern if it is below 80% -​ If its reduced get them used to breathing in more and other techniques ​ The predicted has to correlated with their physiology Factors we ignore ​ These do not contribute to normative data to determine predicted values because they vary significantly from the norm ○​ Aerobic conditioning – increased in athletes ○​ Profession – increased in singers ​ What is the limiting variable? The lungs can only expand so much because the ribcage cannot expand limiting what you inhale Lung volume normalization -​ Go back to this slide Pulmonary subdivisions -​ Our REL vital capacity is at 40% already, you can go 60% above it or 40% below it, which is why you can inhale more than you can exhale from REL Vital capacity ​ Breathe in as much as you can and blow out as much as you can – exchange biggest amount of air you can exchange ​ Peak expiratory to peak inspiration Tidal volume ​ Amount of air exchanged in a single cycle of respiration in quiet breathing ○​ Working out your tidal volume will be bigger ○​ Peak quiet expiration to peak quiet inspiration Inspiratory reserve volume ​ Volume of air that you can inhale beyond the end inspiration point of tidal breathing ○​ Referenced to tidal volume Inspiratory capacity ​ Volume of air that can be inhaled from resting expiratory level (TV+IRV) ○​ Referenced to resting expiratory level  ○​ If persons REL is changing, it will drift up, making inspiratory capacity appear to be smaller than it actually is Expiratory reserve volume ​ Volume of air that can be exhaled from resting expiratory level Residual volume ​ Air that cannot be exhaled een with maximal expiration ​ This is because of the pleural linkage, you can never squish your lungs all the way down to get all the air out, pleural linkage ensures that there is always air in the lungs as the lungs are expanded from their natural position (collapsed) ​ In highly trained classical singers, it is small -​ Good you can use more of your lung capacity -​ Can access more of expiratory reserve volume -​ Smaller residual volume more air you use, the better Total lung capacity -​ If i could empty al the air put my lungs, what would my volume be (everything combined) -​ Which support will have athletes with the greatest inspiratory capacity -​ Swimmers because of the water pressure resistsance 10/8 – Speech Breathing -​ Ventilation = breathing for staying alive Respiration for speech ○​ Start with regular tidal breath, REL at 30% vc ○​ Pause where atmospheric = pressure in lungs ○​ Take a bigger breathe to talk and prolong the expiration Ventilation/Quiet breathing Speech breathing Location of air intake Nose Mouth Frequency of breathing 12 breaths per minute Depends on how long utterance is Lung volume comparison Tidal volume (10% VC) Twice your tidal volume (20% VC) inspiratory/expiratory time 1:1 1:5  External Intercostals and Diaphragm External intercostals and diaphragm (also Inspiratory muscle activity control descent of ribcage to counteract passive expiratory forces) No expiratory muscle activity Only when speaking below REL to overcome Expiration muscle activity passive forces and talk longer Location of air intake ​ Quiet breathing is through the nose, speech breathing is through the mouth ​ Resistance of airflow from the nose because of the various tissue in there! ​ We want breathing during speech to be effortless, less resistance the better ​ Mouth is better for speech breathing because there is less resistance, straight shot to the trachea, it is easier ○​ You can breathe in more in less period of time with you mouth than your nose ​ Frequent mouth breathing dries up the oral cavity and vocal tract Frequency of breathing ​ Changes a lot with development and physical condition the individual is in ​ Someone breathing quickly is under respiratory distress ​ Tachypnea: abnormally rapid breathing Newborns ​ Newborn respiratory distresses is mode than 60 respirations per minute ​ In healthy children → newbies breathing the quickest → around 12 months breathing slows, at age 4 things gradually slow down and plateau to a regular rate Adults ​ Normal respiration rate for an adult at rest is 12 (on breathe every five seconds) to 20 breaths per minute ​ People can train to be slower or longer ○​ Slower in swimmers or people who train to be underwater End of life ​ Breathing becomes rapid when you are close to death ​ Respiratory arrest is a vital sign in the assessment of patients, strongly associated with mortality Lung volume comparison ​ Referenced to percent of vital capacity you’re using ○​ Quiet breathing → Tidal volume → 10% VC in quiet breathing (300cc) ○​ Conversational speech → around 20% VC being exchanged, typically twice your tidal (600cc) -​ Can vary and be from anywhere from 10%-100%  ○​ Loud speech is around 40% ​ If a male has VC of 5L=5000cc we expect him to breathe in about 500cc during tidal breathe 10% of VC Inspiratory to expiratory time ​ Quiet breathing has this as around a 1:1 ration, inhaling an amount of time, exhaling the same amount of time ​ Normal ratio for slow breathing can be 4:6 ​ If we used this same ratio during speech breathing, the speech would be broken up and shorter utterances to allow for breath ○​ Instead we breathe in and extend how much we breathe out ○​ More Like 1:5 Expiratory muscle acidity ​ During quiet breathing: no muscle activity all muscles relax → diaphragm and external intercostal muscles ​ Speech breathing: use them when were below REL to overcome passive forces Principle of less effort ​ Speak in the middle range of vital capacity, centering around REL ​ Why is this an advantage? → requires least muscular effort above and below REL Muscle activity in speech ​ To maintain a constant subglottal pressure we need muscle activity ​ This helps with loudness ​ Inspiratory: external intercostals and diaphragm to counteract passive expiratory forces ​ Talking below REL requires Expiratory muscles : internal intercostals and abdominals to counteract passive inspiratory forces -​ When you finish speaking relax to return to REL Measure adequacy of subglottal pressure for speech ​ 5 centimeters of water for 5 seconds, they have enough driving force to generate their voice ​ Phonation threshold pressure – gets it started ​ The 5 cm of water pressure is what is maintained ​for subglottal pressure ​ Gets harder for increased loudness at 10cm Breathing pattern for speech ​ Breathe in → that exact changing point from inspiration to expiration si when phonation begins ​ Tendency to breathe more deeply for louder, longer utterances ​ Someone with laryngeal muscle weakness (one of the nerves is damaged) they are breathy when they speak, cannot adduct vf quickly, using more air as a result of incomplete vf closure Respiratory needs for speech ​ Breathing for speech requires relatively little VC, you only need 20% of VC really ​ Respiratory contributions to voice/speech problem are usually related to control at the laryngeal level NOT the respiratory level -​ Need to regulate and manage it at the laryngeal valve Normal speech breathing ​ Ribcage can expand and diaphragm can descent ​ Greatest contributor to lungs getting bigger is the ribcage, diaphragm does not help as much ​ ¾ of how much air you can take in is because of ribcage expansion and pleural linkage ​ Body type can affect if you expand ribcage or abdomen Clavicular breathing ​ Not as common as people think ​ Inefficient breathing pattern ​ Can contribute to laryngeal muscle tension ​ Can happen when you are tensed or to augment a breathe Circular breathing -​ A wind instrument technique that allows player to sustain a tone for an extended period of time -​ Accomplished by storing air in the mouth at the cheek and using the reservoir of air to inhale through the nose while air is still coming out Summary of speech breathing ​ Longer expiratory duration than rest breathing ​ increase lung volume & subglottal pressure used for loud speech ​ Efficient operation range for conversational speech = mid range of vital capacity !!! Breathing throughout the lifespan *** newborns cages are not rigid or bony*** -​ The cage surrounding our lungs is pretty flexible -​ The recoil of the lung is almost as strong as adult lungs, but still linked to ribcage with pleural linkage -​ Lungs really want to collapse →Lungs pulling ribcage inward more making them smaller -​ Babies respiratory system is forced to a much smaller vital capacity level bc the ribcage can come in more -​ Consequences: infants work hard just to breathe -​ Gas exchange is not as great at low lung volume -​ Needs to exert effort to stay above REL otherwise it will collapse to 10% of VC -​ Back to sleep campaign made to help babies breathe easier on their back so they are not also using effort to lift body weight and ribcage -​ Used to put baby on tummy, putting baby on tummy forces them to work against lungs pulling ribcage in and also have their body weight to lift up to breathe in -​ Can expand their ribcage without being pressed into mattress making breathing easier Fetal lung development -​ Few alveoli and lungs are bypassed initially as air exchanges occurs through the placenta in utero -​ Ove time number of alveoli increase, Lungs get bigger -​ Airways get bigger (trachea and bronchi) -​ We care about how wide they are, the internal diameter (where resistance is) -​ Greater internal diameter, less resistance -​ Breathing gets less effortful, respiratory rate goes down -​ Thoracic cavity increases in size and Ribcage gets bonier less cartilaginous -​ As everything gets bigger resistance gets smaller, easier breathing Functional behavior -​ Pulmonary Subdivision volume increases -​ Respiratory rate decreases ventilation/gas exchange -​ Pulmonary circulation development is completed (how oxygen and co2 are pumped through lungs and heart) -​ Maximal oxygen uptake increases Nervous system -​ Myelin sheath of tissue around nerve  -​ Myelination increases around nerves, nearing completion like insulation surrounding a wire, ensuring that impulses from nerve to stimulate muscle are more accurate, stronger and faster -​ More efficient muscle stimulation (faster stronger) -​ Biggest effect of myelination is on the brain, sensory and motor areas continue to develop -​ Speech development is a result of more developed neuronal transmissions and connection infant/toddler speech breathing -​ Do we naturally know where to breathe in speech ? -​ Honestly.. YES -​ Phonation on expiration indicates that the respiratory system and larynx are coordinates as early as 5 weeks of age -​ Respiration coordinated with laryngeal system early on -​ Kids have the basics down almost immediately Characteristics ​ Efficient in using midrange of predicted VC ​ Large variety in chest wall behavior in individuals – they try out various behaviors -​ 2-3 year olds tend to use abdomen ​ No size difference until puberty there is no gender difference in terms of how they breathe Study 1 Lung volume of 7 year old -​ Initiate and terminate breath groups at higher lung volumes -​ Breathe in higher for the VC than older kids -​ This is because they are built smaller, Increased resistance of vocal tract due to smaller size -​ To talk louder they need more air for more subglottal pressure 10-16 years -​ Differences start to go away, and use more Adult like strategies except for fewer syllable per breath group and higher percent VC per syllable -​ Results in breathier speech Children adolescent conclusions -​ Body size ,makes the biggest difference but at 10 they use more adultlike strategies just with more air overall Study 2: Comparison of speech breathing between children and adults ​ Independent Variables -​ Age: adult versus child -​ Active: Loudness versus conversational/comfortable -​ Active: High volume constant (unvoiced fricatives take the most) vs low volume consonants ​ Result: children only changed breathing when system was maximally taxed (i.e. both high volume C and increased loudness) -​ Suggests that with just talking loud, they use laryngeal strategy to increase intensity for low volume consonants -​ In high volume consonants they increased lung volume when speaking loud. ​ Adults during low airflow volume consonants breathe in more for louder versus conversational , kids used the same breathe for low volume airflow in conversational and loud speech ​ Smaller residual volume in youngest group -​ Good they are using more of their expiratory reserve volume and total lung capacity ​ More VC/syllable in adult, vocal folds not touching as much need more vital capacity, because air is escaping Implications -​ In order for kids to increase lung volumes they had to be maximally taxed (loud and high volume) 10/15 Speech breathing and aging ​ Slopes up as you age even further ​ Muscle contraction rate and force decrease ​ Overall lung size decreases because of poor posture and thoracic shape changing like in Parksinson’s ​ Costal cartilage ossify Physiological vs chronological age ​ You are as old as you feel ​ You are as old as your physiological day  ​ Ex. 80 year old still running marathon and 80 year old in assisted living -​ Jack La Lanne “the godfather of fitness” ​ Need to consider physiological components like weight blood pressure etc to find physiological age La Lanne Secret to Aging gracefully -​ Move and eat well! Exercise and Selected disorders Collapsed lung -​ Air gets in to plural linkage -​ Got pneumothorax from singing high pitched songs during karaoke -​ Can heal on its own if its little -​ Can also occur from marathon running, specifically around the heart area -​ Treatment: small problem can be resolved on its own, most people made full recovery without intervention iatrogenic -​ Relating to illness caused by medical examination or treatment Respiration signaling heart attack -​ Agonal breathing experienced when having a heart attack -​ Gasping sound , usually infrequent -​ There is an app Can detect agonal breathing 97% of the time Traumatic brain injury -​ Vital capacity testing -​ Subdivision most impaired is ERV -​ Two potential reasons: expiratory muscle weakness & it was just hard to do Parkinson’s -​ Progressive neurological diseases -​ Muscle become rigid, restricting range of movement -​ Also impacted by perceived reduced range of motion -​ SPEECH BREATHING: Not breathing in as much as they should be, Multiple sclerosis ​ Demyelinating disease of central nervous system ​ 14/19 patients in largest study had respiratory muscle weakness ​ Need larger percentage of VC to produce speech requires increased muscle effort, no longer in the efficient midrange of VC curve to breathe for speech ​ More effortful Cerebellar disease -​ Cerebellum coordinates voluntary movement in terms of speed, direction and force -​ If damaged movements are no longer smooth -​ Difficulty coordinating chest wall movements Cerebral palsy -​ Characterized by abnormalities in muscle tone posture and movement Mechanical ventilation -​ Problems: -​ Timing with speech ventilator -​ Adjusting to subglottal pressure – begin high, change quickly -​ Balancing requirements for ventilation with requirements for speech -​ Can get used to it over time but can lead to shorter utterances asthma ​ Air resistance is greater during asthma attack making it harder to breathe, can affect speech ​ More difficulty breathing in, having to breathe in slower and bigger Vocal nodules -​ Caused by misuse or overuse, speaking out of range too loud Hearing impairment -​ Lung volume initiation is below normal,it is more effortful -​ Increased cc/syl – breathy -​ May phrase inappropriately due to need for air -​ With cochlear implants, all parameters become more normal Acoustics Acoustic and perceptual terms ​ Pitch is perceptual correlate of frequency ○​ Frequency is measured in cycles per second, called Hertz (Hz) ○​ Pitch is described as high versus low ​ Loudness (don’t say volume) is the perceptual correlate of intensity, amplitude, sound pressure level Characterize waveforms ​ Period is the time it takes to complete one cycle of vibration ○​ As it decreases there can be more cycles per second to frequency increases ​ Frequency is the number of cycles per second (perceived as pitch) ○​ As period increases, there can be more cycles per second and increased frequency ○​ Period and frequency are inversely related → shorter period = higher frequency ​ Amplitude is the magnitude of vibration determined by displacement of air particles and is perceived as loudness Types of waveforms ​ Pure tone: is a sine wave, not heard in nature usually used for audiology hearings with just one frequency ○​ Less complex to see how person's hearing is over wide range of frequencies ​ Complex wave: combination of sine waves of different frequencies and amplitude and phases ○​ What produced with our voice ○​ Most sounds produce vibrations that are complex Phase ​ Temporal relation of sine waves within a complex wave ​ Determined by the synchrony of pressure peaks (how they line up with each other) ○​ If they are aligned, they will increase amplitude ○​ If they are the same frequency but 180 degrees out of phase (high pressure of one lined up with low pressure of another) they cancel each other out creating no energy, or silence → perfectly out of phase ○​ We usually end up with something in between these two Types of interference ​ Constructive interference: wave forms add together, increase amplitude, areas of compression combine  ​ Descriptive interference: waveforms cancel each other out Complex waveforms ​ Several frequencies combine creating irregular waves for speech ​ Lowest frequency is always the strongest, the others that follow are harmonics and they go down in amplitude ○​ We hear them all at the same time ○​ The other frequencies and their amplitude all work together ○​ The one we actually hear is the fundamental frequency ​ Even though it is complex,it still has a regular repeating pattern so it is periodic Periodicity ​ Periodic waveform: repeats in a predictable pattern over term ○​ More smooth and normal ​ Aperiodic waveform: no obvious repeated pattern, perceived as noise ○​ One cycle of VF vibration does not = the next Fourier analysis or spectral analysis -​ Breaks down complex wave in to the sine waves that are present in a complex wave -​ Typical in speech = sawtooth wave -​ More than one frequency in the graph = complex wave -​ Slice in time = spectrum Periodic complex tones -​ Average harmonics in the human male voice -​ Harmonic = frequency, whole number multiples -​ First = 100Hz (100x1) -​ Second 200HZ (100x2) -​ Third 300Hz -​ Fourth 400Hz -​ Fifth 500Hz -​ All area simultaneously present in a person’s voice -​ Children FF = 300 Hz so their harmonics are farther apart -​ Female voice FF = 100 Hz Line versus continuous waveforms and spectra -​ Speech spectra = lots of frequencies present -​ Show up as harmonics on spectral analysis -​ Spectral envelope – general curve peaks Speech spectrogram -​ Low fundamental frequency = dense spectrum harmonics close together, powerful strong vice -​ High fundamental frequency, much more spread out less dense, not as powerful or rich Signal to noise ratio -​ Relative intently f the signal compared with the background noise -​ Large numbers are better -​ Low signal to noise ratios make it hard to hear or detect the signal -​ Picture trying to talk at a noisy party 10/22 – Laryngeal Anatomy Cartilage and bone ​ Laryngeal structure are structures suspended in the neck ​ Problems in voice come with too much muscle tensions, eliminating suspended structure ​ Note the space between hyoid bone and thyroid cartilage – this is the thyroid-hyoid space -​ smaller space = more tension ​ Important to know placement to help with muscle tension using laryngeal massage to lower the thyroid cartilage Cross sectional view ​ Epiglottis is the point of reference ​ False vocal folds more visible = person working too hard to produce their voice ​ Expect open trachea with air that sets vocal folds in to vibration with false VF out of the way Superior view  ​ Bottom is the front of your laryngeal ​ Thyroid cartilage: shaped like a shield -​ Point of V is where vocal folds attach to thyroid cartilage -​ Designed to protect the airway ​ Arytenoid cartilage: help the VF move swinging them open and close -​ Longer part goes in to the VF is vocal process -​ Side of arytenoid is the muscular process where muscles attach -​ Sit on top of large part of cricoid cartilage -​ As they move the muscles they are attached to help open and close the VF ​ Glottis: Space between folds when open ​ Cricoid cartilage: shaped like a signet ring (thick ring base is in the back -​ thyroid is directly above with attachment ​ Tracheal rings: line the trachea, protecting the airway and open in the back Laryngeal muscles ​ Interact in a complex manner, simultaneously during voice ​ The function of the muscles occur as a result of the contraction ​ Muscle movements can be described as isometric or isotonic ○​ Isometric: muscle tension while not changing length, attached structures do not move ○​ Isotonic: muscle contraction moves structure Muscle Points of Attachment Function Thyroarytenoid (Vocalis) 1.​ Inside front of thyroid cartilage Isometric contraction increases 2.​ Vocal process of arytenoid longitudinal tension and increases pitch slightly, no other movement Isotonic contraction shortens/relax muscle, thyroid cartilage and arytenoid move inward increasing mass of VFs → decreasing pitch Cricothyroid Pars recta: at low part of Cricoid Pars recta rocks bringing thyroid cartilage cartilage (front) and front edge of closer to cricoid cartilage, responsible big thyroid cartilage pitch changes Pars oblique: cricoid cartilage Pars oblique brings thyroid cartilage away posterior inferior horn of thyroid from arytenoids, passively stretches the cartilage thyroarytenoid Lateral cricoarytenoid Attached to front muscular process Contraction brings vocal process to the of arytenoid cartilage and side of middle adducting the vocal folds working cricoid cartilage as a medial compressor Interarytenoid Transverse: posterior arytenoid Contraction slides the arytenoid cartilages on top of the cricoid cartilage to come Oblique: posterior arytenoid together closing the posterior cartilaginous portion of VF, Posterior cricoarytenoid Back of muscular process of Contraction swings vocal processes of arytenoid cartilage and back bigger arytenoid open and open the vocal folds area of cricoid cartilage Only muscle that opens Used for voiceless sounds Study of muscles ​ Studied 5 people in thyroid surgery, hooked electrodes in pars oblique and recta ​ Able to see how the muscles were used ​ Pars recta and oblique movement are individualized by person ○​ This depends on: the joints kind of like a ball and socket ○​ If hey have a tight joint = more rocking ○​ Looser joint = pars oblique movement Vocal nodules ​ Occur at mid membranous portion of VFs ​ Area of greatest lateral excursion away from midline ​ Greatest elastic recoil and highest collision forces returning to middle VF terminology ​ Adduction: body of the vocal folds coming to the midline (coming together) by action of adductor muscles ​ Abduction: body of the vocal folds is moved away from the midline by contraction of posterior cricoarytenoid ​ Opening – when vocal folds vibrate, once VFs adduct, the mucosal covering moves away from the midline -​ Open during quClosing -​ iet breathing Vocal folds ​ Combined too much with medial compression causes spasmodic dysphonia  -​ Contact ulcers can occur at the arytenoid process hurting the tissue Interarytenoids -​ If they dont adduct, there can be a posterior glottal chink -​ Back portion of VF doesn't close -​ Believed to cause breathiness Lamina propria & vibrations Knowledge check Which muscle is responsible for closing the cartilaginous portion of the vfs -​ Interarytenoids The muscle responsible for large increase in pitch is the: -​ Rocking and gliding of cricothyroid, for big pitch changes – smaller pitch changes are from thyroarytenoids The body of the vocal fold is made up of the -​ Thyroarytenoid The only muscle for vocal fold abduction is -​ If the interarytenoids do not contract the individual will have -​ Posterior glottal chink , there wll be open space at the end, Lamina propia -​ Different tissue on top of th vocal folds -​ All of these tissue are engaged when vocal folds vibrating -​ Each serves a different purpose Functional layers -​ Cover of vocal fold -​ Epithelium -​ Superficial lamina propia -​ Body of vocal fold -​ thyroarytenoid muscle -​ Each layer has a different consistency -​ layer composition Role in vibration epithelial Mucosal lining of inside of mouth what we see vibrating upon observation of vocal folds Superficial lamina propria Soft jello like structure Most active structure doing the actual vibration intermediate Elastic fibers After the VF are stretched (USUALLY FROM PASSIVE ACTION) they help return the VF to rest position deep Sturdy collagen and thicker fibers Just a transition support structure between intermediate lamina propria and thyroarytenoid muscle Thyroarytenoid muscle -​ Superficial: right underneath the mucosa, the most important to understand -​ It is what really moves the most when vocal folds are vibrating -​ Soft jello like structure doing the vibrating -​ Also known as reinke’s space: when we have fluid accumulation in VF it accumulates here -​ Reinke’s edema can occur in the morning when fluid accumulates during sleep or severe with years of smoking -​ Becomes a problem with people who need to sing high early in the morning -​ -​ Intermediate lamina propria: fibers are stretchy and elastic, like mini rubber bands. they run along the length of the vocal folds -​ Elastic fibers: run longitudinally – active in returning VFs back to rest position after elongation or tension -​ Not active in return vocal folds to midline during the closing phase of VF vibration -​ Deep layer: closet to thyroarytenoid muscle, like a support structure, made up of collagen and thicker fibers (cotton thread) not super elastic, supportive and sturdy -​ Acts as transition to the thyroarytenoid muscle -​ Not involved in vibration -​ Thyroarytenoid muscle: VF at midline, vibration happens as air flows by superficial layer Myoelastic aerodynamic theory -​ Voice is produced by an interaction of muscle forces, elastic recoil forces of the tissue and airflow and air pressure -​ The lamina propria does the vibrating -​ Myo- muscle, elastic - natural tissue elasticity returning to rest , aerodynamic - the airflow and pressure through VF  ENT Scope -​ ENTs look for this when viewing vocal folds: -​ Straightness of edges -​ Color – white/translucent Phonatory threshold pressure -​ This is the pressure required to initiate vibration -​ Good indicator of vf health -​ Usually around 3-6c H2O -​ If its more than that ? – fluid accumulation, really tense vocal folds creating extra pressure, -​ If its less than that? Not getting complete closure to begin with PTP basis -​ Pressure built up in the oral cavity for a voiceless /p/ is comparable to subglottal pressure Challenges in acquiring PTP Steps to get vocal fold vibration 1.​ First you take a breath in 2.​ Your vocal folds are closed by lateral cricoarytenoid and interarytenoid 3.​ Air goes from lungs through the larynx as you start to exhale 4.​ The air starts to build up underneath the vocal folds – this is subglottal pressure 5.​ Once pressure builds up air blows through 6.​ VFs vibrate Steps of VF vibration 1.​ Breathe in 2.​ Vocal folds adducted by lateral cricoarytenoid (anterior ⅓ together) and interarytenoid (posterior ⅔ together) to phonatory set position 3.​ Subglottal pressure builds 4.​ Phonation threshold pressure is reached (subglottal pressure > supraglottal pressure) 5.​ Vocal fold mucosa is blown away from midline to open vocal folds (thyroarytenoid stays at midline) 6.​ Vocal mucosa is brought back to midline by elastic recoil of tissues a.​ bernoulli forces completes the midline closure with negative pressure 7.​ Airflow continues passive vibration Models of VFs as Constructed tube -​ How the bernoulli effect/forces are involved -​ 125 cc/second entering tube, same volume of air must exit tube -​ At constriction Bernoulli Effect -​ Airflow going through the constriction generates negative pressure -​ Fall in pressure is inversely proportional to the velocity of airflow -​ Inverse relationship between pressure and velocity -​ As velocity increases pressure decreases, bringing VFs together for final closure -​ Negative pressure = sucked together Pressure Changes -​ After adduction, subglottal pressure builds -​ When it exceeds supraglottal pressure, the VFs will open -​ This transglottal pressure drop is considered driving pressure of the VFs -​ Infraglocanvascattal pressure drops as velocity of airflow increases due to the construction -​ Additional info: -​ Elastic recoil is greatest and Bernoulli Effect is lowest when VFs are at maximal amplitude from midline -​ Vfs APPROACH ONE ANOTHER, VELOCITY INCREASES Single cycle of VF vibration -​ Closed at midline -​ Mucosa opening – moving away from midline util maximal lateral excursion is reached -​ Mucosa closed with elasticity, bernoulli effect helps with complete closure Why does VF need to be closed for loud speech? – greater pressure build up = louder Types of phonatory onset -​ Onset of vibration depends upon the relative timing of expiratory airflow and vocal fold vibration -​ Ideal is that vocal folds begin to vibrate before they reach the midline Breathy onset -​ Vocal folds open with unmodulated airflow before vibration begins -​ Problem – wasting air Abrupt phonatory onset -​ Aka hard glottal attack -​ Vocal folds closed before vibration begins and airflow begins abruptly after building up PSG -​ problem: creates a squeak? Simultaneous onset -​ Preferred -​ Vocal fold is coming to midline and begin vibrating as air flows is moving through them Vocal fold vibration – 11/5 ​ Hypertension, too much effort to talk too much muscle tension for voice BUT voicing ing shouldn't be hard ○​ It is passive, a self sustaining oscillation ​ Requires ○​ a steady source of energy – the airflow ○​ Nonlinear interaction between the among internal components. they are not just moving back and forth, there are other movements: →​ Vertical phase shift →​ Longitudinal phase shift (along the length) -​ Not as easily observable, open posterior to anterior -​ Not a simultaneous closure Cover body theory ​ Everything happens simultaneously ​ The state of the body of the vocal fold determines how the lamina propria is going to be vibrating ○​ Tight thyroarytenoid muscle = restriction of movement ○​ Relaxed thyroarytenoid muscle = high collision forces ​ Part of VF displaced is the superficial layer Key determinant of vibratory frequency ​ Longitudinal tension: can increase with passive stretching…. Relevant for VF vibration ​ Mass: amount of matter in a body → greater mass = slower vibration  ​ Stiffnesdowns = structure’s resistance to displacement ​ Elasticity: tendency to return to rest position following displacement, more tough = the faster recovery from displacement Effect of VF stretching ​ Greater tension requires greater PSG and creates greater elastic recoil, Pitch changes ​ Pitch going down , takes time to complete cycle gets longer ​ Pitching going up – time it takes to complete one cycle gets shroter Intensity control ​ Intensity controlled with subglottal pressure, they are directly related ○​ Increased subglottal pressures → increased amplitude of vibration Knowledge check 1.​ When viewing the vocal folds, ENTs look for what? a.​ Straight edges white or translucent 2.​ What causes the Bernoulli effect? a.​ Narrowing the glottis – space is getting smaller in between i.​ Only happens when vocal folds are really close to midline, suddenly everything narrows,w ant same amount of airflow and quickly so it has to speed up )changes speed through the vf for same amount of air above or below ii.​ Increased velocity → Negative pressure brings the folds together decreasing the glottis 3.​ During a cycle of VF vibration, when is there no transglottal airflow? a.​ When the VFs are closed – does not allow airflow through them 4.​ During a cycle of VF vibration, greater excursion away from the midline corresponds with: a.​ Higher collision forces – VF blow apart further and crash together harder 5.​ Why is the closed phase of VF vibration longer for loud phonation? a.​ Subglottal pressure is greater 6.​ In what type of phonatory onset does airflow begin before the vfs begin to vibrate? a.​ Breathy 7.​ In what type of phonatory onset does airflow begin as the vfs begin to vibrate? a.​ Simultaneous 8.​ Which contributor to self sustained oscillation is unlikely in a female voice? a.​ Vertical phase shift i.​ Females have twice as many cycles &, no vertical phase shift = greater chance of nodules 9.​ Passive stretching and thyroarytenoid contraction a.​ Increases longitudinal tension and pitch 10.​ The lamina propria comprises a.​ The cover of the vocal folds  11.​ The superficial layer of the lamina propria a.​ Is susceptible to fluid accumulation – makes vocal folds look puffy (happens when we sleep during the night) 12.​ The intermediate layer of the lamina propria has elastin fiber a.​ Running longitudinally – help bring tissue back after VFs passively stretched Laryngeal imaging – 11/5 Review of Steps of VF vibration 1.​ Breathe in 2.​ Vocal folds adducted by lateral cricoarytenoid (anterior ⅓ together) and interarytenoid (posterior ⅔ together) to phonatory set position 3.​ Subglottal pressure builds 4.​ Phonation threshold pressure is reached (subglottal pressure > supraglottal pressure) 5.​ Vocal fold mucosa is blown away from midline to open vocal folds (thyroarytenoid stays at midline) 6.​ Vocal mucosa is brought back to midline by elastic recoil of tissues a.​ Bernoulli forces completes the midline closure with negative pressure 7.​ Airflow continues passive vibration Vocal registers ​ Specific modes of vibration ○​ Three registers ○​ Two commonly heard in conversational speech Modal register ​ Most frequently used, chest register ​ Most commonly heard in conversational speech Pulse register ​ AKA vocal fry , lowest and often at the ends of utterances ​ Thick, relaxed vocal folds ​ Low subglottal pressure – low collision forces, does not damage the vocal folds not abusive Distinguish glottal/vocal fry from harshness ​ Harshness is aperiodic and often effortful ​ Glottal fry is periodic and low effort Falsetto ​ Very high (for men) – similar to chest register for women ​ Lng stiff vocal folds & thin along edges ​ Minimal vocal fold vibration (only at edges) ​ Can be easier and low effort after accident Maximum fundamental frequency range ​ Needed in voice evaluation ​ How low and how high you can go ○​ Sigh down – easier to model, keep it smooth no glottal fry ○​ Move voice up ​ We care about the physiological range even if it sounds “bad” ○​ Singers care more about aesthetic range and what sounds good ​ Adult males and females after puberty differ the most in fundamental frequency ○​ Kids 300 Hz ○​ Females 200 Hz – over the years voices have gotten lower and lower ○​ Males 100 Hz – male in higher range are in falsetto Visualization of VF Vibration ​ Need to have normative value of how severe the voice problems, how far are they from the normal ○​ Make sure ENT looks at their VFs for health (nodules, laryngeal cancer, polyps, ulcers) ​ Indirect laryngoscopy – not commonly performed ○​ Light shined on to mirror and reflected down to VFs ○​ Mirror or iphone for straight ness of edges and color -​ Iphone view – indirect laryngoscopy, cool view ​ Laryngeal endoscopy with flexible scope ○​ Used for people who can’t tolerate rigid scope ○​ Advantage: person can actually talk unlike the rigid scope, nasal cavity is anesthetized and relatively not intrusive ​ Rigid scope ○​ Straight in persons mouth, same visualization of flex scope ​ Direct laryngoscopy ○​ ENT, gets tissue sample for biopsy (i.e. for suspected laryngeal cancer) ○​ Very invasive need to be asleep ​ Ultra high speed photography ○​ Regular film camera at high speed to get 4000 frames a second ​ Laryngeal videostroboscopy: common in ENT offices ○​ EGG strapped around neck – used to synchronize light pulses with vocal fold vibration  ○​ Image produced by stroboscopy: sample of each cycle of vibration – in sync with vf vibrating, get a sense of their actual continuous vibration pattern ○​ Limitation: with several hoarse voice, vocal folds do not vibrate periodically, so EGG cannot sync VF vibration with lightstrobe ​ High speed videoendoscopy ○​ Fast picture of each cycle of vibration ○​ True slow motion view of VF and each cycle IMAGING TECHNOLOGY DESCRIPTION ​ Not commonly performed ​ Requires light shined on to a mirror and reflected down to Indirect laryngoscopy VFs (specialized equipment is not needed) ​ Can observe straightness of edges and color. ​ Requires an ENT getting tissue sample for biopsy when laryngeal cancer is suspected Direct Laryngoscopy ​ Invasive procedure requiring general anesthesia ​ Allows for direct visualization and manipulation of VFs ​ Comfortable/less invasive adaptation to traditional scope ​ Scope passed through nasal cavity (after anesthesia) down Laryngeal Endoscopy to vocal folds (flexible scope) ​ Allows for comfortable speech during observation ​ Most normal VF vibration in real time ​ Requires scope to be directly inserted in to mouth (metal rod with camera at the end) Laryngeal Endoscopy ​ Feed from camera shown on screening real time (rigid scope) ​ Allows for observation of VFs and vibrations ​ Uncomfortable and slightly invasive ​ Most commonly used in ENT offices ​ EGG strapped to neck to sync with VF vibrations ​ Light pulses emitted with VF vibrations once synced Laryngeal Videostroboscopy creating an image after each cycle ​ Allows for visualization of the continuous vibration pattern in slow motion ​ Cannot be used if voice is hoarse or strained (can’t to sync) ​ Faster version of videostroboscopy High Speed Videoendoscopy ​ Captures 2000-4000 frames per second  ​ Yields high temporal resolution for detailed assessment ​ Does not rely on pitch, can be used for range of voices ​ Rarely used and very expensive ​ Captures at least 4000 frames per second Ultra High Speed Photography ​ Yields a slow motion/stop motion video with detailed visualization of rapid VF vibration ​ Does not rely on pitch, can be used for range of voices VOCAL REGISTER DESCRIPTION ​ The chest register ​ Most frequently used register for conversational speech Modal ​ Chest is a resonator and amplifies sound ​ VFs are relatively relaxed with moderate tension, vibrating long their length ​ The vocal fry ​ Lowest register, noted at end of utterances Pulse ​ VFs are thick and relaxed with low subglottal pressure ​ Not an abusive register, is periodic with low effort & collision forces ​ Not natural register Falsetto ​ Very high in males but comparable to female chest register ​ VFs are long and stiff with thin edges ​ Minimal vocal fold vibration occurs at the edges Laryngeal Imaging and movement Maximum phonation time -​ Average is 15-25 seconds -​ Less = respiratory or laryngeal problem -​ More = possibly too much laryngeal muscle tension -​ This gives an indication of vocal fold closure, common measure before or after surgical intervention from ENT -​ Needs to be smooth and at normal comfortable phonation -​ IF YOU DO MULTIPLE TRIALS, report the longest, its the maximum result! Loudness range -​ Loudness range is not always needed but habitual loudness is needed -​ In parkinson’s – person is soft and breathy, main intervention is lee silverman voice treatment to get people to be louder -​ Measure sound pressure level as an indicator of successful treatment and maintenance of person’s ability -​ Referred to as their intensity in studies -​ Can be measured using smartphone app using external microphone, need to note the distance from mic to have a reference for the level of intensity Acoustic -​ Simple to acquire and analyze when it is automated -​ Can be from visipitch or praat the free software -​ They might not always correspond to what you hear -​ Go with perception and see if objective data supports Jitter ​ This is the observable variation in frequency or pitch perturbation where one cycle to the next has different frequencies ​ Can make the voice sound pressed or strained ​ This variation in frequency is short term (from on cycle to the next) Shimmer ​ Aka amplitude perturbation, in one cycle compared to the next, amplitude varies, vocal folds open at different degrees Signal to noise ratio -​ Aka harmonics to noise ratio -​ This is the relative intensity of the signal compared with the background noise -​ If my signal is 200Hz anything above or below that is noise Multidimensional voice profile -​ Report the same measures for before and after in pretty diagrams -​ Shows the different acoustic measures and if they are at appropriate levels -​ Need 15 “AH”s for valid measures -​ Gives good measure of shimmer, jitter and SNR -​  Cepstral analysis -​ More wholistic, can be used in connected speech so this is an advantage -​ Can get valid measures without using sustain vowels -​ Need peak values above the noise line -​ In adult female with hoarseness there may be lack of clear peaks identified as noise in the voice Steven tyler vocal use -​ Uses loud voice in concerts, high collision force -​ Evidence of extreme vocal strain – working too hard to sing Knowledge check 1.​ When noise is added to voice, it appears on the spectrum as energy between the harmonics (inharmonic energy) 2.​ The vocal register heard most commonly in conversational speeches modal or chest 3.​ Physiological fundamental frequency range is usually greater than their aesthetic range 4.​ Typical physiological fundamental frequency range for an untrained singer is at least 2 octaves 5.​ An adults maximum phonation time should be 15-25 seconds 6.​ The main contributors to perceived vocal quality are completeness of closure and periodicity of vibration a.​ Harshness is heard as aperiodic vibration with complete closure b.​ Breathe is incomplete closure and periodic vibration c.​ Hoarseness is incomplete closure and aperiodic vibration – most common voice quality in people with vice disorders (i.e. cookie monster voice) Laryngeal airway resistance -​ Aerodynamic measure -​ Easy to get if equipment is available -​ Tells you how much resistance vocal folds are providing to the air trying to pass through them -​ Implication of values -​ High resistance = high tension -​ Low resistance = VFs not meeting at midline, breathier voice -​ NORMAL = around 40cm H2o/LPS for both males and females Vocal and laryngeal development Newborn larynx -​ Positioned very high in neck  -​ Less area for food/liquid to miss esophagus and enter airway → this is a survival adaptation -​ In adults: The cartilaginous portion of vocal fold is the posterior ⅓, the vocal process is responsible for swinging it open -​ In babies it takes up half of the vocal folds, as they grow the membranous portion also develops Changes in vf -​ At both membranous length = 2 mm males and females -​ As adults it grows, and males are longer than females -​ Vocla fold length Early development -​ Adult lamina propria = epithelial, superficial, intermediate, deep -​ In newborn the layers are no differentiated yet they look like one big superficial layer Later childhood adolescence -​ Huge variation in voice change -​ Typically begin to change 12-13 years and is completely between 15-18 -​ Lower pitches tend to be more stable than upper pitch ranges -​ Most active changes to tend occur within one year -​ Dealing with voice changes in puberty -​ Changes with girls -​ Much less obvious -​ Exhibit increased breathiness and occasional cracking -​ Lowering average speaking fundamental frequency Adult voice Transgender voice -​ SLPs can help people develop voice that goes with their gender identity -​ Female to male – can make thick using a procedure, naturally lowering the fundamental frequency -​ Male to female – harder to make voice harder, estrogen does not lessen muscle fibers in VFs -​ Some possible surgical things can be done to shorten VF Androgyny – gender fluidity -​ When a person does not wish to be identified as male or female Laryngela layers and aging -​ If someone takes care of voice, you won't notice changes -​ Differential gender effects across layers -​ Most obvious changes in women Females -​ Superficial layer becomes edematous (swollen, fluid filled) -​ Intermediate layer: elastic fibers atrophy and decrease in number -​ Deep layer – collagenous fibers increase in size and density -​ these changes happen after menopause, added mass in superficial and deep layer lower pitch as she ages -​ Added mass -​ Loss of flexibility -​ Lower fundamentally frequency Males -​ Higher fundamental frequency -​ Less affected by edema -​ ,ay be affected by loss of fiber mass, thyroarytenoid muscle loses mass -​ Pitch is higher -​ Less impact of collagen fibers thickening Male female coalescence model -​ Difference become less obvious when you get even older -​ Hormonal changes associated with menopause under the hormonal related difference that males and females have at puberty -​ Male voice gets higher, female voice gets lower -​ There can still be many individual differences and inconsistencies 1.​ Newborn larynx designed to protect the airway 2.​ The cartilaginous portion of a newborn vocal fold takes up ½  3.​ Throughout life, compared to female vocal folds, males vocal folds grow faster and they are LONGER 4.​ During the change associate with male puberty boys can, Monitor their voice to minimize pitch breaks 5.​ Adult singers may notice a change in their vocal control due to ossification of laryngeal cartilages 6.​ With age and no training, men's and women's pitches respectively increase and decrease Velopharyngeal function -​ Hard to assess but good to know the anatomy basics Velopharyngeal muscles Levator veli palitini -​ This muscle works to elevate the velum/ soft palate when it contracts/shorten Superior pharyngeal constrictor -​ A horseshoe shaped muscle that forms abc and side walls of pharynx -​ Bulks up back of throat/pharyngeal muscle when contracted -​ Function matters if they have a short soft palate and cant get a good closure so the back of pharyngeal wall will bulk up and create more mass so there's less distance between soft palate and pharyngeal wall as compensatory strategy Velopharyngeal closure -​ When talking about this cavity it is RESONANCE not voice -​ Hypernasal resonance or nasal resonance Why does it matter socially? -​ Very negative perception of hypernasality – it is socially unacceptable -​ It is usually associated with developmental disability Why does it matter acoustically? -​ The soft tissue absorbs the energy and muffles the sound as it goes through the nasal cavity Why does it matter physiologically/phonemically? -​ Open velopharyngeal port makes sound slike fricatives and stops Nasalization -​ The existence of communication between the nasal cavity and the rest of the vocal tract -​ Normal for nasal sounds -​ Requires open velopharyngeal port -​ Acoustic energy present in the nose Hypernasality -​ Inappropriate edition of the nasal cavity to the vocal tract -​ Not the same as nasal air emission -​ It doesn't have to be large amounts of nasal airflow, it is more connected to nasal resonance and energy in the cavity phrase to determine hypernasality -​ You can use the following phrases to identify if they have hypernasality -​ Need to have liquids and glides cant have nasals or high pressure sounds -​ Ex: how are you?, Denasality/hyponasality -​ Not enough nasality -​ Lack of nasal resonance on sounds that should be nasal -​ n, m, ng -​ Essentially never worked on in treatment, organic problem usually caused by congestion -​ Usually socially acceptable -​ Will be referred to someone who can fix the underlying problem phrases to determine hyponasality -​ Phrases should contain nasals -​ Ex: mama made lemon marmalade Assimilative nasality -​ Addition of perceived nasal resonance on non nasal sounds because it is surrounded by nasal sounds (like the a in man) -​ Naturally sounds influence each other so some assimilation is acceptable if not perceived -​ If you can perceive it it is abnormal Phrases to determine assimilative nasality -​ Make sure the sentence has no plosives or fricatives and all nasals -​ Ex: a man will Nasal air emission -​ Listener hears noise escaping through the nose/nasal cavity -​ Typically occurs in high pressure sounds (plosives and fricatives) Phrase to determine nasal air emission -​ Needs lots of plosive and fricatives, high pressure is better -​ Ex. Peter piper picked a peck of pickled peppers or sally sells seashells by the sea shore Cul de sac resonance -​ Typically due to posterior tongue retraction , they pull their tongue all the way back, changing resonance -​ May occur with spastic dysarthria or in deaf community -​ Not hypernasal or denasal Phrases to determine cul de sac resonance -​ Get them to produce front sounds -​ Heed the steed (alveolars & /i/ ) Nasal twang versus hypernasality -​ People like fran drescher have nasal resonance but isn't losing any air through the nasal cavity -​ They don't lose acoustic energy -​ Velopharyngela port is not open so not muffled -​ It is more harsh and edgy -​ Its more like a drumhead effect – very tight oral structures, air vibrates in nasal cavity Velopharyngeal port -​ At rest, -​ When saying a non nasal sound, the soft palate the lateral and posterior walls get thicker and raise, Predominant closure patterns -​ Coronal – just soft palate elevates enough to get closure  -​ Circular – complete color with soft palate elevation and posterior and lateral walls come in -​ You can check with mirror and phone light -​ Use abrupt /ah/, any lateral or posterior pharyngeal wall movement? Nasal airflow during normal speech -​ There should be no nasal airflow during the production of non-nasal sounds (consonants & vowels) -​ There is complete velopharyngeal closure Normal velopharyngeal closure -​ Nasal airflow graphed only peaks at nasal sounds Velopharyngeal development ​ In very young children, it can be problematic ​ Between 3-5, soft tissue is growing faster than bony structures of the skull, resulting in soft tissue occlusion and nasal airway is not open as it should be (it is the narrowest at this point of development) ○​ Nasal resistance values are at tier greatest ○​ They will likely be mouth breathers The problem: sleep apnea ​ The excess tissue during early development poses a problem as : it can cause sleep apnea ○​ This is when the person stops breathing during sleep, especially common in young kids ○​ Look at size of tonsils, ask about sleep problems, if they snore, if they are a mouth breathe ○​ If yes to the above, recommend ENT exam and sleep study ​ This can effect development due to inadequate release of growth hormone which is released in deep sleep → they might be shorter Assessing sleep apnea -​ Monitor breathing and EEG activity -​ Frequency and duration of breathing arrests -​ less than 0.5 instances per hour WNL Aging & velopharyngeal function -​ No age related differences -​ You don't just get hypernasal when you're older Assessing velopharyngeal function -​ Need connected speech that is dynamic -​ Using static production doesn't tell you about how their vp functions in regular speech Ideal measurement technique -​ Non invasive -​ Able to assess VP function during speech without disruption normal articulation, voicing or respiration -​ Correlates with what you perceived/sensory feedback Fiberoptic endoscope -​ Used to visualize velopharyngeal function -​ Works similar to endoscope for laryngeal imaging just stop before the larynx Indirect measure -​ Pressure articulation tests (fricative and plosives) -​ Aerodynamic measure – nasal resistance with pressure and flow, complicated and don't correlate well with what we hear -​ Acoustic measure: use a nasometer, picks nasal and oral acoustic energy, and puts in to software showing the relationship between the two measures -​ Easy to use, kids tolerate it -​ Given snetnes and non nasal passages they can read or repeat -​ Can address hyponasality as well -​ Important cutoff = relationship of nasal to oral acoustic energy < 28% is typically nasal and does not require intervention Velopharyngeal incompetence -​ When there is damage to the nerve that innervates the muscles that close the velopharyngeal port SLPs are involved -​ Neurological problem where the velar and pharyngeal tissue is there but does not function/move because it is not innervated -​ Typical causes of this are TBI & stroke Treatment -​ If nerve is not there, gag reflex is gone so they can use a palatal lift prosthesis -​ Hooks on to molar teeth and prompts up the velum up, preventing air from going into the nasal cavity -​ Mechanical props up velum, impedes airflow through nasal cavity  -​ Challenges: Usually used with people who may struggle cognitively (TBI), may also have trouble with swallowing so need to get used to swallowing -​ Most effective for: people with incomplete velopharyngeal closure -​ Effectiveness depends on -​ Type of closure pattern -​ Tolerance for wearing it -​ Lack of gag reflex (it won't be tolerable if you have one) -​ Won't work with people with spasticity -​ Kick it down with a swallow and have low tolerance -​ Memory: ability to keep track of it – or taking it out to eat -​ Recommend cautiously Velopharyngeal insufficiency -​ Also known as velopharyngeal inadequacy -​ Not enough tissue present to make closure even with the innervated nerve -​ There is no soft palate to prop up so you need something else Treatment -​ Use a palatal obturator to fill in velopharyngeal port and block air Knowledge Check 1.​ The muscle that movies the side and pack of the pharyngeal area inward is the superior pharyngeal constrictor 2.​ The correct term for inappropriate addition of natality to speech is: hypernasality or hypernasal resonance 3.​ What are the impacts of hypernasality on the spectrum? ○​ Dampens the energy because of soft tissue ○​ This reduces the signal to noise ratio ○​ Increases impact of breathiness has similar characteristics 4.​ Nasal air emission occurs on: high pressure sounds 5.​ The most common vp closure pattern is: coronal 6.​ Normal nasal airflow during the production of non-nasal sounds is: 0 7.​ A possible prosthetic intervention for vp incompetence is palatal lift 8.​ The palatal lift decreases nasal resonance by: impeding the flow of air into the nasal cavity 9.​ The palatal obturator: adds bulk to replace missing tissue 10.​ Resonance will be perceived to be WNL if nasalance is less than 28% 11.​ A palatal lift my cause: increased saliva generation 12.​ An utterance appropriate to assess nasal air emission is: peter will keep at the peak (need high pressure sounds, plosive and fricatives with no nasals)  13.​ An utterance appropriate to assess hypernasality is: how are you? (non nasal sounds) 14.​ An utterance appropriate to assess hypernasality is: mama made lemon jam (loaded with nasals) Vowels and source filter Source filter theory ​ Fundamental concept of how we speak ​ The sound produced at the level of the vocal folds/source is modified as it is transmitted through the vocal tract/filter ​ Physiologically, the Source = vocal fold and the filter = upper vocal tract ​ Acoustics of source filter theory ○​ Source = fundamental frequency and whole number multiples of the fundamental ○​ Filter = configuration of vocal tract that gives formants (greater acoustic energy) ​ Primarily applies to vowels ○​ Not typical in dysarthria oral motor development issues ○​ Can be altered if they have motor apraxia ○​ Mainly matters in accent modification/expansion -​ Can vary on region even within states and countries Transfer function -​ Transfer function: how the source is modified as it travels through the vocal tract -​ Formant = effect of signal traveling through upper vocal tract -​ Spectrums cn show an acoustic representation of the human voice with harmonics and fundamental frequency -​ From the initial source, what is the output? -​ If the vocal tract is a resonator + frequency selective → some of the frequency region s will get through the local tract without losing energy -​ It is never just one frequency BUT some lose energy a they travel through -​ Whatever frequency is at the source is the frequency that come out at the mouth. None are added after the vocal fold level -​ The frequencies that make it through AKA resonating frequencies, do not depend on the fundamental frequency -​ Can be calculated/deduced from physical principles like vocal tract shape and length -​ Visualizing the vocal tract as a tube -​ Closed end is the vocal folds, and open mouth is the open end -​ The resonating space can be modified by the shape of the tract (tongue has biggest influence) Physical aspects of frequency -​ Low frequency wavelength has a longer period -​ Takes up more space as it travels through the vocal tract -​ High frequency wavelength has a smaller period resonators -​ Everything has a natural vibration g frequency that allows certain waveforms to pass through easily maintaining their amplitude or loss energy -​ This depends on their shape and size -​ Big space = lower resonant frequency Vocal tract -​ The vocal tract is our resonating space → quarter wavelength resonator -​ Lowest wavelength that goes through is ¼ of the vocal tract -​ Have to physically picture what waveforms can pass through the vocal tract (depends on shape) -​ Like any resonator is has its own preferred resonating frequencies -​ Modification of source by the filter (upper vocal tract) os what gives us the perceived sounds -​ Tongue Position gives us the space/shape of vocal tact for vowel resonant frequencies Vocal tract length -​ Has the biggest influence on resonating frequencies -​ Child = 8cm -​ Adult female = 14 cm -​ Adult male = 17cm -​ The longer the vocal tract → the lower the resonating frequencies, shifting the frequencies downward -​ Lip rounding lengthens the vocal tract causes lower resonating frequencies Formants -​ Formants are composed of resonant frequencies -​ They are determined by natural resonance of the vocal tract -​ They have the greatest transfer of energy represented by a dark band on a spectrogram -​ This is the range of frequencies that transferred through the vocal tract -​ Definition: harmonics that are close to resonating frequencies of the vocal tract, determined by tongue position and the wavelength that passes through Fundamental frequency -​ Fundamental frequency effect the harmonic spacing of the spectral envelope but the shape of formants remains the same Vocal effort -​ When amplitude increases the harmonic spacing remains constant and shape of formant is maintained, they are just louder Rule of thumb -​ Large resonating space = low frequency, -​ Small resonating space yields a high frequency, -​ Space behind constriction (pharyngeal space) = F1 -​ high/low vowel determine F1 -​ High tongue = low F1, low tongue = high F2 -​ Space anterior to constriction = F2 -​ Front/back vowel determine F2 -​ Front = high F2, Back - low F2 -​ Spectra and spectrogram -​ Entire spectrum goes through upper vocal tract -​ When it is shaped in the position not produced different vowel sounds we can see the formants -​ Qua