Voice Anatomy, Physiology, and Clinical Evaluation (II).ppt

Voice Anatomy, Physiology, and Clinical Evaluation (II) Physiology Airway protection Respiration Phonation Airway Protection Simply by glottic closure Evoluation of amphibious life Laryngeal closure is triggered via a reflex arc made up of the superior laryngeal nerve and the recurrent nerve. Laryngospasm represents exaggeration or perpetuation of reflex laryngeal closure. Cough and Throat Clearing Airway protection together with respiratory component. Glottic closure permits to raise subglottic air pressure and use high-pressure forceful exhalation to clear an irritant or obstruction. Respiration Posterior cricoarytenoid Counteract and anticipate the negative intraluminal pressure by diaphgram. Ability to respond to air pressure, temperature, humidity, and CO2 concentration. Voice Larynx : main source of energy for phonation Nasal and oral cavities: modify laryngeal output Phonation Myoelastic-aerodynamic theory of phonation Glottic Cycle Begin with accumulation of air pressure Air column compresses vocal folds laterally. Once the glottis is restored to original position, the cycle repeats. Oscillation of Glottic Cycle Pressure waveform Amplitude = loudness Freuqnecy = pitch Wave morphology = wave quality Loudness Raise the subglottic air pressure Frequency A function of vocal fold tension Mechanism involves an interaction between cricoarytenoid and the thyroarytenoid muscle. Examination Stroboscopy is the only technique that allows routine clinical imaging of vocal fold oscillation, and as a rsultit is likely the single strongest diagnostic instrument in most cases of dysphonia Dysphonia Disruptions of phonatory physiology Treatment must focus on the restoration of nomal physiology rather than excision of a specific lesion or alteration