SPPA 4030 Speech Science1 UNIT 2 RESPIRATION & PHONATION

SPPA 4030 Speech Science2 Structure and Mechanics of Respiratory System  Pulmonary system Lungs and airways  Upper respiratory system  Lower respiratory system  Chest wall system Necessary for normal vegetative and speech breathing

SPPA 4030 Speech Science3 Pulmonary system: lower respiratory tract

SPPA 4030 Speech Science4 Pulmonary system: lower respiratory tract

SPPA 4030 Speech Science5 Chest wall system  Rib cage  Abdomen  Diaphragm

SPPA 4030 Speech Science6 Chest wall-Lung relation  Lungs not physically attached to the thoracic walls  Lungs: visceral pleura  Thoracic wall: parietal pleura  Filled with Pleural fluid  P pleural < P atm - “pleural linkage” allows the lungs to move with the thoracic wall  Breaking pleural linkage P pleural = P atm - pneumothorax

SPPA 4030 Speech Science7 Thorax

SPPA 4030 Speech Science8 Abdomen

SPPA 4030 Speech Science9 Diaphragm

SPPA 4030 Speech Science10 Respiratory muscles  Diaphragm  External intercostals  Internal intercostals (interosseus & intercartilaginous)  Costal elevators  Serratus posterior superior  Serratus posterior inferior  Sternocleidomastoid  Scalenes  Trapezius Pectoralis major Pectoralis minor Serratus anterior Transverse throacis Rectus abdominis External obliques Internal obliques Transversus abdominis Quadratus lumborum

SPPA 4030 Speech Science11 Moving Air  V t =  P alv P alv < P atm (- P alv ) P differential = density differential  air molecules flowing into lungs = inspiration  V t =  P alv P alv > P atmos (+ P alv ) P differential = density differential  air molecules flow out of lungs = expiration Patm: atmospheric pressure Palv: alveolar pressure Vt: thoracic volume P = k/V: Boyle’s Law

SPPA 4030 Speech Science12 Changing lung volume (  V lung )  pleural linkage:  V lung =  V thoracic   V thoracic is raising/lowering the ribs (circumference)  Raising:  V thoracic = inspiration  Lowering:  V thoracic =expiration Raising/lowering the diaphragm (vertical dimension)  Raising:  V thoracic =expiration  Lowering:  V thoracic =inspiration

SPPA 4030 Speech Science13 Rest breathing vs. speech breathing  What are the goals?  Rest breathing ventilation  Speech breathing communication ventilation

SPPA 4030 Speech Science14 Quantifying respiratory function  What measures would be useful?

SPPA 4030 Speech Science15 Measuring respiratory function Volume Spirometer  “wet” and “dry” varieties

SPPA 4030 Speech Science16 Measuring respiratory function Pressure Manometer Specialized pressure transducers  measures pressure at specific locations  For example, When swallowed, thoracic and abdominal pressures “inserted” into the trachea for tracheal pressure placed strategically along the vocal tract

SPPA 4030 Speech Science17 Measuring respiratory function Flow Rate Spirometer  nonspeech Pneumotachograph  Airflow during speech and nonspeech  Vented mask the covers mouth and nose

SPPA 4030 Speech Science18 Spirometry Lung Volume

SPPA 4030 Speech Science19 Lung Volumes REL

SPPA 4030 Speech Science20 A Review of volumes and capacities Tidal Volume (TV) Volume of air inspired/expired during rest breathing. Expiratory Reserve Volume (ERV) Volume of air that can be forcefully exhaled, “below” tidal volume. Inspiratory Reserve Volume (IRV) Volume of air that can be inhaled, “above” tidal volume. Residual Volume (RV) Volume of air left after maximal expiration. Measurable, but not easily so. Total Lung Capacity (TLC) Volume of air enclosed in the respiratory system (i.e. TLC=RV+ERV+TV+IRV) Functional Residual Capacity (FRC) Volume of air in the respiratory system at the REL (i.e. FRC=RV+ERV) Inspiratory capacity (IC) TV + IRV Vital Capacity (VC) Volume of air that can be inhaled/exhaled (i.e. VC=IRV +TV+ERV)

SPPA 4030 Speech Science21 NOTE  Some authors use the term FRC (functional residual capacity) instead of REL (resting end-expiratory level)  Behrman uses resting lung volume (RLV)  Refers to equivalent “place” in the lung volume space

SPPA 4030 Speech Science22 Some typical adult values Typical Volumes & Capacities Vital Capacity (VC) 4-5 liters Total Lung Capacity (TLC) ~ one liter more than VC Resting Tidal Volume (TV) ~ 10 % VC Resting expiratory end level (REL) ~ 35-40% VC when upright Typical Rest Breathing Values Respiratory rate breaths/minute Alveolar Pressure P alv +/- 2 cm H 2 0 Airflow ~ 200 ml/sec

SPPA 4030 Speech Science23 Respitrace

SPPA 4030 Speech Science24

SPPA 4030 Speech Science25 Speech vs. Life Breathing Rest Breathing Volume 10 % VC at rest Alveolar Pressure P alv +/- 2 cm H 2 0 Average Airflow ml/sec Ratio of inhalation to exhalation ~40/60 to 50/50 Speech Breathing Volume % normal loudness (note Kent reports lower values) 40 % loud speech Alveolar Pressure P alv cm H 2 0 on expiration Average Airflow ml/sec Ratio of inhalation to exhalation ~ 10/90

SPPA 4030 Speech Science26 Respiratory System Mechanics

SPPA 4030 Speech Science27 Respiratory System Mechanics  It is spring-like (elastic)  Elastic systems have an equilibrium point (rest position)  What happens when you displace it from equilibrium?

SPPA 4030 Speech Science28 equilibrium Longer than equilibrium Displacement away from equilibrium Restoring force back to equilibrium

SPPA 4030 Speech Science29 equilibrium Shorter than equilibrium Displacement away from equilibrium Restoring force back to equilibrium

SPPA 4030 Speech Science30 equilibrium Shorter than equilibrium Longer than equilibrium Displacement away from equilibrium Restoring force back to equilibrium

SPPA 4030 Speech Science31 Equilibrium point ~ REL

SPPA 4030 Speech Science32 REL Lung Volume Below REL Lung Volume Above REL Displacement away from REL Restoring force back to REL

SPPA 4030 Speech Science33 Is the respiratory system heavily or lightly damped?

SPPA 4030 Speech Science34 Respiratory Mechanics: Bellow’s Analogy  Bellows volume = lung volume  Handles = respiratory muscles  Spring = elasticity of the respiratory system – recoil or relaxation pressure

SPPA 4030 Speech Science35  No pushing or pulling on the handles ~ no exp. or insp. muscle activity  Volume ~ REL  P atmos = P alv, no airflow

SPPA 4030 Speech Science36 muscle force elastic force pull handles outward from rest V increases ~ P alv decreases Inward air flow INSPIRATION At REL

SPPA 4030 Speech Science37 muscle force elastic force push handles inward from rest V decreases ~ P alv increases outward air flow EXPIRATION At REL

SPPA 4030 Speech Science38 Respiratory Mechanics: Bellow’s Analogy Forces acting on the bellows/lungs are due to  Elastic properties of the system Passive Always present  Muscle activity Active Under nervous system control (automatic or voluntary)

SPPA 4030 Speech Science39 Forces due to elasticity of system (no active muscle activity)  Recoil forces are proportionate to the amount of displacement from rest  Recoil forces ~ P alv  Relaxation pressure curve Plots P alv due to recoil force against lung volume

SPPA 4030 Speech Science40 Relaxation Pressure Curve (as in Behrman)

SPPA 4030 Speech Science41 Relaxation Pressure Curve (Our version)

42 % Vital Capacity Alveolar Pressure (cm H 2 0) relaxation pressure REL

SPPA 4030 Speech Science43 Breathing for Life: Inspiration pulling handles outward with net inspiratory muscle activity

SPPA 4030 Speech Science44 Breathing for Life: Expiration No muscle activity Recoil forces alone returns volume to REL

45 % Vital Capacity Alveolar Pressure (cm H 2 0) relaxation pressure 10 % ~ 2 cm Breathing for Life

SPPA 4030 Speech Science46 Respiratory demands of speech  Conversational speech requires “constant” tracheal pressure for driving vocal fold oscillation brief, “pulsatile” changes in pressure to meet particular linguistic demands  emphatic and syllabic stress  phonetic requirements

SPPA 4030 Speech Science47 Respiratory demands of speech  Conversational speech Volume solution  Constant tracheal pressure 8-10 cm H 2 0 Pulsatile solution  Brief increases above/below constant tracheal pressure  Driving analogy Volume solution  Maintain a relatively constant speed Pulsatile solution  Brief increases/decreases in speed due to moment to moment traffic conditions

SPPA 4030 Speech Science48 Example Time Pressure wrt atmosphere

49 Breathing for Speech: Inspiration pulling handles outward with net inspiratory muscle activity Rate of volume change is greater than rest breathing

50 % Vital Capacity Alveolar Pressure (cm H 2 0) relaxation pressure 20 % ~ 8-10 cm Breathing for Speech

51 % Vital Capacity Alveolar Pressure (cm H 2 0) relaxation pressure 20 % ~ 8-10 cm Breathing for Speech

52 Breathing for Speech: Expiration Expiratory muscle activity & recoil forces returns volume to REL Pressure is net effect of expiratory muscles (assisting) and recoil forces (assisting)

53 % Vital Capacity Alveolar Pressure (cm H 2 0) relaxation pressure 20 % ~ 8-10 cm Breathing for Speech

SPPA 4030 Speech Science54 Summary to this point Muscle activity for Inhalation  Life Active inspiration to overcome elastic recoil  Speech Active inspiration to overcome elastic recoil Greater lung volume excursion  Longer and greater amount of muscle activity Rate of lung volume change greater  Greater amount of muscle activity

SPPA 4030 Speech Science55 Summary to this point Muscle activity for exhalation  Life No active expiration (i.e. no muscle activity) Elastic recoil force only  Speech Active use of expiratory muscles to maintain airway pressures necessary for speech (8-10 cm water) Degree of muscle activity must increase to offset reductions in relaxation pressure

SPPA 4030 Speech Science56  This meets our needs to provide ‘constant’ pressure of 8-10 cm H 2 0  What about meeting our ‘pulsatile’ pressure demands?

SPPA 4030 Speech Science57 What is required to provide these pressure ‘pulses’?  Brief, robust expiratory muscle activity  We need a ‘well-tuned’ system Chest wall must be ‘optimized’ so that rapid changes can be made Optimal environment created by active muscle activity  A ‘modern’ view of speech breathing

SPPA 4030 Speech Science58 What we know now vs. then  “Classic” studies of speech breathing University of Edinburgh Draper, Ladefoged & Witteridge (1959, 1960)  “Contemporary” studies of speech breathing Harvard University Hixon, Goldman and Mead (1973) Hixon, Mead and Goldman (1976)

SPPA 4030 Speech Science59 What we know then and now Then  Inspiratory muscles only Now  Coactivation of  Rib cage (insp)  Abdomen (exp)  ‘net’ inspiration Net Inspiratory Muscle Pressure

SPPA 4030 Speech Science60 What we know then and now Then  All muscles are silent Now  Coactivation of Rib cage (insp) Abdomen (exp) System ‘balanced’ Net Zero Muscle Pressure

SPPA 4030 Speech Science61 What we know then and now Then  RC muscles Now  Rib cage (exp)  Abdomen (exp) Net Expiratory Muscle Pressure

SPPA 4030 Speech Science62 Interpretation of information  Constant muscle activity may serve to “optimize” the system in various ways For example,  Abdominal activity during inspiration  pushes on, and stretches the diaphragm  Optimal length-tension region of diaphragm  Increase ability for rapid contraction which is needed for speech breathing

SPPA 4030 Speech Science63 Interpretation of information  Constant muscle activity may serve to “optimize” the system in various ways For example,  Abdominal activity during expiration  Provides a platform for rapid changes in ribcage volume (pulsatile)  Without constant activity, abdomen would ‘absorb’ the forces produced by the ribcage

SPPA 4030 Speech Science64 So what?  Suggests speech breathing is more ‘active’ than originally thought  Passive pressures (recoil forces) of the system is heavily exploited in life breathing  speech breathing requires an efficient pressure regulator and therefore relies less on passive pressures

SPPA 4030 Speech Science65 Summary: Muscle activity Inspiration Life  Active inspiratory muscles Speech  COACTIVATION OF inspiratory muscles expiratory muscles (specifically abdominal)  INS > EXP = net inspiration  System ‘tuned’ for quick inhalation Expiration Life  No active expiration (i.e. no muscle activity) Speech  Active use of rib cage expiratory muscles  Active use of abdominal expiratory muscles  System “Tuned” for quick brief changes in pressure to meet linguistic demands of speech

SPPA 4030 Speech Science66 Summary: Muscle activity No Airflow Life  Minimal muscle activity Speech  Coactivation of Rib cage (inspiratory) Abdomen (expiratory) System ‘balanced’

SPPA 4030 Speech Science67 Lifespan considerations (Kent, 1997)  Respiratory volumes and capacities  until young adulthood  young adulthood to middle age  during old age   stature   elastic properties   muscle mass

SPPA 4030 Speech Science68 Lifespan considerations (Kent, 1997)  Maximum Phonation Time (MPT) Longest time you can sustain a vowel Function of  Air volume  Efficiency of laryngeal valving Follows a similar pattern to respiratory volume and capacities

SPPA 4030 Speech Science69 Lifespan considerations (Kent, 1997)  Birth Respiration rate breaths/minute Evidence of ‘paradoxing’ Limited number of alveoli for oxygen exchange

SPPA 4030 Speech Science70 Lifespan considerations (Kent, 1997)  3 years Respiration rate breaths/minute Speech breathing characteristics developing

SPPA 4030 Speech Science71 Lifespan considerations (Kent, 1997)  7 years Adult-like patterns > subglottal pressure than adults Number of alveoli reaching adult value of 300,000  10 years Functional maturation achieved  years Increases in lung capacities and volume

SPPA 4030 Speech Science72 Clinical considerations  Parkinson’s Disease  Cerebellar Disease  Spinal cord Injury  Mechanical Ventilation

SPPA 4030 Speech Science73 Parkinson’s Disease (PD)  Rigidity, hypo (small) & brady (slow) kinesia Speech breathing features   muscular rigidity   stiffness of rib cage   abdominal involvement relative to rib cage   ability to generate P trach   modulation P trach  Speech is soft and monotonous

SPPA 4030 Speech Science74 Cerebellar Disease  dyscoordination, inappropriate scaling and timing of movements Speech breathing features  Chest wall movements w/o changes in LV (paradoxical movements)   fine control of P trach  Abnormal start and end LV (below REL)  speech has a robotic quality

SPPA 4030 Speech Science75 Spinal cord injury  Remember those spinal nerves…  Paralysis of many muscles of respiration Speech breathing features  variable depending on specific damage   abdominal size during speech   control during expiration resulting in difficulty generating consistent P trach and modulating P trach  Treatment: Support the abdomen (truss)

SPPA 4030 Speech Science76 Mechanical Ventilation  Breaths are provided by a machine Speech breathing features   control over all aspects of breath support  Length of inspiratory/expiratory phase  Large, but inconsistent P trach  Inspiration at linguistically inappropriate places  Speech breathing often occurs on inspiration  Treatment: “speaking valves”, ventilator adjustment, behavioral training

SPPA 4030 Speech Science77 Other disorders that may affect speech breathing  Voice disorders  Hearing impairment  Fluency disorders  Motoneuron disease (ALS)