1. SPPA 2050 Speeech Anatomy & Physiology Tasko
The Phonatory System
SPPA 2050 Speeech Anatomy & Physiology Tasko

2. SPPA 2050 Speeech Anatomy & Physiology Tasko
Outline
ANATOMY OF THE PHONATORY SYSTEM
Bones, Cartilages & Joints
Ligaments and membranes
Innervation of the larynx
Muscles of the Larynx
Laryngoscopic, coronal and dorsal views of larynx and associated structures
Vocal Fold Structure
PHYSIOLOGY OF PHONATORY SYSTEM
Laryngeal function
Description of vocal fold vibration
Necessary & sufficient conditions for phonation
SPPA 2050 Speeech Anatomy & Physiology Tasko

3. The Larynx: Key Functions
Airway Protection
Intrathoracic pressure generation
Valving for speech
SPPA 2050 Speeech Anatomy & Physiology Tasko

4. SPPA 2050 Speeech Anatomy & Physiology Tasko
The larynx: in situ
larynx
thyroid gland
trachea
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5. SPPA 2050 Speeech Anatomy & Physiology Tasko

6. SPPA 2050 Speeech Anatomy & Physiology Tasko
Midsagittal section
Figure 37.3
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7. SPPA 2050 Speeech Anatomy & Physiology Tasko
Spin 180º
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8. SPPA 2050 Speeech Anatomy & Physiology Tasko
Superior view
dorsal
Vocal folds
glottis
ventral
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9. Bones, Cartilages & Joints
SPPA 2050 Speeech Anatomy & Physiology Tasko

10. SPPA 2050 Speeech Anatomy & Physiology Tasko
Skeletal Structure
Hyoid Bone
Thyroid Cartilage
Cricoid Cartilage
Epiglottis
Arytenoid Cartilage
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.21

11. Hyoid Bone, Thyroid Cartilage & Epiglottis
Figure 37.21
Figure 37.17
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12. SPPA 2050 Speeech Anatomy & Physiology Tasko
Cricoid Cartilage
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.19

13. Arytenoid Cartilages (paired)
Figure 37.20
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14. SPPA 2050 Speeech Anatomy & Physiology Tasko
Laryngeal Joints
Movement Basics
6 degrees of freedom possible
Translation – 3 degrees
Rotation – 3 degrees
Pitch
Roll
Yaw
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15. SPPA 2050 Speeech Anatomy & Physiology Tasko
Laryngeal Joints
Figure 37.21
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16. SPPA 2050 Speeech Anatomy & Physiology Tasko
Joint Articulation
Thyroepiglottic joint
pitch
Cricothyroid joint
Pitch
Translation
Cricoarytenoid joint
Pitch and roll – rocking
Translation – sliding or gliding
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17. Ligaments & Membranes: Epiglottis
Hyoepiglottic l.
Thyroepiglottic l.
Glossoepiglottic folds (median and lateral)
Aryepiglottic fold
SPPA 2050 Speeech Anatomy & Physiology Tasko

18. Ligaments & Membranes: Epiglottis
Hyoepiglottic l.
Thyroepiglottic l.
Glossoepiglottic folds (median and lateral)
Aryepiglottic fold
SPPA 2050 Speeech Anatomy & Physiology Tasko

19. Ligaments & Membranes: Thyroid & Cricoid cartilages
Thyrohyoid m.
Ceratocricoid l.
Conus elasticus
Vocal l.
Cricotracheal m.
Posterior Cricoarytenoid l.
Figure 37.21
SPPA 2050 Speeech Anatomy & Physiology Tasko

20. Conus Elasticus & Vocal Ligament
Figure 37.21
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21. SPPA 2050 Speeech Anatomy & Physiology Tasko

22. Laryngeal Anatomy: “Surface Geography” – Superior view
esophagus
Dorsal/Posterior
arytenoid
glottis
Pyriform sinus
True vocal fold
aryepiglottic fold
False (ventricular) fold
epiglottis
Ventral/Anterior
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23. Anterior View of Larynx
Figure 37.31
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24. Interior view of larynx
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.23

25. SPPA 2050 Speeech Anatomy & Physiology Tasko
Coronal View
Rostral (superior)
Caudal (inferior)
Ventricular
(false) folds
ventricle
True vocal folds
glottis
Subglottal area
Supraglottal cavity
(aditus)
SPPA 2050 Speeech Anatomy & Physiology Tasko

26. SPPA 2050 Speeech Anatomy & Physiology Tasko
Coronal section
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.23

27. Laryngeal Anatomy Posterior view
Laryngeal Vestibule (aditus)
Pyriform Recess (fossa)
Figure 36.28
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28. SPPA 2050 Speeech Anatomy & Physiology Tasko
Nerve supply to larynx
Cranial Nerve X (Vagus N.)
provide motor supply to all intrinsic muscles
major nerve communicating sensory information to the CNS
2 branches important for larynx
Superior laryngeal nerve
Internal branch – provides sensory supply
External branch – supplies cricothyroid m.
Recurrent laryngeal nerve
Motor to all other intrinsic muscles
SPPA 2050 Speeech Anatomy & Physiology Tasko

29. SPPA 2050 Speeech Anatomy & Physiology Tasko
Nerve supply to Larynx
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.26
Figure 36.33

30. SPPA 2050 Speeech Anatomy & Physiology Tasko
Nerve supply to Larynx
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.28

31. Laryngeal Anatomy: The muscles
1. Intrinsic muscles
Both origin and insertion are within the larynx
2. Extrinsic muscles
An origin or insertion is within the larynx
3. Supplemental muscles
No origin/insertion within the larynx, but affects the location of larynx in the neck
SPPA 2050 Speeech Anatomy & Physiology Tasko

32. Intrinsic Laryngeal muscles
Key Actions
Position
Adduct
Abduct
Tension
Tense
Slacken
Length
Lengthen
Shorten
ADDUCTION
ABDUCTION
SPPA 2050 Speeech Anatomy & Physiology Tasko

33. Lateral cricoarytenoid (LCA)
Origin:
Superior edge of
lateral border of cricoid
cartilage
Insertion:
muscular process of
arytenoid
Action: adducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

34. Lateral cricoarytenoid (LCA) Action
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

35. Posterior cricoarytenoid (PCA)
Origin:
Posterior (dorsal) surface
of cricoid cartilage
Insertion:
muscular process of
arytenoid
Action: abducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

36. Posterior cricoarytenoid (PCA)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

37. Posterior cricoarytenoid (PCA) Action
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

38. SPPA 2050 Speeech Anatomy & Physiology Tasko
Thyroarytenoid (TA)
Often considered to have 2 parts
Vocalis
Thyromuscularis
Origin:
Internal surface of the thyroid
angle
Insertion:
Vocal and muscular process of
arytenoid
Action: shorten & adducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

39. SPPA 2050 Speeech Anatomy & Physiology Tasko
Thyroarytenoid (TA)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

40. Thyroarytenoid (TA) Action
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

41. (Inter)arytenoid (IA)
Often considered to have 2 fiber types
Oblique
Transverse
Origin:
Posterior (dorsal) surface of
arytenoid surface
Insertion:
opposite arytenoid
Action: adducts VF
Motor Supply: CN X
(recurrent laryngeal nerve)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

42. Interarytenoid (IA) Action
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

43. SPPA 2050 Speeech Anatomy & Physiology Tasko
Cricothyroid (CT)
Often considered to have 2 fiber types
Oblique
Vertical
Origin:
ventral and lateral surfaces of
arch of cricoid cartilage
Insertion:
Caudal border of the thyroid
cartilage and anterior surface of
inferior horn
Action: lengthens and tenses VF
Motor Supply: CN X
(external branch of superior laryngeal nerve)
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.22

44. Cricothyroid (CT) Action
From Netter
SPPA 2050 Speeech Anatomy & Physiology Tasko

45. SPPA 2050 Speeech Anatomy & Physiology Tasko
Summary of Key actions
Box 37.20
SPPA 2050 Speeech Anatomy & Physiology Tasko

46. Extrinsic laryngeal muscles
refers to muscles with a single attachment to a laryngeal cartilage
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47. Extrinsic muscles: Sternothyroid
Origin:
superior and posterior
portion of the sternum and
first costal cartilage
Insertion:
oblique line of thyroid
Action: depresses thyroid
cartilage
Motor Supply: C1-C3
Ansa cervicalis
SPPA 2050 Speeech Anatomy & Physiology Tasko

48. Extrinsic muscles: Thyrohyoid
Origin:
oblique line of thyroid
Insertion:
hyoid bone
Action: depresses hyoid or
elevates thyroid cartilage
Motor Supply: C1
SPPA 2050 Speeech Anatomy & Physiology Tasko

49. SPPA 2050 Speeech Anatomy & Physiology Tasko
Ansa Cervicalis
SPPA 2050 Speeech Anatomy & Physiology Tasko

50. SPPA 2050 Speeech Anatomy & Physiology Tasko
Ansa Cervicalis
SPPA 2050 Speeech Anatomy & Physiology Tasko

51. Supplemental laryngeal muscles
no direct attachments to laryngeal cartilages
attach on/near the hyoid bone
“Suspends” larynx in the neck
may elevate or depress hyo-laryngeal complex
Suprahyoid muscles: muscles that attach to sites rostral to the hyoid bone
Infrahyoid (aka ‘strap’) muscles: muscles that attach to sites caudal to the hyoid bone
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52. Supra and infra hyoid muscles
Figure 37.7
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53. SPPA 2050 Speeech Anatomy & Physiology Tasko
Geniohyoid
Figure 37.8
Figure 37.15
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54. SPPA 2050 Speeech Anatomy & Physiology Tasko
Mylohyoid
Figure 37.8
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55. Digastric and Stylohyoid
Figure 37.8
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.7

56. SPPA 2050 Speeech Anatomy & Physiology Tasko
Hyoglossus
Figure 36.23
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57. Sternohyoid & Omohyoid
Figure 37.15
SPPA 2050 Speeech Anatomy & Physiology Tasko
Figure 37.8

58. Sternohyoid & Omohyoid
Figure 37.7
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59. SPPA 2050 Speeech Anatomy & Physiology Tasko
Flex.mpg
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60. Vocal Fold paralysis video
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61. SPPA 2050 Speeech Anatomy & Physiology Tasko
Superior view
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62. “Layered” structure of vocal fold
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63. Basic Structure of the vocal fold
epithelium
connective tissue
superficial layer
tissue loosely connected to the other layers
intermediate layer
elastic fibers (stretchy)
deep layer
collagen fibers (not stretchy)
muscle (TA)
Lamina
propria
Vocal ligament
SPPA 2050 Speeech Anatomy & Physiology Tasko

64. SPPA 2050 Speeech Anatomy & Physiology Tasko
Vocal Fold Lesions
SPPA 2050 Speeech Anatomy & Physiology Tasko

65. SPPA 2050 Speeech Anatomy & Physiology Tasko
Laryngeal Physiology
SPPA 2050 Speeech Anatomy & Physiology Tasko

66. What is the function of the larynx?
Protection
Pressure generation
Valving for speech
SPPA 2050 Speeech Anatomy & Physiology Tasko

67. Laryngeal function during Swallowing
Within the SLP scope of practice
Role of larynx in swallowing
protect the airway from food/liquids.
Levels of protection
True vocal folds
Ventricular folds (false folds)
Adduction and anterior motion of arytenoids
“Retroflexion” of the epiglottis
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68. SPPA 2050 Speeech Anatomy & Physiology Tasko
Posterior (dorsal)
Anterior (ventral)
SPPA 2050 Speeech Anatomy & Physiology Tasko

69. Videofluoroscopy tape
Figure 37.3
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70. What is the function of the larynx?
Protection
Pressure generation
Valving for speech
SPPA 2050 Speeech Anatomy & Physiology Tasko

71. SPPA 2050 Speeech Anatomy & Physiology Tasko
What did we see?
Alternate opening and closing of the glottis
There are some distinct phases
Opening phase (glottis is getting bigger)
Closing phase (glottis is getting smaller)
Closed phase (glottal opening is absent)
Different parts of the glottis opens and closes at different times
“wave like” action along length of vocal folds
If we could see it, the bottom of the fold opens first and closes first (vertical phase difference)
SPPA 2050 Speeech Anatomy & Physiology Tasko

72. SPPA 2050 Speeech Anatomy & Physiology Tasko

73. SPPA 2050 Speeech Anatomy & Physiology Tasko
What did we see?
Different parts of the glottis opens and closes at different times
“wave like” action along length of vocal folds
If we could see it, the bottom of the fold opens first and closes first (vertical phase difference)
SPPA 2050 Speeech Anatomy & Physiology Tasko

74. SPPA 2050 Speeech Anatomy & Physiology Tasko

75. Why does phonation occur?
Aerodynamic-myoelastic theory of phonation
Glottal vibration is the result of an interaction between aerodynamic forces and vocal fold muscular forces
Three things are necessary and sufficient for phonation to occur
Adduction (often termed medial compression)
Longitudinal tension (the vocal fold must have an appropriate amount of tension along its length)
Aerodynamic forces (pushing and pulling by air flow and pressure)
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76. SPPA 2050 Speeech Anatomy & Physiology Tasko

77. Do we need a larynx to phonate?
Insufflation test
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