corso di anatomia dell’apparato uditivo e vocale e di ... · la laringe è formata da vari pezzi...
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Corso di Anatomia dell’Apparato Uditivo e Vocale e di NeuroanatomiaLaringe
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Func
tiona
l Ana
tom
y of
Spe
ech,
Lan
guag
e an
d He
arin
g: A
Prim
er, W
.H. P
erkin
s, R
. Ken
t Al
lyn &
Bac
on I
Edizi
one
1991
Laringe
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Cavità orale
Cavità nasali
Faringe
EsofagoTrachea
Laringe
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Epiglottide Adito laringeo
Laringe
Osso ioide
Cartilagine tiroide
Cartilagine cricoide
TracheaCavità orale
Cavità nasali
Faringe
EsofagoTrachea
Laringe
Imm
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e tra
tta d
a: A
nato
mia
e F
isiol
ogia
del
l’Uom
o, J
ohan
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Sch
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diEr
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999
Scheletro della laringe
La laringe è formata da vari pezzi cartilaginei tra loro articolati per contiguità e, a distanza, tramite legamenti.
I mezzi di fissità della laringe sono rappresentati dalle continuità di quest’organo con la trachea e la faringe, oltre che dai muscoli e dai legamenti che la connettono all’osso ioide superiormente e al torace inferiormente.
La laringe è posizionata, a riposo, nei maschi tra la 3a e 6a vertebra cervicale, nelle femmine e nei bambini leggermente più in alto.
C3: osso ioide C3-C4 (giunzione): bordo superiore della cartilagine tiroide C4-C5 (giunzione): cartilagine tiroidea C6: cartilagine cricoide
168 Chapter 4
If you examine Figure 4-1, you can see the relation between the trachea and larynx. You might recall that the trachea is composed of a series of cartilage rings, connected and separated by a fibroelastic membrane. The larynx sits as an oddly shaped box atop the last ring of the trachea. It is adjacent to cervical vertebrae 4 through 6 in the adult, but the larynx of an infant will be higher. The average length of the larynx in adult males is 44 mm; in females it is 36 mm.
The cricoid cartilage is a complete ring resting atop the trachea and is the most inferior of the laryngeal cartilages. From the side, the cricoid cartilage takes on the appearance of a signet ring, with its back arching up relative to the front. The cricoid and thyroid cartilages articulate at the cricothyroid joint. The thyroid cartilage is the largest of the laryngeal cartilages, articulating with the cricoid cartilage below by means of paired processes that let it rock forward and backward
cricoid: Gr., krikos, ring; “ring-form”
Epiglottis
Cuneiformcartilage
Triticialcartilage
Thyroid cartilage
Corniculatecartilage
Arytenoidcartilage
Cricoidcartilage
Figure 4-1 continued. (E) Exploded view of disarticulated laryngeal cartilages.Source: Delmar/Cengage Learning
(E)
Imm
agin
e tra
tta d
a: A
nato
my
and
Phys
iolo
gy o
f Spe
ech,
Lan
guag
e an
d He
arin
g,
Seike
l, Ki
ng, D
runr
ight
, IV
Edizi
one
2010
Cartilagine tiroide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine tiroide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine tiroide
90°
Immagine tratta da: Anatomia Umana, Balboni C.G et al.. EdiErmes, III Edizione 2000
Cartilagine tiroide nel maschio
120°
Immagine tratta da: Anatomia Umana, Balboni C.G et al.. EdiErmes, III Edizione 2000
Cartilagine tiroide nella femmina
Cartilagine cricoide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine cricoide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine cricoide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine cricoide
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Cartilagini aritenoidi
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
Cartilagini aritenoidi
Movimento delle aritenoidi
movimento di rotazione (rocking) ad angolo retto rispetto all’asse maggiore della lamina cricoidea
movimento di scivolamento (gliding) che consente alle aritenoidi di avvicinarsi o allontanarsi l’una dall’altra
movimento di rotazione (rotating) che consente alle aritenoidi di ruotare (limitatamente) sul proprio asse verticale
186 Chapter 4
To summarize:The laryngeal cartilages have a number of important landmarks • to which muscles are attached.The • cricoid cartilage is shaped like a signet ring, higher in back.The • arytenoid cartilages ride on the superior surface of the cricoid, with the cricoarytenoid joint permitting rotation, rocking, and gliding.The • muscular and vocal processes provide attachment for the thyromuscularis and thyrovocalis muscles.
Figure 4-11. The articular facet for the arytenoid cartilage permits rocking, gliding, and rotation. (A) The shape of the articular facet for the arytenoid cartilage promotes inward rocking of the arytenoid cartilage and vocal folds, as shown by the arrows. (B) The long axis of the facet permits limited anterior-posterior gliding. (C) The arytenoids may also rotate as shown, although this does not appear to be a functional movement for adduction. (Based on data of Broad, 1973; Fink & Demarest, 1978; Netter, 1997; Zemlin, 1998.)Source: Delmar/Cengage Learning
Facet for arytenoid
Facet for arytenoid
Facet for arytenoid
Axis for rocking
Axis for gliding
Axis for rotation ofarytenoid
Arytenoid cartilage
Arytenoid cartilage
Arytenoid cartilage
Cricoid cartilage
Cricoid cartilage
SUPERIOR VIEW
SUPERIOR VIEW
SUPERIOR VIEW
LATERAL VIEW
Cricoid cartilage
(A)
(B)
(C)
Anatesse Lesson
Rocking
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
186 Chapter 4
To summarize:The laryngeal cartilages have a number of important landmarks • to which muscles are attached.The • cricoid cartilage is shaped like a signet ring, higher in back.The • arytenoid cartilages ride on the superior surface of the cricoid, with the cricoarytenoid joint permitting rotation, rocking, and gliding.The • muscular and vocal processes provide attachment for the thyromuscularis and thyrovocalis muscles.
Figure 4-11. The articular facet for the arytenoid cartilage permits rocking, gliding, and rotation. (A) The shape of the articular facet for the arytenoid cartilage promotes inward rocking of the arytenoid cartilage and vocal folds, as shown by the arrows. (B) The long axis of the facet permits limited anterior-posterior gliding. (C) The arytenoids may also rotate as shown, although this does not appear to be a functional movement for adduction. (Based on data of Broad, 1973; Fink & Demarest, 1978; Netter, 1997; Zemlin, 1998.)Source: Delmar/Cengage Learning
Facet for arytenoid
Facet for arytenoid
Facet for arytenoid
Axis for rocking
Axis for gliding
Axis for rotation ofarytenoid
Arytenoid cartilage
Arytenoid cartilage
Arytenoid cartilage
Cricoid cartilage
Cricoid cartilage
SUPERIOR VIEW
SUPERIOR VIEW
SUPERIOR VIEW
LATERAL VIEW
Cricoid cartilage
(A)
(B)
(C)
Anatesse Lesson
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
Gliding
186 Chapter 4
To summarize:The laryngeal cartilages have a number of important landmarks • to which muscles are attached.The • cricoid cartilage is shaped like a signet ring, higher in back.The • arytenoid cartilages ride on the superior surface of the cricoid, with the cricoarytenoid joint permitting rotation, rocking, and gliding.The • muscular and vocal processes provide attachment for the thyromuscularis and thyrovocalis muscles.
Figure 4-11. The articular facet for the arytenoid cartilage permits rocking, gliding, and rotation. (A) The shape of the articular facet for the arytenoid cartilage promotes inward rocking of the arytenoid cartilage and vocal folds, as shown by the arrows. (B) The long axis of the facet permits limited anterior-posterior gliding. (C) The arytenoids may also rotate as shown, although this does not appear to be a functional movement for adduction. (Based on data of Broad, 1973; Fink & Demarest, 1978; Netter, 1997; Zemlin, 1998.)Source: Delmar/Cengage Learning
Facet for arytenoid
Facet for arytenoid
Facet for arytenoid
Axis for rocking
Axis for gliding
Axis for rotation ofarytenoid
Arytenoid cartilage
Arytenoid cartilage
Arytenoid cartilage
Cricoid cartilage
Cricoid cartilage
SUPERIOR VIEW
SUPERIOR VIEW
SUPERIOR VIEW
LATERAL VIEW
Cricoid cartilage
(A)
(B)
(C)
Anatesse Lesson
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
Rotating
Cartilagine epiglottide
Immagine tratta da: Petra Kopf-Maier, Anatomia Umana-Atlante, EdiErmes, I Edizione 2000
Cartilagine epiglottide
Legamenti e membrane
Legamento tiroioideo laterale
Legamenti intrinseci
Legamenti estrinseci
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
Legamenti intrinseci
Legamenti estrinseci
Legamento tiroioideo medioLegamento tiroioideo laterale
Membrana tiroioidea
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
Legamenti intrinseci
Legamenti estrinseci
Legamento tiroioideo laterale
Legamento tiroepiglottico
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
Corno superiore
Legamento tiroioideo laterale (cartilagine triticea)
Grande corno dell’osso ioide
Epiglottide
Corpo dell’osso ioide
Membrana tiroioidea
Cartilagine aritenoide
Processo vocale
Cartilagine cricoide e cono elastico Cartilagine cricoide (arco)
Legamento cricotiroideo medio
Legamento vocale
Cartilagine tiroide
Epiglottide (picciuolo)Legamento tiroepiglottico
Legamento ioepiglottico
Membrana tiroioidea (Leg. tiroioideo medio)
Cartilagine corniculata
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Legamento vestibolare
Membrana quadrangolare
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Osso ioide
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Cartilagine tiroide
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Immagine trattta da: Anatomia del Gray, Vol.3, Zanichelli, IV Edizione
Corno superiore
Legamento tiroioideo laterale (cartilagine triticea)
Grande corno dell’osso ioide
Epiglottide
Corpo dell’osso ioide
Membrana tiroioidea
Cartilagine aritenoide
Processo vocale
Cartilagine cricoide e cono elastico Cartilagine cricoide (arco)
Legamento cricotiroideo medio
Legamento vocale
Cartilagine tiroide
Epiglottide (picciuolo)Legamento tiroepiglottico
Legamento ioepiglottico
Membrana tiroioidea (Leg. tiroioideo medio)
Cartilagine corniculata
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Legamento vestibolare
Grande corno dell’osso ioide
Epiglottide
Membrana tiroioidea
Piccolo corno dell’osso ioide
Leg. tiroioideo medio
Incisura tiroidea superiore
Lamina cricoide, processo vocale
Cartilagine cricoide (arco)
Corno inferiore
Legamento cricotiroideo mediano
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Epiglottide (picciuolo)
Grande corno dell’osso ioide
Legamento tiroioideo laterale (cartilagine triticea)
Membrana tiroioidea
Cartilagine curniculata
Processo muscolare
Epiglottide
Articolazione cricotiroideaLamina cricoide
Legamento cricotiroideo laterale
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Muscoli intrinseci della laringe
Muscolo cricoaritenoideo laterale
Muscolo aritenoideo trasverso
Muscolo aritenoideo obliquo
Muscoli adduttori
M. cricoaritenoideo posteriore
M. vocale
Muscolo cricoaritenoideo laterale
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. cricoaritenoideo laterale
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Muscolo cricoaritenoideo laterale
Muscolo cricoaritenoideo laterale
Origine superficie superiore e laterale della cartilagine cricoide
Inserzione processo muscolare delle cartilagine aritenoidea
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione adduce le corde vocali, aumenta la compressione mediale
M. cricoaritenoideo posteriore
M. aritenoideo obliquo
Muscolo aritenoideo trasverso
M. tiroaritenoideo parte tiroepiglottica
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. aritenoideo trasverso
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Muscolo aritenoideo trasverso
Origine margine laterale della parte posteriore della cartilagine aritenoide
Inserzione margine laterale della superficie posteriore della cartilagine aritenoide opposta
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione adduce le corde vocali
M. cricoaritenoideo posteriore
M. aritenoideo trasverso
M. aritenoideo obliquo
M. tiroaritenoideo parte tiroepiglottica
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. aritenoideo obliquo
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Muscolo aritenoideo obliquo
Origine base posteriore del processo muscolare
Inserzione apice della cartilagine aritenoidea opposta
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione porta gli apici delle cartilagini aritenoidi medialmente
Muscolo cricoaritenoideo posteriore
Muscolo abduttore
M. cricoaritenoideo laterale
M. vocale
M. cricoaritenoideo posteriore
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. cricoaritenoideo posteriore
M. aritenoideo trasverso
M. aritenoideo obliquo
M. tiroaritenoideo parte tiroepiglottica
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. cricoaritenoideo posteriore
M. cricoaritenoideo posteriore
Muscolo cricoaritenoideo posteriore
Origine lamina posteriore della cartilagine cricoide
Inserzione processo muscolare della cartilagine aritenoidea
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione abduce le corde vocali
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Muscoli tensori delle corde vocali
Muscolo cricotiroideo
Muscolo vocale (tiroaritenoideo mediale)
Parte retta Parte
obliqua
Muscolo cricotiroideo
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. cricotiroideo
Muscolo cricotiroideo
Origineparte retta: superficie anteriore della cartilagine cricoide sotto l’arco parte obliqua: cartilagine cricoide lateralmente alla parte retta
Inserzioneparte retta: parte inferiore della lamina tiroidea parte obliqua: cartilagine tiroidea tra la lamina ed il corno inferiore
Innervazione nervo vago (X), nervo laringeo superiore
Funzionealza la cartilagine cricoide relativamente alla cartilagine tiroide (abbassa la cartilagine tiroide relativamente alla cricoide), tende le corde vocali
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
M. cricoaritenoideo posteriore
M. cricoaritenoideo laterale
Muscolo vocale
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. vocale
Muscolo vocale (tiroaritenoideo mediale)
Origine angolo diedro della cartilagine tiroidea
Inserzione superficie laterale del processo vocale della cartilagine aritenoidea
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione tende le corde vocali
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Muscoli rilassatori delle corde vocali
Muscolo tiroaritenoideo laterale
M. tiroaritenoideo parte tiroepiglottica
M. cricoaritenoideo laterale
M. cricoaritenoideo posteriore
Muscolo tiroaritenoideo
M. ariepiglottico
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. tiroaritenoideo
Muscolo tiroaritenoideo laterale
Origine angolo diedro della cartilagine tiroidea
Inserzione processo muscolare e base della cartilagine aritenoidea
Innervazione nervo vago (X), nervo laringeo ricorrente
Funzione rilassa le corde vocali
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Altri muscoli intrinseci
Muscolo tiroaritenoideo, parte epiglottica (Muscolo tiroepiglottico)
Muscolo ariepiglottico
M. tiroaritenoideo
M. cricoaritenoideo laterale
M. cricoaritenoideo posteriore
Immagine tratta da:Anatomia Umana-Atlante tascabile-Splancnologia, Fritsch e Kuhnel, Casa Editrice Ambrosiana, II Edizione
M. tiroaritenoideo parte tiroepiglottica
M. ariepiglottico
Muscoli che modificano la glottide: cricoaritenoideo posteriore e laterale, aritenoideo obliquo e trasverso;
Muscoli che regolano lo stato di tensione dei legamenti vocali: cricotiroideo, cricoaritenoideo posteriori, tiroaritenoideo e vocale;
Muscoli che modificano l’adito della laringe: aritenoideo obliquo, ariepiglottico e tiroepiglottico.
Azione dei muscoli intrinseci
M. ariepiglottico
M. aritenoidei (trasverso ed obliquo)
Processo muscolare
M. cricoaritenoideo posteriore
M. cricoaritenoideo laterale
M. cricotiroideoAtla
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M. aritenoideo trasverso
M. aritenoideo obliquo
M. ariepiglottico
M. tiroepiglottico
M. tiroaritenoideo
M. vocale
Legamento vocale e muscolo vocale
M. cricoaritenoideo laterale
M. cricoaritenoideo posteriore
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Mucosa
Vestibolo laringeo o cavità sopraglottica
Segmento inferiore o cavità sottoglottica
Ventricolo laringeo o segmento medio
Immagine tratta da: Anatomia e Fisiologia dell’Uomo, Johann S. Schwegler, EdiErmes, I Edizione 1999
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
Physiology of Phonation 227
In summary:We use the larynx and associated structures for many • nonspeech functions, including coughing, throat-clearing, and abdominal fixation.These functions serve important biological needs and provide us • with the background for useful clinical intervention techniques.
LARYNGEAL FUNCTION FOR SPEECHBefore discussing phonation, we must look at the primary physical principle supporting phonation: the Bernoulli effect.
The Bernoulli Effect
Vocal folds are masses that may be set into vibration. The larynx is the cartilaginous structure housing the two bands of tissue we call the vocal folds. The paired vocal folds are situated on both sides of the larynx so that they actually intrude into the airstream, as you can see from the schematic in Figure 5-2. This figure is a view from above and a view from behind. From above, you can see that the vocal folds are bands of tissue that are actually visible from a point immediately behind your tongue, looking down toward the lungs. From behind, you can see that the vocal folds are also a constriction in the airway, a critical concept for phonation.
You will remember from our discussion of respiratory physiology that any constriction in the airway greatly increases airway turbulence. If you are a passenger in a car and put your hand out of the window, you will feel the force of the wind dragging against your hand and you will hear the turbulence associated with it. You can rotate your hand so that the turbulence is reduced or increased; as the force on your hand increases, it becomes more difficult to keep your hand in the airstream.
The vocal folds are also a source of turbulence in the vocal tract. Without them, air would pass relatively unimpeded out of the lungs and into the oral cavity. The addition of the vocal folds results in air
See Chapter 3 for a discussion of respiratory physiology.
Epiglottis
Ventricular folds
Vocal folds
SUPERIOR VIEW
Figure 5-2. (A) Vocal folds from above. (continues)Source: Delmar/Cengage Learning
(A)
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
A: commessura anteriore, E: epiglottide, F: plica ventricolare (corda falsa), T: plica vocale (corda vera), V: ventricolo laringeo (di Morgagni)
Immagine tratta da: Hystology and Cell Biology , A.L. Kierszenbaum, Mosby I Edizione 2002
Epitelio pavimentoso pluristratificato (<0.1 mm)
Lamina propria, strato superficiale: fibre di elastina con disposizione disordinata
Lamina propria, strato intermedio (1-2 mm): fibre di elastina con disposizione in senso antero-posteriore
Lamina propria, strato profondo (1-2 mm): fibre di collagene con disposizione in senso antero-posteriore
Muscolo vocale
Epitelio pavimentoso pluristratificato (<0.1 mm)
Lamina propria strato superficiale: fibre di elastina con disposizione disordinata
Lamina propria strato intermedio (1-2 mm): fibre di elastina con disposizione in senso antero-posteriore
Lamina propria strato profondo (1-2 mm): fibre di collagene con disposizione in senso antero-posteriore
Muscolo vocale
Legamento vocale
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, Thomson Delmar Learning III Edizione 2005
228 Chapter 5
Thyroid cartilage
Ventricular(false) folds
Laryngealventricle
Vocal folds
Epiglottis
Cricoid cartilage
CORONAL SECTION, FROM BEHIND
Figure 5-2 continued. (B) Anterior view of larynx, showing constriction in laryngeal space caused by the vocal folds.Source: Delmar/Cengage Learning
(B)
Bernoulli Effect in BaseballExamples of the Bernoulli effect are apparent throughout daily life. If you are a baseball fan, you will appreciate the amazing curve ball of your favorite pitcher more when you realize that the Bernoulli effect is the driving force behind it. In this case, the pitcher ensures that the ball begins its flight with the smooth surface toward the front and that the seam on the ball rotates to the side of the ball sometime during its brief flight. The seam acts as a constriction: The pressure on the seam side is lower than that on the opposite smooth side, and the ball is “sucked” toward the seam.
For an excellent discussion of this effect, see Adair (2002).
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F: plica ventricolare (corda falsa), T: plica vocale (corda vera), VL: legamento vocale, VM: muscolo vocale.
Muscoli estrinseci della laringe
Muscoli elevatori della laringe e dell’osso ioide
Muscolo digastrico anteriore e posteriore
Muscolo stiloioideo
Muscolo miloioideo
Muscolo genioioideo
Muscolo genioglosso
Muscolo ioglosso
Muscolo tireofaringeo (Muscolo costrittore inferiore della faringe)
Muscolo digastrico (ventre anteriore e posteriore)
Origineventre anteriore: superficie interna della mandibola ventre posteriore: processo mastoideo dell’osso temporale
Inserzione osso ioide, mediante un tendine
Innervazioneventre anteriore: nervo trigemino (V) ramo mandibolare ventre posteriore: nervo faciale (VII), ramo digastrico
Funzioneventre anteriore: porta l’osso ioide verso l’alto e in avanti ventre posteriore: porta l’osso ioide verso il basso e all’indietro; insieme: alzano l’osso ioide
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
Muscolo digastrico(ventre posteriore)
Muscolo digastrico(ventre anteriore)
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
Muscolo digastrico
Muscolo stiloioideo
Origine processo stiloioideo dell’osso temporale
Inserzione corpo dell’osso ioide
Innervazione nervo faciale (VII)
Funzione eleva l’osso ioide e lo muove posteriormente
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
Muscolo digastrico(ventre anteriore)
Muscolo digastrico(ventre posteriore)
Muscolo stiloioideo
Muscolo miloioideo
Origine linea miloioidea, faccia interna della mandibola
Inserzione corpo dell’osso ioide
Innervazione nervo trigemino (V) ramo mandibolare
Funzione alza l’osso ioide o abbassa la mandibola
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. miloioideoM. miloioideo(sezionato e sollevato)
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. miloioideo
Muscolo genioioideo
Origine spina mentale, faccia interna della mandibola
Inserzione corpo dell’osso ioide
Innervazione nervo ipoglosso XII
Funzione alza l’osso ioide, abbassa la mandibola
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. genioioideo
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. genioioideo
Muscolo ioglosso
Origine margine della lingua
Inserzione grande corno dell’osso ioide
Innervazione nervo ipoglosso XII
Funzione alza l’osso ioide, abbassa la mandibola
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. ioglosso
Muscolo genioglosso
Origine superficie interna della mandibola a livello della sinfisi
Inserzione lingua e osso ioide
Innervazione nervo ipoglosso XII
Funzione alza l’osso ioide
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. genioglosso
Muscolo tirofaringeo (costrittore inferiore della faringe)
Origine rafe posteriore della faringe
Inserzione lamina della cartilagine tiroidea e corno inferiore
Innervazionenervo vago (X), nervo laringeo ricorrente (ramo laringeo esterno) nervo vago (X), nervo laringeo superiore (ramo faringeo)
Funzione alza la laringe e costringe la faringe
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. tirofaringeo
M. costrittore inferiore della faringe
Muscoli depressori della laringe e dell’osso ioide
Muscolo sternoioideo
Muscolo omoioideo
Muscolo sternotiroideo
Muscolo tiroioideo
Muscolo sternoioideo
Origine manubrio dello sterno e clavicola
Inserzione margine inferiore del corpo dell’osso ioide
Innervazione ansa cervicale da C3 a C4
Funzione abbassa l’osso ioide
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. sternoioideo
Muscolo omoioideo (ventre superiore e inferiore)
Origineventre superiore: corpo dell’osso ioide ventre inferiore: margine superiore della scapola
Inserzione osso ioide mediante un tendine
Innervazioneventre superiore: ramo superioe dell’ansa cervicale da C1 ventre inferiore: ansa cervicale C2-C3
Funzione abbassa l’osso ioide
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. omoioideo
Muscolo sternotiroideo
Origine manubrio dello sterno
Inserzione linea obliqua della cartilagine tiroidea
Innervazione nervo ipoglosso (XII) e nervi spinale C1, C2
Funzione abbassa la cartilagine tiroidea
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. sternotiroideo
Muscolo tiroioideo
Origine linea obliqua della cartilagine tiroidea
Inserzione grandi corna dell’osso ioide
Innervazione nervo ipoglosso (XII) e fibre del nerv spinale C1
Funzione abbassa l’osso ioide o alza la cartilagine tiroidea
Immagine tratta da: Anatomia Umana, Martini, Timmons, Tallitsch, EdiSes, III Edizione 2008
M. tiroioideo
Vascolarizzazione
Le principali arterie della laringe sono i rami laringei delle arterie tiroidee superiore e inferiore.
Il sangue venoso viene drenato da vene che fanno capo sia alla vena tiroidea superiore, tributaria della giugulare interna, sia alla vena tiroidea inferiore, che drena nella vena brachiocefalica sinistra.
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Superior thyroid artery
Inferior thyroid artery
Innervazione
La laringe è innervata dal nervo laringeo superiore e dal nervo laringeo inferiore, rami del nervo vago.
Il nervo laringeo superiore fornisce rami sensitivi a tutta la mucosa laringea e rami motori al muscolo cricotiroideo.
Il nervo laringeo inferiore, ramo del nervo laringeo ricorrente, è esclusivamente motore ed innerva tutti gli altri muscoli intrinseci della laringe.
Immagine tratta da: Gray’s Anatomy, Churchill Livingstone Elsevier, 40a Edizione 2008
Nervo laringeo interno
Nervo laringeo ricorrente
Nervo laringeo esterno
Nervo laringeo superiore
Anatomia funzionale della laringe
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Parte intercartilaginea
Parte intermembranosa
Piega vocalePiega ventricolare
Tubercolo cuneiforme
Tubercolo curniculato
Margine dell’epiglottide
Parte cartilaginea
Incisura interaritenoidea
Cono elastico e rima della glottide (pars intercartilaginea)
Legamento vocale e rima della glottide (pars intermembranacea)
Processo muscolareFaccetta articolare aritenoidea
Apice
Cartilagine cricoidea, articolazione tiroidea
Arco cricoideo
Legamento cricoaritenoideo medio Inserzione del legamento vocale
Piega ariepliglottica
In posizione di riposo
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Corno superioreCartilagine aritenoidea
Plica interaritenoidea
Durante una inspirazione
profonda
Trachea
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Rima della glottide (pars intercartilaginea)
Rima della glottide (pars intermembranacea)
Durante la fonazione con
normale tono di voce
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Rima della glottide (pars intercartilaginea)
Plica vocale, rima della glottide (pars intermembranacea)
Durante la fonazione con
parola bisbigliata
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
Rima della glottide (pars intermembranacea)
Apice
Durante la fonazione in
falsetto
Atlas der topographischen und angewandten Anatomie des Menschen, Urban & Schwarzenberg, 1964
In posizione di riposo
Durante una normale fase respiratoria
Immagine tratta da: Anatomia Umana, Balboni C.G et al.. EdiErmes, III Edizione 2000
Durante la fonazione con normale tono di voce
Durante la fonazione con parola bisbigliata
Immagine tratta da: Anatomia Umana, Balboni C.G et al.. EdiErmes, III Edizione 2000
Aperta durante la respirazione
Aperta durante un’ispirazione forzata (apertura massima)
Chiusa durante la fonazione
Immagine tratta da: Anatomia dell’Uomo, G. Ambrosi et al., Edi-Ermes II Edizione 2006
Funzione della glottide come valvola durante i processi vitali di base
Respirazione
abduzione ad una posizione intermedia
abduzione laterale
Deglutizione
Generazione di pressione (es. per lo starnuto, tosse, ecc.)
Se noi usassimo le funzioni di valvola della laringe così come funzionano nei riflessi biologici di base, il linguaggio sarebbe impossibile.
Chiaramente, abbiamo ereditato riflessi adatti alle peculiari caratteristiche del linguaggio. Invece di essere compresse a tal punto da impedire il passaggio dell’aria, le corde vocali adducono quanto basta affinchè possano entrare in vibrazione.
Ciclo della glottide
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
Physiology of Phonation 229
having to make a detour around the folds, and the result of that detour invokes a discussion of the Bernoulli effect.
Daniel Bernoulli, a seventeenth-century Swiss scientist, recognized the effects of constricting a tube during fluid flow. The Bernoulli effect states that, given a constant volume flow of air or fluid, at a point of constriction there will be a decrease in pressure perpendicular to the flow and an increase in velocity of the flow. If you put a constriction in a tube, air flows faster as it through the constriction, and the pressure on the wall at the point of constriction will be lower than that of the surrounding area. Let us examine this statement.
Airfl ow IncreaseFigure 5-3 shows a tube with a constriction in it representing the vocal folds. If you have placed your thumb over a garden hose, you know that the rate of water flow increases as a result of that constriction. Likewise, if you have ever been white-water rafting, you will immediately recognize that the white water rapids arise from constrictions in the flow of the river, in the form of boulders. As the water flows through the constriction, the rate of flow increases, giving you a thrill as you speed uncontrollably toward your fate.
Figure 5-3. Rate of airflow through the tube will increase at the point of constriction, and air pressure will decrease at that point as well.Source: Delmar/Cengage Learning
Effetto Bernoulli
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Effetto Bernoulli
All’inizio della fonazione le parti intermembranosa e intercartilaginea della glottide sono ridotte ad una fessura lineare dai movimenti di intrarotazione e scivolamento (mediale) delle articolazioni cricoaritenoidee, dovuti alla contrazione dei muscoli cricoaritenoideo laterale (intrarotazione) e trasverso (scivolamento mediale)
La chiusura della glottide comporta, al di sotto delle pieghe vocali, un aumento della pressione dell’aria sufficiente ad allontanarle.
La caduta di pressione, conseguente alla separazione delle corde vocali, e la loro elasticità intrinseca richiudono la glottide.
Ciò è coadiuvato dal risucchio dovuto all’improvvisa riduzione di pressione (effetto Bernoulli).
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Physiology of Phonation 231
What you hear as voicing is the product of the repeated opening and closing of the vocal folds. The motion of the tissue and the resultant airflow disturb the molecules of air, causing the phenomenon we call sound.
The act of bringing the vocal folds together for phonation is referred to as adduction, and the process of drawing the vocal folds apart to terminate phonation is called abduction. As we shall see, both of these movements are achieved using specific muscles, but the actual vibration of the vocal folds is the product of airflow interacting with the tissue in the absence of repetitive muscular contraction.
If you have followed this introductory discussion of the principles governing vocal fold vibration, you are prepared to examine the structures of the larynx.
In summary:Phonation• , or voicing, is the product of vibrating vocal folds within the larynx.The • vocal folds vibrate as air flows past them; the Bernoulli phenomenon and tissue elasticity help maintain phonation.
ANTERIOR VIEW
(A)
(B)
(C)
(D)
(E)
(F)
(G)
Figure 5-4. One cycle of vocal fold vibration as seen through a frontal section. (A) Air pressure beneath the vocal folds arises from respiratory flow. (B) Air pressure causes the vocal folds to separate in the inferior. (C) The superior aspect of the vocal folds begins to open. (D) The vocal folds are blown open, the flow between the folds increases, and pressure at the folds decreases. (E) Decreased pressure and the elastic quality of vocal folds causes folds to move back toward midline. (F) The vocal folds make contact inferiorly. (G) The cycle of vibration is completed.Source: Delmar/Cengage Learning
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
La singola vibrazione della corda vocale viene definita ciclo della glottide. Il ciclo della glottide è il blocco base con cui viene costruita la voce.
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Ciclo della glottide
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
ANTERIOR VIEW SUPERIOR VIEW
(A)
A.
(B)
(C)
(D)
(E)
(F)
(G)
Z
X
Mucosal membrane
Y
m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
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(B)
ANTERIOR VIEW SUPERIOR VIEW
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A.
(B)
(C)
(D)
(E)
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Mucosal membrane
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m k1
k2M
Thyrovocalis
Glottis
Figure 5-5. (A) Graphic representation of vertical and transverse phase relationships during one glottal cycle. Note that generally the vocal folds open from inferior to superior and also close from inferior to superior. Simultaneously, the glottis grows generally from posterior to anterior, but the vocal folds close from anterior to posterior. (B) The mucoviscoaerodynamic theory of vocal fold vibration (Titze, 1973) holds that vocal fold vibration can best be explained if the mechanism is viewed as a series of masses (m) linked by spring elements (k). (Redrawn by permission, from Titze [1973] “The Human Vocal Cords: A Mathematical Model, Part I.” Phonetica, 28, 129–170.)Source: Delmar/Cengage Learning
236
(A)
(B)
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Il suono prodotto viene trasmesso alla colonna d’aria che si estende dalle corde vocali fino all’esterno, prevalentemente attraverso l’orifizio orale ma una quantità significativa passa di solito anche attraverso le cavità nasali.
Immagine tratta da: Functional Anatomy of Speech, Language and Hearing: A Primer, W.H. Perkins, R. Kent Allyn & Bacon I Edizione 1991
Physiology of Phonation 245
condition, this would be the same as optimal pitch. For some individuals, there are compelling reasons to alter their everyday pitch in speech beyond the range expected for their age, size, or gender. Although the choice to use an abnormally higher or lower fundamental frequency is often not a conscious decision, it will have an effect on phonatory efficiency and effort. When the vocal folds are forced into the extremes of their range of ability, greater effort is required to sustain phonation, and this will result in vocal and physical fatigue. Many different techniques are used to estimate this from a speech sample, including asking the individual to sustain a vowel or sustain a vowel in a spoken word.
Average Fundamental FrequencyThe average fundamental frequency of vibration of the vocal folds during phonation may reflect the frequency of vibration of sustained phonation, or some other condition, such as conversational speech. This actually reflects habitual pitch over a longer averaging period, and the use of conversational speech or reading of passages probably more accurately reflects an individual’s true average rate of vocal fold vibration than a single vowel sample.
Pitch RangePitch range refers to the range of fundamental frequency for an individual and is calculated as the difference between the highest and lowest frequencies. The vocal mechanism is quite flexible and is capable of approximately two octaves of change in fundamental frequency from
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Age (days)
Voca
l Fol
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ngth
(m
m)
Age (years)
Male and Female
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Female
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Figure 5-8. Changes in vocal fold length for males and females as a function of age. Note that males and females have essentially the same length of vocal folds until puberty, at which time both genders undergo marked physical development. (Data of Kaplan, 1971.)Source: Delmar/Cengage Learning
Lunghezza della corde vocali e sviluppo
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246 Chapter 5
the lowest possible frequency to the highest. An individual with a low fundamental frequency of 90 Hz will be able to reach a high of about 360 Hz (octave 1 = 90 Hz to 180 Hz; octave 2 = 180 to 360 Hz). This range is often reduced by laryngeal pathology, such as, for example, vocal nodules. The normal range can be expanded through voice training. Let us examine how we make changes in vocal fundamental frequency, hence in perceived pitch.
Pitch-Changing MechanismFundamental frequency increase comes from stretching and tensing the vocal folds using the cricothyroid and thyrovocalis muscles. Here is the mechanism of this change.
Laryngeal developmentIn Chapter 8 we will discuss the development of the larynx in the context of swallowing, but let us discuss some specific laryngeal changes that arise from birth to puberty. At birth, the vocal folds are approximately 4 mm long, as opposed to the adult length of between 12 and 15 mm. If you look at Figure 5-8, you can see the steady progression of vocal fold length as the individual develops. If you look now at the data of Kazarian et al. (1978), you can see the lifespan development (Figure 5-9). Pay special attention to changes that occur between 11 and 16 years, when puberty begins. The vocal folds of both males and females increase in length, but that of males become much longer. Take a look at Kent’s (1976) plot of the vocal
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0
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0 2 6 11 16 21 31 41 51 61 7 1
Birth
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(m
m)
Figure 5-9. Length change of the vocal folds over the lifespan for males and females. (Drawn from the data of Kazarian, A. G., Sarkissian, L. S., & Isaakian, D. G. (1978). Length of the human vocal folds by age. Zhurnal Eksperimentalnoi Klinicheskoi Meditsiny, 18, 105–109.)Source: Delmar/Cengage Learning
Lunghezza della corde vocali in funzione dell’età
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
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Physiology of Phonation 247
fundamental frequency of males and females from birth to adulthood (Figure 5-10), and you can clearly see the effect of this change. The fundamental frequency (denoted as f0) tends to stabilize in adulthood. As you can see from this figure, when you spread out the adult range, males undergo a gradual increase in f0 after age 50 or so, while females hold quite steady throughout life. You will also see that the average male f0 is around 130 Hz at 20 years, increasing to about 140 Hz at 80 years of age. Females, on the other hand, hold steady at around 190 Hz throughout adult life.
In Chapter 4 we discussed the importance of a viable respiratory source for phonation. It should not surprise you, then, to know that as our respiratory function matures our ability to sustain phonation increases as well. Kent (1994) demonstrated that males and females both show a rather steady increase in the ability to sustain phonation. At 3 years of age a child can sustain a vowel for around 7 seconds, but that ability climbs by about 1.4 seconds per year through young adulthood (till around 17 years of age). By 17, an adolescent should be able to sustain a vowel for 26 seconds or so, although the variability in function is quite large at all ranges.
Tension, Length, and Mass. The changeable elements of the vocal folds are tension, length, and mass. We cannot actually change the mass of the vocal folds, but we can change the mass per unit length by spreading the muscle, mucosa, and ligament out over more distance. We can also change the tension of the vocal folds by stretching them tighter or relaxing them. Both of these changes arise from elongation.
When the cricothyroid muscle is contracted, the thyroid tilts down, lengthening the vocal folds and increasing the fundamental frequency. When the tension on the vocal folds is increased, the natural frequency of vibration will increase.
The thyrovocalis is a tenser of the vocal folds as well, because contraction of this muscle will pull both cricoid and thyroid closer
The natural frequency of vibration refers to the frequency at which a body vibrates given the mass, tension, and elastic properties of the body.
Age (years)
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Male
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fo(Hz)
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Figure 5-10. Fundamental frequency change over the lifespan for males and females. Source: Note. Adapted from Reference Manual for Communicative Sciences and Disorders: Speech and Language (p. 160), by R.D. Kent, 1994, Austin, TX: PRO-ED. Copyright 1994 by PRO-ED, Inc. Adapted with permission.
Immagine tratta da: Anatomy and Physiology of Speech, Language and Hearing, Seikel, King, Drunright, IV Edizione 2010
Frequenza fondamentale in funzione dell’età
La banda di frequenza caratteristica della voce umana va da 60 a 500 Hz.
Il valore medio nei maschi è circa 120 Hz. Frequenza fondamentale da 85 a 155.
Il valore medio nelle femmine è circa 225 Hz. Frequenza fondamentale da 165 a 255.
Il valore medio nei bambini è circa 265 Hz.