335 8.3 Tongue and Vocal Tract

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Author:
shanamd2010
ID:
141174
Filename:
335 8.3 Tongue and Vocal Tract
Updated:
2012-03-12 13:30:43
Tags:
Tongue muscle cavities vocal tract
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Description:
tongue muscles and vocal tract
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  1. Genioglossus muscle
    • prime mover of the tongue
    • makes uo deep bulk
    • 0 - inner mandibular surface at symphysis
    • c - fans up and back
    • i - tip and dorsum of tongue and body of hyoid bone
    • inn - XII Hypoglossus nerve
    • f - anterior fibers retract tongue, posterior fibers protrude tongue, collectively they depress the tongue
    • paired
  2. styloglossus
    • o - styloid process of the temporal bone
    • c - forward and down
    • ins - inferior sides of the tongue
    • inn - XII hypoglossus nerve
    • f - draws the tongue back and up
    • paired
  3. hypoglossus
    • o - greater horn and lateral body of the hyoid bone
    • c - upward
    • ins - sides of the tongue
    • inn - XII hypoglossus nerve
    • f - pulls sides of tongue down
    • paired
  4. describe the pharynx
    • 3 divisions
    • 12 cm in length
    • extends from vocal folds up to the region posterior to the nasal caivty
    • tube lined with muscles that aid in deglutition (swallowing) and velopharyngeal closure
  5. cavities of the vocal tract
    • nasopharynx
    • oropharynx
    • laryngopharynx
  6. nasopharynx placement
    • space above soft palate
    • upper most portion of the vocal tract
  7. nasopharynx contains
    • lateral wall contains orifice to Eustachian tube - actively opened through contraction of tensor veli palatini muscle
    • pharyngeal tonsils (adenoids) - can help close off nasal cavity
  8. oropharynx
    placement / boundaries
    • portion posterior to the faucial arches
    • superior boundary is velum
    • lower boundary is hyoid bone
  9. laryngopharynx
    boundaries
    • anterior boundary is epiglottis
    • inferior boundary is esophagus
    • superior boundary is hyoid bone
  10. laryngectomy surgery =
    reconstruction of the larynx
  11. laryngectomy surgery reconctruction 5
    • trachea sutured to bse of neck
    • creation of a stoma (hole) for breathing
    • pharyngeal wall sutured together
    • inferior portion of the pharynx joined to upper esophagus
    • superior portion of pharynx sutured to base of tongue
  12. total laryngectomy results in 7
    • creation of a stoma for breathing
    • separates the eating/drinking tract from te breathing tract
    • loss of normal speech
    • need to learn an artificial way of talking
    • reduced sense of smell and taste
    • loss of ability to swim
    • increased risk for respiratory disease
  13. alaryngeal
    without a larynx
  14. 3 methods of alaryngeal speech
    • artificial larynx (AL)
    • esophageal speech (ES)
    • tracheoesophageal speech (TES)
  15. artificial larynx (AL)
    • synonymous with electrolarynx
    • battery powered devices
    • 2 types : intra-oral and neck
  16. intra-oral artificial larynx
    • useful immediately after surgery
    • gets in way of articulation
    • not really sanitary
  17. neck artificial larynx
    • cannot use immediately after surgery due to discomfort and swelling
    • many types : Servox, Neovox, NewVois
  18. AL advantages
    • immediate use after surgery with intra-oral device
    • relatively easy to learn
  19. AL disadvantages
    • not very sanitary
    • voice is not natural sounding
    • occupies one hand
    • very obvious to others
  20. esophageal speech (ES)
    • works by injecting air into esophagus, expelling it to vibrate PE segment
    • oral cavity then forms vibation into speech sounds
  21. P.E. is
    • cricopharyngeus muscle / upper esophageal sphincter (UES)
    • aka neoglottis or pseudo-glottis
  22. ES advantages
    • hands free
    • no need to worry about atteries
    • no extra cost associated with device
  23. ES disadvantages
    • very hard to learn
    • difficult to talk after meals
    • only short sentences as you have to keep swallowing air
    • if cricopharyngeus muscle it too tight or too lose then you are not a good candidate
  24. tracheoesophageal speech TES
    5 steps
    • fistula surgically created at time of laryngectomy or afterwards
    • voice prosthesis fitted into fistula
    • air from trachea is occluded from exiting stoma
    • now redirected through the tracheoesophageal punctures (TEP) vibrating the PE segment and creating voise
    • articulated out the mouth
  25. speaking valves
    • used in TES
    • blocks stoma to divert air to esophagus
    • come in varying resistances
    • need to be tested
    • typically glued around stoma
  26. TES advantages
    sounds very natural air coming from lungs so you can speak for a longer period of time
  27. TES disadvantages
    • not everyone can do TES - if walls of esophagus are too tight, air will not pass through
    • the voice prosthesis must be removed and cleaned periodically

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