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Larynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The glottis, or rima glottidis, is the aperture or space bounded by the vocal cords and arytenoid cartilages, and is not an anatomical structure as such but provides a practical division of the larynx into supraglottic, glottic and subglottic areas. Clinically relevant spaces within the larynx include the paraglottic space, which is lateral to the vocal cords, and the pre-epiglottic space, which is anterior to the epiglottic cartilage. The laryngeal ventricle is a cavity bounded by the false cords superiorly and the true cords inferiorly (Figure 11.1) and extends superiorly a variable distance.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The laryngeal cavity is shaped like an hourglass, composed of the laryngeal vestibule above the vestibular folds (false vocal folds), and the infraglottic cavity inferior to the vocal folds (which include the vocal ligaments) (Plate 3.44). The vestibular fold and the vocal fold (true vocal fold) are separated by a space called the laryngeal ventricle, which is quite variable in extent. The glottis includes the vocal folds and the space between them, which is designated the rima glottidis.
Vocal Motor Disorders *
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Vocalization structures: The active force in the production of the voice is the airflow (Van Leden, 1961). Voice production originates from the vibration emanating from the vocal folds (Razak et al., 1983). It is then processed by the posterior oral-pharyngeal and nasopharyngeal ports (Merson, 1967). The space between the vocal folds is the rima glottidis. Its shape is determined by the position, tension, and length of the vocal cords, as well as the intensity of expiration changes in vocal pitch (Moore & Dalley, 2006, with diagrams, pp. 1089–1095). Cartilages of the larynx, trachea, and bronchia maintain the larger respiratory tubes; branchial motor axons of glossopharyngeal nerve serve the stylopharyngeus muscle that elevates the pharynx during swallowing and speech (Wilson-Pauwels et al., 1988, p. 117). The fleshy tongue manipulates the food particles to and from moving teeth on route to the mouth and throat for swallowing. Complex musculature raises and lowers the tongue, pushes it forward, and changes its shape (Butler & Hodos, 1996, pp. 56–157). The basicranial region in human infants is similar to that of monkeys and apes (see Vocalization Structures, below).
Global and regional connectivity analysis of resting-state function MRI brain images using graph theory in Parkinson’s disease
Published in International Journal of Neuroscience, 2021
Rutvi Prajapati, Isaac Arnold Emerson
Several studies have been reported to understand the progression of PD using brain images. The automatic segmentation algorithm is used to segment the rima glottidis area from a 4 D CT image that indicates vocal impairment symptoms. This algorithm utilizes a support vector machine (SVM) with 65% accuracy [7]. In another study, a novel pattern recognition framework is used in the sub-regions with the highest variance in SPECT intensities across PD patients, thus provide important potential biomarkers in PD progression [8]. Moreover, the molecular imaging-based PET technique investigates the texture quantification to find out the correlation between the clinical severity of Parkinson’s and texture metrics [9]. Among the entire test, EEG plays a vital role in early diagnosis. For example, the convolution neural network is established for an automatic determination of EEG signals. The accuracy of this method reached around 88.25% due to the long-term tool in PD diagnosis [10]. Also, the analysis of beta waves in EEG signals can determine the freezing of gait symptoms which is a highly debilitating and poorly understood symptom in PD [11]. Likewise, the increased resting-state functional connectivity in PD patients is observed in the MEG test using the synchronization likelihood method [12]. Compared to all the imaging techniques the EEG provides better accuracy for early diagnosis, whereas the MRI image data offers several features that help us to find a way to diagnose the progression of PD.
Therapeutic efficacy of intralesional bleomycin injection for laryngopharyngeal haemangioma in adults
Published in Acta Oto-Laryngologica, 2019
Feifei Liu, Yang Xiao, Jun Wang
Our surgical experience indicates that haemangiomas involving multiple anatomic areas around the rima glottis can severely block the rima glottis. In such cases, patients with preoperative dyspnoea should undergo prophylactic tracheotomy, and patients without dyspnoea and those with a slight feeling of difficulty breathing can undergo treatment several times. Each operation focused on only one anatomic site, especially in cases involving two or more sites, such as the vocal cords, false vocal cords, and laryngeal ventricle, or the arytenoid or postcricold area. To avoid excessive swelling of the tumour site after surgery and prevent suffocation, it is advisable to treat multiple sites in separate operations. At the same time, attention should be paid to ensure that the total dose of a single injection is not too large to affect patient safety. We observed that local oedema was most obvious within 24 h after the injection and gradually subsided after 48–72 h; therefore, the patient's breathing should be closely observed for 72 h after surgery.
The laryngoscope and nineteenth-century British understanding of laryngeal movements
Published in Journal of the History of the Neurosciences, 2019
Marjorie Perlman Lorch, Renata Whurr
Ryland presented a clear summary of what was known about physiological action of the larynx from pathological cases and experiments with dogs: [M]ost of the physiologists of the present day, consider this power as residing in the thyro-arytaenoid muscles. The reasons for this belief are, 1st, the situation of these muscles, their attachment to the vocal cords, and the influence they are capable of exercising over the vibrations of these cords; 2d, the effects of the division of the recurrent nerves which supply these muscles—if both are cut the voice will cease, if only one is cut the voice will only be half lost; 3d, the loss of voice that results from ulceration, purulent infiltration, or atrophy of these muscles. ‘The extinction of the voice is carried to the highest degree, if the thyro-arytaenoid muscles have undergone any of the alterations that we have mentioned,’ observes M. [Gabriel] Andral. These observations are sufficient to prove that the contractions of the muscles in question are necessary to the production of voice, and, together with the experiments of [François] Magendie—in which the glottis of an animal being laid bare at the moment that it cried, the vocal cords were seen vibrating—show beyond all doubt that the primary tone of the voice is due to the action of the thyro-arytaenoid muscles and ligaments, and probably to their vibrating backwards and forwards, and thus alternately allowing and intercepting the passage of the air which is forcibly expelled from the lungs through the rima glottidis. (Ryland, 1837, pp. 18–19)