Feminisation of the larynx and voice
James Barrett in Transsexual and Other Disorders of Gender Identity, 2017
The skeleton of the larynx consists of a series of single and paired cartilages united by ligaments and membranes (seeFigure 13.1). The larger single cartilages are the thyroid and cricoid. The principal paired cartilages are the arytenoids which lie on the superior edge of the lamina of the cricoid cartilage. The epiglottis consists of a thin sheet of elastic cartilage lined on all surfaces with mucous membrane. During swallowing, the epiglottis flops down and back over the laryngeal inlet and protects the airway. This protection is reinforced by the closure of the true and false vocal cords and by the tongue base pushing back during swallowing. The hyoid bone supports the larynx in the neck, and is suspended by muscles and ligaments from the skull base, mandible and tongue. The thyroid cartilage has two laminae that are fused anteriorly to form the anterior commisure. The posterior border of each thyroid lamina has a superior and inferior horn. The inferior horns of the thyroid cartilage articulate with the cricoid cartilage at the cricothyroid joint. There is a synovial joint between the base of the arytenoid cartilages and the superior edge of the lamina of the cricoid cartilage. The vocal fold and vocal ligament attach to the vocal process of the arytenoid cartilage and insert into the posterior aspect of the anterior commisure of the thyoid cartilage, approximately halfway down. Through the action of the cricothyroid muscle, the thyroid cartilage tilts forwards and downwards and lengthens and tensions the vocal folds (seeFigure 13.2).
Cardiorespiratory system
Helen Butler, Neel Sharma, Tiago Villanueva in Student Success in Anatomy - SBAs and EMQs, 2022
For each of the following questions, select the most appropriate answer from the above list of options. Each option may be used once, more than once or not at all. Name a structure of the superior mediastinum.Which muscle tightens the vocal cords and is supplied by the superior laryngeal nerve?Which U- shaped bone is at the level of C3–C4?Which muscle connects the hyoid bone to the larynx?Name the structure inferior to the thyroid cartilage and shaped like a signet ring.
Surgical Anatomy of the Neck
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The hyoid is an important bony landmark in the neck. Sitting in the midline of the neck, superior to the thyroid cartilage, the hyoid is a horseshoe-shaped bone with a central body and paired greater and lesser cornus. The greater cornu acts as a guide to the lowermost extent of the marginal mandibular branch of the facial nerve and the level of the hyoid divides nodal levels II and III. The hyoid bone has many muscular attachments; the mylohyoid, geniohyoid and hyoglossus insert onto the superior aspect of the body of the hyoid, whereas the omohyoid, sternohyoid and thyrohyoid muscles insert onto the inferior border. Fibres of the middle constrictor muscles insert into the greater cornu and the stylohyoid ligament attaches to the lesser cornu. Inferiorly the thyrohyoid membrane connects the body of the hyoid to the thyroid cartilage.
A pilot investigation of twang quality using magnetic resonance imaging
Published in Logopedics Phoniatrics Vocology, 2021
Karen Perta, Youkyung Bae, Kerrie Obert
Vocal tract measurements during twang and speaking quality productions were obtained using a 3D visualization/processing software, Amira 5.6 (ThermoFisher Scientific, Hillsboro, OR). As summarized in Table 1, in-plane resolution varied from 1.9 × 1.9 mm2 to 3.0 × 1.9 mm2 across datasets included in the analyses. For enhanced visualization, all images used for vocal tract measurements were post-processed using the Amira built-in interpolation algorithm (i.e. bilinear interpolation approach). A midsagittal slice for each participant was determined in reference to midsagittal anatomic landmarks, including the posterior border of the vomer bone, pituitary gland, and outline of the fourth ventricle. Midsagittal measurements included larynx height and velar height (Figure 1). Larynx height was defined as the perpendicular distance from the inferior most point on the hyoid bone to a reference line along the hard palate line (anterior to posterior nasal spine). The hyoid bone was selected as a reference point in order to account for possible additional vocal tract variations from laryngeal tilting or arytenoid movement [17,25] that may extraneously affect measurement. Velar height was defined as the perpendicular distance from the inferior tip of the uvula to the hard palate line (adapted from Echternach et al. [3]).
Expiratory muscle strength training improves swallowing and respiratory outcomes in people with dysphagia: A systematic review
Published in International Journal of Speech-Language Pathology, 2019
Marinda Brooks, Emma McLaughlin, Nora Shields
Respiratory muscle strength training is a motor exercise technique where resistive load is increased during inspiration and/or expiration using a pressure threshold device (Sapienza, Troche, Pitts, & Davenport, 2011). The key principle in strength training is progressive overload. Extensive clinical research has been completed in this field, and expiratory muscle strength training is an emerging intervention option for speech–language pathologists working with individuals presenting with acquired motor based communication and/or swallowing impairments that may be related to expiratory muscle weakness. The training aims to increase active expiratory pressure by increasing the ability of the expiratory muscles to generate enough force for adequate ventilation and cough. Research has also demonstrated that during expiratory muscle strength training there is increased and prolonged activation of the suprahyoid muscle group (Wheeler, Chiara, & Sapienza, 2007; Wheeler-Hegland, Rosenbek, & Sapienza, 2008). The suprahyoid muscle group (digastric, stylohyoid, geniohyoid and mylohyoid) is located above the hyoid bone in the neck. These muscles assist in elevating the hyolaryngeal complex and opening the upper oesophageal sphincter during swallowing. These movements are important for airway defence during swallowing and breathing (Wheeler et al., 2007). Expiratory muscle strength training has been shown to increase movement of the hyolaryngeal complex during swallowing and increased opening of the upper oesophageal sphincter (Troche et al., 2010; Wheeler-Hegland et al., 2008).
Thyroglossal duct cysts in children: a 30-year survey with emphasis on clinical presentation, surgical treatment, and outcome
Published in Acta Chirurgica Belgica, 2019
Tom Danau, Guy Verfaillie, Frans Gordts, Thomas Rose, Antoine De Backer
Those 104 patients were operated upon mostly by pediatric surgeons, but a few also by ENT surgeons, plastic surgeons, head and neck surgeons, and maxillofacial surgeons. This could partially explain the diversity in surgical choices. In fact, three different surgical treatment strategies were followed. The Sistrunk operation was the most commonly used surgical intervention proceeded in 89.4% of the cases (n = 93). Of all patients who underwent a Sistrunk procedure, seven showed a TGDC recurrence afterward (7.5%). Noteworthy, one out of those seven patients underwent an incision and drainage of the cyst before surgery and another two of those seven patients already had a first TGDC removed (without excising the central part of the hyoid bone) in another medical center before admission for a Sistrunk procedure at the UZB. The remaining patients with a TGDC were either treated with a simple excision of the cyst (n = 9, 8.7%) or a marsupialization of the cyst (n = 2, 1.9%). No recurrences appeared in the patients treated with the latter intervention, but, after a simple cyst excision, 55.6% showed a TGDC recurrence (n = 5). Comparing the number of recurrences in the group of patients who underwent a Sistrunk procedure with the group of patients who only received a simple cyst excision, a significant difference was reached (p = .001) (Figure 2).
Related Knowledge Centers
- Bone
- Cervical Vertebrae
- Mandible
- Thyroid Cartilage
- Joint
- Neck
- Larynx
- Glossary of Shapes With Metaphorical Names
- Chin
- Epiglottis