CETP - Voice Disorders Complete Review Guide
2025 | Pass First Try | Verified Test Bank
Why is it difficult to make generalizations about the geriatric voice? - Voice quality is
effected by overall health and disease conditions
Biological valve located at the top of the trachea; closes the entry into the trachea so
food/liquid/foreign particles cannot enter the lungs - Larynx
Superior vs. inferior connections of the larynx - Superiorly connects to the oral cavity and
vocal tract; inferiorly connects to the trachea and lungs
How does the larynx assist w/ biological functions? - Through closure, subglottal pressure
builds up below the larynx, which assists w/ biological functions like waste excretion, coughing,
heavy lifting, and child bearing
The larynx houses ____________, which vibrate to produce _______________. - vocal
folds; voice
Adduction vs. Abduction - Adduction refers to movement towards the midline of the
body, while Abduction refers to movement away from the midline
Glottis - Opening between the vocal folds (through which air passes when we produce
speech or breathe)
Describe the layered structure of the vocal folds - - Epithelium
- Lamina propria (superficial (Reinke's space), intermediate, and deep layers)
- Thyroarytenoid muscle (spec. the internal portion, aka the vocalis)
Cover-body theory of phonation - Consider three vibratory divisions:
1) Cover = epithelium + superficial layer of LP
2) Transition = intermediate + deep layers of LP
3) Body = vocalis muscle
The intermediate + deep layers help transition btwn soft vibration of superficial layers and the
stiff/tense body. If there was no transition, the difference in denseness between the cover and
body would be too much and vibration wouldn't be as efficient.
,Hirano's theory explains HOW our VFs vibrate; it is a passive event that occurs d/t differential
tension and mass of cover layers vs. the body; mucosal wave action occurs in the looser cover
portion.
According to this theory, the cover layers vibrate over a relatively stationary body.
Mucosal wave action - Refers to the movement of the mucous membrane of the VFs.
Involves three components, as follow:
1) Horizontal: Medial to lateral movements
2) Longitudinal: Anterior-posterior "zipperlike" wave
3) Vertical: Inferior to superior movements
Thus, the VFs don't just open and shut, but move along these different planes
How may repeated vocal surgeries reduce mucosal wave action? - By changing the
structure of the VFs; post-Sx, the voice may be perceived differently (rough/gravelly)
Ventricular (false) VFs - Lie above the true VFs; vibrate during activities like lifting and
coughing, remaining inactive during normal phonation
Aryepiglottic folds - Lie above the ventricular folds; separate the pharynx and laryngeal
vestibule, helping to preserve the airway
List the biological functions of the larynx - 1) Connects trachea and pharynx
2) Valving (prevention of aspiration into lower resp. passage)
3) Thoracic fixation
4) Sound production
Thoracic fixation - Closure of the laryngeal valve, to build up abdominal pressure during
physical exertion (heavy lifting), airway clearing (coughing), or intra-abdominal pressure for
things like defecation, vomiting, or birthing
,Three laryngeal compartments - 1) Laryngeal vestibule (AKA Laryngeal additus - above
the entry to the VFs)
2) Laryngeal ventricle (area btwn true and false VFs)
3) Inferior laryngeal ventricle (under the VFs, right before the trachea; cannot be seen during
endoscopic examination, as it's usually hidden by the VFs)
T/F: CNX is the only cranial nerve innervating laryngeal structures - F: CNVII (facial)
innervates the posterior belly of the digastric muscle and CNV (trigeminal) innervates the
anterior belly of the digastric muscle (i.e., suprahyoid muscle); all other muscles involved in
laryngeal function are innervated by CNX
SLN vs. RLN (specifically for the larynx) - SLN has two branches (internal + external);
internal carries all sensory information to the larynx, while the external supplies motor
innervation only to the cricothyroid muscle.
RLN supplies all motor innervation other than the cricothyroid (i.e., IAs, PCA, TA, LCA). Also
supplies all sensory information below the VFs.
Vascular supply to the larynx - Three primary feeding arteries:
1) Superior laryngeal
2) Cricothyroid
3) Inferior laryngeal
Superior laryngeal and cricothyroid arteries are branches of the superior thyroid, which is part
of the external carotid.
Anatomical pathways of the SLN and RLN - - CNX -> Through the pharyngeal plexus, into
the posterior throat, downwards through the side of the neck and branching into the two
laryngeal nerves (SLN and RLN)
- SLN branches to where it needs to go and splits into the internal and external part; external
branch goes directly to CT
- RLN on the right side, goes down towards the sternum, comes back up, and goes through the
CT space and innervates the remaining 4 intrinsic laryngeal muscles; on the left, the RLN takes a
, longer route downwards, then comes up to the CT cartilage, through the CT membrane and
innervates the left set of intrinsic muscles
- We may see injury of the RLN with neck injuries (sternum or thyroid)
- We may see injury of the left RLN if a patient has heart surgery or thoracic injuries; don't
expect vocal pathology in these cases, but COULD occur
Three "all except" rules for intrinsic laryngeal muscles - 1) All laryngeal muscles are
paired (right and left muscle), except for the interarytenoid, which functions as a single unit to
bring the arytenoids closer together
2) All intrinsic muscles are adductors, which bring the VFs closer together, except for the PCA,
which functions as the sole abductor
3) All muscles are innervated by the RLN of CNX, aside from the CT muscle, which is innervated
by the external branch of the SLN
How does the hyoid relate to the larynx? - The hyoid is a bone below the mandible, from
which the larynx suspends. Many extrinsic laryngeal muscles are attached to the hyoid bone
Epiglottis - Leaf shaped cartilage, which covers the larynx during swallowing, essentially
protecting the trachea and airway
Thyroid cartilage - - Largest laryngeal cartilage (AKA Adam's apple), which shields other
laryngeal structures from damage
- Composed of two lamina (plates of cartilage) which come together at the midline and form an
angle
Cricoid cartilage - - Second largest laryngeal cartilage, sometimes referred to as the
uppermost tracheal ring
- Completely surrounds the trachea, and is linked w/ paired arytenoid cartilages and the thyroid
Arytenoid cartilages - - Pair of pyramid-shaped cartilages positioned on the
supraposterior surface of the cricoid, on either side of the midline
- Vocal processes = most anterior angle of the base of the arytenoids; the true VFs attach at the
vocal processes
Corniculate cartilages - - Two small cone-shaped cartilages that sit on the apex of the
arytenoids
- Minor role in vocalization
2025 | Pass First Try | Verified Test Bank
Why is it difficult to make generalizations about the geriatric voice? - Voice quality is
effected by overall health and disease conditions
Biological valve located at the top of the trachea; closes the entry into the trachea so
food/liquid/foreign particles cannot enter the lungs - Larynx
Superior vs. inferior connections of the larynx - Superiorly connects to the oral cavity and
vocal tract; inferiorly connects to the trachea and lungs
How does the larynx assist w/ biological functions? - Through closure, subglottal pressure
builds up below the larynx, which assists w/ biological functions like waste excretion, coughing,
heavy lifting, and child bearing
The larynx houses ____________, which vibrate to produce _______________. - vocal
folds; voice
Adduction vs. Abduction - Adduction refers to movement towards the midline of the
body, while Abduction refers to movement away from the midline
Glottis - Opening between the vocal folds (through which air passes when we produce
speech or breathe)
Describe the layered structure of the vocal folds - - Epithelium
- Lamina propria (superficial (Reinke's space), intermediate, and deep layers)
- Thyroarytenoid muscle (spec. the internal portion, aka the vocalis)
Cover-body theory of phonation - Consider three vibratory divisions:
1) Cover = epithelium + superficial layer of LP
2) Transition = intermediate + deep layers of LP
3) Body = vocalis muscle
The intermediate + deep layers help transition btwn soft vibration of superficial layers and the
stiff/tense body. If there was no transition, the difference in denseness between the cover and
body would be too much and vibration wouldn't be as efficient.
,Hirano's theory explains HOW our VFs vibrate; it is a passive event that occurs d/t differential
tension and mass of cover layers vs. the body; mucosal wave action occurs in the looser cover
portion.
According to this theory, the cover layers vibrate over a relatively stationary body.
Mucosal wave action - Refers to the movement of the mucous membrane of the VFs.
Involves three components, as follow:
1) Horizontal: Medial to lateral movements
2) Longitudinal: Anterior-posterior "zipperlike" wave
3) Vertical: Inferior to superior movements
Thus, the VFs don't just open and shut, but move along these different planes
How may repeated vocal surgeries reduce mucosal wave action? - By changing the
structure of the VFs; post-Sx, the voice may be perceived differently (rough/gravelly)
Ventricular (false) VFs - Lie above the true VFs; vibrate during activities like lifting and
coughing, remaining inactive during normal phonation
Aryepiglottic folds - Lie above the ventricular folds; separate the pharynx and laryngeal
vestibule, helping to preserve the airway
List the biological functions of the larynx - 1) Connects trachea and pharynx
2) Valving (prevention of aspiration into lower resp. passage)
3) Thoracic fixation
4) Sound production
Thoracic fixation - Closure of the laryngeal valve, to build up abdominal pressure during
physical exertion (heavy lifting), airway clearing (coughing), or intra-abdominal pressure for
things like defecation, vomiting, or birthing
,Three laryngeal compartments - 1) Laryngeal vestibule (AKA Laryngeal additus - above
the entry to the VFs)
2) Laryngeal ventricle (area btwn true and false VFs)
3) Inferior laryngeal ventricle (under the VFs, right before the trachea; cannot be seen during
endoscopic examination, as it's usually hidden by the VFs)
T/F: CNX is the only cranial nerve innervating laryngeal structures - F: CNVII (facial)
innervates the posterior belly of the digastric muscle and CNV (trigeminal) innervates the
anterior belly of the digastric muscle (i.e., suprahyoid muscle); all other muscles involved in
laryngeal function are innervated by CNX
SLN vs. RLN (specifically for the larynx) - SLN has two branches (internal + external);
internal carries all sensory information to the larynx, while the external supplies motor
innervation only to the cricothyroid muscle.
RLN supplies all motor innervation other than the cricothyroid (i.e., IAs, PCA, TA, LCA). Also
supplies all sensory information below the VFs.
Vascular supply to the larynx - Three primary feeding arteries:
1) Superior laryngeal
2) Cricothyroid
3) Inferior laryngeal
Superior laryngeal and cricothyroid arteries are branches of the superior thyroid, which is part
of the external carotid.
Anatomical pathways of the SLN and RLN - - CNX -> Through the pharyngeal plexus, into
the posterior throat, downwards through the side of the neck and branching into the two
laryngeal nerves (SLN and RLN)
- SLN branches to where it needs to go and splits into the internal and external part; external
branch goes directly to CT
- RLN on the right side, goes down towards the sternum, comes back up, and goes through the
CT space and innervates the remaining 4 intrinsic laryngeal muscles; on the left, the RLN takes a
, longer route downwards, then comes up to the CT cartilage, through the CT membrane and
innervates the left set of intrinsic muscles
- We may see injury of the RLN with neck injuries (sternum or thyroid)
- We may see injury of the left RLN if a patient has heart surgery or thoracic injuries; don't
expect vocal pathology in these cases, but COULD occur
Three "all except" rules for intrinsic laryngeal muscles - 1) All laryngeal muscles are
paired (right and left muscle), except for the interarytenoid, which functions as a single unit to
bring the arytenoids closer together
2) All intrinsic muscles are adductors, which bring the VFs closer together, except for the PCA,
which functions as the sole abductor
3) All muscles are innervated by the RLN of CNX, aside from the CT muscle, which is innervated
by the external branch of the SLN
How does the hyoid relate to the larynx? - The hyoid is a bone below the mandible, from
which the larynx suspends. Many extrinsic laryngeal muscles are attached to the hyoid bone
Epiglottis - Leaf shaped cartilage, which covers the larynx during swallowing, essentially
protecting the trachea and airway
Thyroid cartilage - - Largest laryngeal cartilage (AKA Adam's apple), which shields other
laryngeal structures from damage
- Composed of two lamina (plates of cartilage) which come together at the midline and form an
angle
Cricoid cartilage - - Second largest laryngeal cartilage, sometimes referred to as the
uppermost tracheal ring
- Completely surrounds the trachea, and is linked w/ paired arytenoid cartilages and the thyroid
Arytenoid cartilages - - Pair of pyramid-shaped cartilages positioned on the
supraposterior surface of the cricoid, on either side of the midline
- Vocal processes = most anterior angle of the base of the arytenoids; the true VFs attach at the
vocal processes
Corniculate cartilages - - Two small cone-shaped cartilages that sit on the apex of the
arytenoids
- Minor role in vocalization
