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ANAT in class notes/slides
Anatomy and physiology of respiration
-esophagus posterior to trachea
-lungs consists of lobes, apeical is the apex
-larynx is cap to trachea
- signet ring (crico bone)
- gingiva (gums)
Respiration

Inspiration/expiration. Primary purpose of respiratory system = “the exchange of
oxygen between an organism and its environment”, tales place in alvuli

Respiration is the energy supply for speech (voice production)

Respiratory problems cause reduction in lung volume
o Which results in reduced vital apacity
o Reduced pressure generation ability
o Reduced phrasing in speech
o Reduced vocal intensity
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The respiratory system
o Large airways
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Trachea
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Right bronchus
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Left bronchus
o Smaller airways
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Dichotomous branches
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Pleural membranes
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Outer parietal
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Inner visceral
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Brathing can be viewed in terms of cycle of respiration
o This picture illustrates quiet tidal respiration
o Notice that an entire cycle takes around 10 seconds
o About 4 seconds for inspiration
o 6 seconds for expiration
o This varies based on level of activity


How many cycles of breathing per minute
o Avg 12 breaths per minute

Respiration= echalation and inhalation = gas exchange
o Occurs with minute air sacs called ”alveoli”
o Active muscular process
o Seeks balance and equilibrium
o Cant happen without air pressure exerted on walls of a chamber ( lungs)
by molecules of air
o What happens if you have a punctured lung?
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
Respiration for speech
o Remember

The basic needs of the body will always be met before speech
needs are met
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You breathe 12 times per minute, whether you are speaking or not

The pressures for life must be maintained whether you or speaking
or not.
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Quiet and forced inspiration
o In quiet inspiration
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Diaphragm and external intercostals contact
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Compresses abdominal viscera, abdomen bulges out
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About 500cc flow in/out of lungs
o In forced inspiration
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Diaphragm contracts, abdomen protrudes
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Thorax expands and elevates
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Compresses abdominal viscera, but not as much as when expire!
o Diaphragm accounts for 60% of inspiratory capacity
o Accessory muscles account for other 40%
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Tidal volume (TV): volume if air inhaled and exhaled during any single
expiratory cycle
o Males and females vary, based on body and thorax size
o For a young adult female at rest: TV=450cc
o Young adult male at rest: TV= 600cc
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o Female + male average TV at rest = 525cc
o Tidal volume during heavy work: as high as 2300cc
o Functional residual capacity -how much we can take in and push out

Measurement of volume
o Spirometer

Measures volume of air that is displaced
o Pressure
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Manometer (cm or inches f H20 elevated)

-force over area
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P = F/A
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As force increases, pressure increases
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As area increases, pressure decreases
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High heel shoes versus snowshoes
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Same force (weight of individual)

High heel: tiny area = great pressure
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Snowshoe: huge area = small pressure
o Pressures of the tissues
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Relaxation pressure
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Inspiratory pressure
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Expiratory pressure
o Boyles law: pressure varies inversely with volume for a given gas On test
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When piston s pushed down
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Molecules are closer together
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
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Molecular forces of repulsion increase pressure
Pressure increases

P=F/A (force over area= amount of force required to
overcome inertia: force exerted on an area)
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Rib cage and diaphragm
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Changes of thoratic volume for inspiration
o Two planes of movement when youre inspiring
o Vertical (up down)
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From contraction of diaphragm
o Transverse
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Transverse dimension
Lateral view diaphragm
o When the thorax expands in the transverse dimension the thoracic cavity
increases in volume
o When thethorax expands in the vertical dimension (by diaphragm
contracting) the thoratic volume increases
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Structures of respiration
o Bony thorax
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Vertebral column -7 cervical vertebrae
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Anterior view of thorax: clavical, sternum, ribs
o Visceral thorax
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Respiratory passageway (mouth and nose; tracgea and bronchi)
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Lungs
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mediastinum
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be able to recognize the muscles of inspiration and expiration (pg. 92 SDH)
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muscles of inspiration … thorax, neck, back and upper limb
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muscles of expiration.. thorax, back, upper, limb, abdominal muscles
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diaphragm = primary
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sterocleidomastoid (SCM)
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external intercostals
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pectoralis major and minor
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scalenes
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diapgragm
o only unpaired muscle of respiration
o thin
o musculotendinous
o separates thorax and abdomen
o dome shaped higher than left
o “inverted dome”
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Sternal Costal Vertbral portions of diaphragm
o Innervation : phrenic nerve
o Function: expand thorax in vertical dimension
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Diaphragmatic hiatuses
o Aortic hiatus
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Descending abdominal aorta from thorax to abdomen
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Esophogeal hiatus
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Passageway for esophageus
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Foramen vena cava
o For inferior vena ceva (vein from lower body)
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Action of diaphragm
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Contraction pulls central tendon down
o Increases vertical dimension of thorax (up-down
dimension)
o Compresses abdominal viscera
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Muscles of expiration
o Expiration
o Two ways to exhale
o Passive and active
o Function: compress abdominal viscera
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Transversus thoracis
o Inncervation: intercostal nerves
o Function: pulls ribs down
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RInternal intercostals:
o FUNCTION: depress/pull down rib cage for expiration
o Internal intercostals are muscles of expiration except the chondral portion
which is used in inspiration>
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Pathologies that affect speech
o Any physical pathology or trauma that causes a deficit have an impact o
speech production!
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A few problems
o Acute/Suddent conditions
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E.g., Aspiration (a type of bacterial pneumonia)
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Punctured lung = pneumothorax
o Chronic/Continuing conditions
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When the serious fluid between the pleural linings is lost or
reduced, a person is said to have pleurisy
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COPD, sleep apnea, pulmonary fibrosis, asthma, lung cancer
o Neurological: progressive neuromuscular, brain and/or nerve damage.
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Chronic Obstructive Pulmonary disease (COPD)
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Has two major subtypes
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Chronic bronchitis
o Most often caused by tobacco smoking
o Affect about 5% of adults and 6% of children in world- = about 2.9
million deaths world -wide annually
o Definition: productive cough that lasts for 3 months or longer, twice in
one year for 2 years
o Caused by inflammation of bronchial passageways
o Results in excessive musus, cough, wheezing, shortness of breath
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May lead to rib fractures, consciousness loss
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o Diagnostic indicators: poor lung function, including reduced capacity
o Treatments: bronchodilators, steroids to reduce inflammation, long term
oxygen therapy, lung transplant
o Effect on speech: reduced vocal intensity, short phrasing, fatigue during
speech
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Emphysema
o Second type of COPD
o Results from loss of continuity of alveoli
o Inner alveolar walls break down so that alveolar surface area declines
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Walls weaken and rupture
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Reduces oxygen transfer
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Symptoms: shortness of breath, fatigue
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Most often caused by tobacco smoke, second-hand smoke, or
environmental polutions
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Symptoms can develop between 40 and 60 years
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Complications
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Pneumothorax
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Heart problems: increases workload of heart
Physical changes
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Barrel chest
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Paradoxical respiration
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Diaphragm cant descend further, contraction actuallu
shortens fibers horizontally and pulls lower thorax in
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Emphysema and speech: short phrasing, limited phonotary ability,
significant fatigue
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Asthma
o Physical changes: narrowing of bronchial passageway, extra mucus,
inflammation of bronchi
o May be life-threatening
o Signs and symptoms
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Shortness of breath
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Chest pain or tightness
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Sleep disturbance
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Wheezing, coughing
o May arise form exercise, occupational irritants, cold air, some
medications, emotional stress, gastroesophageal reflux, or allergy (spores,
cat dander, etc.)
o Emergency treatment for rapidly increasing difficulty
o Long-term treatment: bronchial dilator (inhaler)
o Effects on speech:
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Paradoxical vocal fold movement
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Can result in paradoxical vocal fold movement (PVFM)
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Involuntary adduction of vocal folds during inspiration
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PVFM can co-occur with asthma, or occur separate from
asthma
o Reduced vocal intensity, short phrasing, physical weakness and fatigue
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Lung cancer
o Leading cause of cancer deaths in US
o Risk factor: smoking tobacco
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The longer you smoke, the greater the risk
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Smoke contains carcinogens
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Radon: can cause cancer and also increase risk in smokers
Symptoms:
o Persistent cough
o Coughing blood
o Chest pain, hoarseness, unanticipated weight loss
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Treatment: surgical, chemotherapy, radiation therapy
o Surgical: from wedge resection (small section) to
lobectomy (lobe) or
pneumonectomy (whole lung)
o New therapies: targeted drug therapies, immunotherapy
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Effects on speech
o Pretreatment: short phrasing, shortness of breath, fatigue
o Post-treatment: chemotherapy issues and cognition, shortness of breath,
fatigue
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