Physiology of the Larynx

The larynx has a number of functions

1. Protection of the airway: this is the primary function of the larynx

- closure if the larynx
- cough reflex

2. Respiration

3. Phonation: secondary function

4. Chest fixation: by glottic closure

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I. Protection of the larynx

a. Closure of larynx:
As we mentioned in previous lectures, the primitive larynx
functioned as a simple sphincter to protect the lower airway
from the intrusion of foreign matter.
Therefore, the primary function of the larynx is to prevent
food and liquids from entering the airway; this is done in 3
steps.
. elevation of the larynx by the suprahyoid muscles
. sequential closure of the glottis, false cords, and
vestibule.
. the epiglottis goes from a vertical to a more
horizontal position, and helped by the bolus of food it will
seal the laryngeal inlet.

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b. Cough

Cough ejects mucus and foreign matter from the lungs, and
maintains the patency of the pulmonary alveoli.
May be voluntary, but more often in response to
stimulation of receptors in the larynx or lower respiratory
tract.
This is done in 3 phases
1. Inspiratory: the larynx opens wide to permit rapid
and deep inspiration.
2. Compressive: tight closure of the glottis and strong
activation of expiratory muscles.
3. Expulsive: larynx opens widely and a sudden outflow
of air occurs in the range of 6-10 Liter/Second.

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II. Respiration

The larynx is the entry point from upper respiratory to lower

respiratory systems.
It acts as a valve which can control air pressure and airflow.
The vestibule is open. (epiglottis in vertical position)
The vocal cords are slightly abducted in quiet respiration, and
widely open during forced inspiration.

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III. Fixation of chest (or effort closure)

This is a less known function of the larynx.

It is important to increase intraabdominal pressure.
There is tight closure of vocal cords for active fixation of the
chest and raising intraabdominal pressure, which is required in
daily activities, as in climbing, lifting weights, and even during
defecation and urination.
Expiratory effort against a closed glottis is called Valsalva
maneuver.
During any form of exertion, the vocal folds are adducted,
preventing expulsion of air and collapse of chest wall.

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 IV. Phonation

To produce a voice and speech, we need 3 elements:

- Power source: the lungs

- Phonation: production of sound by vibrations of the vocal
cords
- Modulation (of sound): by resonance and articulation in the
upper aerodigestive tract

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The larynx acts as a transducer during phonation, converting the
aerodynamic energy generated by the lungs (helped by diaphragm and
abdominal muscles), into acoustic (sound) energy.

The laryngeal transduction occurs precisely at the space between the 2

vocal folds, the glottis.

The requirements for normal phonation are as follows:

1. Active respiratory support

2. Adequate glottic closure
3. Normal mucosal covering of the vocal cords
4. Adequate control of vocal cord length and tension

Initiation of voice

- Immediately before phonation, the vocal folds rapidly abduct

to allow the intake of air. This is termed as “prephonatory
inspiration phase”.
- The vocal cords are adducted by action of the adductor
intrinsic muscles mainly the cricoarytenoid and transverse
arytenoid muscles.
- The vocal note is generated by air from the lungs as it is
exhaled between the adducted vocal folds.
Therefore, the vocal cords constitute the vibrator which is
activated by the exciter which is the exhaled air.

- This action is repeated, so the production of the vocal note is

the result of the repeated vibratory movement of the vocal
folds known as the vocal folds oscillation.

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The vibratory cycle

Each vibratory cycle of the vocal folds consists of 3 phases

a. Adduction
b. Aerodynamic separation
c. Recoil

a. Adduction: during adduction, the closed phase, the air pressure

builds up below the vocal cords.
b. When the increased subglottic air pressure overcome the
resistance of the adducted vocal folds at the onset of phonation,
the vocal folds peel apart, from the inferior side to superior part.
The strength of this explosion determines the loudness of the
sound coming directly from larynx.
c. After release of the puff of air there is reduction of the subglottic
pressure, and the vocal cords approximate each other again,
because the myoelastic forces of the vocal cords exceeds the
aerodynamic force.
The myoelastic forces are enhanced because air current flowing
through a narrow channel exerts a negative pressure on the
channel walls. This is the basis of Bernouilli’s principle.

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Bernouilli principle:

It is a physics equation where flow has higher velocity when it

goes into a smaller caliber pipe, but there is also drop of pressure
in the tight area.

In the larynx it is described as follows: when air passes from a

large space to another (lungs to pharynx), through a tight area
(the glottis), the velocity will be greatest and the pressure least at
the site of the constriction.
As a result of the drop in pressure at the glottis, the vocal fold
mucosa is drawn into the space between the vocal cords.

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Each cycle of adduction, separation, and recoil is the
manifestation of a mucosal wave travelling from the inferior to
the superior surface of each vocal cord.

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Voice characteristics

Fundamental Frequency:

For voice, frequency is the number of times the vocal folds open
and close per second. The vibration of a tuning fork results in a
pure tone, as the tuning fork vibrates at only one frequency.
The vibration of the vocal cords is much more complex, due to its
structure. Vibration of the vocal folds produces a complex tone,
one that is composed of several frequencies.
Fundamental frequency is the lowest frequency component of the
complex tone.
Frequency relates directly to pitch.

Pitch:

The faster the vocal cords vibrate, meaning the higher the
frequency, the higher the pitch.
In males, ranges between 90-500Hz with an average of 115Hz
In females, ranges between 150-1000Hz with an average of 200Hz
Vocal cords vibrate faster when they are pulled longer, thinner,
and more tense; and vibrate slowly when they are shorter, thicker
and floppier.

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The cricothyroid and thyroarytenoid muscles coordinate with
each other to create different pitches.

According to these we have 6 basic voice types

In males: Bass – Baritone – Tenor
In females: Contralto – Mezo-Soprano – Soprano

Vocal range:

Lowest to highest range of pitches someone can reach.

Intensity:

It is the amplitude of the vocal cord vibrations, thus depends on

the pressure of the subglottic air stream.
The greater the expiratory effort the greater the vocal volume.
Another component of vocal intensity is the resonators.
A wide flexible vocal tract enhance voice, and a narrow
constricted or emotionally tightened throat, produces a sound
with poor carrying power.

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