Ear Pain in Patients with Oropharynx Carcinoma: Karlt.Beer Peter Vock How MRI Contributes to the Explanation Richard H
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The Articulatory System Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D
The articulatory system Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D. STRUCTURE/FUNCTION VOCAL TRACT CLASSIFICATION OF CONSONANTS AND VOWELS MORE ON RESONANCE ACOUSTIC ANALYSIS/ SPECTROGRAMS SUPRSEGMENTALS, COARTICULATION 1 Midsagittal dissection From Kent, 1997 2 Oral Cavity 3 Oral Structures – continued • Moistened by saliva • Lined by mucosa • Saliva affected by meds 4 Tonsils • PALATINE* (laterally – seen in oral periph • LINGUAL (inf.- root of tongue) • ADENOIDS (sup.) [= pharyngeal] • Palatine, lingual tonsils are larger in children • *removed in tonsillectomy 5 Adenoid Facies • Enlargement from infection may cause problems (adenoid facies) • Can cause problems with nasal sounds or voicing • Adenoidectomy; also tonsillectomy (for palatine tonsils) 6 Adenoid faces (example) 7 Oral structures - frenulum Important component of oral periphery exam Lingual frenomy – for ankyloglossia “tongue-tie” Some doctors will snip for infants, but often will loosen by itself 8 Hard Palate Much variability in palate shape and height Very high vault 9 Teeth 10 Dentition - details Primary (deciduous, milk teeth) Secondary (permanent) n=20: n=32: ◦ 2 incisor ◦ 4 incisor ◦ 1 canine ◦ 2 canine ◦ 2 molar ◦ 4 premolar (bicuspid) Just for “fun” – baby ◦ 6 molar teeth pushing in! NOTE: x 2 for upper and lower 11 Types of malocclusion • Angle’s classification: • I, II, III • Also, individual teeth can be misaligned (e.g. labioversion) Also “Neutrocclusion/ distocclusion/mesiocclusion” 12 Dental Occlusion –continued Other terminology 13 Mandible Action • Primary movements are elevation and depression • Also…. protrusion/retraction • Lateral grinding motion 14 Muscles of Jaw Elevation Like alligators, we are much stronger at jaw elevation (closing to head) than depression 15 Jaw Muscles ELEVATORS DEPRESSORS •Temporalis ✓ •Mylohyoid ✓ •Masseter ✓ •Geniohyoid✓ •Internal (medial) Pterygoid ✓ •Anterior belly of the digastric (- Kent) •Masseter and IP part of “mandibular sling” •External (lateral) pterygoid(?)-- also protrudes and rocks side to side. -
Dr. Maue-Dickson Is Associate Professor of Pediat- Rics, University of Miami, Mailman Center for Child Development, University
Section II. Anatomy and Physiology WILMA MAUE-DICKSON, Ph.D. (CHAIRMAN) Introduction Middle Ear Musculature, The Auditory Tube, and The Velopharyngeal This Section has been prepared for the Mechanism purpose of updating the previous report, "Status of Research in Cleft Palate: Anat- 1. Tur Mippour® Ear omy and Physiology," published in two parts in the Cleft Palate Journal, Volume 11, The authors of the previous report 1974, and Volume 12, 1975. questioned the validity of the concept that As indicated in the previous two-part the tensor tympani and the stapedius mus- report, it is imperative to consider not only cles provide protection to the inner ear the palate but all of the oral-facial-pharyn- from loud sounds, except perhaps for geal system, both in normal and abnormal minimal protection (less than 10 dB) at low conditions, and both in the adult and in frequencies. They also cited research the developing child. Thus, this review in- which indicated that stapedius contraction cludes normal, abnormal, and develop- is more closely associated with voicing and mental studies on middle ear musculature, coughing than with acoustic stimuli, and the auditory tube, the velopharyngeal that the middle ear muscles might be in- mechanism, the tongue, the larynx, the volved in auditory tube opening. face and mandible, and blood supply and The literature reviewed for this report innervation relevant to cleft lip and palate. does not resolve all of these questions, but Though the relevance of embryology of it does add some focus for future research. the orofacial complex is obvious, it has Greisen and Neergaard (1975) used extra- been reviewed in a recently published re- tympanic phonometry to study middle ear port (Dickson, 1975) and will not be in- reflex activity and were able to demon- cluded as a separate topic in this review strate a tensor tympani reflex in response because of space limitations. -
The Myloglossus in a Human Cadaver Study: Common Or Uncommon Anatomical Structure? B
Folia Morphol. Vol. 76, No. 1, pp. 74–81 DOI: 10.5603/FM.a2016.0044 O R I G I N A L A R T I C L E Copyright © 2017 Via Medica ISSN 0015–5659 www.fm.viamedica.pl The myloglossus in a human cadaver study: common or uncommon anatomical structure? B. Buffoli*, M. Ferrari*, F. Belotti, D. Lancini, M.A. Cocchi, M. Labanca, M. Tschabitscher, R. Rezzani, L.F. Rodella Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy [Received: 1 June 2016; Accepted: 18 July 2016] Background: Additional extrinsic muscles of the tongue are reported in literature and one of them is the myloglossus muscle (MGM). Since MGM is nowadays considered as anatomical variant, the aim of this study is to clarify some open questions by evaluating and describing the myloglossal anatomy (including both MGM and its ligamentous counterpart) during human cadaver dissections. Materials and methods: Twenty-one regions (including masticator space, sublin- gual space and adjacent areas) were dissected and the presence and appearance of myloglossus were considered, together with its proximal and distal insertions, vascularisation and innervation. Results: The myloglossus was present in 61.9% of cases with muscular, ligamen- tous or mixed appearance and either bony or muscular insertion. Facial artery pro- vided myloglossal vascularisation in the 84.62% and lingual artery in the 15.38%; innervation was granted by the trigeminal system (buccal nerve and mylohyoid nerve), sometimes (46.15%) with hypoglossal component. Conclusions: These data suggest us to not consider myloglossus as a rare ana- tomical variant. -
Head & Neck Muscle Table
Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine HEAD‐NECK MUSCLE TABLE PROXIMAL ATTACHMENT DISTAL ATTACHMENT MUSCLE INNERVATION MAIN ACTIONS BLOOD SUPPLY MUSCLE GROUP (ORIGIN) (INSERTION) Anterior floor of orbit lateral to Oculomotor nerve (CN III), inferior Abducts, elevates, and laterally Inferior oblique Lateral sclera deep to lateral rectus Ophthalmic artery Extra‐ocular nasolacrimal canal division rotates eyeball Inferior aspect of eyeball, posterior to Oculomotor nerve (CN III), inferior Depresses, adducts, and laterally Inferior rectus Common tendinous ring Ophthalmic artery Extra‐ocular corneoscleral junction division rotates eyeball Lateral aspect of eyeball, posterior to Lateral rectus Common tendinous ring Abducent nerve (CN VI) Abducts eyeball Ophthalmic artery Extra‐ocular corneoscleral junction Medial aspect of eyeball, posterior to Oculomotor nerve (CN III), inferior Medial rectus Common tendinous ring Adducts eyeball Ophthalmic artery Extra‐ocular corneoscleral junction division Passes through trochlea, attaches to Body of sphenoid (above optic foramen), Abducts, depresses, and medially Superior oblique superior sclera between superior and Trochlear nerve (CN IV) Ophthalmic artery Extra‐ocular medial to origin of superior rectus rotates eyeball lateral recti Superior aspect of eyeball, posterior to Oculomotor nerve (CN III), superior Elevates, adducts, and medially Superior rectus Common tendinous ring Ophthalmic artery Extra‐ocular the corneoscleral junction division -
Initial Stage of Fetal Development of the Pharyngotympanic Tube Cartilage with Special Reference to Muscle Attachments to the Tube
Original Article http://dx.doi.org/10.5115/acb.2012.45.3.185 pISSN 2093-3665 eISSN 2093-3673 Initial stage of fetal development of the pharyngotympanic tube cartilage with special reference to muscle attachments to the tube Yukio Katori1, Jose Francisco Rodríguez-Vázquez2, Samuel Verdugo-López2, Gen Murakami3, Tetsuaki Kawase4,5, Toshimitsu Kobayashi5 1Division of Otorhinolaryngology, Sendai Municipal Hospital, Sendai, Japan, 2Department of Anatomy and Embryology II, Faculty of Medicine, Complutense University, Madrid, Spain, 3Division of Internal Medicine, Iwamizawa Kojin-kai Hospital, Iwamizawa, 4Laboratory of Rehabilitative Auditory Science, Tohoku University Graduate School of Biomedical Engineering, 5Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan Abstract: Fetal development of the cartilage of the pharyngotympanic tube (PTT) is characterized by its late start. We examined semiserial histological sections of 20 human fetuses at 14-18 weeks of gestation. As controls, we also observed sections of 5 large fetuses at around 30 weeks. At and around 14 weeks, the tubal cartilage first appeared in the posterior side of the pharyngeal opening of the PTT. The levator veli palatini muscle used a mucosal fold containing the initial cartilage for its downward path to the palate. Moreover, the cartilage is a limited hard attachment for the muscle. Therefore, the PTT and its cartilage seemed to play a critical role in early development of levator veli muscle. In contrast, the cartilage developed so that it extended laterally, along a fascia-like structure that connected with the tensor tympani muscle. This muscle appeared to exert mechanical stress on the initial cartilage. -
Volume 1: the Upper Extremity
Volume 1: The Upper Extremity 1.1 The Shoulder 01.00 - 38.20 (37.20) 1.1.1 Introduction to shoulder section 0.01.00 0.01.28 0.28 1.1.2 Bones, joints, and ligaments 1 Clavicle, scapula 0.01.29 0.05.40 4.11 1.1.3 Bones, joints, and ligaments 2 Movements of scapula 0.05.41 0.06.37 0.56 1.1.4 Bones, joints, and ligaments 3 Proximal humerus 0.06.38 0.08.19 1.41 Shoulder joint (glenohumeral joint) Movements of shoulder joint 1.1.5 Review of bones, joints, and ligaments 0.08.20 0.09.41 1.21 1.1.6 Introduction to muscles 0.09.42 0.10.03 0.21 1.1.7 Muscles 1 Long tendons of biceps, triceps 0.10.04 0.13.52 3.48 Rotator cuff muscles Subscapularis Supraspinatus Infraspinatus Teres minor Teres major Coracobrachialis 1.1.8 Muscles 2 Serratus anterior 0.13.53 0.17.49 3.56 Levator scapulae Rhomboid minor and major Trapezius Pectoralis minor Subclavius, omohyoid 1.1.9 Muscles 3 Pectoralis major 0.17.50 0.20.35 2.45 Latissimus dorsi Deltoid 1.1.10 Review of muscles 0.20.36 0.21.51 1.15 1.1.11 Vessels and nerves: key structures First rib 0.22.09 0.24.38 2.29 Cervical vertebrae Scalene muscles 1.1.12 Blood vessels 1 Veins of the shoulder region 0.24.39 0.27.47 3.08 1.1.13 Blood vessels 2 Arteries of the shoulder region 0.27.48 0.30.22 2.34 1.1.14 Nerves The brachial plexus and its branches 0.30.23 0.35.55 5.32 1.1.15 Review of vessels and nerves 0.35.56 0.38.20 2.24 1.2. -
Functional Anatomy of the Soft Palate Applied to Wind Playing
Review Functional Anatomy of the Soft Palate Applied to Wind Playing Alison Evans, MMus, Bronwen Ackermann, PhD, and Tim Driscoll, PhD Wind players must be able to sustain high intraoral pressures in dition occurs because of a structural deformity, such as with order to play their instruments. Prolonged exposure to these high cleft palate. It is also associated with some other speech dis- pressures may lead to the performance-related disorder velopharyn- orders. VPI occurs when the soft palate fails to completely geal insufficiency (VPI). This disorder occurs when the soft palate fails to completely close the air passage between the oral and nasal close the oronasal cavity while attempting to blow air through cavities in the upper respiratory cavity during blowing tasks, this clo- the mouth, resulting in air escaping from the nose.5 Without sure being necessary for optimum performance on a wind instru- a tight air seal, the air passes into the nasal cavity and can ment. VPI is potentially career threatening. Improving music teach- then escape out the nose. This has a disastrous effect on wind ers’ and students’ knowledge of the mechanism of velopharyngeal playing, as the power behind the wind musicians’ sound closure may assist in avoiding potentially catastrophic performance- related disorders arising from dysfunction of the soft palate. In the relies on enough controlled expired air through the mouth. functional anatomy of the soft palate as applied to wind playing, Understandably, this disorder may potentially end the musi- seven muscles of the soft palate involved in the velopharyngeal clo- cian’s career.6 sure mechanism are reviewed. -
Atlas of the Facial Nerve and Related Structures
Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries. -
Appendix B: Muscles of the Speech Production Mechanism
Appendix B: Muscles of the Speech Production Mechanism I. MUSCLES OF RESPIRATION A. MUSCLES OF INHALATION (muscles that enlarge the thoracic cavity) 1. Diaphragm Attachments: The diaphragm originates in a number of places: the lower tip of the sternum; the first 3 or 4 lumbar vertebrae and the lower borders and inner surfaces of the cartilages of ribs 7 - 12. All fibers insert into a central tendon (aponeurosis of the diaphragm). Function: Contraction of the diaphragm draws the central tendon down and forward, which enlarges the thoracic cavity vertically. It can also elevate to some extent the lower ribs. The diaphragm separates the thoracic and the abdominal cavities. 2. External Intercostals Attachments: The external intercostals run from the lip on the lower border of each rib inferiorly and medially to the upper border of the rib immediately below. Function: These muscles may have several functions. They serve to strengthen the thoracic wall so that it doesn't bulge between the ribs. They provide a checking action to counteract relaxation pressure. Because of the direction of attachment of their fibers, the external intercostals can raise the thoracic cage for inhalation. 3. Pectoralis Major Attachments: This muscle attaches on the anterior surface of the medial half of the clavicle, the sternum and costal cartilages 1-6 or 7. All fibers come together and insert at the greater tubercle of the humerus. Function: Pectoralis major is primarily an abductor of the arm. It can, however, serve as a supplemental (or compensatory) muscle of inhalation, raising the rib cage and sternum. (In other words, breathing by raising and lowering the arms!) It is mentioned here chiefly because it is encountered in the dissection. -
Palatoglossus Muscle Stimulation for Treatment of Obstructive Sleep Apnea
Palatoglossus Muscle Stimulation for Treatment of Obstructive Sleep Apnea Summary A Vanderbilt researcher has developed a device to stimulate the palatoglossus muscle in order to treat sleep apnea. This has the potential to treat patients who have failed to succeed with current sleep apnea treatments. Addressed Need Hypoglossal nerve stimulation (HNS) has been established as an effective form of treatment for patients with obstructive sleep apnea who cannot tolerate positive airway pressure. HNS works by stiffening the tongue muscles to increase pharyngeal airway size. However, patients with significant retropalatal airway collapse are not candidates for HNS offered in the US. This new treatment would provide these patients with an alternative therapy method to combat sleep apnea. Unique Features Electrical stimulation of the nerve to the palatoglossus muscle Potential to dilate retropalatal space and reduce obstructive sleep apnea Can treat patients who may be unsuccessful with other sleep apnea treatments Technology Description The palatoglossus muscle forms the anterior tonsillar pillar. It approximates the tongue and soft palate, sealing off the oral cavity and dilating the retropalatal space. This muscle is innervated by branches of the pharyngeal plexus and functions independently of the hypoglossal nerve innervating the remaining tongue musculature. Electrical stimulation of the nerve to the palatoglossus muscle has the potential to dilate the retropalatal space and reduce the burden of obstructive sleep apnea. Technology Development Status The treatment process has been designed, and physiological studies are pending. Cadaveric studies are being completed to evaluate the accessibility of the palatoglossus muscle through the neck. Intellectual Property Status A patent application has been filed. -
Anatomy and Physiology of the Velopharyngeal Mechanism
Anatomy and Physiology of the Velopharyngeal Mechanism Jamie L. Perry, Ph.D.1 ABSTRACT Understanding the normal anatomy and physiology of the velopharyngeal mechanism is the first step in providing appropriate diagnosis and treatment for children born with cleft lip and palate. The velopharyngeal mechanism consists of a muscular valve that extends from the posterior surface of the hard palate (roof of mouth) to the posterior pharyngeal wall and includes the velum (soft palate), lateral pharyngeal walls (sides of the throat), and the posterior pharyngeal wall (back wall of the throat). The function of the velopharyngeal mechanism is to create a tight seal between the velum and pharyngeal walls to separate the oral and nasal cavities for various purposes, including speech. Velopharyngeal closure is accomplished through the contraction of several velopharyngeal muscles including the levator veli palatini, musculus uvulae, superior pharyngeal con- strictor, palatopharyngeus, palatoglossus, and salpingopharyngeus. The tensor veli palatini is thought to be responsible for eustachian tube function. KEYWORDS: Anatomy, physiology, velopharyngeal muscles, cleft palate anatomy Downloaded by: SASLHA. Copyrighted material. Learning Outcomes: As a result of this activity, the reader will be able to (1) list the major muscles of the velopharyngeal mechanism and discuss their functions; (2) list the sensory and motor innervation patterns for the muscles of the velopharyngeal mechanism; and (3) discuss the variations in velopharyngeal anatomy found in an unrepaired cleft palate. Understanding the normal anatomy and and treatment for children born with cleft lip physiology of the velopharyngeal mechanism is and palate. Most of the diagnostic and therapy the first step in providing appropriate diagnosis approaches are based on a strong foundation of 1Department of Communication Sciences and Disorders, Guest Editor, Ann W. -
Soft Palate and Its Motor Innervation: a Brief Review
Review Article Anatomy Physiol Biochem Int J Volume 5 Issue 4 - April 2019 Copyright © All rights are reserved by Liancai Mu DOI: 10.19080/APBIJ.2019.05.555672 Soft Palate and Its Motor Innervation: A Brief Review Liancai Mu1*, Jingming Chen1, Jing Li1, Stanislaw Sobotka1,2 and Mary Fowkes3 1Department of Biomedical Research, Upper Airway Research Laboratory, Hackensack University Medical Center, USA 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA 3Department of Pathology, Icahn School of Medicine at Mount Sinai, USA Submission: March 29, 2019; Published: April 18, 2019 *Corresponding author: Liancai Mu, MD, Ph.D, Upper Airway Research Laboratory, Department of Biomedical Research, Hackensack University Medical Center, 40 Prospect Avenue, Hackensack, NJ, 07601, USA Abstract Human soft palate plays an important role in upper airway functions such as speech, swallowing and respiration. However, neural control of the soft palate is poorly understood because innervation of this structure has long been controversial. In this review, the inconsistent and even contradictory observations regarding the motor innervation of the palatal muscles are summarized. We emphasize to use Sihler’s stain for documenting the nerves and their supply patterns within individual palatal muscles as studies have demonstrated that Sihler’s stain permits mapping of entire nerve supply within organs, skeletal muscles, mucosa, skin, and other structures. This wholemount nerve staining has unique advantage over other anatomical methods as all the nerves within the muscles processed with Sihler’s stain can be visualized in their 3-dimensional positions. Advanced knowledge of the neural organization of the soft palate is critical for a better understanding of its functions and for the development of novel neuromodulation therapies to treat soft palate-related upper airway disorders such as obstructive sleep apnea.