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The Human Voice

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by

David E.

on 27 October 2016

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Transcript of The Human Voice

The Human Voice
http://en.wikipedia.org/wiki/File:Larynx_external_en.svg#file
http://upload.wikimedia.org/wikipedia/commons/3/3a/Illu_larynx.jpg
http://upload.wikimedia.org/wikipedia/commons/thumb/5/50/Gray956.png/120px-Gray956.png
Voice Disorders (Sapienza & Ruddy, 2009)
Vocal Folds
Anatomy
Physiology
Voice Disorders (Sapienza & Ruddy, 2009)
Breathing and Swallowing
Thoracic fixation
Coughing
Voicing (Phonation)
Voice Disorders (Sapienza & Ruddy, 2009)
Movement
Via Cricothyroid Joint
Cricothyroid Joint
The cricothyroid joint allows the thyroid to move anteriorly or posteriorly on the cricoid cartilage
Vocal Fold Layers
Voice Disorders (Sapienza & Ruddy, 2009)
Differences between males and females
Males have a larger thyroid lamina and a more acute thyroid angle, the “Adam’s apple”
Thicker vocal folds and a larger glottal space
Differences in pitch
Average frequency for an adult male is 100 Hz
Average frequency for an adult female is 250 Hz
Average frequency for a young child is 300 Hz
Anatomical Differences
1843 by Johannes Muller
MYO - musculature
ELASTIC - malleable but returns to original form
AERO - air flow & pressure
DYNAMIC - opens & closes
Myoelastic Aerodynamic Theory of Voice Production
Voice Disorders (Sapienza & Ruddy, 2009)
The minimum pressure amount needed to sustain vocal fold vibration is called the phonation threshold pressure (PTP)
Many factors can alter PTP including:
hydration level
vocal skill
vocal fatigue
sound intensity and vocal pitch as they relate to glottal diameter
Phonation Threshold Pressure

Nessun Dorma
Vocal Quality
Hydration
Allergens
Medications

Vocal Hygiene
Voice Care
Decreased action of cilia in the respiratory tract leading to decreased mucus production (i.e. dryness)
Inflammation
Coughing
Hoarseness
Cigarette Smoke
Voice Disorders (Sapienza & Ruddy, 2009)
Continual cough and throat clearing can have deleterious effects on vocal fold health due to the high expiratory pressures and shearing forces causing tissue irritation and damage to the vocal folds over time
Coughing and Throat Clearing
Voice Disorders (Sapienza & Ruddy, 2009)
Caffeine is a diuretic, meaning that it contributes to the elimination of water through the body, potentially contributing to dehydration
Reduce caffeine intake
Increasing water intake
Caffeine Intake
Voice Disorders (Sapienza & Ruddy, 2009)
Strategies to increase hydration include :
Hydrate yourself in advance of your performance
Adding a humidifier to maintain the environment at 30% humidity or higher
Increased water intake reduces
Vocal fold swelling
Vocal fold lesion size such as nodules
Dehydration
Voice Disorders (Sapienza & Ruddy, 2009)
Most people require an average of 8 to 9 hours per night but this can vary from as little as 6 hours to as many as 10 hours
Optimal voice may not be achieved when a person is tired
Sleep Deprivation
Voice Disorders (Sapienza & Ruddy, 2009)
Individuals who engage in prolonged periods of voice use are at an increased risk for vocal fatigue
Pastors and teachers
Singers and actors
Symptoms of vocal fatigue include:
Odynophonia - soreness or pain in the throat
Dysphonia – changes in vocal quality
Periods of voice loss
Vocal Fatigue
Voice Disorders (Sapienza & Ruddy, 2009)
An overreaction of the immune system to a substance
Common symptoms include:
runny nose
sore throats
breathing (wheezing)
persistent cough
a cold that won’t go away
and/or a voice disturbance
Allergies
Voice Disorders (Sapienza & Ruddy, 2009)
Drying and/or thickening of upper respiratory tract secretions, dehydration, and sedation
An expectorant such as Guaifenesin can minimize drying out of the mucosal secretions
Water is the best mucolytic agent
Respiratory and laryngeal lubrication are directly related to normal vocal fold function
Antihistamines
Voice Disorders (Sapienza & Ruddy, 2009)
Avoid long-term use of aspirin or ibuprofen which can increase the risk of vocal fold hemorrhage
The reason for the pain should not be ignored
Pain relievers
LUCIA DI LAMMERMOOR – Natalie Dessay. Production photos by Terrence McCarthy.
http://www.sanfranciscosentinel.com/wp-content/uploads/2008/07/lucia-dammermoor.JPG
The Performer’s Voice
Air traffic controllers/pilots
Lawyers
Military personnel
Ministers
Sales personnel
Stage performers
Teachers
Factory workers
Preachers
Telemarketers
TV and radio broadcasters
Sports coaches
Aerobic/fitness instructors
Professionals at Risk
Voice Disorders (Sapienza & Ruddy, 2009)
High Risk Performers
The types of voice disorders theme park performers present with include vocal fold nodules, vocal fold polyps, edema, and hemorrhagic conditions
Voice Disorders (Sapienza & Ruddy, 2009)
Over-compensation during laryngeal infection or irritation
Excessive muscle tension
Engaging in phonotraumatic behaviors (i.e. yelling, screaming, talking too loudly)
Causes of Dysphonia
Voice Disorders (Sapienza & Ruddy, 2009)
Improper vocal training
Singing in an unnatural pitch or tense, poor amplification
Poor environmental conditions, and emotional reaction stemming from the stresses of one’s daily lifestyle
Causes of Dysphonia
Idina Menzel
Julie Andrews
Luciano Pavarotti
Sarah Brightman
http://www.musicalschwartz.com/wicked-lyrics-10.htm
Singers who developed nodules
Performer's Voice
Voice Disorders (Sapienza & Ruddy, 2009)
Respiratory support
Relaxation
Good vocal hygiene
Functional
Organic
Neurologic
Common Vocal Fold Disorders

Alteration in the histological organization of the vocal fold
Identified via visual inspection
Structural Pathologies
High Speed Video Laryngoscopy
Voice Pathology
Common benign pathology
Caused from phonotraumatic behaviors
Vocal Fold Nodules
Common benign pathology
Caused from phonotraumatic behaviors
Vocal Fold Nodules
Inflammatory degeneration of the superficial layer of the lamina propria
Typically form bilaterally
High impact stress during phonation
(1) Acute
(2) Chronic
(3) Reactive
Vocal Nodules
Voice quality varies from early to mature formation
Raspy
Hoarse
Breathy
Easily fatigues
Singers
Loss of vocal range
Loss of vocal endurance
Vocal Nodules Symptoms
Behavioral voice therapy
Vocal hygiene therapy
Phonosurgery
Avoidable in most cases
Requires behavioral therapy to prevent future nodules
Vocal Nodules Management
Fluid-filled lesion
Superficial layer of the lamina propria
Has its own blood supply
Forms unilaterally
Caused by acute vocal trauma
Vocal Fold Polyps Symptoms
Behavioral voice therapy
Vocal hygiene
Medical
Phonosurgery
Vocal Fold Polyps Management
Inflammatory condition of the vocal fold mucosa
Causes:
Reaction to viral or bacterial infection
Traumatic incident
Autoimmune diseases
Laryngitis
Mild
Hoarseness
Sore throat, cough, and fever
Severe
Aphonia
Caused by continued voice use during the bout of laryngitis
Laryngitis Symptoms
Often resolves with rest and hydration
Antibiotics
Necessary to pinpoint the cause of the inflammation
Remove the causative irritant or pathogen
Vocal hygiene
Laryngitis Management
Puberphonia
Muscle Tension Dysphonia
Functional Voice Disorders
The pitch is higher than it should be
Breathy
Low vocal loudness
Puberphonia
Increased muscle activity in the head and neck
Possible causes:
Stress, anxiety, depression, high vocal demand, issues with time management, and general complaints of being overloaded both physically and emotionally
Laryngopharyngeal reflux
Muscle Tension Dysphonia
Voice quality:
Strained
High pitch
Breathy
Muscle Tension Dysphonia
Voice therapy:
Biofeedback
Laryngeal relaxation techniques
Resonant voice therapy
Circumlaryngeal massage
Accent method
Muscle Tension Dysphonia
From the YouTube clip description: "Twenty-two minutes after she was asked to cover for her ailing friend, Luciano Pavarotti, Aretha Franklin takes the stage to perform the legendary aria 'Nessun Dorma,' a piece she sang previously a few days earlier (in her own register, I might add), without changing Pavarotti's key - which is no minor achievement. It begets one of the most extraordinary musical moments in awards show history. It brought the audience to a thunderous ovation."
Drink a glass of water for every cup of coffee consumed.
Diagnosing
Voice Disorders

Voice Disorders (Sapienza & Ruddy, 2009)
Visual assessment
Medical referral
Second-hand smoke causes 40% of the damage that primary exposure causes.
The
voice
of the Lord is over the waters; the God of glory thunders, the Lord, over many waters.
The
voice
of the Lord is powerful; the
voice
of the Lord is full of majesty. -Psalm 29:3-4 (ESV)
By G. Berger (lithography) (http://ihm.nlm.nih.gov/images/B19893) [Public domain], via Wikimedia Commons
My sheep hear my
voice
and I know them and they follow me. -John 10:27
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