Foundations of Speech and Hearing: Anatomy and Physiology

Jeannette D. Hoit, PhD, CCC-SLP (Retired), is Professor Emerita in the Department of Speech, Language, and Hearing Sciences and former director of Postdoctoral Affairs at the University of Arizona. Dr. Hoit received her BA in anthropology from the University of California at Los Angeles, her MA in communication disorders from San Diego State University, and her PhD in speech and hearing sciences from the University of Arizona and pursued postdoctoral study at the Harvard School of Public Health Respiratory Biology Program and Massachusetts Institute of Technology Speech Research Laboratory. Dr. Hoit's research focused on speech physiology with an emphasis on normal aging and development, neuromotor speech disorders, and respiratory function and dysfunction. Dr. Hoit is past editor of the American Journal of Speech-Language Pathology, a fellow of the American Speech-Language-Hearing Association, and University of Arizona College of Science Galileo Fellow. She has received a Distinguished Alumnus Award from San Diego State University and several teaching and mentoring awards from the University of Arizona.Gary Weismer, PhD, is Oros-Bascom Professor Emeritus in the Department of Communication Sciences & Disorders, University of Wisconsin-Madison. He received his bachelor's and master's degrees from the Pennsylvania State University and his doctorate from University of Wisconsin-Madison in 1975. Dr. Weismer's research publications concern speech production in healthy talkers, as well as speech production and speech intelligibility in persons with motor speech disorders. Dr. Weismer served twice as Associate Editor for the Journal of Speech, Language, and Hearing Research (formerly the Journal of Speech and Hearing Research), as Associate Editor at Folia Phoniatrica et Logopaedica (FPL) from 2004 to 2011, and as Editor-in-Chief at FPL from 2011 to 2016. During his 35 years at University of Wisconsin-Madison, Dr. Weismer won several teaching awards, including for mentoring efforts in the University of Wisconsin-Madison Honors program. Dr. Weismer mentored 16 doctoral students during his career, many of whom are currently scientific leaders and university administrators. He is a past member of the Executive Board of the International Association of Logopedics and Phoniatrics (IALP), an Honored Member of IALP, a Fellow of the Acoustical Society of America, and past chair of his department. He has edited, authored, and coauthored five textbooks.Brad H. Story, PhD, is Professor in the Department of Speech, Language, and Hearing Sciences and Associate Dean of Faculty Affairs in the College of Science at the University of Arizona. Dr. Story received his BS in Applied Physics from the University of Northern Iowa in 1987 and his PhD in Speech and Hearing Sciences from the University of Iowa in 1995. From 1987-1991, he was employed in industry as an engineer where he developed computational models and instrumentation systems for designing and measuring the performance of mufflers. Dr. Story's research publications concern the mechanics, aerodynamics, and acoustics of speech production, as well as the perception of speech sounds. Dr. Story is a past Associate Editor for the Journal of the Acoustical Society of America, a fellow of the Acoustical Society of America (ASA), and recipient of the ASA's Rossing Prize in Acoustics Education in 2016. Dr. Story was recognized by the American Speech Language and Hearing Association in 2013 with the Willard R. Zemlin Lecture Award, and by the University of Iowa in 2018 with a Distinguished Alum Award. His research has been supported by the National Institutes of Health and the National Science Foundation.Rosemary A. Lester-Smith, PhD, CCC-SLP, is an Associate Professor of Speech, Language, and Hearing Sciences at The University of Texas at Austin. She received a BA in speech and hearing sciences from the University of New Mexico, an MA in speech and hearing sciences from Indiana University, an MS in clinical investigation from Northwestern University, and a PhD in speech, language, and hearing sciences with a minor in neuroscience from the University of Arizona. She completed postdoctoral training at Mayo Clinic, Boston University, Northwestern University, and Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago). Dr. Lester-Smith's research focuses on voice production in speakers with neurological disorders, healthy speakers, and singers with the goal of understanding factors that impair or improve vocal control. Her research is supported by the National Institutes of Health. Dr. Lester-Smith is also a certified speech-language pathologist and has worked in a variety of clinical settings, primarily evaluating and treating adults with voice and swallowing disorders.

• ContentsPrefaceAcknowledgmentsAbout the AuthorsAbout the Illustrator CHAPTER 1. INTRODUCTION TO BASIC CONCEPTS Introduction Stages of Spoken Communication Subsystems Speech Subsystems Hearing Subsystems Directions and Planes Directions Anterior/Posterior (Ventral/Dorsal) Superior/Inferior (Rostral/Caudal) Medial/Lateral Proximal/Distal External/Internal (Superficial/Deep) Ipsilateral/Contralateral Planes Sagittal Plane Coronal Plane Horizontal Plane Tissue Types Neural Tissue Muscle Tissue Connective Tissue Epithelial Tissue Movements and Forces Review CHAPTER 2. NEURAL STRUCTURES AND FUNCTIONS FOR SPEAKING, HEARING, AND SWALLOWINGIntroduction Organizing Concepts Central Versus Peripheral Nervous System Anatomical Planes and Directions Gray Matter and Nuclei White Matter and Fiber Tracts Ganglia Efferent and Afferent Lateralization, Specialization, and Somatotopic Organization Motor and Sensory Integration Cerebral Hemispheres Frontal Lobe Primary Motor Cortex Broca's Area Premotor and Supplementary Motor Area Prefrontal Cortex Parietal Lobe Temporal Lobe Occipital Lobe Insula Limbic System (Limbic Lobe) Cerebral White Matter Association Tracts Striatal Tracts Commissural Tracts Descending Projection Tracts Ascending Projection Tracts Subcortical Nuclei and Cerebellum Basal Ganglia Thalamus Cerebellum Brainstem Surface Features of the Brainstem: Ventral View Ventral Surface of Midbrain Ventral Surface of Pons Ventral Surface of Medulla Surface Features of the Brainstem: Dorsal View Dorsal Surface of Midbrain Dorsal Surface of Pons Dorsal Surface of Medulla Cranial Nerves and Associated Brainstem Nuclei Cranial Nerve V (Trigeminal) Cranial Nerve VII (Facial) Cranial Nerve VIII (Vestibulocochlear) Cranial Nerve IX (Glossopharyngeal) Cranial Nerve X (Vagus) Cranial Nerve XI (Spinal Accessory Nerve) Cranial Nerve XII (Hypoglossal) Spinal Cord Spinal Nerves Cortical Motor Innervation Patterns Nervous System Cells Glial Cells Neurons Cell Body (Soma) Dendrites Axon and Terminal Segment Synapse Presynaptic Membrane Postsynaptic Membrane Synaptic Cleft Electrochemical Transmission Resting Potential Action Potential Synaptic Transmission and Neurotransmitters Neuromuscular Junction Meninges, Ventricles, and Blood Supply Meninges Ventricles and CSF Blood Supply of Brain Anterior Circulation Posterior Circulation Circle of Willis Review References CHAPTER 3. RESPIRATORY STRUCTURE AND FUNCTION Introduction Respiratory Anatomy Skeletal Framework Respiratory System Subdivisions Pulmonary Apparatus Chest Wall Pulmonary Apparatus-Chest Wall Unit Forces of the Respiratory System Passive Force Active Force Muscles of the Rib Cage Wall Muscle of the Diaphragm Muscles of the Abdominal Wall Summary of Passive and Active Forces Realization of Passive and Active Forces Movements of the Respiratory System Movements of the Rib Cage Wall Movements of the Diaphragm Movements of the Abdominal Wall Relative Movements of the Rib Cage Wall and Diaphragm-Abdominal Wall Forces Underlying Movements Respiratory Control Variables Lung Volume Alveolar Pressure Chest Wall Shape Neural Control of Breathing Control of Tidal Breathing Control of Special Acts of Breathing Peripheral Nerves of Breathing Ventilation and Gas Exchange During Tidal Breathing Speech Breathing Extended Steady Utterances Connected Speech Activities Variables That Influence Respiratory Structure and Function Body Position Body Type Age Sex Ventilation and Drive to Breathe Cognitive-Linguistic and Social Variables Clinical Measurements of Respiratory Function Spirometry Manometry Plethysmography Pulse Oximetry Clinical Case: Spinal Cord Injury Review References Answers to Clinical Case Questions CHAPTER 4. LARYNGEAL STRUCTURE AND FUNCTION Introduction Laryngeal Anatomy Skeletal Framework Thyroid Cartilage Cricoid Cartilage Arytenoid and Corniculate Cartilages Epiglottis Hyoid Bone Laryngeal Joints Cricothyroid Joints Cricoarytenoid Joints Internal Topography Laryngeal Cavity Vocal Folds Ventricular Folds Laryngeal Ventricles Ligaments and Membranes Forces of the Larynx Intrinsic Laryngeal Muscles Extrinsic Laryngeal Muscles Supplementary Muscles Infrahyoid Muscles Suprahyoid Muscles Summary of the Laryngeal Muscles Movements of the Larynx Movements of the Vocal Folds Vocal Fold Abduction Vocal Fold Adduction Vocal Fold Length Change Movements of the Ventricular Folds Movements of the Epiglottis Movements of the Laryngeal Housing Laryngeal Control Variables Laryngeal Opposing Pressure Laryngeal Airway Resistance Glottal Size and Configuration Stiffness of the Vocal Folds Effective Mass of the Vocal Folds Neural Control of the Larynx Laryngeal Function and Speech Production Transient Noise Production Sustained Noise Production Sustained Voice Production Vocal Fold Vibration Fundamental Frequency Sound Pressure Level Fundamental Frequency-Sound Pressure Level Profiles Spectrum Voice Registers Connected Speech Activities Fundamental Frequency Sound Pressure Level Spectrum Articulation Variables That Influence Laryngeal Structure and Function Age Sex Clinical Measurements of Laryngeal Function Endoscopy Electroglottography Aeromechanical Observations Clinical Case: Vocal Fold Paralysis Review References Answers to Clinical Case Questions CHAPTER 5. VELOPHARYNGEAL-NASAL STRUCTURE AND FUNCTIONIntroduction Velopharyngeal-Nasal Anatomy Skeletal Framework Pharynx Velum Nasal Cavities Outer Nose Forces of the Velopharyngeal-Nasal Mechanism Muscles of the Pharynx Muscles of the Velum Muscles of the Outer Nose Movements of the Velopharyngeal-Nasal Mechanism Movements of the Pharynx Movements of the Velum Movements of the Outer Nose Movements That Change the Size of the Velopharyngeal Port Velopharyngeal-Nasal Control Variables Velopharyngeal-Nasal Airway Resistance Velopharyngeal Sphincter Compression Velopharyngeal-Nasal Acoustic Impedance Neural Control of the Velopharyngeal-Nasal Mechanism Velopharyngeal-Nasal Function and Ventilation Velopharyngeal Function and Speech Production Sustained Utterances Connected Speech Activities Variables That Influence Velopharyngeal-Nasal Structure and Function Body Position Age Sex Clinical Measurements of Velopharyngeal-Nasal Function Nasendoscopy Aeromechanical Observations Nasometry Clinical Case: Cleft Lip and Palate Review References Answers to Clinical Case Questions CHAPTER 6. PHARYNGEAL-ORAL STRUCTURE AND FUNCTION Introduction Pharyngeal-Oral Anatomy Skeletal Framework Maxilla Mandible Temporomandibular Joints Internal Topography Pharyngeal Cavity Oral Cavity Buccal Cavity Mucous Lining Forces of the Pharyngeal-Oral Mechanism Muscles of the Pharynx Muscles of the Mandible Muscles of the Tongue Muscles of the Lips Movements of the Pharyngeal-Oral Mechanism Movements of the Pharynx Movements of the Mandible Movements of the Tongue Movements of the Lips Pharyngeal-Oral Control Variables Pharyngeal-Oral Lumen Size and Configuration Pharyngeal-Oral Structural Contact Pressure Pharyngeal-Oral Airway Resistance Pharyngeal-Oral Acoustic Resonances Neural Control of the Pharyngeal-Oral Mechanism Speech Production: Sound Generation and Filtering Speech Production: Articulatory Descriptions Vowels Place of Major Constriction Degree of Major Constriction Lip Rounding Real-Life Vowels Diphthongs Consonants Manner of Production Place of Production Voicing Real-Life Consonants Speech Production: Articulatory Processes Coarticulation Articulatory Phonology or Gesture Theory Variables That Influence Pharyngeal-Oral Structure and Function Age Sex Clinical Measurements of Pharyngeal-Oral Structure and Function Structural and Functional Imaging Articulatory Tracking Acoustic Observations and Measurement Clinical Case: Glossectomy Review References Answers to Clinical Case Questions CHAPTER 7. SWALLOWING STRUCTURE AND FUNCTION Introduction Anatomy Esophagus Stomach Salivary Glands Forces and Movements of Swallowing Oral Preparatory Phase Oral Transport Phase Pharyngeal Phase Esophageal Phase Overlap of Phases Breathing and Swallowing Neural Control of Swallowing Role of the Peripheral Nervous System Role of the Central Nervous System Variables That Influence Swallowing Bolus Characteristics Consistency and Texture Volume Taste Swallowing Mode Single Versus Sequential Swallows Cued Versus Uncued Swallows Body Position Age Sex Clinical Measurements of Swallowing Videofluoroscopy Endoscopy Ultrasonography Manometry Clinical Case: Parkinson's Disease Review References Answers to Clinical Case Questions CHAPTER 8. AUDITORY SYSTEM STRUCTURE AND FUNCTION Introduction Skeletal Framework Peripheral Anatomy of the Ear Outer Ear (Conductive Mechanism) Pinna External Auditory Meatus Tympanic Membrane Middle Ear (Conductive Mechanism) Ossicles and Associated Structures Ligaments and Muscles of the Middle Ear Eustachian Tube Summary of Middle Ear Structures Inner Ear (Sensorineural Mechanism) Semicircular Canals Vestibule Cochlea Cochlear Nerve Transformation of Sound by the Ear Transformation of Sound by the Conductive Mechanism Transformation of Sound by the Sensorineural Mechanism Central Auditory Pathways Clinical Measurements of Hearing Pure-Tone Audiometry Auditory Brainstem Response Otoacoustic EmissionsClinical Case: Unilateral Hearing Loss Review References Answers to Clinical Case QuestionsIndex