SPEECH

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ORAL AND MAXILLOFACIAL PATHOLOGY

CONTENTS
Definition History Physiology of speech Speech centers of brain Reparatory system Larynx Phonation Articulation Resonators Vowel sounds Consonants Influence of malocclusion and dental procedures on speech sounds
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DEFINITION

In humans sounds of a carefully controlled kind are produced as a means of communication , such sounds are called speech.

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The word speech is derived from old English speche related to specan which means to speak

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HISTORY

French physician Ferrein (1741), who was the first to perform laryngeal experiments. French neurologist Paul Broca, controlling muscles of the lips, jaw s, soft palate and vocal cords.

w (1824-1880)
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1874 by German neurologist Carl Wenickle (1848-1904),

areas receiving auditory and visual information

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PHYSIOLOGY OF SPEECH
The speech process involves the i) speech center of the brain ii) the respiratory center in the brain stem iii) the respiratory system iv) the larynx v) the nose and nasal cavities vi) the structures of the mouth and related facial muscles.
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SPEECH CENTER OF BRAIN

Control of vocalization is from the cerebral cortex, called Brocas area. It controls word formation and the necessary adjustment to respiration by activating appropriator muscle signals in the motor cortex. It is in turn control of Wernicks area Linked to Brocas area by arcute fasciculus.
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Lesion of wernicks area / fasciculus results in a condition termed fluent aphasia Lesion of Brocas results in errors of articulation Speech production is controlled from categorical hemisphere; lesions on the representational side have no effect on speech.

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RESPIRATORY SYSTEM

Mouth can control and modify air flow through it self and this provides the means of altering expiration of air produce a variety of sounds which can then be used for communication .

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During phonic respiration, i.e. our breathing during speech, the inhalation time is reduced ( sometimes to as little as half a second), whereas the exhalation time is increased to about 5-10 se conds, though in rapid, excited speech when we wish to convey more speech it can go up considerably.

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(a) there is a gradual automatic change from resting to speech respiration

(b) the degree of internal verbalization (activatio n of motor speech areas) defines the degree of activation of the speech respiratory pattern ( conord , schole P, 1979)

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LARYNX
The larynx is comprised of a number of cartilages.

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Larynx midsagittal view

Epiglottis Thyroid cartilage

Arytenoid cartilage

Cricoid cartilage
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Trachea
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Larynx lateral view

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Larynx posterior view

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The production of intelligible speech sounds is a modification of expiration by forcing by the out flowing air through a narrow gap bounded by structures of variable and controlled elasticity.

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MYOELASTIC THEORY

They are caused to vibrate, and hence to impart vibration to the air passing through them , by their own elastic resistance to the airflow.

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AERRODYNAMIC THEORY
The combination of movement and recoil induced in them by the combination and recoil induced in them by the vortices generated on the side away from as the air flow as the wider pipe it reaches on the side of the cords.

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The vocal folds are made up of fibro elastic connective tissue and contains two muscles, the lateral crico-arytenoid and thyro- arytenoid Thyro arytenoid controls the tension of the cord - vocalis muscle In normal respiration the vocal folds give very little restriction to air flow.
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The triangular space between them the rima gl ottis is sufficiently wide to allow air to pass easily. In swallowing or vomiting , the lateral crico aryretynoid muscles and thyro-arytenoid muscle s cause the cricoid cartilages to rotate and their arms to move together; simultaneously the trans verse and oblique arytenoid arms to move together.
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Simultaneously the transverse and oblique arytenoid muscles move the picot points of the cartilages together.

This combination of activities closes the glottis and stops air flow, protecting the respiratory tract .

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In order to generate sounds the glottis must be close d but only to such a degree that it can be forced open by the airflow. A tightly closed glottis is associated with louder sounds because a greater air pressure is needed to open it ; when the cords are only lightly approximate d because a greater air pressure is needed to open it. when the cords are only lightly approximated the expi SONUS Reviving 27 ratory pressure can be small and the sound quite.

The compressed air will force apart the vocal folds so th at a little air escapes for a brief moment. This phase is t he release. As the air flows past, the vocal folds are brought back to gether as a result of two forces: the elasticity of the folds, and the so-called Bernouilli effect. The air rushes through the narrow opening in the vocal folds at great speed (faster than the usual outflow speed from the lungs). As a result, the pressure between the vocal folds drops (i SONUS Reviving 28 n relation to the pressure above and below them).

wThe cycle of glottal vibration (from Daniloff, p. 171) w1. folds at rest
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w2. muscle w contraction

w5. explosion w open

w6. acoustic w shockwave

w3. increase in w pressure

w4. forcing folds w apart

w7. rebound toward w closure

w8. folds close, w goto step (3)

wThe cycle of glottal vibration (from Pickett, p. 50)

wopening to closure, 2.4 to 4.5 msec

wclosure to opening, 0 to 2.1 msec

w(F0 = 222 Hz)

It is the force of this negative pressure which sucks the vocal folds back together. This phenomenon has been named after the Swiss physicist Daniel Bernouilli (1700-1782), who discovered a similar process during his experiments with fluids and gases.

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In whispering only the anterior part of the rime glottis is closed and the cords are separated posteriorly. The initial max frequencies is given by the length and tension of the vocal folds or cords.

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wTypes of phonation (from Daniloff, p. 194)

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wquiet wbreathing

wforced winhalation

wnormal wphonation

wwhisper

The neural control of the sound frequencies generated at the cords is the vagus nerve, princi pally through the recurrent laryngeal nerve. Cricothyroid muscle is innervated by external laryngeal nerve.

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The sound generated is modification of mixture by stoppage or airflow and amplification of certain frequencies that turns sound into speech. The sound frequency is related to the length an d tension of the cords and a number of harmonic s of these.

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In males upon puberty the length of the vocal do ubles to about 15mm. In females it grows about 7-8mm

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Frequency of Male voice - 100 to150Hz Female voice 200 to 300 Hz Human ear is sensitive to 1000-4000Hz Singers can be trained to produce note as low a s 27 Hz and upper limit of 4000Hz

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Loudness of the sound depends primarily on the force of expiration,

Measurement of the loudness achieved by shou ting gives figures up to 110dB.

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There is simultaneous comparison of the sound intended with that produced and then heard by the ears to give the final tuning. A complication is that sound produced is produc ed by bony conduction , whereas in the matchin g with an externally generated sound the latter is heard by airborn conduction.

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Speech is composed of two mechanical functions: (1) phonation, which is achieved by the larynx, and (2) articulation, which is achieved by the structures of the mouth.

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PHONATION
During normal breathing, the cords are wide ope n to allow easy passage of air. During phonation, the cords move together so that passage of air between them will cause vibration

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The muscles within the vocal cords can change the shapes and masses of the vocal cord edges, sharpening them to emit high-pitched sounds an d blunting them for the more bass sounds.

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ARTICULATION
The three major organs of articulation are the lip s, tongue, and soft palate.

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RESONATERS
The resonators include the mouth, the nose and associated nasal sinuses, the pharynx, and even the chest cavity. Frequencies are selected by the use of Helmholt z resonators.

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There are no of pipe resonators : Larynx , pharynx and the nose

The upper respiratory tract infections like the common cold , and abnormalities of the pipe such as a cleft palate giving communication between the oral and nasal cavities, will produce predictable changes in the sound of the voice.
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Oral resonators is readily divided into two resonators: the anterior and the posterior which is separated by the tongue.

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The position of the tongue in relation to the palate can be varied and thus the relative sizes of the these two resonating chambers can also b e varied. The two frequencies selected in this way are known as format and they give the characteristic sound of vowel.

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Vowel sounds
Anterior chamber is the labial resonators Posterior resonators are the laryngeal resonators The two main formant frequencies for vowel are: Lower frequency amplified by posterior chamber Higher frequencies are amplified by the anterior chamber. The third format frequency has been described f or vowel sounds but is relatively constant for all English language SONUS Reviving 48

CONSONANTS
Consonants are produced by stopping airflow, th e site and manner of stoppage give the sound. It can be classified either according to the struct ure involved in the airflow stoppage or accordin g to the completeness of the stoppage.

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Anatomical classification: Labiodental, linguodental and linguopalatal

Linguopalatal is subdivided defining the specific areas of palate involved and so termed alveolar, prepalatal, (medio)platal, velar and glottal

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Complete followed by release impedanc e

Partial stoppage in mouth , escape through nose

Partial

Release

Of airflow

Plosive Bilabial Labiodent al Interdental Alveolar Prepalatal Palatal Velar

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nasal b m

Lateral

Trill/roll

Fricative w v f

Affricative

that thin d t z v l g k ng
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s sh j ch

Glottal

H (aspirate)

INFLUENCE OF MALOCCLUSION AND DENTAL PROCEDURES ON SPEECH SOUNDS

The position or size of structures involved in imp ending airflow during articulation, will effect the q uality of speech. High and low palatal vault with tongue large or s mall in relation to the size of the oral cavity Cleft palate Hypertrophy of the lymphoid tissues
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Deficiency of the palatal musculature Functionally abnormal as in neurotransmission effect in myasthenia gravis Short upper lip, missing/ malposition upper/lower incisors,when tongue to palatal contact is difficult - consonantal sounds will change

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Lips may arise from almost any condition upper i ncisors are displaced or absent and where the t ongue-palate contact is difficult to achieve. Angles class II relationship predisposition to ali sp. Fitting odf a denture/orthodontic appliance result s in change in s and the th sounds.
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AGING
As the person ages the speech is not affected b ut the lower frequencies may be lost as tissue el asticity decreases.

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REFERENCES
Oral Biosciences, David B. Ferguson Text book of Medical Physiology ,Guyton & Hall, 11th Edition. The physiology of speeech production. Speech and respiration.Conorad, Schonle P. 1 979 Apr 12;226(4):251-68. Review of medical physiology , William Ganong 2Oth Edition

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Upper dentures induce a whistle every time the wearer speaks. Adjusting the thickness of the base plate or sligh tly moving the incisors may eliminate this.

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THANK YOU
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