Larynx

“ The Larynx. The larynx is the enlarged upper end of the air-passage which leads from the pharynx to the lungs. It is a box composed of pieces of cartilage connected by ligaments and moved by muscles, and it is lined by mucous membrane. At the root of the tongue about one centimeter caudad of the body of the hyoid bone is the triangular leaf-like epiglottis (Fig. 95, e, page 227) . When food is taken this closes the opening into the larynx, and the food passes over it into the œsophagus. It is so curved that its apex is directed craniad. ”

“ Nor, among the least important of these organs, should be reckoned the larynx, which, for the delicate simplicity of its structure, no less than for the number, importance, and complexity of its functions, is not exceeded by any other organ of the human frame. ”

“ It is impossible to produce good tone with a high larynx. When the larynx rises, the throat closes and you must always have your throat open. Don’t forget, your throat must be open and you can get it open only by keeping the larynx low.” He tries again with the same result and awaits further instructions. I take another tack and say to him, “Your tongue rises every time you sing and impairs the form of the vocal cavity. Keep it down below the level of the teeth, otherwise your vowels will be imperfect. You should practice a half hour each day grooving your tongue.” ”

“ Because the mucous membrane has become so swollen that the nasal passages are obstructed and the mucous membrane of the larynx has to perform a double function, that of heating the air as it is brought to the lungs in the process of respiration, as well as carrying out its own obligation to the scheme of nature. By a strange coincidence, this membrane of the larynx is supplied with sensation by the same nerve that conveys motion to one of its tensor muscles. ”

“ If we remember that the larynx, which is the cavity in the throat behind the tongue, is capable of considerable flexibility, as well as the trachea or windpipe, we have good materials for ventriloquial effect; thus the mouth and tongue have really, but not apparently, a great deal to do with the modifications of the assumed voice. A clever ventriloquist recommends the mouth to be kept closed, and the tongue rolled back, so as to regulate, as it were, the sound which is formed in the larynx. This may be done by strengthening the abdominal muscles ”

“ It is to be emphasized that while some pressure is necessary in the lifting motion, great force should never be used; the art is a gentle one. The first view is apt to find the larynx in state of spasm, and affords an excellent demonstration of the fact that the larynx can he completely closed without the aid of the epiglottis. ”

“ The middle one of these lobes is the largest; it is free, and rests immediately over the triangular orifice of the larynx just described, which, when depressed, it is in size adapted to cover. In a line continuous with the floor of the upper larynx and penetrating beneath the epiglottis, is a cavity or sac lined with mucous membrane. ”

“ The bare fact that the voice is produced in the larynx is ascertainable by anybody through the medium of the laryngoscope, but to arrive only thus far the throat has to be forced into a position directly antagonistic to the production of those very qualities of tone that form the subject of desired investigation. Open chest voice, there is every reason to believe, is in great part produced by the drawing down of the larynx by means of the sterno-thyroid muscles, so that it becomes part of a compact mass of bone, tissue, and cartilage all vibrating together. ”

“ When the child recognizes the tender cares of its mother, its voice becomes less shrill and broken; its tones have a less acute range, and are more poised and even. The larynx, which is very impressionable and the thermometer of the sensitive life, becomes modified, and produces sounds and inflections in perfect unison with the sentiments they convey.
All this, which man expresses in an imitative fashion, is numbered, weighed and measured, and forms an admirable harmony. This language through the larynx is universal, and common to all sensitive beings. It is universal with animals as with man. ”

“ The tongue and the larynx are placed very far forwards in the mouth and, during the act of swallowing, the larynx approaches the chin, or it may even protrude out of the mouth to secure breathing during the often painfully protracted act. ”

“ By the use of a laryngoscope and a cocaine spray the most irritable throat can now be made tolerant of the presence of the small mirror, and thus the medical man is enabled to make a prolonged and thorough examination of the interior of the larynx and even to perform delicate operations upon it. Foreign bodies which have become caught in the larynx can thus be seen and extracted, and small growths can be satisfactorily removed even from the vocal cords themselves. ”

“ In the larynx are the two true vocal cords, the vibration of which produces voice; and this voice, passing into the mouth, is moulded into speech by the organs of articulation.
Control of the breath. There are muscles that act on the lungs and regulate the entrance of air and the exit of breath. The muscles are: pectoral, dorsal, costal, intercostal, abdominal, and the diaphragm. The pectoral [p. 124] muscles hold up the chest and thus allow the air to enter the upper lobes of the lungs. ”

“ The organ of the voice is contained in the larynx in the neck, which joins the head to the body. Just under the chin in front of the neck you can feel what is called the Adam’s Apple, which is the front of the larynx, or voice-box, by which the air coming out of the lungs is formed into sounds. ”

“ The lungs are hollow organs, and we may consider them as really two bags containing air, each of which communicates by a separate orifice with a common air tube, through the upper part of which, the larynx, they freely communicate with the external atmosphere. The orifice of the larynx is guarded by muscles, and can be opened or closed at will. ”

“ The symptoms of a foreign body in the larynx are characteristic and consists in the very sudden appearance of the attacks and also in the severity of the symptoms. There will be a history of something having been in the child’s mouth, or the possibility of the child having placed some object in his mouth. A metallic body can always be located by means of the X-ray. ”

“ Larynx and trachea are other names for the windpipe, and pharynx is another for the gullet. The larynx divides into two branches at the lungs, and goes to each side. Hence, by subdivisions, it passes off in numerous smaller branches, to different parts of the lungs, and terminates in air-cells. The lungs, known in animals by the name of lights, consist of three parts, or lobes, one on the right side, and two on the left.
Alice. The lights of inferior animals are very light and porous—do our lungs resemble them in this? ”

“ An artificial larynx may be made by using elastic bands to represent the vocal cords, and by placing above them chambers which by their resonance will produce the same effect as the cavities lying above the larynx. ”

“ Beattie, in defining the human voice, says, it is air sent out from the lungs, and so agitated, or modified, in its passage through the windpipe and larynx, as to become distinctly audible. The windpipe conveys air into the lungs for the purpose of respiration and speech; the top or upper part of which is called the larynx, 388 consisting of four or five cartilages, that may be expanded or brought together, by the agency of certain muscles which operate all at the same time. ”

“ The exciting causes of hyperæsthesia of the larynx are the long-continued action of the predisposing causes—acute and chronic inflammation, mechanical and chemical irritants, etc. So far as my own experience goes, the use of the voice in an unnatural key, or perhaps rather the strain upon the parts by efforts to force the organ to perform the function of phonation in an abnormal manner, has more frequently been assigned by the patient as the cause than any other one thing. ”

“ In all cases, without regard to stature, the larynx is smaller in women than in men. Its angles are less salient, its muscles weaker, its cartilages thinner, and more supple: the sharp notes of the instrument are the evidences of these peculiarities of conformation. Though our general knowledge of the vocal organs is very positive, nevertheless we are unable to determine the characters of the voice by simply examining the larynx, for it is impossible to compare in all their details those instruments whose good or bad qualities are known. ”

“ The human organ of voice is like the clarionet and the bassoon. The windpipe is the tube containing the column of air. The larynx is the mouth-piece containing the reed. But the reed is double, consisting of two very thin membranous edges, which are made tense or relaxed, and have the interval between them through which the air rushes narrowed or widened by the instinctive, automatic action of a set of little muscles. ”

“ The question may be asked how this information about the action of the vocal cords has been learned, since, Fig. 8. Method of Examining Larynx, the View of which is shown in the Small Cut at the Left (Ingals) . during life, they are out of sight. The use of a mirror by the throat specialist is now so common that it no longer attracts any comment, although this method of examining the larynx of a living subject is yet comparatively recent. ”

“ These sudden attacks of suffocation are due—besides the permanent narrowing of the larynx by the membranes, which gradually increase in thickness—to occasional deposits of mucus upon the abnormal surface of the larynx and vocal cords, by partly-loosened false membrane, which now and then become audible, yielding a flapping sound, by oedema in the neighborhood, and by secondary spasmodic contractions. They are mostly met with in the evening and night; there is often a slight remission in the morning, which rouses new hopes, which soon, however, prove unfounded. ”

“ To these matters I have already called attention in a previous publication, in connection with the man who was deprived of his larynx by a surgical operation, but not of his power of speech.
A similar experiment may be made in regard to breathing. By making the soft palate, representing the thorax, rigid, you will not be able to inspire, though you may expire. By making the bottom of the mouth close to your teeth (the soft palate of the lower jaw) , representing the abdomen, rigid, you will not be able to expire, though you may inspire. With a German the precisely opposite facts prevail. ”

“ The technic of laryngoscopy in the human subject is best perfected by a routine direct examination of the larynx of anesthetized patients after such an operation as, for instance, tonsillectomy, to see that the larynx and laryngopharynx are free of clots. ”

“ The difference in the formation of the larynx in infancy is less striking; but at a later period, it is more developed in the male than in the female. It is very remarkable that this increase is not progressive, like that of other organs, but, on the contrary, develops itself at once at the period of puberty. ”

“ The causes, defect or waste of mucus by exertion of the voice; destruction of the mucus ducts of the larynx; its cartilages ossified; injury of the recurrent nerves; laxity and palsy of the muscles of the glottis and contiguous cartilages; venereal; changes of weather; symptomatic in several diseases. Voice and speech may be injured in all the various parts of their complicated organization; the larynx, the pharynx, the tongue, uvula, fauces, nose, palate, gums, teeth, lips. ”

“ All the muscles of the larynx have names which are not arbitrary but based on the names of the structures to which they are attached, so that one has but to know their connections and the names of the solid structures, which are few, to have a key to the whole nomenclature. ”

“ Moreover, no two persons have their laryngeal muscles arranged in precisely the same manner, a circumstance which of itself goes a considerable way toward explaining the almost infinite variety of human voices. The wonderful diversity of expression in faces which structurally, as we may say, are almost identical, is due to minute differences in the arrangement of the little muscles which move the skin. The same thing holds good of the larynx. ”

“ As old age approaches, the play of the larynx becomes difficult; at first the tone of the voice is lowered, and then its intensity is lessened; the breath comes with less force. Sometimes disease impairs the instrument before the advent of age. While appearing to be intact, the organ often ceases to discharge its functions perfectly, owing to more or less serious affection of the nervous action. ”

“ The nostrils must be cleared of mucus, and the lungs inflated by blowing or bellows, the larynx being pressed back against the gullet to prevent inflation of the stomach. If available electricity may be applied to the chest walls. These measures may be repeated at intervals and the systemic weakness overcome by nourishing food, stimulants and friction of the skin. ”

“ Man breathes by means of lungs; but who can understand their wonderful mechanism, so perfect in all its parts? Though every organ is subservient to another, yet each has its own office to perform. The minute air-cells are for the aeration of the blood; the larger bronchial tubes ramify the lungs, and suffuse them with air; the trachea serves as a passage for the air to and from the lungs, while at its upper extremity is the larynx, which has been fitly called the organ of the human voice. ”

“ When, from the untoward circumstances of the case, or from neglect, the opening in the windpipe remains long open, and becomes fistulous, the larynx contracts, and the voice is in a great measure lost, the patient breathes almost entirely by the unnatural opening, and all the respiratory functions are conducted imperfectly. ”