All About the Voice

Caitlin Castelino
The Vocal Mechanism

● Four subsystems
○ Respiration (Power)
○ Phonation (Source)
○ Resonation (Filter)
○ Articulation
Respiration - Power
Respiration

● The exchange of gas between an organism and its

environment
● Inhalation draws air into the lungs, exchange O2 and
CO2
○ Chest cavity expands as the diaphragm lowers and other
respiratory muscles engage
○ Chest expands→lungs expand→air is inhaled due to lower
pressure in the lungs
○ Muscles contract, reduced volume of chest cavity, causes
exhalation
Respiration

● Respiration provides the air supply (power) needed to

vibrate the vocal folds
○ The foundation and energy for phonation
○ The “generator” of the voice
● Consciously monitor breathing for speech and singing to
meet the demands of the situation
Respiration

http://matterandenergytransformation.wikisp
aces.com/Cellular+Respiration
Phonation - Source
 Phonation
● The production of sound by vibration of the vocal
folds (AKA vocal cords)
● Creates a sound wave
● Exhale→vocal folds brought together (adducted)
→air bursts through the closed vocal
folds→pressure between folds drops, sucks folds
back together (this is the vibration of the vocal folds)
○ Vibration occurs hundreds of times per second, produces
voice
 Larynx

http://www.innovateus.net/health/why-electrolarynx-used http://www.celebritydiagnosis.com/2010/02/
 Cricothyroid

● Responsible for stretching

and tightening the vocal
folds
● Primary means for
controlling pitch
 Phonation
● A man’s larynx is, on average, ~40% taller and
longer than a woman’s larynx
● The length of the portion of the vocal folds that
vibrate is ~60% longer in men than women
● Fundamental frequency
○ Men: 85-180Hz
○ Women: 165-255Hz
○ Gender neutral: 165-180Hz
Phonation
Resonation - Filter
Resonation
● The vocal tract gives individuals their unique
voice
● The sound created by the vocal folds is shaped by
the pharynx, oral cavity, and nasal cavity
○ Different frequencies are amplified or dampened to enhance
harmonics/overtones
○ Resonance can be altered by changes in anatomy or physiology
(a cold or surgical procedure→hypo- or hypernasality)
Harmonics
Harmonics
 Hypernasality
● Hypernasality is our enemy!
● Singers hear “sing in your mask” or “place the
sound more forward”
○ The coach/director often mean they want more
ring in the sound, the singer is singing with their
tongue pulled back which creates a dark sound,
the singer isn’t singing with full resonating space,
there is tension, the larynx isn’t in its optimal
position
○ When the singer hears this, they typically lower
the soft palate and place the sound in the
nose→hypernasality
Hypernasality

● The only sounds which should be resonated in

the nose:
○ M
○ N
○ Ng
○ Sounds surrounding the nasal sounds may be resonated
in the nose (anticipatory or carry over nasalization)
■ The amount of nasality in traditionally non-nasal
sounds can (and should) be modified, especially if the
vowels are sustained
Hypernasality
● Let’s try it!
○ “Peter Piper picked a peck of pickled peppers”
■ Plug nose--any change in sound?
○ “Mary had a little lamb whose fleece was white as snow”
■ Plug nose--any change in sound?
■ Prolong “Maaaaaaaaary”
● Can you make the vibration in your nose stop?
● Can you make the vibration turn on and off?
Articulation

● Once modified by the resonators, the sound is shaped by the

articulators
○ Lips, tongue, and teeth are
primary articulators

https://pancaller27.wordpress.com/2011/10/03/the-production-of-speech-sounds/
Articulation

https://www.youtube.com/watch?v=M2OdAp7MJAI
Putting It All Together!
The vocal mechanism involves
four subsystems and lots of
muscles, several of which are
susceptible to injury. So what do
you do if you start having voice
problems?
Voice Disorder

● Occurs when voice quality, loudness, and/or pitch differ or are

inappropriate for an individual’s age, cultural background, gender,
or geographic location
● Present when an individual expresses concern about having an
abnormal voice that does not meet daily needs
○ Still considered a voice disorder even if other individuals do not
perceive the voice as different or deviant
Causes of Voice Disorders
● Physical changes to the mechanism (i.e. swelling, nodules, changes due to aging)
● Problems with the nervous system(s) (i.e. vocal fold paralysis, tremor)
● Improper or inefficient use of the mechanism with a normal physical structure
○ Muscle tension dysphonia
■ Improper singing or speaking technique
■ Response to a structural cause, response remains after structural cause is resolved
● Vocal fold hypomobility→use improper compensatory strategies→develop
muscle tension dysphonia→vocal fold hypomobility improves→compensatory
strategies remain so voice does not improve
● Psychological stressors that lead to habitual, maladaptive dysphonia or aphonia
(complete lack of voice)
Avoiding Vocally Abusive Behaviors

● Clearing throat or coughing too much

● Yelling, screaming, LOUD whisper
● Being in smoky environment
● Talking too much in an abnormally low or high pitch
● Singing or speaking with excess tension
● Inadequate breath support
● Overusing the voice
Be Aware

● Proper breath support while speaking (and singing) is vital

● Hydration is key
○ Directly impacts tissue viscosity
○ Lowers phonation threshold pressure → reduced effort to
phonate
● Other irritants to the mechanism (reflux, pollution, allergies) can
contribute to vocal issues
● Background noise can contribute to strain
● Poor neck posture can cause strain
● Know what is normal for your voice
Reflux
Recognizing signs of vocal fatigue or abuse

● Difficulty producing sound in parts of your vocal range or reduced vocal

range
● Change in vocal quality (particularly breathy or hoarse)
● Pitch and/or phonation breaks
● Feeling a persistent “lump in your throat”
● Voice “gets tired” easily
● Pain is never good!
Voice Therapy Techniques for the Non-Injured Singer

● Semi-occluded vocal tract exercises

○ Layman’s terms: the mouth is partially closed
○ Narrows the vocal tract above the vocal folds to maximize interaction between
vocal fold vibration (production of sound) and the vocal tract (the sound filter) and
to create resonant voice
○ Increases the air pressure above the vocal folds to reduce the impact collision
force of the vocal folds
○ To put it simply, partially closing the mouth creates back pressure at the lips to help
the folds vibrate with more ease and less muscular effort
Voice Therapy Techniques for the Non-Injured Singer

● Semi-occluded vocal tract exercises

○ Examples:
■ Bubbling (lip trills)
■ Tongue trills
■ Sing on “oh”, “oo”, “v”, “z”
■ Straw phonation
■ Vocal function exercises
○ Focus: Improve breath support and produce voicing without tension
● Yawn-sigh
● Circumlaryngeal massage
What do you do if you find your
voice is changing as you age?
How would you describe an “aging voice”?
The Aging Voice

● ~20-30% of individuals over 50 years of age have altered vocal function

○ Due to onset of disease or age-related physiological changes
● Older individuals are perceived to present with more roughness,
breathiness, strain, and instability
● Studies have shown dramatic impact of dysphonia (voice disorder) on
quality of life
○ 53% reported dysphonia impacted past job functions, 49% for current job
functions, and 76% believe their dysphonia will impact future job functions
○ 75% felt social interactions were adversely affected, with patients
frequently limiting their social interactions
Hormonal Impact on the Voice
● Hormone changes can profoundly affect the voice
● As hormones change throughout the menstrual cycle, the changes can manifest
in the voice
● Changes typically occur right before menstruation, though some women note
changes during ovulation
● Vocal changes can include:
○ Loss of upper range
○ Vocal fatigue
○ Husky vocal quality
○ Reduced vocal flexibility and/or power
○ Reduced vocal efficiency
○ Pitch uncertainty
 Hormonal Impact on the Voice
● Hormone shifts cause laryngeal changes
● Vocal fold bulk increases due to dilated blood vessels and fluid retention
○ Increase in bulk results in lower pitch and change in vibration, resulting in more effortful
speaking and singing
● Hormonal changes affect the fundamental frequency (determined by vocal fold vibration)
and formant frequencies (resonance; determined by size and shape of vocal tract)
○ Studies have shown a link between oral contraceptives and a more stable fundamental
frequency
● Important to note that vocal fold changes can lead to use of compensatory strategies that
can be harmful
○ Increased muscle tension in head, neck, base of tongue, jaw, throat, larynx
○ Can result in vocal fatigue and hoarseness
○ Can result in vocal fold trauma, depending on how long the negative compensatory strategies
are used and how traumatic they are
Voice Changes During Perimenopause and Menopause
● Menopause: a point in time. A person has “reached menopause” when they have not had a
menstrual cycle in one year
● Perimenopause: an extended transitional state. Begins with irregular menstrual cycles and
ends a year after the last period
● Estrogen levels fall and androgen levels increase relatively
● Structural changes and issues impacting voice during
perimenopause and menopause:
○ Drier larynx
○ Less lung power
○ Weakened laryngeal muscles
○ Stiffer laryngeal cartilages
○ Thickened vocal folds (due to relative increase in androgen levels)
○ More masculine voice
 Voice Changes During Perimenopause and Menopause
● Menopausal voice changes have been studied less than the premenstrual phase
voice changes
● Frequently reported menopausal voice changes:
○ Breathiness
○ Decreased range
○ Less breath control
○ Vocal fatigue
○ Pitch inaccuracies
○ Changes in vibrato
● Hormone replacement therapy was frequently offered in the past, though links
to increased incidence of cancer may make hormone replacement unsafe (talk
to MD)
 Causes of Presbyphonia (The Aging Voice)
● Age at which people begin to “sound old” varies widely
○ Time does not define aging, biological changes and the functional deficits of those changes define aging
● Normal aging process can affect the larynx and vocal folds:
○ Muscle atrophy
○ Thinning of mucous membranes
○ Stiffening of connective tissues
● What about the rest of the body?
○ Muscle loss in the other systems involved in speech and singing can
affect the voice
○ Respiration: stiffer and weaker lungs/muscles of respiratory system,
reduced amount of air inhaled, reduced ability to regulate air pressure when
speaking/singing
○ Resonation and Articulation: slowed articulation rate, less precise
articulation, change in shape of resonators impacting overall resonance
Aging Voice Symptoms

● Higher pitch in men (thinning of vocal folds due to

fall in androgen level and relative rise in
estrogen/androgen ratio)
● Lower pitch in women
● Reduced projection
● Loss of resonance
● Reduced endurance
● Voice tremors
● Weak (asthenic), breathy, and/or
strained voice
● Typically gradual
“Normal” Voice
Presbyphonia
 Treatments for the Aging Voice
● Botox injections
○ Can reduce vocal tremor
● Vocal fold filler injections
○ Enlarges vocal folds that have lost muscle tone
● Permanent fat injections
○ Uses abdominal fat to enlarge vocal folds
● Thyroplasty
○ Surgical procedure
○ Portion of the thyroid cartilage or an implant is pushed
towards midline
● Voice therapy by SLP
○ Reduces laryngeal strain/muscle tension dysphonia
○ Improves vocal stamina
○ Assists patient in finding optimal pitch and volume
So What Can You Do?
● Be aware
○ Know the signs of presbyphonia so you can seek help if they begin
● Maintain your overall health
○ Other health issues that restrict breathing (i.e. asthma, allergies, COPD) can affect
your voice
○ Regular exercise improves stamina, builds muscle tone, and improves posture
○ Smoking, alcohol abuse, reflux, inhalation of irritants all worsen the aging process
● Continue using your voice!
○ Make sure your voice is being produced freely. No tension!!
○ The more you use it, the stronger it will be
○ Keep singing in Sweet Adelines!
■ Study showed regular choral singing assists in preserving the speaking voices of
older adults
○ Use it or lose it
So What Can You Do?

● Practice good vocal hygiene

○ No smoking
○ Avoid abusive behaviors (i.e. coughing, throat clearing, yelling, loud whispering)
○ Stay hydrated
■ Adequate hydration directly impacts tissue viscosity
■ Lowers phonation threshold pressure→reduced effort required to produce voice
■ Limit dehydrating drinks (i.e. caffeinated and alcoholic beverages)
● See an ENT if you notice symptoms of presbyphonia
○ Follow up with a voice teacher or Speech-Language Pathologist based on findings from
ENT
■ See a professional sooner rather than later! The longer you wait the more negative
compensatory strategies you may be developing, which could take longer to reverse
○ Talk to your doctor about treatment options if voice therapy does not help
Straw Phonation in Water

● Multiple studies have shown an improvement in vocal quality and perception of severity
of voice disorders when individuals with presbyphonia completed straw phonation in
water
● Lower vocal effort required for phonation when performing straw phonation in water
● Tasks completed over a 6 week exercise program:
○ Abdominal breathing
○ Relaxation exercises
○ Straw phonation in water (submerge bottom of straw 5cm below the surface of the water)
■ Sustained vowels (schwa or “oo”)
■ Pitch glides (ascending and descending)
■ Engine sounds (5-7 “hills” of sound with varying pitch and loudness)
■ Singing the melody of songs
Vocal Function Exercises