Laryngeal Muscles: The striated muscle groups which move the LARYNX as a whole or its parts, such as altering tension of the VOCAL CORDS, or size of the slit (RIMA GLOTTIDIS).Larynx: A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE.Laryngeal Nerves: Branches of the VAGUS NERVE. The superior laryngeal nerves originate near the nodose ganglion and separate into external branches, which supply motor fibers to the cricothyroid muscles, and internal branches, which carry sensory fibers. The RECURRENT LARYNGEAL NERVE originates more caudally and carries efferents to all muscles of the larynx except the cricothyroid. The laryngeal nerves and their various branches also carry sensory and autonomic fibers to the laryngeal, pharyngeal, tracheal, and cardiac regions.Dysphonia: Difficulty and/or pain in PHONATION or speaking.Recurrent Laryngeal Nerve: Branches of the vagus (tenth cranial) nerve. The recurrent laryngeal nerves originate more caudally than the superior laryngeal nerves and follow different paths on the right and left sides. They carry efferents to all muscles of the larynx except the cricothyroid and carry sensory and autonomic fibers to the laryngeal, pharyngeal, tracheal, and cardiac regions.Laryngismus: A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.Vocal Cords: A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production.Phonation: The process of producing vocal sounds by means of VOCAL CORDS vibrating in an expiratory blast of air.Respiratory Physiological Processes: Biological actions and events that support the functions of the RESPIRATORY SYSTEM.Myosin Heavy Chains: The larger subunits of MYOSINS. The heavy chains have a molecular weight of about 230 kDa and each heavy chain is usually associated with a dissimilar pair of MYOSIN LIGHT CHAINS. The heavy chains possess actin-binding and ATPase activity.Muscles: Contractile tissue that produces movement in animals.Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes.Speech: Communication through a system of conventional vocal symbols.Nervous System Physiological Phenomena: Characteristic properties and processes of the NERVOUS SYSTEM as a whole or with reference to the peripheral or the CENTRAL NERVOUS SYSTEM.Muscle Proteins: The protein constituents of muscle, the major ones being ACTINS and MYOSINS. More than a dozen accessory proteins exist including TROPONIN; TROPOMYOSIN; and DYSTROPHIN.Muscle, Smooth: Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant. (From Stedman, 25th ed)Muscle, Skeletal: A subtype of striated muscle, attached by TENDONS to the SKELETON. Skeletal muscles are innervated and their movement can be consciously controlled. They are also called voluntary muscles.Androgens: Compounds that interact with ANDROGEN RECEPTORS in target tissues to bring about the effects similar to those of TESTOSTERONE. Depending on the target tissues, androgenic effects can be on SEX DIFFERENTIATION; male reproductive organs, SPERMATOGENESIS; secondary male SEX CHARACTERISTICS; LIBIDO; development of muscle mass, strength, and power.Sex Characteristics: Those characteristics that distinguish one SEX from the other. The primary sex characteristics are the OVARIES and TESTES and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction.Muscle Fibers, Skeletal: Large, multinucleate single cells, either cylindrical or prismatic in shape, that form the basic unit of SKELETAL MUSCLE. They consist of MYOFIBRILS enclosed within and attached to the SARCOLEMMA. They are derived from the fusion of skeletal myoblasts (MYOBLASTS, SKELETAL) into a syncytium, followed by differentiation.Muscle, Smooth, Vascular: The nonstriated involuntary muscle tissue of blood vessels.Xenopus laevis: The commonest and widest ranging species of the clawed "frog" (Xenopus) in Africa. This species is used extensively in research. There is now a significant population in California derived from escaped laboratory animals.Dihydrotestosterone: A potent androgenic metabolite of TESTOSTERONE. It is produced by the action of the enzyme 3-OXO-5-ALPHA-STEROID 4-DEHYDROGENASE.Muscle Development: Developmental events leading to the formation of adult muscular system, which includes differentiation of the various types of muscle cell precursors, migration of myoblasts, activation of myogenesis and development of muscle anchorage.Vocal Cord Paralysis: Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA.Laryngoplasty: Restoration, reconstruction, or improvement of a defective or damaged LARYNX.Thyroid Cartilage: The largest cartilage of the larynx consisting of two laminae fusing anteriorly at an acute angle in the midline of the neck. The point of fusion forms a subcutaneous projection known as the Adam's apple.Voice Quality: That component of SPEECH which gives the primary distinction to a given speaker's VOICE when pitch and loudness are excluded. It involves both phonatory and resonatory characteristics. Some of the descriptions of voice quality are harshness, breathiness and nasality.Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation.Muscle Denervation: The resection or removal of the innervation of a muscle or muscle tissue.Arytenoid Cartilage: One of a pair of small pyramidal cartilages that articulate with the lamina of the CRICOID CARTILAGE. The corresponding VOCAL LIGAMENT and several muscles are attached to it.Muscular Dystrophies: A heterogeneous group of inherited MYOPATHIES, characterized by wasting and weakness of the SKELETAL MUSCLE. They are categorized by the sites of MUSCLE WEAKNESS; AGE OF ONSET; and INHERITANCE PATTERNS.Muscular Dystrophies, Limb-Girdle: A heterogenous group of inherited muscular dystrophy that can be autosomal dominant or autosomal recessive. There are many forms (called LGMDs) involving genes encoding muscle membrane proteins such as the sarcoglycan (SARCOGLYCANS) complex that interacts with DYSTROPHIN. The disease is characterized by progressing wasting and weakness of the proximal muscles of arms and legs around the HIPS and SHOULDERS (the pelvic and shoulder girdles).Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion.Muscular Dystrophy, AnimalSuccinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.Neuromuscular Nondepolarizing Agents: Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.Neuromuscular Blockade: The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.Androstanols: Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.Thumb: The first digit on the radial side of the hand which in humans lies opposite the other four.Laryngeal Neoplasms: Cancers or tumors of the LARYNX or any of its parts: the GLOTTIS; EPIGLOTTIS; LARYNGEAL CARTILAGES; LARYNGEAL MUSCLES; and VOCAL CORDS.Carcinoma, Squamous Cell: A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed)Laryngectomy: Total or partial excision of the larynx.Head and Neck Neoplasms: Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)Laryngeal Nerve Injuries: Traumatic injuries to the LARYNGEAL NERVE.Recurrent Laryngeal Nerve Injuries: Traumatic injuries to the RECURRENT LARYNGEAL NERVE that may result in vocal cord dysfunction.Struthioniformes: An order of flightless birds comprising the ostriches, which naturally inhabit open, low rainfall areas of Africa.Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game.Rheiformes: An order of large, long-necked, long-legged, flightless birds, found in South America. Known as rheas, they are sometimes called American ostriches, though they are in a separate order from true OSTRICHES.Postmortem Changes: Physiological changes that occur in bodies after death.Abattoirs: Places where animals are slaughtered and dressed for market.Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple).Autopsy: Postmortem examination of the body.
Myotube heterogeneity in developing chick craniofacial skeletal muscles. (1/197)
Avian skeletal muscles consist of myotubes that can be categorized according to contraction and fatigue properties, which are based largely on the types of myosins and metabolic enzymes present in the cells. Most mature muscles in the head are mixed, but they display a variety of ratios and distributions of fast and slow muscle cells. We examine the development of all head muscles in chick and quail embryos, using immunohistochemical assays that distinguish between fast and slow myosin heavy chain (MyHC) isoforms. Some muscles exhibit the mature spatial organization from the onset of primary myotube differentiation (e.g., jaw adductor complex). Many other muscles undergo substantial transformation during the transition from primary to secondary myogenesis, becoming mixed after having started as exclusively slow (e.g., oculorotatory, neck muscles) or fast (e.g., mandibular depressor) myotube populations. A few muscles are comprised exclusively of fast myotubes throughout their development and in the adult (e.g., the quail quadratus and pyramidalis muscles, chick stylohyoideus muscles). Most developing quail and chick head muscles exhibit identical fiber type composition; exceptions include the genioglossal (chick: initially slow, quail: mixed), quadratus and pyramidalis (chick: mixed, quail: fast), and stylohyoid (chick: fast, quail: mixed). The great diversity of spatial and temporal scenarios during myogenesis of head muscles exceeds that observed in the limbs and trunk, and these observations, coupled with the results of precursor mapping studies, make it unlikely that a lineage based model, in which individual myoblasts are restricted to fast or slow fates, is in operation. More likely, spatiotemporal patterning of muscle fiber types is coupled with the interactions that direct the movements of muscle precursors and subsequent segregation of individual muscles from common myogenic condensations. In the head, most of these events are facilitated by connective tissue precursors derived from the neural crest. Whether these influences act upon uncommitted, or biased but not restricted, myogenic mesenchymal cells remains to be tested. (+info)Atrophy of the posterior cricoarytenoid muscle as an indicator of recurrent laryngeal nerve palsy. (2/197)
BACKGROUND AND PURPOSE: The posterior cricoarytenoid (PCA) muscle is one of the intrinsic muscles of the larynx innervated by the recurrent laryngeal nerve. As such, recurrent laryngeal nerve palsy should not only result in paralysis of the true vocal cord or thyroarytenoid muscle but also in a similar change in the PCA muscle. The ability of CT and MR imaging to depict denervation atrophy in the PCA muscle in patients with recurrent laryngeal nerve palsy was evaluated. METHODS: Two investigators reviewed the CT and/or MR studies of 20 patients with a clinical history of vocal cord paralysis. The appearance of the PCA muscle was given a rating of 0, 1, 2, 3, or 4, with 0 being definitely normal and 4 being definitely abnormal or atrophic. Each study was also reviewed for the presence or absence of other features of vocal cord paralysis: thyroarytenoid muscle atrophy, anteromedial deviation of the arytenoid cartilage, an enlarged piriform sinus and laryngeal ventricle, and a paramedian cord. RESULTS: Atrophy of the PCA muscle was shown unequivocally in 65% of the cases and was most likely present in an additional 20%. The frequency with which other features of vocal cord paralysis were seen was as follows: thyroarytenoid atrophy, 95%; anteromedial deviation of the arytenoid cartilage, 70%; enlarged piriform sinus, 100%; enlarged laryngeal ventricle, 90%; and a paramedian cord, 100%. CONCLUSION: Atrophy of the PCA muscle may be commonly documented on CT and MR studies in patients with recurrent laryngeal nerve palsy and vocal cord paralysis, and therefore should be part of the constellation of imaging features of vocal cord paralysis. This finding is particularly useful when other imaging findings of vocal cord paralysis are absent or equivocal. (+info)Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing. (3/197)
The durations and temporal relationships of electromyographic activity from the submental complex, superior pharyngeal constrictor, cricopharyngeus, thyroarytenoid, and interarytenoid muscles were examined during swallowing of saliva and of 5- and 10-ml water boluses. Bipolar, hooked-wire electrodes were inserted into all muscles except for the submental complex, which was studied with bipolar surface electrodes. Eight healthy, normal, subjects produced five swallows of each of three bolus volumes for a total of 120 swallows. The total duration of electromyographic activity during the pharyngeal stage of the swallow did not alter with bolus condition; however, specific muscles did show a volume-dependent change in electromyograph duration and time of firing. Submental muscle activity was longest for saliva swallows. The interarytenoid muscle showed a significant difference in duration between the saliva and 10-ml water bolus. Finally, the interval between the onset of laryngeal muscle activity (thyroarytenoid, interarytenoid) and of pharyngeal muscle firing patterns (superior pharyngeal constrictor onset, cricopharyngeus offset) decreased as bolus volume increased. The pattern of muscle activity associated with the swallow showed a high level of intrasubject agreement; the presence of somewhat different patterns among subjects indicated a degree of population variance. (+info)Discharge characteristics of laryngeal single motor units during phonation in young and older adults and in persons with parkinson disease. (4/197)
Discharge characteristics of laryngeal single motor units during phonation in young and older adults, and in persons with Parkinson disease. The rate and variability of the firing of single motor units in the laryngeal muscles of young and older nondisordered humans and people with idiopathic Parkinson disease (IPD) were determined during steady phonation and other laryngeal behaviors. Typical firing rates during phonation were approximately 24 s/s. The highest rate observed, during a cough, was 50 s/s. Decreases in the rate and increases in the variability of motor unit firing were observed in the thyroarytenoid muscle of older and IPD male subjects but not female subjects. These gender-specific age-related changes may relate to differential effects of aging on the male and female voice characteristics. The range and typical firing rates of laryngeal motor units were similar to those reported for other human skeletal muscles, so we conclude that human laryngeal muscles are probably no faster, in terms of their contraction speed, than other human skeletal muscles. Interspike interval (ISI) variability during steady phonation was quite low, however, with average CV of approximately 10%, with a range of 5 to 30%. These values appear to be lower than typical values of the CV of firing reported in three studies of limb muscles of humans. We suggest therefore that low ISI variability is a special although not unique property of laryngeal muscles compared with other muscles of the body. This conceivably could be the result of less synaptic "noise" in the laryngeal motoneurons, perhaps as a result of suppression of local reflex inputs to these motoneurons during phonation. (+info)Assessing the laryngeal cough reflex and the risk of developing pneumonia after stroke: an interhospital comparison. (5/197)
BACKGROUND AND PURPOSE: We sought to evaluate the efficacy of testing the laryngeal cough reflex in identifying pneumonia risk in acute stroke patients. METHODS: We performed a prospective study of 400 consecutive acute stroke patients examined using the reflex cough test (RCT) compared with 204 consecutive acute stroke patients from a sister facility examined without using the RCT. The binary end point for the study outcome was the development of pneumonia. RESULTS: Of the 400 patients examined with the RCT, 5 developed pneumonia. Of the 204 patients examined without the RCT, 27 developed pneumonia (P<0.001). Three of the 27 patients died in the rehabilitation hospital of respiratory failure secondary to pneumonia. Seven others were transferred to the emergency department with acute respiratory distress. Power analysis for this comparison was 0.99. There were no other significant differences between the 2 groups. CONCLUSIONS: A normal RCT after an acute stroke indicates a neurologically intact laryngeal cough reflex, a protected airway, and a low risk for developing aspiration pneumonia with oral feeding. An abnormal RCT indicates risk of an unprotected airway and an increased incidence of aspiration pneumonia. Alternate feeding strategies and preventive measures are necessary with an abnormal RCT. Clinical treatment algorithm and prescription of food, fluids, and medications are discussed on the basis of RCT results. (+info)Differential effects of clonidine on upper airway abductor and adductor muscle activity in awake goats. (6/197)
The purpose of this study was to determine the extent to which alpha(2)-adrenoceptor (alpha(2)-AR) pathways affect the central motor output to upper airway muscles that regulate airflow. Electromyogram (EMG) measurements were made from posterior cricoarytenoid (PCA), cricothyroid (CT), thyroarytenoid (TA), and middle (MPC) and inferior (IPC) pharyngeal constrictor muscles in awake standing goats. Systemic administration of the alpha(2)-AR agonist clonidine induced a highly dysrhythmic pattern of ventilation in all animals that was characterized by alternating episodes of tachypnea and slow irregular breathing patterns, including prolonged and variable expiratory time intervals. Periods of apnea were commonly observed. Dysrhythmic ventilatory patterns induced by clonidine were associated with differential recruitment of upper airway muscles. alpha(2)-AR stimulation preferentially decreased the activity of the PCA, CT, and IPC muscles while increasing TA and MPC EMG activities. Clonidine-induced apneas were associated with continuous tonic activation of laryngeal (TA) and pharyngeal (MPC) adductors, leading to airway closure and arterial oxygen desaturation. Tonic activation of the TA and MPC muscles was interrupted only during the first inspiratory efforts after central apnea. Laryngeal abductor, diaphragm, and transversus abdominis EMG activities were completely silenced during apneic events. Ventilatory and EMG effects were reversed by selective alpha(2)-AR blockade with SKF-86466. The results demonstrate that alpha(2)-AR pathways are important modulators of central respiratory motor outputs to the upper airway muscles. (+info)Cisatracurium neuromuscular block at the adductor pollicis and the laryngeal adductor muscles in humans. (7/197)
We have compared the dose-response relationship (n = 30) and time course of neuromuscular block (n = 20) of cisatracurium at the laryngeal adductor and the adductor pollicis muscles. ED95 values for cisatracurium were 66.8 (95% confidence interval 61.3-72.3) micrograms kg-1 at the larynx and 45.2 (42.1-48.3) micrograms kg-1 at the adductor pollicis muscle (P < 0.0001). After administration of cisatracurium 0.1 mg kg-1, onset time was 2.7 (2.2-3.2) min at the larynx and 3.9 (3.0-4.8) min at the adductor pollicis (P < 0.0001). Time to 95% recovery of the first twitch of the TOF was 26.9 (20.1-33.7) min and 45.6 (39.7-51.5) min, respectively (P < 0.0001). We found that the laryngeal adductors were more resistant to the action of cisatracurium than the adductor pollicis muscle, but onset and recovery were faster at the larynx. (+info)Modulation of laryngeal responses to superior laryngeal nerve stimulation by volitional swallowing in awake humans. (8/197)
Laryngeal sensori-motor closure reflexes are important for the protection of the airway and prevent the entry of foreign substances into the trachea and lungs. The purpose of this study was to determine how such reflexes might be modulated during volitional swallowing in awake humans, when persons are at risk of entry of food or liquids into the airway. The frequency and the amplitude of laryngeal adductor responses evoked by electrical stimulation of the internal branch of the superior laryngeal nerve (ISLN) were studied during different phases of volitional swallowing. Subjects swallowed water on command while electrical stimuli were presented to the ISLN at various intervals from 500 ms to 5 s following the command. Laryngeal adductor responses to unilateral ISLN stimulation were recorded bilaterally in the thyroarytenoid muscles using hooked wire electrodes. Early ipsilateral R1 responses occurred at 17 ms, and later bilateral R2 began around 65 ms. The muscle responses to stimuli occurring during expiration without swallowing were quantified as control trials. Responses to stimulation presented before swallowing, during the swallow, within 3 s after swallowing, and between 3 and 5 s after a swallow were measured. The frequency and amplitude of three responses (ipsilateral R1 and bilateral R2) relative to the control responses were compared across the different phases relative to the occurrence of swallowing. Results demonstrated that a reduction occurred in both the frequency and amplitude of the later bilateral R2 laryngeal responses to electrical stimulation for up to 3 s after swallowing (P = 0.005). The amplitude and frequency of ipsilateral R1 laryngeal responses, however, did not show a significant main effect following the swallow (P = 0.28), although there was a significant time by measure interaction (P = 0.006) related to reduced R1 response amplitude up to 3 s after swallowing (P = 0.021). Therefore, the more rapid and shorter unilateral R1 responses continued to provide some, albeit reduced, laryngeal protective functions after swallowing, whereas the later bilateral R2 responses were suppressed both in occurrence and amplitude for up to 3 s after swallowing. The results suggest that R2 laryngeal adductor responses are suppressed following swallowing when residues may remain in the laryngeal vestibule putting persons at increased risk for the entry of foreign substances into the airway. (+info)
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Advanced computing solutions for analysis of laryngeal disorders.
Laryngeal NeoplasmContractile properties and myosin heavy chain isoform composition in single fibre of human laryngeal muscles.
Muscles of the neck, tongue, trachea and laryngeal cartilages | Anatomia Collection: anatomical plates 1522-1867
GMS | 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V. | HNOD...
The Physiology of Human Language & Speech: Respiratory, Phonatory, & Articulatory Systems | Study.com
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How do cats purr? - PoCContractile properties and myosin heavy chain isoform composition in single fibre of human laryngeal muscles. | IRIS UNIPV
ElectromyographyPharyngealParalysisAdductorNerveParesisThyroarytenoidSuperiorAspirationLeftImagesPatientsReviewContractionThyroidInnervated by the recurrent larynLesionsElectromyographyCartilagesNeckSyringeal musclesVagus nerveNerveRecurrent Laryngeal NeuropathyInnervationSpasmMucosaSkeletonCricoid cartilageTensionTreatment of laryngealExtrinsic laryngealSurgicalRelaxantsHyoidLateralInferiorPhonationAnatomyHumansMaskBilateralDiagnosisDiaphragmTracheal tubeCricothyroid muscleObstructionInletMovementsSomatic
Electromyography1
- To assess laryngeal muscle activity in unilateral vocal fold paralysis (UVFP) patients using laryngeal electromyography (LEMG) and coronal images. (unboundmedicine.com)
Pharyngeal4
- Illustrates the phases of the vibratory cycle and the functions of the larynx and pharynx during singing as well as the concept of "registers" as defined by changes in laryngeal and pharyngeal position during singing through a wide range of pitches. (voicefoundation.org)
- The study purpose is to determine if patients with LP sensory and motor deficits are at increased risk for laryngeal penetration and aspiration during swallowing, and to determine the relationship between pharyngeal motor weakness and LP sensory deficits. (elsevier.com)
- Pharyngeal muscle strength was assessed by noting presence or absence of pharyngeal contraction during voluntary adduction of the vocal folds (pharyngeal squeeze). (elsevier.com)
- 0001). Conclusion: Absence of the LAR and impaired pharyngeal squeeze puts patients with dysphagia at high risk for laryngeal penetration and aspiration compared with patients with an intact LAR and intact pharyngeal squeeze. (elsevier.com)
Paralysis1
Adductor1
- The control group was 76 patients with normal sensitivity, determined by an intact laryngeal adductor reflex (LAR) on air pulse stimulation of the mucosa innervated by the superior laryngeal nerve. (elsevier.com)
Nerve2
- Muscle Nerve 39: 91-94, 2009. (lu.se)
- author = {Häger, Mattias and Durbeej-Hjalt, Madeleine}, issn = {0148-639X}, language = {eng}, number = {1}, pages = {91--94}, publisher = {John Wiley & Sons}, series = {Muscle and Nerve}, title = {Intrinsic laryngeal muscles are spared from degeneration in the dy(3k)/dy(3k) mouse model of congenital muscular dystrophy type 1A. (lu.se)
Paresis1
- Other variants of vocal cord paresis include LCA-only , TA-only , TA + LCA , and IA-only (interarytenoid muscle). (laryngopedia.com)
Thyroarytenoid1
- MU recruitment in thyroarytenoid/lateral cricoarytenoid (TA/LCA) muscle complex results were 1+ for 4 patients, 2+ for 5, 3+ for 6, and 4+ for 6. (unboundmedicine.com)
Superior1
- And parenteral thioxanthenes have similar activity, as they move toward the neck innervates the transversus abdominis muscle lies superior to the stage of in ammation, vasodilation and increased leptin production (trujillo et al. (puc.edu)
Aspiration1
- Each group was given puree followed by thin liquid, noting presence or absence of laryngeal penetration and aspiration. (elsevier.com)
Left3
- PCA muscle of the right vocal cord (left of image) is not working. (laryngopedia.com)
- This indicates a functioning LCA muscle on the right, and not only on the left. (laryngopedia.com)
- Left cord (right of photo) remains at midline and vocal process remains in line with the membranous cord, suggesting that the LCA muscle on the left (right of photo) is working. (laryngopedia.com)
Images1
- There is no audio superimposed on the laryngeal images. (voicefoundation.org)
Patients1
- MU recruitments of TA/LCA muscle complex in UVFP patients may be related to phonatory function and the vertical position of the affected fold. (unboundmedicine.com)
Review1
- This 9 minute educational videotape provides a review of laryngeal structures, as well as abnormal conditions. (voicefoundation.org)
Contraction14
- http://jslhr.pubs.asha.org/article.aspx?articleid=1768836 Reflex Contraction of Middle-Ear Muscles Secondary to Stimulation of Laryngeal Nerves Electromyographic evidence of middle-ear muscle activity in association with vocalization has been reported in the waking cat and in man. (asha.org)
- Reflex contraction of the stapedius and tensor tympani muscles was elicited by electrical stimulation of the internal branch of the superior laryngeal nerve. (asha.org)
- The reflex discharges in the tympanic muscles occurred in association with reflex contraction of the cricothyroid muscle. (asha.org)
- Although not conclusive, the reflex contraction of the middle-ear muscles elicited by internal laryngeal nerve stimulation appeared to be bilateral. (asha.org)
- A dystonia is a movement disorder characterized by inappropriate contraction (tightening) of muscle groups. (ohsu.edu)
- A muscle that on contraction draws a part away from the median plane of the body or the axial line of an extremity. (thefreedictionary.com)
- These results show that large numbers of superfast fibre types are present in intrinsic syringeal muscles of a songbird, providing further confirmation of rapid contraction kinetics. (biologists.org)
- At the signal of an impulse traveling down the nerve, the muscle fiber changes chemical energy into mechanical energy, and the result is muscle contraction. (thefreedictionary.com)
- Unlike the involuntary muscles, which can remain in a state of contraction for long periods without tiring and are capable of sustained rhythmic contractions, the voluntary muscles are readily subject to fatigue. (thefreedictionary.com)
- The contraction and relaxation of cardiac muscle continues at a rhythmic pace until death unless the muscle is injured in some way. (thefreedictionary.com)
- Voluntary muscles extend from one bone to another, cause movements by contraction, and work on the principle of leverage. (thefreedictionary.com)
- These are mainly considered here as masticatory loads due to the contraction of paired primary chewing muscles such as masseter, temporalis, and pterygoid that attach to cranial elements. (wiley.com)
- Spasmodic dysphonia (SD) is a chronic voice disorder of unknown origin that is characterized by excessive or inappropriate contraction of laryngeal muscles during speech. (medscape.com)
- The gag reflex protects the airway and triggers the contraction of the superior laryngeal muscles. (google.com)
Thyroid6
- Diagram of the posterolateral view of the laryngeal skeleton (right thyroid lamina removed) shows the PCA muscle ( middle arrow ) arising from the cricoid lamina ( lower arrow ) posteriorly and inserting on the arytenoid cartilage ( upper arrow ). (ajnr.org)
- The thyroid cartilage is the largest of the nine laryngeal cartilages. (visiblebody.com)
- Potential major complications of thyroid surgery include bleeding, injury to the recurrent laryngeal nerve (see the first image below), hypoparathyroidism, hypothyroidism, thyrotoxic storm, injury to the superior laryngeal nerve (see the second image below), and infection. (medscape.com)
- The sternohyoid muscle is retracted ventrally to expose the lateral aspect of the thyroid and cricoid cartilages. (vin.com)
- Also, locate the hyoid bone , laryngeal prominence , thyroid cartilage , cricoid cartilage and trachea . (umich.edu)
- 4. Identify the triangles of the neck and clean the strap muscles and reflect them to expose the ansa cervicalis and the thyroid gland. (umich.edu)
Innervated by the recurrent laryn2
- This muscle is innervated by the recurrent laryngeal nerve branch of the vagus nerve, the same nerve that innervates the thyroarytenoid muscle, which accounts for the bulk of the true vocal cord. (ajnr.org)
- All intrinsic laryngeal muscles except the cricothyroids are innervated by the recurrent laryngeal nerve. (wikipedia.org)
Lesions3
- Conclusion A brief rise in voice tremor can correspond to a critical change in laryngeal muscle tissues seen as a condition where continued vocal effort can increase the risk of lesions or other conditions affecting voice. (asha.org)
- Skeletal muscle metastases from cancer occur rarely and there are no clear guidelines for appropriate work-up and management of these lesions. (biomedcentral.com)
- Otolaryngologists can be experts in managing specific laryngeal lesions to improve voice. (springer.com)
Electromyography2
- Method In a previous study, a technique of electromyography (EMG) served to define physiological signs of "voice fatigue" in laryngeal muscles involved in voicing. (asha.org)
- Changes in suprahyoid muscle activation during normal swallowing and THS with 1/3rd and 2/3rd tongue protrusions using surface electromyography were observed. (springer.com)
Cartilages11
- Which parts of the laryngeal skeleton are Elastic cartilages? (brainscape.com)
- Which parts of the laryngeal skeleton are Hyaline cartilages? (brainscape.com)
- Various muscles wrap the cartilages which produce movements at the cricoarytenoid and cricothyroid joints. (lecturio.com)
- Laryngeal cartilages and trachea, with attached neck muscles, shown in isolation, in 6 numbered illustrations. (utoronto.ca)
- Deep dissection of the the neck, showing laryngeal cartilages. (utoronto.ca)
- What are laryngeal cartilages bound by? (flashcardmachine.com)
- what are laryngeal cartilages lined with? (flashcardmachine.com)
- During phonation, the vocal folds are brought together by muscles attached to the arytenoids (cartilages structure). (ohsu.edu)
- The cricoarytenoideus dorsalis muscle abducts the arytenoid cartilages at each inspiration. (vin.com)
- Laryngeal surgery is directed at removing or repositioning laryngeal cartilages that obstruct the rima glottidis. (vin.com)
- An assistant should be available to observe per os the size of the laryngeal opening achieved to ensure that adequate abduction of the laryngeal cartilages has been obtained. (vin.com)
Neck7
- The laryngeal muscles are a set of muscles in the anterior neck responsible for sound production. (visiblebody.com)
- Superficial dissection of neck muscles. (utoronto.ca)
- Botox is injected into the laryngeal muscles via the neck (just under the adam's apple) using EMG guidance or through the mouth using a special needle that curves over the tongue. (ohsu.edu)
- The production of speech sounds requires that head, neck, and trunk muscles work in a coordinated fashion. (encyclopedia.com)
- The SLN (Superior Laryngeal Nerve) may also be injured during head or neck surgery. (selfgrowth.com)
- Using a sharp scalpel, remove the remaining skin of the neck below the mandible, being careful to preserve the delicate underlying muscle layer. (umich.edu)
- Recurrent laryngeal nerve stimulation is delivered by applying electric charge from an electrode in the form of a probe or an indwelling device to the intact neck skin at specific points. (google.com)
Syringeal muscles2
- However, syringeal muscles are composed of two fibre types which raises questions about the neuromuscular control of this heterogeneous muscle architecture. (biologists.org)
- For example, in brown thrashers ( Toxostoma rufum ) electromyographic (EMG) recordings from syringeal muscles during spontaneous singing suggest that the tracheobronchial muscles regulate airflow by adducting (m. tracheobronchialis dorsalis) and abducting (m. tracheobronchialis ventralis) the lateral labium ( Goller and Suthers, 1996a ). (biologists.org)
Vagus nerve2
- The superior laryngeal nerve is a branch of the vagus nerve. (wikipedia.org)
- Control over these muscles is provided by two branches of the vagus nerve: the recurrent laryngeal nerve and the superior laryngeal nerve. (ohsu.edu)
Nerve26
- The ability of CT and MR imaging to depict denervation atrophy in the PCA muscle in patients with recurrent laryngeal nerve palsy was evaluated. (ajnr.org)
- Muscle Nerve 39: 91-94, 2009. (lu.se)
- author = {Häger, Mattias and Durbeej-Hjalt, Madeleine}, issn = {0148-639X}, language = {eng}, number = {1}, pages = {91--94}, publisher = {John Wiley & Sons}, series = {Muscle and Nerve}, title = {Intrinsic laryngeal muscles are spared from degeneration in the dy(3k)/dy(3k) mouse model of congenital muscular dystrophy type 1A. (lu.se)
- The cricothyroid muscles are innervated by the superior laryngeal nerve. (wikipedia.org)
- The superior laryngeal nerve consists of two branches: the internal laryngeal nerve (sensory), which supplies sensory fibers to the laryngeal mucosa, and the external laryngeal nerve (motor), which innervates the cricothyroid muscle. (wikipedia.org)
- Because the aorta is inferior to the subclavian artery, the left recurrent laryngeal nerve is a bit longer than the right recurrent laryngeal nerve. (wikipedia.org)
- The superior laryngeal nerve descends, by the side of the pharynx, behind the internal carotid artery, and divides into two branches -the external laryngeal nerve and the internal laryngeal nerve. (wikipedia.org)
- The external laryngeal nerve is the smaller, external branch. (wikipedia.org)
- The external laryngeal nerve gives branches to pharyngeal plexus and the superior portion of the inferior pharyngeal constrictor, and communicates with the superior cardiac nerve behind the common carotid artery. (wikipedia.org)
- The internal laryngeal nerve is the internal branch. (wikipedia.org)
- Below the vocal folds it is by way of branches of the recurrent laryngeal nerve. (wikipedia.org)
- Damage to the superior laryngeal nerve leaves the vocal cord abducted and poses an aspiration risk. (wikipedia.org)
- Irritation of the internal laryngeal nerve results in uncontrolled coughing - usually as a result of food or water in the laryngopharynx. (wikipedia.org)
- Anatomy of the recurrent laryngeal nerve (RLN). (medscape.com)
- Superior laryngeal nerve (SLN). (medscape.com)
- The superior laryngeal nerve carries signals to the cricothyroid muscle. (selfgrowth.com)
- Dedo first introduced recurrent laryngeal nerve section for the treatment of spasmodic dysphonia (SD) in 1976. (medscape.com)
- [ 2 ] Other investigators modified this approach by crushing the recurrent laryngeal nerve. (medscape.com)
- This leads to the hoarseness, aspiration, and other symptoms associated with laryngeal nerve injury. (ohsu.edu)
- The laryngeal recurrent nerve innervates this muscle. (vin.com)
- A method and devices for transcutaneous or transmucosal stimulation of the recurrent laryngeal nerve are provided. (google.com)
- 2. A device as described in claim 1, further comprising means for generating an electrical current to the leads such that the electrodes produce an electrical stimulus, wherein the electrical stimulus has a frequency which is selected to evoke a predetermined amount of stimulation in at least one laryngeal muscle and a current effective to selectively stimulate at least a portion of the recurrent laryngeal nerve. (google.com)
- Direct stimulation of the recurrent laryngeal nerve (RLN) results in a characteristic movement of the vocal cords that is frequency dependent. (google.com)
- paresis is the partial interruption of nerve impulse, resulting in weak or abnormal motion of laryngeal muscles. (entnet.org)
- The recurrent laryngeal nerve (RLN) carries signals to different voice box muscles responsible for opening vocal folds (as in breathing, coughing), closing the folds for vibration during voice use, and closing them during swallowing. (entnet.org)
- Neurotrophin expression and laryngeal muscle pathophysiology following recurrent laryngeal nerve transection. (abcam.com)
Recurrent Laryngeal Neuropathy2
- Horse vets are very familiar with left sided recurrent laryngeal neuropathy: indeed, our evidence suggests that most if not all large breed horses have some degree of left sided neuropathy. (ivis.org)
- In this presentation, I will present the clinical data and investigation of outbreaks of bilateral recurrent laryngeal neuropathy that occurred in 2016 in the UK, involving 10s to 100s of horses. (ivis.org)
Innervation3
- Access detailed definitions for all structures, including details on origins and insertions, muscle actions, blood supply, and innervation. (apple.com)
- Lyon, M.J. (2000) Nonadrenergic innervation of the rat laryngeal vascular supply. (upstate.edu)
- Identify and list the attachments, innervation and action of the sternocleidomastoid, digastric and infrahyoid (strap) muscles. (umich.edu)
Spasm4
- My doctors are stumped, I"ve had all sorts of tests, the last to be a muscle biopsy in the area where the spasm occur the most. (medicinenet.com)
- hissing respiration from spasm of laryngeal and bronchial muscles). (homeoint.org)
- The muscles spasm as the person tries to speak. (sharecare.com)
- By injecting it into the laryngeal muscles, the spasm breaks. (sharecare.com)
Mucosa2
- The disarticulated arytenoid cartilage is only attached to the vocal cord, aryepiglottic fold and laryngeal mucosa. (vin.com)
- Invasion through the laryngeal mucosa is avoided. (vin.com)
Skeleton4
- What makes up the laryngeal skeleton? (brainscape.com)
- Under this condition, a fine needle aspiration punction (FNAP) was done in another hospital, and cytological result was neolplasm of skeleton muscle cells, suggested by adult rhabdomyoma (Picture 3). (arquivosdeorl.org.br)
- The movements of the laryngeal skeleton open and close the glottis and regulate the degree of tension in the vocal folds. (visiblebody.com)
- The cartilage is actually nine separate components called the laryngeal skeleton. (study.com)
Cricoid cartilage2
- The PCA muscle, the only abductor of the vocal cords, is readily identifiable on cross-sectional CT and MR studies as a triangular muscle bundle along the posterior surface of the cricoid cartilage ( Figs 1 and 2 ). (ajnr.org)
- This muscle arises along the posterior surface of the cricoid cartilage and extends superolaterally to insert on the muscular processes of the arytenoid cartilage (4, 5) ( Fig 2 ). (ajnr.org)
Tension15
- Seyyedeh Maryam Khoddami, Noureddin Nakhostin Ansari, Farzad Izadi, and Saeed Talebian Moghadam, "The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review," The Scientific World Journal , vol. 2013, Article ID 507397, 6 pages, 2013. (hindawi.com)
- A semiparametric effect compartment pharmacodynamic model was fit to values for rapacuronium plasma concentrations and twitch tension of the adductor pollicis and laryngeal adductors. (nih.gov)
- The steady state rapacuronium plasma concentration that depressed twitch tension by 50% and the Hill factor were similar for the two muscles. (nih.gov)
- What are muscle tension dysphonias? (brainscape.com)
- What are the two types of muscle tension dysphonia? (brainscape.com)
- What do primary muscle tension dysphonias result from? (brainscape.com)
- If a voice has a rough, unmusical sound due to excessive laryngeal tension, what quality disorder might we classify that as? (brainscape.com)
- Rigidity due to laryngeal muscle tension, often accompanied by a vocal wobble. (voiceteacher.com)
- Since this muscle adjusts the tension of the vocal folds for high notes especially during singing. (selfgrowth.com)
- Muscle tension dysphonia, or voice strain, can occur even when there is no damage to your vocal cords. (dukehealth.org)
- If your voice is tired, your throat feels tight, or it hurts to talk, you may have muscle tension dysphonia, or voice strain. (dukehealth.org)
- Muscle tension dysphonia can make your voice sound strained and feel uncomfortable when you talk. (dukehealth.org)
- Muscle tension dysphonia can happen when you've been sick and developed an injury to the vocal cords, such as laryngitis or swelling of the vocal cords. (dukehealth.org)
- Other factors that may contribute to muscle tension dysphonia include excessive talking without breaks, screaming, talking loudly in noisy environments, or habitually speaking at a pitch that is too high or too low for you. (dukehealth.org)
- As part of our comprehensive voice evaluation , we use videolaryngostrobscopy, a highly specialized exam that can uncover the patterns of muscle strain that cause muscle tension dysphonia. (dukehealth.org)
Treatment of laryngeal1
- Mass General's Voice Center Research Laboratories are designed to develop novel technologies, biomaterials, devices, and surgical tools for advancing the diagnosis, management and treatment of laryngeal diseases and pathologies that affect voice. (massgeneral.org)
Extrinsic laryngeal3
- Extrinsic laryngeal muscles" by Henry Vandyke Carter. (lecturio.com)
- To describe a case of rhabdomioma affecting extrinsic laryngeal muscle, discussing diagnoses and therapeutic aspects. (arquivosdeorl.org.br)
- We will introduce below a case of a patient with adult rhabdomyomas affecting extrinsic laryngeal muscle, image and cytological (aspiration punction) findings, surgical access and histopathological aspects related to the tumor as well. (arquivosdeorl.org.br)
Surgical3
- Early laryngeal cancer can be treatment by laser surgery or radiotherapy, intermediate and advanced laryngeal carcinoma mainly surgical treatment. (bioportfolio.com)
- We report here on a patient that had been previously treated for squamous cell laryngeal cancer with surgical resection and adjuvant systemic chemotherapy that presented with a metastasis to the rectus abdominis muscle without evidence of recurrent disease at the primary site. (biomedcentral.com)
- Over the past twenty years, team members of the Mass General Center for Laryngeal Surgery & Voice Rehabilitation have designed, developed and perfected many surgical procedures now currently in use to enhance the treatment of benign and malignant laryngeal and pharyngeal disease. (massgeneral.org)
Relaxants8
- Results: At pre-test, the study participants had deficient knowledge and negative beliefs regarding the use of muscle relaxants with laryngeal mask airways. (depaul.edu)
- 7,8 All clinical studies with the ILMA device have used intubating doses of nondepolarizing muscle relaxants "to provide optimum conditions. (asahq.org)
- Although anecdotal reports have described successful intubations using the ILMA without the use of muscle relaxants, 4,9 the effect of these drugs on the success rate when using this device for tracheal intubation has not been previously studied. (asahq.org)
- Nondepolarizing muscle relaxants differ in their time course at the laryngeal adductors and the adductor pollicis, a result of differences in equilibration delays between plasma and effect sites, the sensitivity of each muscle to the relaxant, and the steepness of the concentration-effect relation at each muscle (the Hill factor). (nih.gov)
- Unlike the finding for other nondepolarizing muscle relaxants, the laryngeal muscles are not resistant to rapacuronium. (nih.gov)
- The dosages of muscle relaxants used in various researches vary greatly. (clinicaltrials.gov)
- It is necessary to use muscle relaxants in laryngeal mask incubation under non-special circumstances. (clinicaltrials.gov)
- Sevoflurane does not prevent the increase in IOP after intubation without muscle relaxants. (nih.gov)
Hyoid1
- At the very top of the trachea, just below the mouth and nasal cavity, we have a strange assortment of moveable cartilage, muscles, tendons, tissues, and the hyoid bone. (study.com)
Lateral4
- A 52-year-old male with a history of laryngeal cancer was found on routine physical examination to have a 2 cm subcutaneous nodule in the left mid-abdomen approximately 2 cm superior and 4 cm lateral to the umbilicus. (biomedcentral.com)
- This occurs when the muscles which close the vocal folds (thyroarytenoids and lateral cricoarytenoids) contract with excess force. (ohsu.edu)
- Lateral rectus muscle, one of the extraocular muscles. (thefreedictionary.com)
- In clinical practice, referred to as the lateral rectus muscle. (thefreedictionary.com)
Inferior1
- Note thin black line of fat between muscle and pharynx ( arrowhead indicates inferior constrictor muscle). (ajnr.org)
Phonation1
- Stemple et al introduced a set of exercises based on a physiologic model of voice therapy which include a series of voice manipulations that were designed to strengthen and balance the laryngeal musculature as well as the coordinated interaction of respiration, phonation and resonance. (springer.com)
Anatomy4
- The aim of the study is to assess the efficiency and limitations of ultrasound in detecting and characterizing laryngeal anatomy and study of some laryngeal disorders and their ultrasonogr. (bioportfolio.com)
- Incredible 3D gross human anatomy models: Over 600 muscles and more than 200 bones. (apple.com)
- Test your knowledge by taking dozens of muscle and bone anatomy quizzes. (apple.com)
- iMedical Apps calls Muscle Premium "incredibly impressive at highlighting complex anatomy…The combination of impressive detail and 3D graphics mean this app is a market leader. (apple.com)
Humans1
- most of the muscle in humans is skeletal. (thefreedictionary.com)
Mask7
- Objectives: The purpose of this study was to evaluate the knowledge and beliefs of anesthesia providers about muscle relaxant use with laryngeal mask airways before and after reviewing an evidence-based educational module. (depaul.edu)
- Method: A descriptive online survey research design was utilized to determine Illinois Association of Nurse Anesthetist members' knowledge and beliefs regarding muscle relaxant use with laryngeal mask airways. (depaul.edu)
- Conclusion: This study found that study participants have a lack of knowledge and negative beliefs towards muscle relaxant use with laryngeal mask airways prior to an educational intervention. (depaul.edu)
- There is a need for additional studies that would support a position statement for a standard of practice and policy making for muscle relaxant use with laryngeal mask airways in contemporary anesthesia practice. (depaul.edu)
- The intention of this study is to compare the performance of the single-use I-gel laryngeal mask with the classic laryngeal mask in 50 patients with a BMI>25 during elective surgery. (bioportfolio.com)
- Previous studies have shown that the amount of muscle relaxant required for laryngeal mask intubation is smaller than that required for endotracheal intubation. (clinicaltrials.gov)
- If the laryngeal mask insertion condition of this patient is satisfactory, the next patient will use the lower dose. (clinicaltrials.gov)
Bilateral1
- In the spring of 2016, 2 groups of horses in the south of England presented with varying degrees of bilateral laryngeal neuropathy. (ivis.org)
Diagnosis2
- By this study, we reveal new opportunities and potentials of vision-based computerized solutions for evaluation, early diagnosis, and prevention of laryngeal disorders. (bioportfolio.com)
- An optimum combination of equipment and technique leads to a cost-effective, high yield and accurate diagnosis for laryngeal problems. (voicedoctor.net)
Diaphragm1
- Developmental changes in sequential activation of laryngeal abductor muscle and diaphragm in infants. (biomedsearch.com)
Tracheal tube1
- The twitch tensions of the adductor pollicis and the laryngeal adductors (via a tracheal tube cuff positioned at the vocal cords) were measured in 10 volunteers who were anesthetized with propofoL Rapacuronium, 1.5 mg/kg, was given and blood samples were collected. (nih.gov)
Cricothyroid muscle1
- The external branch functions to tense the vocal cords by activating the cricothyroid muscle, increasing pitch. (wikipedia.org)
Obstruction1
- Inducible laryngeal obstruction: Endoscopic quantitative analysis of glottic aperture. (bioportfolio.com)
Inlet1
- This muscle's function is to widen the laryngeal inlet. (wikipedia.org)
Movements2
- Controlled movements involve two opposing muscles: the agonist muscle produces the main action, while the antagonist muscle produces the opposite action to a lesser degree. (thefreedictionary.com)
- Observing laryngeal movements of stutterers. (springer.com)
Somatic1
- Twelve patients with varying degrees of clinically evident involvement of somatic muscles were studied. (annals.org)
