Let’s talk Larynx

If you are interested in voice and voice disorders, like me, you may have found that your interest in knowledge of voice anatomy did not peak until you were waist-deep in your graduate studies. Or maybe you have always been doodling posterior cricoarytenoid muscles in the corner of your MEAD spiral notebook pages. (WARNING: the previous link transports you to a very graphic video of an actual larynx…not for the weak) I studied and memorized all the muscle names for each test during school. It one day dawned on me that it was just easier to know the ins and outs of the laryngeal mechanism in order to better understand my craft. But, why didn’t this occur to me years earlier? Like, perhaps, when I began singing? Or better yet, when I discovered the left true vocal fold cyst that plagued the beginning of my college vocal performance career.

I have found that the more I know about the larynx and its muscles, the better I am at explaining therapy techniques, lay-man’s terms anatomy and vocal fold vibratory dynamics to my patients. This is great because when I first began my experience with voice patients in my internships, I was allowed to provide descriptive verbal anatomy to the patients. Man was I excited. I would practice my “spiel” on the way to and from the clinic. I would wait nervously during each videostroboscopy I was observing until it was my turn to give them the best anatomy lesson of all time!! But, I would get weird looks when I spoke of a thyrohyoid space or healthy looking thyroarytenoids. It was great that I knew the anatomy, but no one cared. They just wanted to understand why the physician had sent them and what magic we were going to prescribe. I had a patient’s wife tell me recently that she was so thankful I had taken the time to actually talk to her and her husband about the exam in a way they could understand. I took this pat on the back and thought, “Maybe I finally am able to find a good mix between medical terminology and real-world explanations.”

I am always finding a new and better way to explain things, and when one perfect way of describing something finds its way into my brain, I’m sure a few gems from a while back make their way out. It reminds me of a Married With Children Episode I watched a long time ago where Al puts Kelly on a trivia game show,  but for each new thing that she learns, a previously learned fact is forgotten. While I am glad that this is not real life, I went to a continuing education seminar this summer where I was able to take in succinctly presented information on vocal anatomy. While Kelly loses an old fact with each new one learned, I felt that I continued to fine tune my knowledge base and built upon what was already there. (Please visit the voiceboxvalhalla laryngeal anatomy website here. Thank you TCU.) It’s a nice change of learning style when you can learn the fun things like pathologies after you already spent the time learning the dry names and functions. (Think late-night graduate study cram sessions where 3am rolls around, you are all batty from red-bull and lack of sleep, quizzing each other as if it were some sick-twisted endless Jeopardy episode.)

The larynx is such an amazing apparatus housing those vocal folds that are, as Ingo Titze says in his book (Fascinations with the Human Voice), “woefully undersized.” With our dime sized vocal folds and our 7 inch vocal tract (epilarynx) we are able to completely mesmerize an auditorium full of audience members with no amplification whatsoever. Our larynx is made entirely of muscles and ligaments, with the hyoid as the only bone. Just as I fine tune my explanations, I work on keeping my larynx free from tension. This is a daily learning experience, which can be frustrating at times, but I feel I have a much more efficient practice technique with all the anatomical knowledge I know possess. And if I forget things, I won’t be calling Kelly…


Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. She rehabilitates voice and swallowing at her private practice, a tempo Voice Center, and lectures on vocal health to area choirs and students. She also owns and runs a mobile videostroboscopy and FEES company, Voice Diagnostix. She is an affiliate of ASHA Special Interest Group 3, Voice and Voice Disorders, and a member of the National Association of Teachers of Singing and the Pan-American Vocology Association. Knickerbocker blogs on her website at  www.atempovoicecenter.com. She has developed a line of kid and adult-friendly therapy materials specifically for voice on TPT or her website. Follow her on Pinterest, on Twitter and Instagram or like her on Facebook.


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