The Physiology of Respiration -

The Physiology of Respiration -

Respiration: from Physiology to Phonetics Alain Marchal Laboratoire Parole et Langage CNRS Aix-en-Provence F. Rohrer (1925): Treatise on respiratory movements: the basis of Respiratory Physiology. W. Fenn: Extension of this work in the 1940s.

Ladefoged et al. (1957): First phonetic studies examining the relationship between respiration and phonation. The way in which respiration is modified to accommodate speech production. Vital Function of Respiration To ensure the exchange of gases between air and blood.

The respiratory cycle comprises two phases: inhalation and exhalation. Inhalation: Intake of air into the lungs, bringing oxygen to the organism. Exhalation: Emptying the lungs and expelling the carbon dioxide accumulated by the blood. The Lungs Situated in the rib cage,

2 lungs: - shape of air-filled pyramids, - separated by the mediastinum Divided into two bronchial tubes, subdividing into bronchioles and alveoli. The two lungs are envelopped in a serous membrane: the pleura. 2 layers: visceral and parietal. The pleural fluid allows the layers to slide over one

another; The pleura ensures the functional coupling between the chest wall and the lungs. Mechanics of breathing The lungs and thorax have elastic properties: The property of elasticity plays a great role in normal respiration:

- elongation during inhalation - return to rest position during exhalation due to the relaxation forces. Elasticity can be estimated using the pleural pressure The Respiratory System - The Structural Supports 1 The rib cage

2 The visceral thorax 3- The respiration muscles The rib cage : 12 spinal vertebrae, 12 pairs of ribs, : The sternum. Bounded at the top by the neck and at the bottom by the diaphragm. Rib Cage = Protective shield From Marchal (2007)

Head of each rib joined to the spinal column by sliding joints. Displacement of the ribs = enlargement of the cage - Raising of the ribs: transverse and lateral increase - Forward and upward movement of the sternum: increase of the antero-posterior diameter. Movements of the diaphragm: vertical dimension. Some Principles of Aerodynamics

Boyles law: When the dimensions of a container are enlarged, its volume increases; the molecules of air become more spaced out, and air pressure falls. Conversely, when the dimensions are reduced, the volume decreases, the air molecules become compressed, and the pressure increases The pressure of air in the lungs depends on the force exerted on the thoracic walls by the molecules of air inside them.

Some Principles of Aerodynamics An increase in pulmonary volume > lowering of pressure which results in the drawing in of air from outside. A decrease in pulmonary volume > increase in pressure which pushes the air out. How to Measure Air Pressure ?

The U tube manometer measures the height of a column of water when a given pressure is applied to one arm of the tube Electronic transducers for dynamic speech pressure measurements are now used

Air Pressures in the Vocal Tract Pressure is defined as the force per unit area acting perpendicular to a surface Absolute pressure is of little value to the speech scientist or speech therapist Pressures in the respiratory tract (vocal tract) are expressed relative to the atmospheric pressure = gauge or gage pressure Speech pressures are commonly expressed in CmH2o

Airflow Airflow occurs when there is a difference between pressures; Air flows from a region of high pressure to one of low pressure. The bigger the difference, the faster the flow When flow is low and through narrow tubes, it tends to flow in a straight line: Laminar airflow When air flows at higher velocities, flow is disorganized, chaotic and forms eddies: Turbulent airflow

How to Measure Flow ? Spirometer: Basic equipment for pulmonary function tests Differential pressure transducers for the measurement of flow rates Unsuited for speech

How to Measure Flow during a Speech Task ? Pneumotachograph Measurement of pressure differences across a fine mesh Electronic transducers of various types For speech Airtight mask which fits over

the mouth and nose Mouth mask and catheter in nostrils Microphone Body plethysmograph Recording Session with EVA2 in Aix Normal Respiration Inhalation:

Contraction of the external intercostal muscles and of the diaphragm > raising and widening the rib cage > Increase of the pulmonary volume. The intrapulmonary pressure > negative relative to the atmospheric pressure > the lungs fill by aspiration. Air intake: about 1/2 liter Normal Respiration Exhalation:

Normal exhalation is an entirely passive, involuntary process caused by the elastic recoil of the pulmonary tissue and the ribs. Return to equilibrium. Air out: same volume as intake Aerodynamic Data for Normal Respiration Ratio between inhalation and exhalation is 1:1. Rate is 12 to 18 cycles per minute.

Flow: 0,3 -0,5 L/s Volume: 500 cm3 Pulmonary Pressure: 1-3 cm H2O (With forced inhalation and severe muscular effort during exhalation, the rate of flow can increase to more than 50 l/s and intra-pulmonary pressure can go up to 100 cm H2O). Respiration Muscles The 3 dimensions of the rib cage (vertical, transversal

and antero-posterior increase during inhalation and decrease during exhalation. muscles of inhalation Principal INSPIRATORY Diaphragm External intercostals Interchondral part of

internal intercostals Accessory Scalenes Pectoralis major Pectoralis minor Sternocleidomastoid Respiratory Muscles for Inhalation

Inhalation Muscle: action of the diaphragm The diaphragm: Flattens the dome Pushes the abdominal organs down

Enlarges the thoracic cavity in the vertical dimension. Action of the Thoracic Muscles in the Inhalation Phase After Hardcastle, 1976 The external intercostals: Rotation outwards and upwards: Antero-posterior dimension increase. Supplementary muscles: Major and minor pectoral muscles , Scalene muscles.

Exhalation Muscles In normal respiration, exhalation is an entirely passive phenomenon due the combination of the forces of relaxation: the lungs deflate and return to their rest position. In forced respiration, supplementary pressure must be exerted on the rib cage to prolong the exhalation phase. This action results from the working of three groups of

muscles: the thoracic, the abdominal and the dorsal muscles Exhalation Muscles The thoracic muscles: the internal intercostals and the transverse thoracic The abdominal muscles: the transverse abdominal, the internal and external oblique and the rectus abdominis - The dorsal muscles:

the great dorsal and the iliocostal. The internal intercostals are the most important of the exhalation muscles. Principal EXPIRATORY Internal intercostals Accessory

Transversus abdominis External obliques Internal obliques Rectus abdominis Action of some Thoracic Muscles in the Exhalation Phase After Hardcastle, 1976

Pulmonary Capacity and Pulmonary Volume Pulmonary Capacity and Pulmonary Volume Pulmonary volume = quantity of air that the lungs contain Ventilation amplitude = fn of oxygen need Total pulmonary volume = total lung capacity Residual volume = Air in the lungs after forced exhalation Vital capacity. Quantity of air that can be expired down to the residual volume. The vital capacity is important for determining how long phonation can be

maintained whether for singing or speaking Tidal volume. The difference between the inhaled and exhaled volumes in normal respiration Expiratory reserve = difference between the residual volume and the tidal Respiration in Phonation Normal respiration is automatic Respiration in speech is very finely controlled: to allow for breathing and simultaneously producing a

complete utterance without a need for taking a breath at an inappropriate moment. Control of Respiration during Speech Respiration must thus be modified to increase the volume of available air: - increase of inhalation, - control of exhalation to prolong and regulate the output of air.

Exhalation must provide an output of air sufficient to maintain stable subglottal pressure for the whole duration of the utterance. The respiratory cycle during Speech The respiratory cycle is profoundly altered by speech production The ratio between inhalation and exhalation > 1:4 and up to > 1:10 Inhalation is much faster (via the mouth rather than the nose), to

avoid lengthy interruptions. Exhalation > Longer: from 2-3 seconds in resting respiration to 15-20 seconds, varying according to the length of the utterance. Pulmonary volume: About 1 l.; double that of resting respiration. Half that of vital capacity. Exhalation is organized in Breath Groups (after Lieberman, 1965) Declination line of Fo from start to end of a breath group

The pitch span as the range of Fo values : baseline and plateau (after Vaissire, 1983) Muscular Control during Exhalation for Speech after Ladefoged (1967) At the start of exhalation, the inhalation muscles: external intercostals Then : the exhalation muscles Increasingly strong contractions of the

internal intercostals compress the rib cage and force out the air remaining in the lungs. Towards the end of exhalation, their action is reinforced by the exhalation accessory muscles Some Neglected Aerodynamic Issues

Transglottal pressure = Subglottal pressure - intraoral pressure Subglottal pressure Level of intensity Subglottal pressure and laryngeal tension Fo Consonantal constrictions and closures modify the impedance of the buccal cavity

Consonantal closures change intraoral pressure. For a given laryngeal state, why changes of intraoral pressure do not necessarily result in Fo variations ? How can the absence of continuous variations of intensity be explained ? Recording of some of the Respiratory Muscles Simultaneous recording of the pulmonary volume, the acoustic signal and EMG of the internal and

external intercostals, the diaphragm and the abdominal muscles. Respiration tasks: normal, forced, apnea List of 30 plurisyllabic words, 40 non sense words, 10 sentences varying in length and syntaxic complexity, and spontaneous speech. Experiment conducted with professors Jammes, Y and Grimmaud, Ch

at University Hospital La Timone in Marseille 15 repetitions, 2 speakers, standard french General Theory of Co-ordinated Movement Hoshiko (1960), Adam and Munro (1973), and Marchal (1988) reconsider the organization of muscular activity during speech.

For speech activity, the intercostal muscles and the diaphragm appear to act synergistically during both the inhalation and exhalation phase. The diaphragm has a role up from the start to the end of the exhalation involved in both speech and singing as hypothesized by Sundberg et al., 1999; Lindblom and Sundberg, 2005). Control of respiration as a Co-ordinated Movement

Zinkin (1958): Diaphragm: control of the air supply and of subglottal air pressure. Marchal (1988, p. 6) looks at the asynchronous peaks of activity in the diaphragm and the internal intercostals which he interprets as a response to the need to modify the supply of air according to the impedance of the larynx and the vocal tract. EMG of the respiratory muscles during a speech task

Revised Model of the Control of Respiration Marchal observes asynchronous peaks of activity in the diaphragm and the intercostals during exhalation It appears that the curve of the diaphragm does not return in a linear way during phonation exhalation . The speed of the rise of the diaphragm varies according to the phonetic structure of the utterance. Hypothesis: a response to the need to modify the supply of air according to the impedance of the larynx and the vocal tract.

These findings support Zinkin (1958), for whom the control of the phonatory air-supply is due to the controlled behavior of the diaphragm. Linguistic Functions Pulmonary Initiation Egressive airflow: most common process for the production of speech segments Respiratory activity and the syllables

Stetsons (1951) : Syllables initiated by a contraction of the II , interrupted by contraction of the EI > ballistic pulses Syllables delimited by alternating actions in the internal and external intercostals in delimiting syllables. Linguistic Functions Ladefoged (1962) disagreed with Stetsons theory of the syllable.

Not supported by experimentally robust data. Lebrun (1966) considers that muscular activity has been more inferred from observation of the ribcage movements than directly measured. Respiration and the Syllable Difficult to establish an unequivocal relationship between syllables and muscular activity. (relationship: not systematic; differences between activity peaks and numbers of syllables)

Marchal (1988) has only been able to make such a connection for slow read speech (as in lists of words and nonsense words) and in syllables accentuated for phrasal emphasis. Respiration and the Syllable Variation of impedande of the supralaryngeal tract: Hypothesis of an aerodynamic influence by consonantal closure: in very rare cases, it may be that the chest

movement is a continuous, slow controlled movement of expiration, and that the syllable is due to the holistic stroke of the consonant EMG Data and V/C Distinction The data often suggests that vowels are marked by a high point in the diaphragm and consonants more by increased activity in the external intercostals. At a normal rate and for open syllables, an almost syllabic division between the secondary patterns of

EMG activity can be seen. (diaphragm; EI) EMG Data and V/C Distinction Where there are closed syllables or combinations of consonants followed by liquids, a peak in the diaphragm following the consonant can be seen, as if there were a [] that is however not visible ] that is however not visible ] that is however not visible on the acoustic trace. Should we therefore see an exceptional structure in the vowel-consonant combination

(Lenneberg, 1967)? The question is open. Air Pressures in the Respiratory system and in the Vocal Tract Intra-pulmonary Pressure = Alveolar Pressure: Pressure in the lungs Pleural Pressure : pressure in the pleural space due to relaxation forces = Oesophageal pressure is a good approximation Subglottal Pressure: Pressure below the vocal folds

Supraglottal pressure: Pressure above the vocal folds Air Pressures in the Vocal Tract Transglottal pressure = Difference between subglottal and supraglottal pressure. Driving force for the vibration of the Vocal Folds Intra-oral pressure: Pressure in the oral cavity During voiceless stop production: Alveolar pressure = Subglottal pressure = Intra-oral pressure

The Subglottal Pressure Variations in subglottal pressure play a central role in speech production. Subglottal pressure corresponds to the intrapulmonary pressure, when the glottis is closed This pressure has to be sufficiently strong to overcome the resistance to airflow presented by the glottis and upper airways. It must also be controlled to ensure both the stability of phonation and a response to the global demands posed by the evolution of prosodic parameters, principally of intensity and Fo. Several methods, direct and indirect, have been used to measure

subglottal pressure. Measurement of Subglottal Pressure Direct methods - The catheter Van den Berg (1956) used an open catheter made of polyethylene which was introduced via the nose into the pharynx, then sucked into the glottis with a very strong inbreath.

The vocal cord region was slightly anaesthetised by the catheter. Pressure was registered by an optical manometer. This technique is often difficult to speaker to tolerate (nausea can result), and there is a serious risk of disrupting phonation. This technique is therefore seldom used for phonetic studies. Measurement of Subglottal Pressure - The intratracheal needle Inserted into the trachea at a point two rings below the

cricoid cartilage (Lieberman, 1968; Strik and Boyes, 1992, 1995, Giovanni, 2005,2006...) It provides an immediate direct pressure reading. Recordings require an appropriate medical infrastructure, which makes it cumbersome to use. In practice, it proves hard to convince professional speakers and, even more so, singers that the procedure is harmless. Direct Subglottal Pressure Recording

Intratracheal needle (CHU, La Timone, 2012) Indirect Methods - Measurement of oesophageal pressure A rubber balloon, about 10cm long, 1cm in diameter with a millilitre of air in it, inserted via the nose into the oesophagus by means of a fine catheter, 34cm from the

nostrils. The balloon reaches the lower third of the oesophagus, presses against the membrane that is the posterior wall of the trachea. The variations of pressure in the balloon was in some studies seen as directly relating to subglottal pressure. Measurement of Oesophageal Pressure This method was in fact subject to an important error: it did not take into account the effect of the

forces of relaxation and elasticity which affect the balance of air pressure in the respiratory organs. Several studies found a difference between oesophageal pressure and directly measured subglottal pressure at the end of the expiratory phase. Subglottal Pressure = Poes Relaxation Pressure Research into pulmonary physiology shows that intrapleural pressure equates to intrathoracic pressure.

Intrapleural pressure = pulmonaty pressure + pressure generated by elastic forces. It has moreover been established that that oesophageal pressure is a good indication of intrapleural pressure. Thus: oesophageal pressure= subglottal pressure + the pressure resulting from the forces of elasticity in the lungs. If measuring oesophageal pressure, it is therefore appropriate to correct the values by referring to

Subglottal Pressure = Poes Relaxation Pressure Only the use of a body-plethysmograph gives reliable continuous information about the pulmonary volume without interfering with speech. (Marchal, 1977; Binazzi, et al., 2006). This indirect method of measuring subglottal pressure has the advantage of being not very invasive, but it requires a large array of equipment available only in a hospital setting. This feature surely explains the small number of studies

Body-Plethysmograph Measurement of Intra-oral Air-pressure Because of the difficulties posed by the direct methods and the oesophageal method of measuring subglottal pressure, some studies have relied on intra-oral pressure. When the vocal tract is completely closed, pressure is equalised in the whole of the vocal tract below the place of closure. This is what happens in the case of a voiceless plosive consonant: in these

circumstances, intrapulmonary pressure is the same as intra-oral pressure and equates to subglottal pressure (Kitajima et Fujita, 1990; Hertegard et al.(1995); Giovanni, et al., 2000). The measure of intra-oral pressure is thus necessarily of limited practicality and can rarely be used to study variations of subglottal pressure in continuous speech. Perk Values of Subglottal Pressure

In resting respiration, the values of subglottal pressure during exhalation approximate 1-3 cm of water. They can rise to 100 cm during violent exhalatory efforts, as in coughing. Phonation initiation requires pressure above 2cm of water and the current values in normal speech are in the region of 215cm of water. Similarly, pressure varies according to linguistics needs. Several studies have examined the relationship between subglottal pressure, intensity f0 and a range of variations occasioned by the prosodic organisation of the utterance.

Subglottal Pressure and Intensity Muller (1837) used excised larynxes to show the effects of an increase in subglottal pressure on intensity. Van den Berg (1956) measured the relationship between the level of sound, subglottal pressure and the average output of air for the vowel /a/ with different fundamental tones, and with chest voice, head voice and falsetto voice. He confirmed that the behaviour of the glottis as a generator of sound is quadratic

rather than linear for the vowel /a/. The studies of Marchal (1979),Ladefoged and McKinney (1963), Isshiki (1964), Strik and Boves (1992), show that there is a very strong relationship between subglottal pressure and intensity. Intensity is practically proportional to the square of the pressure across the whole range of voice registers: INT x SGP. 3.3O7 Ladefoged and Kinney (1963) also find a

relationship between sound pressure, perception of intensity and subglottal pressure. Proportional linear relationship between perceived intensity and subglottal pressure. This result suggests that the subjects who did these

tests were particularly aware of physiological effort. Subglottal Pressure Intensity- Vowel Subglottal Pressure is not the only factor to influence vocal intensity. Laryngeal adjustment, the impedance of the vocal tract and

radiation also play a part. Marchal and Carton (1980) and Lecuit and Demolin (1998) find distinct regression curves according to the vowels and four levels of Fo. Subglottal Pressure and Fundamental Frequency

Fo is largely conditioned by transglottal pressure, i.e. the difference between pressure above and pressure below the vocal folds. On average, increase of 5 Hz per cm H2O chest voice =1-3 Hz per cm H2O low chest voice = 2-6 Hz par cm H2O falsetto voice (5-10 Hz par cm H2O) (Titze, 1989). Subglottal Pressure and Fundamental Frequency Fundamental frequency variation also depends from

laryngeal tension. when subglottal pressure lowers towards the end of an utterance, Fo can rise, as is particularly apparent in interrogative utterances with rising intonation. Strik and Boves (1992) model the relationship between subglottal pressure and laryngeal adjustments in the control of Fo. Subglottal Pressure and the Spectrum Papers by Shutte (1992), Sundberg et al. (1999) and

Sjlander and Sundberg (2004) examine the relations between subglottal pressure, the quality of the glottal source and the spectrum. In particular they measured F1 energy in singers and concluded that there was a linear relationship: When subglottal pressure doubled, it produced a rise of 12 dB. Subglottal Pressure and Stress

The notion of expiratory effort Studies have focused on: - the activity of the respiration muscles - the links between variations in: Subglottal pressure and lexical accent emphasis, phrasal accent. Research has chiefly focused on French and English. Subglottal Pressure and Lexical Accent

Lieberman (1965): Difference in realisation between light housekeeper and lighthouse keeper, Accented syllable is marked by a peak in respiratory effort reflected by a peak in subglottal pressure.

Subglottal Pressure and Lexical Accent (Lieberman, 1965) The link between a rapid increase in subglottal pressure and syllable accentuation is also found in French for

syllables marked for stylistic effect (Benguerel, 1973; Marchal, 1976). Subglottal Pressure and Emphasis (after Marchal, 1980) Subglottal Pressure and Emphasis (after Benguerel, 1973)

Some credit to the Motor Theory of Speech Perception ? It would be tempting to see in the link between subglottal pressure variation and the presence of accent a confirmation of the motor theory of perception according to which the listener is aware of the physiological effort of speech production. We think however that variation in subglottal pressure is probably an indicator, but not the only one. Moreover, these same studies find that in French there is an

absence of such a link for phrasal accents, which are never associated with any significant variation in subglottal pressure. Phonetic Consequences of some Respiratory Troubles Dysarthria: Neurogenic disorder Disturbance in muscular control Possible disruption of all basic motor processes of speech .

Weak or uncoordinated muscles of breathing Shortness of phrases, prolonged intervals, added pauses, slow rate, loudness decrease Asthma, emphysema: reduction of lungs capacity Diminution of exhalation volume Shorter breath groups, shorter phrases, loss of intensity, diminution of pitch range Selected References

Adam, C, and Munro, R R. 1973. The Relationship between Internal Intercostal Muscle Activity and Pause Placement in the Connected Utterance of Native and Non-Native Speakers of English. Phonetica 28:227-250. Anthony, J. K. F. (1982). Breathing and Speaking. The Modification of Respiration for Speech. Wetherby: British Library. Benguerel, A.P., 1973. Corrlat physiologique de laccent en Franais. Phonetica 27: 21-35. Binazzi, B., Lanini, B., Bianchi, R., Romagnoli, I., Nerini, M., Gigliotti, F., Duranti, R., Milic-Emili, J. & Scano, G. (2006). Breathing Patterns and Kinematics in Normal Subjects in Speech, Singing and Loud Whispering. Acta Physiologica Scandinavica 186(3).

233-246. Draper, M H, Ladefoged, P, and Whitteridge, D. 1959. Respiratory Muscles in Speech. Journal of Speech and Hearing Research 2:16-27. Fenn, W O, and Rahn, H eds. 1964. Handbook of Physiology, Respiration I. Washington: American Physiological Society. Giovanni, A., Heim, C., Demolin, D. & Triglia, J. M. (2000). Estimated Subglottal Pressure in Normal and Dysphonic Subjects. Annals of Oto Rhinol laryngology 109. 500-504. Hertegard, S., Gauffin, J. & Karlsson, I. (1992). Physiological Correlates of Inverse Filtered Waveforms. Journal of Voice 6. 224234.

Hixon, T ed. 1987. Respiratory Function in Speech and Song. London: Taylor & Francis, Ltd. Selected References Hoshiko, M S, and Berger, K W. 1965. Sequence of Respiratory Muscle Activity during varied Vocal Attack. Speech Monographs 32:185191. Isshiki, N. (1964). Regulatory Mechanism of Voice Intensity Variations. Journal of Speech and Hearing Research 7. 17-29. Kitajima, K. & Fujita, F. (1990). Estimation of sub-glottal pressure with intra-oral pressure. Acta Otolaryngologica (109). 473 - 478. Ladefoged, P., Draper, M. H. & Whitteridge, D. (1957). Respiratory Muscles in Speech. Journal of Speech and Hearing Research 2. 16-27. Ladefoged, P. (1960). The Regulation of Subglottic Pressure. Folia Phoniatrica 12. 169-175. Ladefoged, P. (1962). Subglottal Activity during Speech. 4th International Congress of Phonetic Sciences. Mouton, The Hague. 73-91.

Ladefoged, P. & Mc Kinney, N. P. (1963). Loudness, Sound Pressure, and Subglottal Pressure in Speech. Journal of the Acoustical Society of America 35. 454-460. Ladefoged, P. (1967). Three Areas of Experimental Phonetics. London: Oxford University Press Lebrun, Y. (1966). Sur l'activit du diaphragme au cours de la phonation. La Linguistique (2). 71-78. Lecuit, V. & Demolin, D. (1998). The Relationship between Intensity and Subglottal Pressure with Controlled Pitch. International Congress of Spoken Language Processing. Sydney: Australian Acoustical Society. 3079-3082. Lieberman, P. (1965). Intonation, Perception and Language. Cambridge: MIT Press Selected References

Lindblom, B. & Sundberg, J. (2005). The Human Voice in Speech and Singing. Berlin: Springer Marchal, A. (1977). Quelques notions de physiologie pulmonaire appliques la description de l'accent d'insistance en Franais. In Sguinot, A. (ed.), L'accent d'insistance. Montral: Didier. 93-121. Marchal, A. & Carton, F. (1979). La pression sous-glottique: mesure et relation avec l'intensit et la frquence fondamentale. In Bo, L. J., Descout, R. & Gurin, B. (eds.), Larynx et Parole. Grenoble: GALF. 313-327. Marchal, A. 1988. Contrle de la respiration dans la phonation. Folia Phoniatrica 40:1-11. Marchal, A. (2009). From Speech Physiology to Linguistic Phonetics. Hoboken, NJ: Wiley-ISTE Mc Farland, D H. 2001. Respiratory Markers of Conversational Interaction. Journal of Speech, Language and Hearing research 44:128-143. Mead, J. (1973). Respiration: Pulmonary Mechanics. Annals of Otolaryngology. Mead, J. & Bunn, J. C. (1974). Speech as Breathing. In Wyke, B. (ed.), Ventilatory and Phonatory Control Systems. London: Oxford University

Press. Chapter 3. Mller, J. (1837). Von der Stimme und Sprache. Handbuch der Physiologie des Menschen. Koblenz: Holscher. 133-245. Netsell, R. (1969). Subglottal and Intraoral Air Pressure during Intervocalic Contrast of /t/ and /d/. Phonetica 20. 68-73. Selected References Rohrer, F. (1925). Physiologie der Atembewegung. Handbuch der Normalen und Pathologischen Physiologie. Berlin: Springer. 70-127. Sjlander, P. & Sundberg, J. (2004). Spectrum Effects of Subglottal Pressure Variation in Professional Baritone Singers. Journal of the Acoustical Society of America 115(3). 1270-1273. Slifka, J. 2003. Respiratory Constraints on Speech Production: Starting an Utterance. Journal of the Acoustical Society of America 114:3343-3353.

Stetson, R. H. (1951). Motor Phonetics: A Study of Speech Movements in Action(2nd ed.). Amsterdam: North Holland. Strick, H. & Boves, L. (1992). Control of fundamental frequency, intensity and voice quality in speech. Journal of Phonetics (20). 15-25. Sundberg, J., Anderson, M. & Hultqvist, C. (1999). Effects of a Subglottal Pressure Variation on Professional Baritone Singers. Journal of the Acoustical Society of America 105. 1965-1971. Titze, I. R. (1989). Regulation of Vocal Power and Efficiency by Subglottal Pressure and Glottal Width. In Fujimura, O. (ed.), Vocal Physiology: Voice Production, Mechanism and Functions. New-York: Raven Press. 227-237. Van den Berg, J. (1956). Direct and Indirect Determination of the Mean Subglottic Pressure. Folia Phoniatrica 8. 1-24. Yanagihara, N, Koike, Y, and Leden, H V. 1966. Phonation and Respiration. Folia Phoniatrica 18:323-340. Zinkin, N. I. (1958). Les mcanismes de la parole (en Russe). Moscou: Acadmie des sciences pdagogiques

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