This refers to the degree of sharpness with which the tissue and motor operations within a particular individual are able to carry out a particular task. As an example, to play a good game of tennis requires any of the following:

1. Well developed arm, wrist and hand action
2. Eye to hand coordination
3. Fast reflex time

Physiological acuity involves both tissue development and tissue operation. The muscles, ligaments etc have to be developed into the appropriate configurations and they have to be able to be used accurately to carry out the required skill. In addition neurons in the tissue have to be connected to the brain in a manner that enables effective use of this configuration. All parts are necessary for physiological acuity: correct brain and body development and effective use of it.

Vocal acuity involves development of:

• the vocal chords, so that they work efficiently
• the diaphragm, sacral muscles and the chest, especially the inter-costal muscles, to create an air tight bellow system for applying air to the vocal chords
• facial muscles tlo channel the sound and create expression
  
• breathing, which is the operation of the voice through coordination of air in and air out movements

Vocal qualities are determined largely by the configuration of physiological elements above the vocal chords, such as the palate, cheekbones (which ‘hold’ the palate) and the forehead which helps pull both the palate and the cheekbones upwards. If these three elements do not operate seamlessly in coordination with each other then the voice can be prone to ‘breaking’, tiring, and cracking under stress. Such acuity only occurs in professional singers or orators either as a result of many years’ training or the happenchance consequences of upbringing. Either way, retaining acuity involves practice.

Botox 

In light of the requirements for vocal acuity it can be predicted that the use of Botox to paralyse the muscles of the forehead may sometimes have a negative effect on the voice. This is not absolute but would depend on the well-being of the individual during the Botox treatment period. Any stress experienced while the forehead muscles are paralysed, could result in deterioration of physiological acuity and loss of functionality. However, Botox used while the individual is at their peak is not likely to cause harm.

It is predicted that Botox manufacturers are likely to be a future target for retrospective lawsuits as a result of not providing ample warning of this.