Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ent - Larynx > Nerve Supply Of Larynx And Vocal Cord Palsy > Flashcards

Nerve Supply Of Larynx And Vocal Cord Palsy Flashcards

1
Q

Which nerve supplies the larynx ?

A

Vagus nerve ; vagus nerve emerges through the jugular foramen along with the 9 , 10 ,11 cranial nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many ganglia does the vagus nerve have ?

A

Two

They are the
Superior ganglion of vagus
Inferior ganglion of vagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the branches of the superior ganglion of vagus ?

A

Arnold nerve : auricular branch of the vagus that supplies the Pinna

Pharyngeal branch : this along with the 9th nerve and sympathetic chain forms the pharyngeal plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the nerve arising from the inferior ganglion of vagus ?

A

Superior laryngeal nerve (SLN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

At what level does the superior laryngeal nerve divides into two branches ?

A

At the level of HYOID , SLN divides into INTERNAL LARYNGEAL NERVE and EXTERNAL LARYNGEAL NERVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Internal laryngeal nerve supplies what ?

A

Internal laryngeal nerve gives sensory supply to the upper part of hypopharynx and the supra glottis after piercing the thyrohyoid membrane just above the upper border of inferior constrictor muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Injury to internal laryngeal nerve causes what ?

A

Repeated aspiration of foreign body as sensation to sense this aspiration is lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the external laryngeal nerve supply ?

A

It supplies the only intrinsic muscle that lies externally i.e CRICOTHYROID (tensor of the vocal cords )

External laryngeal nerve accompanies SUPERIOR THYROID VESSELS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does the recurrent laryngeal nerve enters the larynx ?

A

This nerve enters the larynx between the inferior constrictor and the oesophagus behind the cricothryoid joint after running through the tracheo-oesophageal groove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Left RLN arises from where ?

A

Arises from the level of ARCH OF AORTA and has a longer course than the right RLN hence more prone to injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

From where does the right RLN arises ?

A

It arises from the level of subclavian artery ; has a shorter course than left RLN

RLN enters the larynx with the inferior thyroid vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Supply of RLN ?

A

Sensory supply - glottis and subglottis
Motor supply - to all the muscles of larynx except cricothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is cardiovocal syndrome / ortner’s syndrome ?

A

It is the compression of left RLN by enlarged left atrium

Left RLN is more prone to injury at the mediastenum while right RLN is more prone to injury at the level of neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the nerves that are injured in base of skull injury ?

A

Palsy of whole vagus can occur including the pharyngeal branches and at the same time other cranial nerves can also be involved

Involvement of pharyngeal branches leads to dysphagia,regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nerve injury that is associated with carotid triangle surgery ?

A

SLN , ILN , ELN since carotid triangle is at the level of hyoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nerve injury that is associated with cervical spine surgeries

A

RLN

17
Q

What is otner’s syndrome ?

A

Mitral stenosis causing dilatation of left atrium leading to left RLN compression

18
Q

When will the position of the vocal cord will be in midline ?

A

Phonation

19
Q

When will the position of the vocal cord will be in midline ?

A

Phonation

20
Q

Position of vocal cord during whispering ?

A

Paramedian - 1.5mm away from the midline

21
Q

Position of vocal cord in complete palsy?

A

Intermediate / cadaveric position - 3.5mm away from the midline

22
Q

Normal respiration position of vocal cords ?

A

Slight abduction - 7mm from the midline

23
Q

Position of vocal cords in forced respiration ?

A

9.5mm away from the midline - full abduction

24
Q

Position of vocal cord in adductor palsy / complete palsy / SLN + RLN palsy

A

Cadaveric / intermediate position

This is called as adductor palsy as the person is not able to adduct the vocal cords

25
Q

Position of vocal cord in incomplete palsy / RLN palsy / abductor palsy

A

Median / para median according to Wagner and gross man theory

26
Q

What is Wagner and grossman theory ?

A

In RLN palsy all the muscles will be affected except for cricothyroid keeping the vocal cords adducted i.e median / paramedian position

27
Q

Treatment for bilateral RLN palsy

A

Tracheostomy with lateralisation of one vocal cord as the patient will have stridor due to adduction of vocal cords

28
Q

Treatment for unilateral adductor palsy

A

Medialisation of vocal cord in order to correct aphonia

29
Q

Treatment for bilateral adductor palsy

A

Tracheostomy with epiglottopexy

Here voice cannot be restored only the aspiration will be prevented

30
Q

Paralysis of ELN palsy

A

Vocal cord can’t be tensed hence the voice will be low pitched

Vocal cord position : skewed / bowed

31
Q

Most common cause of unilateral and bilateral recurrent laryngeal nerve injury

A

Thyroid surgery

32
Q

Maximum stridor is seen in

A

Bilateral RLN palsy / bilateral incomplete palsy

33
Q

How can we medialise the vocal cords in the unilateral complete palsy ?

A

Inject collagen , silicone , fat , calcium hydroxyapatite , Teflon laterally

Teflon is not recommended due to formation of granulation tissue

34
Q

Lateralisation of vocal cords is done by

A

Cordectomy and arytenoidectomy : woodman’s procedure ; kashima’s procedure

Cordopexy : burning of a portion of vocal cords using laser

35
Q

What is thyroplasty ?

A

Thyroid - framework surgery nothing to do with vocal cords

36
Q

What are the types of thyroplasty ?

A

Proximalisation / medialisation - unilateral complete palsy - TYPE 1

Lateralisation - bilateral incomplete nerve palsy / bilateral RLN palsy -TYPE 2

Shortening - puberophonia / mutational falsetto - TYPE 3

Tightening / lengthening - androphonia - TYPE 4

Ent - Larynx (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions