L11.1 Larynx and Phonation Flashcards

1
Q

Larynx Position

A
  • Begins at epiglottis → lower border of cricoid cartilage (at C6)
  • Hyoid bone at the top
  • Above 1st tracheal ring
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2
Q

Thyroid cartilage

A
  • Prominent angle ANT (adam’s apple)
  • Deficient POS → forms laryngeal inlet (where air gets in and out)
  • 2 Laminas, one on each side
  • INF horn articulates with cricoid cartilage
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3
Q

Cricoid cartilage

A
  • Closed
  • Short ANT arch
  • Tall POS lamina
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4
Q

Arytenoid cartilages

A
  • P-L aspect above lamina
  • Pyramidal, apex at top (pointing up)
  • Vocal process INF → projects into space of larynx
    • Forms attaches to vocal ligaments
  • Muscular process points out
    • Muscles pulling on process → allows ADD/AB of vocal processes
    • Muscles b/w the arytenoid cartilage → produce Sliding movement pulling processes towards midline
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5
Q

Epiglottic cartilage

A
  • Has POS attachment to adam’s apple → projects up to behind hyoid bone and POS surface of the tongue
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6
Q

Membranes b/w cartilage

A
  • Thyrohyoid membrane
  • Cricothyroid membrane/ligament → important for management of emergency airway
  • Quadrangular membrane → attaches from arytenoid cartilage to LAT surface of epiglottic cartilage
    • INF free edge → vestibular ligament
    • SUP free edge → aryepiglottic ligament
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7
Q

Vocal ligaments

A
  • Vocal ligaments projects ANT towards the midline, below the epiglottic cartilage
  • Vibrates against each other to produce sound
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8
Q

Aryepiglottic fold

A
  • Hooks around underneath of vestibular ligament → project LAT → along wall of thyroid cartilage → top of vocal ligaments → continuous down the airway
  • Space b/w 2 folds = ventricles
  • Ligament underneath
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9
Q

True/False vocal cords

A
  • True vocal cords → Vocal folds
    • Relatively avascular
  • False vocal cords → vestibular folds (does not produce sound)
    • A protective barrier for the vocal folds beneath
    • Produces sound in cats
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10
Q

Rima glottis

A
  • Space b/w vocal ligaments
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11
Q

Function of AB/ADD of vocal ligaments

A
  • AB → breathing
  • ADD → phonation
    • Manipulate movements/geometry of vocal ligaments → affects pitch of sound produced
      • High pitch → ligaments stretched and tightened
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12
Q

POS cricoarytenoid

A
  • Cricoid → muscular aspect of aryetenoid
  • AB vocal fold
    • Only muscle which AB vocal folds (critical for breathing)
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13
Q

LAT cricoarytenoid

A
  • LAT cricoid → muscular aspect of aryetenoid
  • Oppose action of POS C.A
  • ADD vocal folds (pulling muscular process away from each other)
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14
Q

Vocalis and thyroarytenoid

A
  • Vocalis along vocal ligament
  • Both work together to pull ANT thryoid cart back to arytenoid cart → Relax vocal ligaments
    • Low pitched
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15
Q

Cricothyroid

A
  • Pull back of thyroid cart fwd → tighten vocal ligaments
    • High pitch
  • Oppose thyroarytenoid & Vocalis
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16
Q

Transverse and oblique arytenoid

A
  • Pull aryetenoid tgt twd midline (sliding mechanism)
  • Closes Rima glottis → help LAT C.A bringing vocal lig together
17
Q

Nerves of the larynx

A
  • Branches of vagus N
    • SUP laryngeal
    • INF recurrent laryngeal
18
Q

SUP laryngeal

A
  • SUP laryngeal N branches into:
    • internal laryngeal → through deficiency in thyrohyoid membrane
      • Sensory to upper mucosa (above level of vocal ligament)
    • ex laryngeal
      • Motor → Cricothyroid muscles
19
Q

INF recurrent laryngeal

A
  • supply mucosa INF to ligament and all other intrinsic muscles
  • May be damaged when operating on patent ductus arteriosum
  • All AB/ADD muscles damaged on that side (except for cricothyroid)
    • Unable to add vocal ligaments on that side → hoarse voice and stridor (sense of effect on talking - ↑energy needed to get folds vibrating tgt)
20
Q

BS of the larynx

A
  • S/I thyroid branches → S/I laryngeal branches
  • Vessels are directly superficial to trachea
21
Q

Emergency airways

A
  • Cricothryoid puncture
  • Only do tracheotomy under full surgical conditions (consider the BVs in there)
  • Intubation tube for artificial ventilation
    • May damage surrounding structures