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Anatomy MD3001 > Larynx > Flashcards

Larynx Flashcards

1
Q

What is the larynx between?

A
  • Oropharynx
  • Trachea
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2
Q

What are the functions of the larynx?

A
  • Transport of air
  • Protective sphincter - closes the trachea e.g. if foreign object
  • Phonation - production of sound (with other parts of the body- resonating chambers, tongue, mouth)
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3
Q

What vertebral level is the larynx?

A
  • approx C3-C6
  • Mobile so this can change
  • Slightly higher in infants
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4
Q

Why is the fact that the larynx is higher in infants significant?

A
  • Tip of the epiglottis is in contact with the soft palate
  • Baby can breast feed and breathe at the same time
  • This means they are mandatory nose breathers which means it is uncomfortable if the nose is blocked
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5
Q

What are the laryngeal cartilages?

A
  • Epiglottis
  • Thyroid
  • Cricoid
  • Arytenoid
  • Corniculate
  • Cuneiform
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6
Q

What is the epiglottis attached to?

A
  • Thyroid cartilage by the thyroepiglottic ligament
  • Hyoid by hyoepiglottic ligament
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7
Q

Describe the position of the epiglottis

A
  • Projects upwards and backwards into the pharynx, beind the posterior part of the tongue
  • Because of the tension of the ligaments, it goes back to the breathing position
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8
Q

Describe the parts of the thyroid cartilage

A
  • Left and right laminae that join at the thyroid angle (laryngeal prominence = more prominent in males = Adams apple)
  • Superior horns that attach to the hyoid
  • Inferior horns that articulate with the cricoid
  • Superior thyroid notch
  • Oblique line for muscle attachment
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9
Q

Red arrow

A

Superior thyroid notch

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10
Q

Green arrow

A

Laryngeal prominence

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11
Q

Purple arrow

A

Oblique line

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12
Q

What is the difference in the laryngeal angle in men and women?

A
  • Men = 90 degrees = more prominent
  • Women = 120 degrees
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13
Q

Describe the cricoid cartilage

A
  • Shape of a signet ring with lamina posteriorly
  • Sloping shoulder on the lamina for arytenoid articulation
  • Ridge for attachment of the oesophagus
  • Depressions for attachment of the posterior crico arytenoid muscle
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14
Q

What does the cricoid cartilage articulate with?

A
  • Arytenoids
  • Thyroid
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15
Q

What do the arytenoids articulate with?

A
  • Sloping shoulders of the cricoid lamina
  • Corniculate cartilage superiorly
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16
Q

What are the parts of the arytenoid?

A
  • Vocal process: anteriorly for the attachment of the vocal ligament
  • Muscular process: posteriorly for the attachment of posterior and lateral crico-arytenoid muscles
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17
Q

Red arrow

A

Vocal process

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18
Q

1

A

Depression for the vestibular ligament

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19
Q

2

A

Depression for the attachment of the vocal muscle

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20
Q

Green arrow

A

Muscular process on the arytenoid

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21
Q

Describe the Thyro-hyoid membrane

A
  • Extends between: Upper edges of the thyroid lamina, the superior horns and the body and the greater horns of the hyoid
  • Thickened anteriorly and posteriorly as the median and lateral thyro-hyoid ligaments
  • Hole on either side where it is pierced by the superior laryngeal vessels and superior laryngeal nerve
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22
Q

Describe the fibro-elastic membranes

A
  • Formed from connective tissue under the laryngeal mucous membrane that stretches between laryngeal cartilages
  • Separated by the laryngeal ventricle
  • Superiorly: Quadrangular membrane
  • Inferiorly: Conus elasticus
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23
Q

Red

A

Quadrangular membrane

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24
Q

Green

A

Conus elasticus

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25
Q

Black arrow

A

Laryngeal ventricle

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26
Q

What does the quadrangular membrane extend between?

A

Lateral aspects of the epiglottis, arytenoid and corniculate cartilage

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27
Q

What are the edges of the quadrangular membrane?

A
  • Aryepiglottic fold (free edge)
  • Vestibular ligamnet
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28
Q

Red arrow

A

Aryepiglottic fold

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29
Q

Green arrow

A

Vestibular ligament

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30
Q

Red arrow

A

aryepiglottic fold

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31
Q

Green arrow

A

Vestibular ligament

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32
Q

What is another name for conus elasticus?

A

Cricovocal membrane

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33
Q

What does the conus elasticus blend with anteriorly and why is it significant?

A
  • Median cricothyroid ligament
  • It is the site of emergency access to the airway- tracheotomy
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34
Q

Red arrow

A

Cricovocal membrane (conus elasticus)

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35
Q

Green arrow

A

Median cricothyroid membrane

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36
Q

What is the function of the vocal cords?

A

They control the laryngeal diameter for:

  • Speech
  • Coughing/sneezing (protective reflexes)
  • Raising intra-abdominal pressure
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37
Q

What type of epithelium lines the upper respiratory tract?

A

Pseudostratified ciliated columnar epithelium

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38
Q

What type of epithelium lines the vocal cord?

A

Stratified squamous epithelium (to withstand the force of vibration

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39
Q

Vestibular cord

A
  • False vocal cord
  • Doesn’t vibrate when talking
40
Q

What is the function of the muscles adjacent to and within the vocal cord?

A

Narrow or widen the opening between them (rims glottis) or alter their tension

41
Q

What are the 3 parts of the laryngeal cavity?

A
  • The vestibule
  • The laryngeal ventricle
  • Infraglottic cavity
42
Q

Laryngeal cavity: the vestibule

A

Between the laryngeal inlet and the vestibular folds

43
Q

Laryngeal cavity: the laryngeal ventricle

A

Recess between the vestibular and vocal folds

• Leads to the saccule which provides lubricating muscles for the vocal folds

44
Q

Laryngeal cavity: Infraglottic cavity

A

Between the vocal folds and the trachea

45
Q

What is the laryngeal inlet bound by?

A

Aryepiglottic folds (free edge of the quadrangular membrane

46
Q

What is the rima glottis bound by?

A

The vocal cords and the vocal processes of the arytenoid

47
Q

Extrinsic laryngeal muscles

A
  • Change the position of the larynx as a whole
  • Suprahyoid and infrahyoid muscles
  • Facilitates the closing of the larynx
  • Extend from the skull neck (more than one place)
48
Q

Intrinsic laryngeal muscles

A
  • Extend between the laryngeal cartilages
  • Adjust the length/tension of the vocal ligaments (tone of voice)
  • Open and close the rima glottis
  • Control the inner dimensions of the vestibule
  • Facilitate the closing of the laryngeal inlet
49
Q

What do the extrinsic laryngeal muscles extend between?

A

• The skull to the larynx and the pharynx

50
Q

Which of the extrinsic laryngeal muscles are elevators?

A
  • Stylopharyngeus
  • Stylohyoid
  • Salpingopharyngeus
  • Palatopharyngeus
  • Mylohyoid
  • Geniohyoid
  • Digastric
  • Thyrohyoid
51
Q

Which of the extrinsic laryngeal muscles are depressors?

A
  • Sternothyroid
  • Thyrohyoid
  • Sternohyoid
52
Q

What are the functions of the intrinsic laryngeal muscles?

A
  • Open/ close the inlet (aryepiglottic folds)
  • Open/close the rima glottis- arytenoid gliding and rotation
  • Lengthen the vocal folds- rocking at the cricothyroid joints
53
Q

Describe the closure of the laryngeal inlet

A

• Elevation of the larynx and pharynx by the extrinsic muscles from the skull to the larynx and pharynx

  • Stylopharyngeus
  • Stylohyoid
  • Salpingopharyngeus
  • Palatopharyngeus
  • Aryepiglottic muscles act like a ‘purse string’
  • Superior fibres of the thyroarytenoid muscle
54
Q

Red arrow

A

Stylohyoid

55
Q

Green arrow

A

Stylopharyngeus

56
Q

Blue arrow

A

Salpingopharyngeus

57
Q

Purple arrow

A

Palatopharyngeus

58
Q

Red arrow

A

Aryepiglottic

59
Q

Opening of the laryngeal inlet

A

• Descent of the larynx (and pharynx) by elastic recoil

(• hyoepiglottic ligament)

60
Q

Opening of vocal folds or rima glottis

A
  • Posterior crico-arytenoid muscle
  • Attached to the muscular process of the arytenoid
61
Q

red arrow

A

Posterior crico-arytenoid

62
Q

Closing of the vocal folds or rima glottis

A
  • Inferior fibres of the thyro-arytenoid
  • Lateral crico-arytenoid
  • Transverse arytenoid
63
Q

Green arrow

A

Transverse arytenoid

64
Q

Blue arrow

A

Thyroarytenoid

65
Q

Red arrow

A

Lateral Crico arytenoid

66
Q

Lengthening the vocal cords

A
  • Thyroid cartilage rocked back and forwards at the cricothyroid joint (rocking backwards lengthens)
  • Cricothyroid muscle lengthens the vocal folds or ligaments
67
Q

Altering the tension of the vocal ligaments

A
  • Vocalis muscle (part of the thyro-arytenoid muscle)
  • Increasing the tension raises the pitch of the voice, decreasing lowers it
68
Q

Describe the folds and rima glottis in quiet respiration

A

• Rima glottis is triangular

69
Q

Describe the folds and rima glottis in forced inspiration

A
  • Rima is rhomboid
  • It is widely opened by the posterior crico-arytenoid, externally rotating the arytenoids
  • Vocal folds are adducted
70
Q

Describe the folds and rima glottis in phonation

A
  • Vocal folds are adducted
  • Air is forced through the vocal folds causing vibration
  • Cord length and tension are altered by cricothyroid, thyroarytenoid and vocalis muscles
71
Q

Describe the folds and rima glottis in effort closure

A
  • Vocal folds and vestibular folds are adducted
  • The airway is closed by the lateral crico arytenoid and transverse arytenoid
  • abdominal pressure is increased
72
Q

What happens during swallowing?

A
  • Laryngeal elevation
  • Closure of the laryngeal inlet by the epiglottis
  • As the larynx descends after swallowing, the epiglottis springs back by the hyoepiglottic ligament
73
Q

Green arrow

A

Superior laryngeal artery

74
Q

Blue arrow

A

Inferior laryngeal artery

75
Q

Describe the venous drainage of the larynx

A
  • Superior laryngeal vein -> Superior thyroid vien -> Jugular internal vien
  • Inferior laryngeal vein -> Inferior thyroid vein -> brachiocephalic vein
76
Q

What is at risk during a tracheostomy?

A

The inferior thyroid veins

77
Q

Black arrow

A

Superior laryngeal vein

78
Q

Green arrow

A

Inferior laryngeal vein

79
Q

Lymphatic drainage above the vocal cord

A

Superior deep cervical lymph nodes

80
Q

Lymphatic drainage below the vocal cord

A
  • Prelaryngeal
  • Pretracheal
  • Inferior deep cervical
  • Supraclavicular lymph nodes
81
Q

What is the lymphatic drainage between the vocal cords

A

There is none

82
Q

Neural supply of the larynx

A

Superior laryngeal nerve (a branch of the vagus):

• Internal branch (internal laryngeal nerve)

  • Sensation of the larynx down to just above the vocal folds
  • Accompanied by the superior laryngeal artery

• External branch (external laryngeal nerve)

  • Supplies the cricothyroid muscle

Vagus -> recurrent laryngeal -> Inferior laryngeal

  • Accompanied by the inferior laryngeal artery

• Recurrent laryngeal

  • All muscles of the larynx except the cricothyroid
  • sensation to the vocal cords and the larynx below
83
Q

Potential spaces

A
  • Between muscles of the floor of the mouth
  • Pre-tracheal space
  • from the neck to the mediastinum

• Retropharyngeal

  • from the base of the skull to the diaphragm
84
Q

Red arrow

A

Inferior laryngeal nerve

85
Q

Green arrow

A

Superior laryngeal

86
Q

Red arrow

A

Internal branch (internal laryngeal nerve)

87
Q

Blue arrow

A

External branch (external laryngeal nerve)

88
Q

What supplies the Cricothyroid muscle?

A

External branch (external laryngeal)

89
Q

What supplies the Muscles of the larynx except the cricothyroid?

A

Recurrent laryngeal nerve

90
Q

What supplies the sensation of the larynx to just above the vocal cords?

A

Internal branch (internal laryngeal nerve)

91
Q

What supplies the sensation of the vocal cords?

A

Recurrent laryngeal

92
Q

Label

A
93
Q

label

A
94
Q

What is this muscle?

A

Tansverse arytenoid

95
Q

What is this muscle?

A

Oblique arytenoid

96
Q

What is this muscle?

A

Lateral crico arytenoid

97
Q

What are the green and red arrows pointing to?

A
  • Red = thryoepiglottic
  • Green = hyoepiglottic

Anatomy MD3001 (13 decks)

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