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Head and Neck Anatomy > The Larynx 1 > Flashcards

The Larynx 1 Flashcards

1
Q

What is the larynx?

A

A valve that protects the entrance to the airway or tracheobronchial tree.

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2
Q

Aside from its protective role, what else is the larynx responsible for?

A

It is involved in the production of speech sounds and in phonation in humans.

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3
Q

What happens if the protective role of the larynx is ineffective?

A

Laryngeal incompetence –> fluid and food is regurgitated into the trachea.

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4
Q

What is the larynx composed off?

A

4 major cartilages that are united by mobile synovial joints.

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5
Q

Aside from the mobile synovial joints, what else fills the spaces between the 4 major cartilages?

A

Ligaments and membranes.

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6
Q

Describe the walls of the larynx.

A

The larynx has outer and inner walls.

These look like 2 flower pots, once placed inside the other.

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7
Q

Where do the outer and inner walls of the larynx arise from?

A

They arise from a circular base which is called the cricoid ring.

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8
Q

Which structures form the outer wall of the larynx?

A
  • thyroid cartilage
  • thyrohyoid cartilage
  • cricoid cartilage
  • cricothyroid cartilage
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9
Q

Which is the largest cartilage of the larynx?

A

The thyriod cartilage is the largest cartilge.

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10
Q

What does the thyroid cartilage consists of?

A

Consists of 2 laminae that meet at the midline.

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11
Q

What does the thyroid cartilage project as?

A

Projects as a laryngeal prominence and this can be seen and palpated in the midline of the neck.

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12
Q

How is the angle between the 2 thyroid laminae different in men and women?

A

In men, the angle is more acute at puberty.

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13
Q

Where can the superior thyroid notch be palpated?

A

It can be palpated between the 2 laminae, above the laryngeal prominence.

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14
Q

Describe the posterior border of each thyroid cartilage?

A

It is extended above and below as slender superior and inferior horns or cornua.

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15
Q

What is the shape of the cricoid cartilage?

A

It is the shape of a signet ring. The narrow part of the ring lies in front and the thick part of the ring behind.

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16
Q

Where can the front of the cricoid be palpated?

A

It can be palpated in the neck below the thyroid cartilage.

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17
Q

What does the inferior cornu of each thyroid lamina articulate with?

A

It articulates with a facet on the side of the cricoid at a synovial articulation.

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18
Q

What is the outer wall of the larynx completed by?

A

It is completed by several membranes.

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19
Q

What does the upper border of each lamina of the thyroid cartilage give attachment to?

A

It gives attachment to the thyrohyoid membrane.

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20
Q

What does the other end of the thyroid cartilage give attachment to?

A

It extends upwards to give attachment to the inner border of the hyoid bone in the floor of the mouth.

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21
Q

How is the lower border of the thyroid cartilage attached to the cricoid?

A

It is attached in the midline by a strong cricothyroid ligament.

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22
Q

Below, how is the lower border of the cricoid attached to the trachea?

A

It is attached to the uppermost ring of the trachea via the cricotracheal ligaments.

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23
Q

What is the inner wall of the larynx composed off?

A
  • membrane
  • muscles
  • arytenoid cartilages posteriorly
  • epiglottis above
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24
Q

How is the structure of the inner wall best appreciated?

A

It we remove 1 thyroid lamina.

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25
Q

What is the epiglottis shaped like?

A

It is shaped like a leaf.

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26
Q

How is the epiglottis attached to the inner surface of the angle of the thyroid laminae?

A

It is attached by a ligament to the inner surface of the angle of the thyroid laminae.

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27
Q

What does the epiglottis project upwards behind?

A

It projects upwards behind the:

  • thyrohyoid membrane
  • hyoid bone
  • tongue
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28
Q

Where do paired arytenoid cartilages sit?

A

Sit on the upper border of the lamina of the cricoid.

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29
Q

What is the shape of each arytenoid cartilage?

A

They are each pyramidal in shape.

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30
Q

What is the joint between the arytenoid and the cricoid?

A

This is synovial.

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31
Q

What is the inner wall of the larynx completed by?

A

It is completed by a membrane which extends from the sides of the epiglottis above to the arytenoid cartilage behind and down to the lower part of the thyroid cartilage below.

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32
Q

What is the quadrangular membrane?

A

This is the part of the fibroelastic membrane that runs between the side of the epiglottis and arytenoid.

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33
Q

What does the quadrangular membrane end?

A

It ends below at a sharp free border that runs between the arytenoid cartilage behind and the thyroid lamina in front.

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34
Q

What is the sharp free border of the quadrangular membrane called?

A

This is called the vestibular ligament.

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35
Q

Describe the upper part of the quadrangular membrane?

A

This is less developed and is replaced by muscle fibres.

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36
Q

What is there below the vestibular ligament?

A

There is a slit like gap.

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37
Q

What is present beneath the slit that is below the vestibular ligament?

A

We have the conus elasticus or the cricovocal membrane.

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38
Q

Anteriorly in the midline, what is the most superficial part of the conus elasticus called?

A

This is called the cricothyroid ligament.

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39
Q

Where does the cricothyroid ligament arise from?

A

It arises from the circular cricoid base.

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40
Q

What does the conus elasticus end as?

A

It ends at a free upper border which forms the lower edge of the slit in the inner wall of the larynx.

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41
Q

Where is the free border of the conus elasticus fixed?

A

It is fixed both front and back within the larynx. `

42
Q

Where does the free border of the conus elasticus run between?

A

It runs between the anterior process or vocal process on the base of the arytenoid cartilge posteriorly to the midline of the 2 thyroid laminae anteriorly.

43
Q

What is the thickened free edge of the conus elasticus called?

A

This is called the vocal ligament.

44
Q

When the vocal ligament is covered with a mucous membrane, what is it called?

A

It is called the vocal fold.

45
Q

What type of cartilage is the thyroid, cricoid and most of the arytenoid cartilage made of?

A

They are mostly made of hyaline cartilage.

46
Q

What is the epiglottis and apices of the arytenoids made of?

A

They are made of elastic fibrocartilage.

47
Q

Where are the 2 small pea like corniculate and quadrangular cartilages located?

A

They are located along the upper border of the quadrangular membrane and its associated muscle.

48
Q

What are the vocal ligaments important for?

A

These structures are involved in the production of sound and the regulation of the airway size.

49
Q

What do movements are the cricothyroid and cricoarytenoid joints produce?

A

They produce changes in the tension and position of these ligaments.

50
Q

What axis does movement occur at the 2 cricothyroid joints?

A

It occurs around the transverse axis.

51
Q

What kind of movement at the cricothyroid joint increases tension of the vocal ligaments?

A

A movement at the joint which tilts the thyroid cartilage forwards will increase tension of the vocal ligament.

52
Q

What kind of movements can occur at the cricoarytenoid joints?

A

The cartilages may be abducted away from the laryngeal midline or adducted towards the laryngeal midline.

The cartilages may slide away from or towards each other and take the vocal processes away from or towards the midline.

53
Q

What happens to the vocal folds on deep inspiration?

A

They move apart on deep inspiration.

54
Q

Why do vocal folds move apart on deep inspiration?

A

The trachea stretches downwards and draws the mucous membrane around the laryngeal inlet while it does this.

55
Q

What is the gap between the vocal ligaments called?

A

This is called the rima glottidis.

56
Q

What happens to the rima glottidis during deep inspiration?

A

It alters in size and shape with abduction and adduction of the vocal ligaments on deep inspiration.

57
Q

What is the shape of the rima glottidis?

A

It is traingular shape.

58
Q

What kind of movements are produced by the arytenoids as the size and the shape of the rima glottis varries?

A

You get lateral movements of the arytenoids.

59
Q

What shape are the cricoarytenoid joints?

A

They are more than likely cylindrical in nature

60
Q

What other kind of movement does the cricoarytenoid cartilages allow?

A

They allow an anteroposterior rocking movement.

61
Q

What happens to the vocal ligaments when the arytenoids rock forwards?

A

When they rock forwards they relax the vocal ligaments.

62
Q

What happens to the vocal ligaments when the arytenoids rock backwards?

A

This increases tension in the vocal ligaments.

63
Q

What are the forward and backward movements at the arytenoids opposed by?

A

They are opposed by muscles that pull in the opposite direction.

64
Q

What are the intrinsic muscles of the larynx?

A

These are the muscles that move the laryngeal cartilages at the cricothyroid and cricoarytenoid joints.

65
Q

What do the extrinsic muscles of the larynx run between?

A

They run between the larynx and the neighbouring structures.

66
Q

What is the function of the extrinsic muscles of the larynx?

A

They move the larynx as a whole up and down the neck.

67
Q

How are the instrinsic muscles divided functionally?

A

They are functionally divided into 3 groups.

68
Q

What are the 3 groups of the instrinsic muscles of the larynx?

A
  1. muscles that move the epiglottis and close the laryngeal inlet
  2. muscles that are responsible for the abduction and adduction of the vocal cords.
  3. muscles that affect tension in the vocal cords.
69
Q

Where is the aryepiglottic muscle?

A

This muscle is in each aryepiglottic fold that extends from the apex of the arytenoid cartilage to the side of the epiglottis.

70
Q

What are the oblique arytenoid cartilages?

A

These cartilages can be traced onwards from the posterior end of each aryepiglottic muscle across the back of the larynx to the opposite arytenoid cartilage.

71
Q

What happens to the 2 oblique arytenoid muscles?

A

These 2 muscles cross each other behind the arytenoid cartilages.

72
Q

What do the aryepiglottic muscles and the oblique arytenoids form together?

A

They form the sphincter of the inlet of the larynx.

73
Q

What happens when there is contraction of the sphincter of the inlet of the larynx?

A

The aryepiglottic muscles can be brought together and the epiglottis is brought closer to the arytenoid cartilages.

74
Q

Where are the thyroepiglottic muscles from?

A

These muscle fibres sweep up from the inside of the thyroid cartilage into the epiglottis on each side.

75
Q

What is the function of the thyrepiglottic muscles?

A

Their action is to open the larynx.

76
Q

Are the thyroepiglottic muscles alone responsible for opening the inlet of the larynx?

A

No, other muscle fibres in the wall of the inlet assist with this.

77
Q

What can the strong sphincteric action at the inlet resist?

A

It can resist high intrathoracic pressures as when coughing or lifting heavy objects.

78
Q

What does adduction and abduction of the vocal folds do?

A

This increases and decreases the volume of air that passes through the larynx.

The instrinsic muscles are all likely active together durign abduction and adduction of the vocal folds.

79
Q

Independently of the action of the intrinsic musculature of the larynx, how are the vocal folds abducted?

A

Stretching the trachea during deep inspiration + activity in the sternothyroid muscle also brings about abduction of the vocal folds.

80
Q

What is the name of the pair of instrinsic muscles that is used for abducting the vocal cords?

A

The posterior-cricoarytenoids.

81
Q

Where do the posterior cricoarytenoids arise from?

A

They arise from the cricoid.

82
Q

Where do the posterior cricoarytenoids converge?

A

They converge onto a lateral angle of the arytenoid cartilage at a point called the muscular process.

83
Q

Describe the posterior cricoarytenoids.

A

These are large fan shaped muscles.

84
Q

How do the upper fibres of the posterior cricoarytenoid muscles act?

A

Many descriptions say that the upper fibres act by rotating the arytenoid cartilage so that the vocal process of the arytenoid cartilage turns laterally and this movement will abduct the vocal cord.

However, if the cricoarytenoid cartilage is really cylindrical then the rotation is not possible therefore it is not agreed that there can be rotation of the arytenoids around the vertical axis.

85
Q

How are the lateral fibres of the posterior cricoarytenoid cartilage orientated?

A

They are orientated so that they can pull the whole of the arytenoid cartilage laterally.

There will be a gliding movement at the cricoarytenoid cartilage.

This is how many people think that the vocal folds are abducted.

86
Q

What is the function of the cricothyroid muscle?

A

This tenses the vocal ligament.

87
Q

What muscle do the posterior cricothyroid muscle resist the pull off?

A

They resist the pull of cricothyroid muscle.

88
Q

What would happen to the arytenoid cartilage if the posterior cricothyroid muscles didnt resist the pull of the cricothyroid muscle?

A

The arytenoid cartilages would just fall forwards when there is strong contraction of the cricothyroid muscles.

89
Q

Where does the lateral cricothyroid muscle arise from?

A

It arises from the lateral side of the cricoid.

90
Q

What does the lateral cricothyroid muscle run towards?

A

It runs obliquely to the muscular process of the arytenoids.

91
Q

What happens when the lateral cricothyroid muscle acts with the posterior cricothyroid?

A

The lateral muscle is positioned appropriately so that it can act with the posterior cricothyroid muscle and abduct the vocal ligaments but it would never be able to abduct the vocal ligaments on their own.

92
Q

What other muscle, besides the oblique arytenoids, will bring together the arytenoids and the vocal ligaments?

A

The transverse arytenoid muscle.

93
Q

What is the path of the transverse arytenoid muscle?

A

It passes horizontally from one arytenoid to the other at the back of the larynx.

94
Q

What happens to the voice when we alter the tension of the vocal ligaments?

A

We alter the pitch.

95
Q

Which muscles control the tension of the vocal ligaments?

A
  • thyroarytenoid (complex muscle)
  • cricothyroid
96
Q

Where does the thyroarytenoid muscle arise from?

A

It arises from the interior midline angle of the thyroid cartilage

97
Q

Where is the insertion of the thyroarytenoid muscle?

A

This muscle sweeps backwards and is inserted into the anterolateral surface of the arytenoid cartilage.

98
Q

What is the name of the fibres of thyroarytenoid muscle fibres that ascend to the epiglottis?

A

These fibres are the thyroepiglottic muscle.

99
Q

What is the function of the thyroepiglottic muscle?

A

It can widen the laryngeal inlet.

100
Q

What is the thyroarytenoid cartilage for?

A

This part draws the arytenoid cartilages forwards and relaxes the vocal ligament.

Head and Neck Anatomy (36 decks)

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