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Ent - Larynx > Clinical Anatomy Larynx : Part - 1 > Flashcards

Clinical Anatomy Larynx : Part - 1 Flashcards

1
Q

What are the cartilages of larynx ?

A

Three paired and three unpaired cartilages - totally nine in number

Paired cartilages : seen in posterior view
Arytenoid / pyramidal cartilage
Corniculate / santorini cartilage
Cuneiform / wrisberg

Unpaired cartilages: seen in anterior view
Epiglottis
Thyroid
Cricoid

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2
Q

What is cartilage of wrisberg ?

A

Cuneiform cartilage

NERVE OF WRISBERG IS sensory part of facial nerve

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3
Q

What is the cartilage of santorini?

A

Corniculate

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4
Q

What are the principle cartilages of larynx?

A

Thyroid
Cricoid
Two - arytenoids

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5
Q

What is the oblique line of thyroid ?

A

On the external aspect of thyroid cartilage , there’s a line extending from the inferior aspect of superior Cornu to the lower border of thyroid cartilage called the OBLIQUE LINE

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6
Q

What are the muscles attached to the oblique line of thyroid cartilage ?

A

Sternothyroid
Thyrohyoid
Thyropharyngeus (part of inferior constrictor muscle )

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7
Q

Thyroid angle in males and females ?

A

Males : 90 degrees - prominence is adams apple
Females :120 degrees

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8
Q

Posterior aspect of thyroid cartilage gives attachment to what structures ?

A

In the median plane on the posterior aspect of thyroid cartilage , the attachment from above downwards is as follows

Thyroepiglottic ligament

A pair of Vestibular ligaments

A pair of Vocal ligaments

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9
Q

Muscles attached to the posterior border of thyroid cartilage ?

A

Longitudinal muscles / dilators of pharynx

Stylopharyngeus
Salphingopharyngeus
Palatopharyngeus

These muscles are inserted as conjoint tendon into the posterior border of thyroid cartilage

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10
Q

Attachment of Epiglottis to hyoid is by?

A

Hyoepiglottic ligament

This ligament divides the Epiglottis into a SUPRAHYOID PART AND INFRAHYOID PART

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11
Q

What is the only complete ring cartilage of larynx ?

A

Cricoid cartilage also known as signet ring cartilage

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12
Q

What is the foundation stone of larynx ?

A

Cricoid cartilage

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13
Q

Level at which cricoid cartilage is situated ?

A

C6 vertebrae

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14
Q

Cricoid cartilage structure?

A

Anteriorly - arch
Posteriorly - lamina

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15
Q

Injury to cricoid causes what ?

A

Leads to healing by fibrosis

Since it’s a complete cartilage it causes laryngeal stenosis as a result of fibrosis

This is the reason for giving incision at 2/3/4 tracheal ring for tracheostomy

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16
Q

Synechiae formation is reduced by which drug ?

A

Mitomycin c

Used in

Laryngeal stenosis repair surgery (since healing again occurs by fibrosis)

Nasal packs following FESS

Choanal atresia

17
Q

What type of joint is cricoarytenoid joint ?

A

Saddle joint

18
Q

What are the two processes of arytenoid ?

A

Muscular process (posterior)- attached to the muscles
Vocal process (anterior)-attached to vocal cords

19
Q

What are intrinsic and extrinsic membrane ?

A

Intrinsic membrane are those that attaches laryngeal structures to one another

Extrinsic membrane are those that attaches laryngeal structures to outside

20
Q

What are the extrinsic membranes?

A

Thyrohyoid
Criocotracheal
Hyoepiglottic

21
Q

What structures pierce the Thyrohyoid membrane ?

A

Internal laryngeal nerve (a branch of Superior laryngeal nerve) and superior laryngeal vessels that supplies the upper part of larynx

Branches of superior laryngeal nerve - internal and external laryngeal nerve

22
Q

In order to take biopsy from upper part of larynx , where should local anaesthesia be given?

A

In between hyoid and thyroid to paralyse the internal laryngeal nerve that supplies the upper part of larynx by piercing the Thyrohyoid membrane

23
Q

What are the intrinsic membranes of larynx?

A

Quadrangular membrane
Cricovocal / conus elasticus

24
Q

Upper border of quadrangular membrane is what?

A

Aryepiglottic fold

25
Q

Lower border of quadrangular membrane is what ?

A

False vocal cords / vestibular ligaments

26
Q

What are the boundaries of laryngeal inlet / epilarynx ?

A

Anterior- epiglottis
Posterior - interarytenoid fold
Lateral - aryepigloettic ligament / fold

27
Q

What happens in laryngomalacia / acute Epiglottitis ?

A

The epiglottis becomes bulky falls down when the patient lies supine closes the inlet of larynx and causes respiratory distress

If the patient lies prone then the distress is relieved

28
Q

Attachments of cricovocal membrane ?

A

Below - cricoid
Above anteriorly to - thyroid
Above posteriorly to - vocal process of arytenoid

29
Q

Upper part of cricovocal membrane forms what ?

A

True vocal cords

30
Q

What is glottis ?

A

Larynx at the level of true vocal cord is glottis

Above glottis - supra glottis

Below glottis - subglottis

31
Q

Gap between vocal cords

A

Gap between

False vocal cords - Rima vestibuli

True vocal cords - Rima glottitis

Between the pair of true and false vocal cords - ventricle

32
Q

Gap between two quadrangular membrane

A

Vestibule

33
Q

What is cricothyroid membrane ?

A

It is the anterior thickening of the cricovocal membrane and is a part of intrinsic membrane

This membrane allows cricothyrotomy/coniotomy/inferior laryngotomy during can’t intubate can’t oxygenate situation - this is usually done when emergency tracheostomy can’t be done when obstruction is above the level of vocal cords

34
Q

What are the intrinsic muscles of larynx?

A

Thyroepiglottis - opening of inlet
Thyroarytenoid
Cricothyroid
Cricoarytenoid (lateral and posterior)
Inter arytenoid
Oblique arytenoid / aryepiglottis -closing of inlet

35
Q

What are the two parts of thyroarytenoid muscle ?

A

Lateral - thyroarytenoid
Medial - vocalis = contraction of vocalis muscle reduces tension on the vocal cords

36
Q

Muscles that attach to the true vocal cords

A

Adductors - all muscles except posterior cricoarytenoid (safety muscle if larynx )
Abductors - posterior cricoarytenoid

Decreases tension over vocal cords - vocalis
Increases tension over the vocal cords - cricothyroid

37
Q

Only muscle with dual nerve supply

A

Interarytenoid

Ent - Larynx (7 decks)

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