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Semester 4 > Head And Neck Session 11 > Flashcards

Head And Neck Session 11 Flashcards

1
Q

What are the cartilaginous components of the larynx?

A

3 singular: thyroid, cricoid and epiglottic

3 paired: arytenoid, corniculate and cuneiform

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2
Q

Which vertebral levels is the larynx located at?

A

C3-6

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3
Q

Which bone is part of the larynx?

A

Hyoid

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4
Q

What are the functions of the larynx?

A

Respiration, phonation, protection of trachea and bronchial tree during swallowing, cough reflex

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5
Q

What covers the anterior aspect of the larynx?

A

Infrahyoid muscles

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6
Q

What is found lateral to the larynx?

A

Loves of thyroid and major BV of neck

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7
Q

What lines the larynx?

A

Ciliated columnar epithelium

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8
Q

Where is the supraglottis?

A

Inferior surface of epiglottis to vestibular folds

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9
Q

What is the alternative name for the vestibular folds?

A

False vocal cords

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10
Q

Where is the vallecula?

A

Between tongue base and epiglottis

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11
Q

Where is the glottis?

A

From the vocal cords to 1cm inferiorly

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12
Q

What is between the supraglottis and glottis?

A

Transglottic space

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13
Q

What is the subglottis?

A

1cm inferior to the vocal cords to border of cricoid cartilage

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14
Q

What does the superior margin of the quadrangular membrane form?

A

Aryepiglottic fold

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15
Q

What are the layers of the vocal cord?

A

Stratified squamous epithelium, Reinke’s space, vocal ligament, vocalis muscle

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16
Q

What are the components of the vestibular fold that runs from the thyroid to the arytenoid?

A

Ventricular ligament and loose mucosa

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17
Q

What is the function of Reinke’s space?

A

Allow free vibration of the epithelium

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18
Q

What does Reinke’s space contain?

A

Watery, amorphous substance

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19
Q

What forms the sub-mucosal fibroelastic membrane of the larynx?

A

Quadrangular membrane and conus elasticus

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20
Q

What forms Adam’s apple?

A

Laryngeal prominence of thyroid cartilage

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21
Q

What attaches to the lateral thyroid ligaments?

A

Thyrohyoid membrane

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22
Q

What does the superior horn of the thyroid cartilage articulate with?

A

Hyoid bone

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23
Q

Which nerves pierce the thyrohyoid membrane?

A

Superior and internal laryngeal nerves

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24
Q

What does the inferior horn of the thyroid cartilage articulate with?

A

Cricoid cartilage

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25
Q

What does the rotation and gliding movement of the cricoid at the inferior horn of the thyroid cartilage allow?

A

Change in vocal fold length

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26
Q

What is the cricoarytenoid joint?

A

Base of arytenoid and superolateral cricoid

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27
Q

What movements does the cricoarytenoid joint facilitate?

A

Slide, tilt and rotate

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28
Q

What action does the cricoarytenoid joint have on the vocal folds?

A

Approximate, tense and relax

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29
Q

What shape is the cricoid cartilage?

A

Signet ring

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30
Q

Which ligaments attach to the cricoid cartilage?

A

Median cricothyroid and cricotracheal

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31
Q

What are the two facets on the cricoid cartilage for?

A

Articulation with arytenoid cartilage and inferior horn of thyroid cartilage

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32
Q

Which muscles attach to the muscular process of the arytenoid cartilage?

A

Posterior and lateral cricoarytenoid muscle

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33
Q

What is the articular facet of the arytenoid cartilage for?

A

Corniculate cartilage

34
Q

What does the apex of the arytenoid cartilage bear?

A

Corniculate cartilage

35
Q

What does the vocal process of the arytenoid cartilage attach to?

A

Vocal ligament

36
Q

Which two cartilages are found in the aryepiglottic fold?

A

Corniculate and cuneiform

37
Q

Which cartilage found in the larynx does not attach to any other cartilages?

A

Cuneiform

38
Q

What provides arterial supply to the larynx?

A

Superior and inferior laryngeal arteries

39
Q

What arteries do those supplying the larynx branch from?

A

Superior and inferior thyroid

40
Q

Which nerve follows the superior laryngeal artery?

A

Superior laryngeal nerve

41
Q

Which nerve follows the inferior laryngeal artery?

A

Internal laryngeal nerve

42
Q

Where does the superior laryngeal vein drain?

A

Into superior thyroid to IJV

43
Q

Where does the inferior laryngeal vein drain?

A

Inferior thyroid or into venous plexus on trachea to L brachiocephalic vein

44
Q

Describe the lymphatic drainage of the larynx.

A

Superior to vocal folds: with superior laryngeal artery to superior deep cervical nodes.
Inferior to vocal folds: pretracheal and paratracheal nodes to inferior deep cervical nodes

45
Q

Which are the extrinsic muscles of the larynx?

A

Suprahyoids, infrahyoids and stylopharyngeus

46
Q

Which are the intrinsic muscles of the larynx?

A

Cricothyroid, thyroarytenoid, posterior cricoarytenoid, lateral cricoarytenoid, transverse and oblique cricoarytenoids

47
Q

What is the action of cricothyroid?

A

Stretch and tense vocal cords

48
Q

What is the action of thyroarytenoid?

A

Relax vocal cords

49
Q

What is the function of posterior cricoarytenoid?

A

Abduct vocal folds

50
Q

What is the action of lateral cricoarytenoid?

A

Addict vocal folds

51
Q

What is the common function of transverse and oblique cricoarytenoids?

A

Adduct arytenoid cartilages

52
Q

Describe the innervation of the intrinsic laryngeal muscles.

A

All internal laryngeal nerve except cricothyroid that is external laryngeal nerve

53
Q

Which structure of the neck does the superior laryngeal nerve travel in?

A

Carotid sheath

54
Q

What innervation does the internal laryngeal nerve supply?

A

Sensory and autonomic to supraglottis

55
Q

What are the two branches of the superior laryngeal nerve?

A

Internal and external

56
Q

What innervation does the external laryngeal nerve give?

A

Motor to inferior pharyngeal constrictor and cricothyroid

57
Q

Which branch of the recurrent laryngeal nerve supplies the larynx?

A

Inferior laryngeal nerve

58
Q

What do the anterior and posterior branches of the inferior pharyngeal nerve give innervation to?

A

Motor to intrinsic muscles and sensory to infraglottic cavity

59
Q

Which membrane of the larynx is incised in the midline to secure the airway?

A

Cricothyroid

60
Q

Why is left recurrent laryngeal nerve palsy more common?

A

Has a longer course

61
Q

What are some causes of recurrent laryngeal nerve palsy?

A

Idiopathic, thyroid surgery, thyroid carcinoma, oesophageal carcinoma, penetrating wounds, bronchial carcinoma, mediastinal lymph node malignancy, aortic aneurysm

62
Q

What is Semon’s law?

A

Incomplete paralysis affects adductors first therefore affected cords remain abducted

63
Q

What are the S/S of recurrent laryngeal nerve palsy?

A

Hoarseness/change in quality of voice, bovine cough

64
Q

What is the treatment for recurrent laryngeal nerve palsy?

A

Teflon injections and voice therapy

65
Q

What type of tumour are virtually all laryngeal carcinomas?

A

SCCs

66
Q

Which area of the larynx is predominantly affected by carcinoma?

A

Glottis

67
Q

What is the male and female distribution of laryngeal carcinoma?

A

Four times more common in men

68
Q

What age range is most commonly affected by laryngeal carcinoma?

A

3/4 of pts >60 y.o.

69
Q

What are the risk factors for laryngeal carcinoma?

A

Smoking, occupational exposures, HPV16

70
Q

What are the S/S of laryngeal carcinoma?

A

Chronic hoarseness, pain, dysphagia, neck lump, persistent cough, earache, weight loss, loss of laryngeal crepitus

71
Q

How is laryngeal carcinoma investigated?

A

CXR, flexible laryngoscopy, fine-needle aspiration, CT, MRI

72
Q

What treatment is available for laryngeal carcinoma?

A

Radiotherapy +/- chemotherapy, laryngectomy, palliation

73
Q

How does the prognosis of laryngeal carcinoma vary depending on its location?

A

Glottis has good prognosis whereas subglottis is poor

74
Q

Why does the carcinoma in the glottis have a good prognosis?

A

Presents early with hoarseness

75
Q

What are the different procedures used in thyroid surgery?

A

Thyroid lobectomy, sub-total thyroidectomy, total thyroidectomy

76
Q

Describe sub-total thyroidectomy.

A

Leave enough gland to retain hormone function to avoid lifelong medication

77
Q

When is total thyroidectomy preferred?

A

Malignancy

78
Q

What complications are associated with thyroid surgery?

A

Bleeding –> tracheal compression, RLN –> partial airway obstruction, hypoparathyroidism, thyrotoxicosis storm, SLN

79
Q

Why is superior laryngeal nerve injury generally only noticed by professional singers?

A

Causes an inability to create high-pitched sound

80
Q

What are the S/S of thyrotoxic storm?

A

Hyperexia, HR>140 bpm, nausea, jaundice, vomiting, confusion, delirium, seizures

Semester 4 (33 decks)

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