Laryngeal Structures and Muscles W3 Flashcards

1
Q

what is the larynx?

A

approx 5cm in length etending from the 3-4th to 6th cervical vertebra primary biological functions include guard do to the airway during swallowing allows pressure build up for physical exertion - hold breath modifies upper airway resistance secondary function - phonation for speech

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2
Q

what are the laryngeal cartilages?

A

major unpaired cartilages: thyroid, cricoid, epiglottis

smaller paired cartilages: arytenoid, corniculate, cuneiform

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3
Q

what is the epiglottis?

A

flexible elastic leaf like cartilage

flips during swallowing to assist airway protection

attached just below thyroid notch via thuroepiglottic ligament

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4
Q

what is thyroid cartilage?

A

largest and most superior laryngeal cartilage

thyroid lamina

thyroid notch

laryngeal prominence - adams apple

superior horns

inferior horns

oblique line

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5
Q

what is cricoid cartilage?

A

sits just below the thyroid cartilage, and just above the superior tracheal cartilage

shaped like a signet ring - anterior aspect is lower than posterior

posterior superior portion articulates with the srytenoid cartilages

lateral edge articulates with the inferior horns of the thyroid cartilage

cricoid arch, laminae, cricothyroid joint - articular facets for inferior thyroid cornu, median vertical ridge

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6
Q

what is arytenoid cartilages?

A

small cone shpaed cartilages paired

sit on top of cricoid cartilage

three processes - apex, muscular and vocal processes (vocal folds)

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7
Q

what are the cricothyroid and cricoarytenoid joints?

A

only functionally mobile points of the laryn

crucial for speech production

cricothyroid - changes in vocal pitch

cricoarytenoid - adduction and abduction of vocal folds (vocal fold vibration) required for phonation

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8
Q

what is the cricothyroid joint?

A

allows thyroid to rock downwards given shape of cricoid

allows thyroid to glide forward and back slightly

when these two structures approximate in the front the thyroid and arytenoids move further apart tensing the vocal folds - provides major adjustment for change in pitch

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9
Q

what are the cricoarytenoid joints?

A

allows rocking and gliding and some rotation of the arytenoids on the cricoid cartilage

rocking = approximation of vocal fgolds

gliding = changes in vocal fold lenth

rotation = extremes of abduction

provides the adduction and abduction required for phonation or voice

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10
Q

what is vocal fold abduction and adduction

A

adduction = vocal processes rotated medially and inferiorly

abduction = vocal processes rotated superiorly and laterally

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11
Q

what are the corniculate cartilages?

A

conical shaped cartilages that sit on the apex of the arytenoid cartilages

continuation of the arytenoid cartilages i.e. forms an apex on the apex

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12
Q

what is cuneiform cartilages?

A

situated in the aryepiglottic folds

cant be directly visualised

seen by presence of cuneiform tubercles

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13
Q

what is the hyoid bone?

A

horseshoe shaped

situated at the level of c3 - important structure for swallowing

body

greater horns

lesser horns

does not articulate with any other bone - held in position by a muscular sling

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14
Q

what is the difference between intrinsic and extrinsic laryngeal muscles?

A

intrinsic have both their origin and insertion on laryngeal cartilages, fine adjustmaents to the vocal mechanism, important in speech

extrinsic have one attachment on a laryngeal cartilage and one attachment outside the larynx, position the larynx i.e. elevation or depression, important in swallowing

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15
Q

what are the intrinsic laryngeal muscles?

A

adductors - lateral cricoarytenoid, interarytenoid muscle (transverse arytenoid amd oblique arytenoid)

abductor - posterior cricoarytenoid

glottal tensors - cricothyroid, thyroarytenoid vocalis

glottal relaxor - thyroarytenoid muscularis

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16
Q

what is lateral cricoarytenoid?

A

intrinsic laryngeal adductor

origin: cricoid arch
insert: muscular process of the arytenoids

contraction pulls the muscular process and rotates the vocal processes towards the medial line adducting vocal folds

innervated by the RLN of the vagus cn x

17
Q

what is transverse arytenoid?

intrinsic laryngeal adductor

A

intrinsic laryngeal adductor

deeper portion of the intersrytenoid muscle

origin: lateral margins of arytenoid
insertion: lateral margin of other arytenoid

pulls the two arytenoids together

innervated by the RLN of the vagus cn x

18
Q

what is the oblique arytenoid?

A

intrinsic laryngeal adductor

origin: muscular process of the arytenoids
insertion: apex of the opposite arytenoid

pulls vocal processes together to approximate the vocal folds

19
Q

what is the posterior cricoarytenoid?

A

intrinsic laryngeal abductor

origin: lamina of the cricoid cartilage
insertio: muscular process of the arytenoid cartilage

pulls vocal processes away from one another, thereby abduction the vocal folds

20
Q

what is the cricothyroid?

A

glottal tensor

origin: external aspect of cricoid arch
insert: inferior border of thyroid lamina and inferior cornu

approximates the anterior edges of the cricoid and thyroid. thereby tightening the vocal folds

innervated by the SLN of the vagus nerve cn x

21
Q

what is the thryoarytenoid muscles?

A

vocal folds two separate muscles

thyrovocalis muscle - medial portion of folds

thyromuscularis muscle - lateral portion of folds

both innervated by RLN of CN x vagus

22
Q

what is the thryovocalis muscle?

A

origin: inside surface of the angle of the thyroid cartilage
insetion: vocal process of the arytenoid

draws anterior aspect of the thyroid and cricoid farther apart

antagonist of the cricothyroid

works as glottal tensor in conjustion with cricothyroid

23
Q

what is the thyromuscularis muscle?

A

origin: inside surface of the angle of the thyroid cartiage
insertion: muscular process of the syrtenoid

clearly differential effects of contractinf with a connection on the muscular process vs the vocal process

  • similar effects as the cricoarytenoid i.e. adduct and lengthen folds
  • may also relax vocal folds due to contraction pulling arytenoids and thyroid together
24
Q

what is the vocal fold structure?

A

multiplelayers important for vocal fold vibration

cover - epithelium and superficial layer of mucose

transition - deep layers of mucose

body - thyroarytenoid muscle

membranous portion anterior, cartilagenous portion posterior

25
what are the extrinsic laryngeal muscles?
depressors: thyrohyoid, sternohyoid, omohyoid, stenothyroid elevators: digstric, mylohyoid, geniohyoid, stylohyoid, hyoglossus
26
what is the thyrohyoid?
origin: thyroid cartilage insert: hyoid bone body 2 functions - depresses hyoid if thyroid fixed, elevated thyroid if hyoid is fixed important for laryngeal elevation during swallowing innervated by ansa cervicalis
27
what is sternohyoid?
origin: manubrium of the sternum and sternal end of the clavicle insertion: hyoid bone body depresses the hyoid bone innervated by ansa cervicalis
28
what is omohyoid?
2 bellies joined by intermediate tendon superior: origin hyoid bone, insert intermediate tendon inferior: origin scapula, inster intermediate tendon depresses the gyoid bone innervated by ansa cervicalis
29
what is sternothyroid?
origin: manubrium of the sternim insert: thyroid lamina depresses the larynx innervated by ansa cervicalis
30
what is digastric?
2 bellies ant and post connected by intermediate tendon joined to the hyoid bone
31
anterior belly of disatric
anterior - origin mandible, insert intermediate tendon connectedto hyoid bone opens jaw when hyoid is fixed by infrahyoids raises hyoid up and forward when mandible fixed innervated by trigeminal nerve cn v
32
posterior belly of digastric
origin mastoid notch insert intermediate tendon connected to the hyoid bone elevated and retracts hyoid bone when mandible stabilised innervated by facial nerve cn vii
33
what is stylohyoid
origin: styloid process of the temporal bone insert: hyoid bone body runs a similar course to the posterior belly of the digastric elevated and retracts the hyoid bone innervated by the facial cn vii
34
identify laryngeal cavities
35
identofy laryngeal regions
supraglottic - above glottic subglottic - below