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1. Anatomy - BLOCK 4 > Larynx > Flashcards

Larynx Flashcards

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1
Q

Larynx:

Hollow musculoligamentous structure with a cartilaginous framework

  1. continuous inferiorly w…?
  2. opens superiorly into …?
A
  1. Continuous inferiorly w **trachea **
  2. opens superiorly into pharynx
    * (postero-inferior to tongue + oral cavity)*
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2
Q

name the following in the larynx:

  • 3 unpaired cartilages
  • 3 paired cartilages
A

3 unpaired cartilages:

  • thyroid
  • cricoid
  • epiglottis

3 paired cartilages:

  • arytenoid
  • corniculate
  • cuneiform
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3
Q

what is the function of membranes and ligaments in relation to the larynx?

A

suspend larynx from hyoid above + trachea below

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4
Q

what is the function of extrinsic muscles in relation to the larynx?

A

move larynx

facilitate **closing laryngeal inlet **during swallowing

facilitate opening esophagus during swallowing

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5
Q

Thyroid Cartilage

what is the usual thyroid angle?

Is it larger in males or females?

A

90-129 degrees

usually smaller in males –>acute angle –> more pronounced bump

(“adam’s apple” laryngeal prominence - just inferior to superior thyroid notch)

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6
Q

Name 3 extrinsic mm. that attach to the oblique line on the lateral surface of the thyroid cartilage laminae?

A

sternothyroid

thyrohyoid

inferior constrictor

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7
Q

Cricoid Cartilage

(facts - 3)

A
  1. Inferiormost laryngeal cartilage
  2. Broad lamina posterior, and narrow arch anterior to airway
  3. Shallow depressions on posterior surface for posterior crico-arytenoid m. attachment
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8
Q

Epiglottis:

  • attached to thyroid angle by what ligament?
  • projects in which direction?
A

thyro-epiglottic ligament

Projects postero-superiorly; upper margin projects superiorly behind the pharyngeal part of tongue

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9
Q

Arytenoid Cartilage:

  1. Name the muscle and ligament that attach to the antero-lateral surface.
  2. where does the vocal ligament attach?
  3. Which 2 muscles attach to the muscular process (lateral angle of base)?
A

1. Vocalis m. and vestibular ligament

2. vocal process (anterior angle of base)

3. Posterior + lateral crico-arytenoid mm.

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10
Q

Corniculate and Cuneiform Cartilages:

  1. what dose the corniculate cartilage attach to?
  2. What does the cuneiform cartilage attach to?
A
  1. corniculate = apex of arytenoid cartilage
  2. cuneiform = Suspended in quadrangular membrane (anterior to corniculate)
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11
Q

Thyrohyoid Membrane

  1. what are the attachment points?
  2. what passes through the opening? (3)
  3. The thick posterior border is the ______________ ligament?
  4. The thick anterior midline is the _______________ligament?
A
  1. Superior edge of thyroid cartilage <—> Superior edge of hyoid
  2. internal laryngeal n. + superior laryngeal a. + lymphatics
  3. = lateral thyrohyoid ligament
  4. = median thyrohyoid ligament
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12
Q

What ligament goes from:

1. anterior surface of epiglottis <–> posterior surface of hyoid

2. Lower border of cricoid <–> Upper border of 1st tracheal ring

A
  1. Hyo-epiglottic ligament
  2. Crico-tracheal ligament
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13
Q

Quadrangular Membrane:

  1. what are the points of attachment?
  2. Free lower margin is _________ ligament
  3. Free upper margin is ____________ fold
  4. What overlies the vestibular ligament?
  5. What separates the vestibular ligament/fold from the vocal ligament/fold?
A
  1. Epiglottis (lateral margin) <–> Arytenoid cartilage (A-L surface)
  2. vestibular ligament (Arytenoid cartilage <–> Thyroid cartilage)
  3. Aryepiglottic fold
  4. Vestibular fold (false vocal cords)
  5. Ventricle
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14
Q
  • *Cricothyroid Membrane:**
    1. Where is it located/attached?
    2. what is the lateral part called?
  1. Upper free margin of conus elasticus forms _____ ligament?
  2. what ligamant is b/t the thyroid cartilage (angle) <–> Arytenoid cartilage (vocal process)
  3. What covers the vocal ligament and vocalis m?
A
  1. Between arch of cricoid cartilage + space enclosed by thyroid cartilage
  2. Conus elasticus
  3. vocal ligament
  4. Vocal ligament
  5. Vocal fold (= true vocal cord)
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15
Q
  1. Vestibular ligament is ________ to vocal ligament (superior view)?
  2. They are sepatated by __________?
A
  1. lateral
  2. ventricle
    * *NOTE: true and false FOLDS are mucouse membranes covering their respective LIGAMENTS)*
    * true = vocal*
    * false = vestibular*
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16
Q
  1. What synovial joint is b/t inferior horn of thyroid cartilage + cricoid cartilage?
  2. What actions does it allow?
A
  1. Crico-thyroid Joint
  2. forward movement + downward rotation of thyroid cartilage on cricoid cartilage
    * (increases length + tension of vocal ligaments)*
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17
Q
  1. What synovial joint is b/t cricoid cartilage (supero-lateral surface) + arytenoid cartilage (base)?
  2. What actions does it allow?
A

1. Crico-arytenoid Joint

  1. arytenoid cartilages slide away or towards each other, and to rotate
    * (Abduction/adduction of vocal ligaments)*
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18
Q

which joint increases length + tension of vocal ligaments?

A

crico-thyroid joint

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19
Q

Which joint sbducts/adducts of vocal ligaments?

A

Crico-arytenoid Joint

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20
Q
  1. What is the superior aperture of the laryngeal cavity?
  2. What are it’s borders?

(anterior, posterior, lateral)

A

1. laryngeal inlet

2. inlet borders:

anterior = superior epiglottic mucosa

posterior = interarytenoid notch b/t corniculate tubercles

lateral = aryepiglottic fold + cuniform + corniculate cartilages/tubercles

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21
Q

The inferior aperture of the laryngeal cavity is continuous with the___________ + encircled by _________?

A

trachea

cricoid cartilage

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22
Q

Name + locate the 3 major divisions of the laryngeal cavity:

A

1. Vestibule: between laryngeal inlet + vestibular fold

2. Ventricle: between vestibular folds (superior) + vocal folds (inferior)

3. Infraglottic space: between vocal folds + inferior aperture of larynx

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23
Q

THIS STRUCTURE IS….

- not part of the laryngeal cavity

- b/t aryepiglottic fold (medial) + thyroid cartilage + thyrohyoid membrane (lateral)

  • a channel to direct solids/liquids from oral cavity into esophagus
A

PIRIFORM RECESS

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24
Q

Laryngopharynx

  1. Where is it located?
  2. what opens into it’s anterior wall?
Study These Flashcards
A
  1. from superior edge of epiglottis <–> top of esophagus
  2. Opening of laryngeal inlet
25
Inferior to the laryngeal inlet, the anterior wall of the laryngopharynx is also....?
≈ posterior wall of larynx
26
The reflection of muscous membrane b/t anterior surface of epiglottis + root of tongue forms 3 longitudinal ridges (b/t base of tongue + epiglottis) called…?
- median glosso-epiglottic fold - lateral glosso-epiglottic folds (2)
27
**Epiglottic valleculae:** What are they? Where are they? What do they do?
● depressions on either side of medial fold (b/t root of tongue + epiglottis) ● posteriorly related to cavity of laryngopharynx ● temporary reservoir of saliva to prevent initiation of swallowing reflex
28
What is the **laryngeal ventricle?** What are the **laryngeal saccule?**
**Laryngeal ventricle:** space between vestibular and vocal folds **Laryngeal saccule:** antero-superior extension of ventricle between vestibular fold and thyroid cartilage *Ÿ (Mucous glands cover wall of saccule)*
29
1. What is the space between adjacent vocal folds; functionally similar to “glottis”? 2. It can be opened/closed by movement of what structures? (2)
1. Rima glottidis 2. arytenoid cartilages + associated fibro-elastic membranes
30
Intrinsic Laryngeal Muscles: **Posterior crico-arytenoid** - attachement/location? - action(s)?
**LOCATION:** cricoid cartilage (posterior surface) ↔ arytenoid cartilage (muscular process) **ACTIONS:** - lateral (external) rotation of arytenoid cartilage - abduction of vocal fold/ligament - opening of rima glottidis \**ONLY PURE ABDUCTOR IN LARYNX\**
31
Intrinsic Laryngeal Muscles: **Arytenoideus** - attachement/location? - action(s)?
**LOCATION:** arytenoid cartilage ↔ contralateral arytenoid cartilage **ACTIONS:** - adduction of arytenoid cartilages (transverse fibers) - narrowing laryngeal inlet by bringing arytenoid cartilages and epiglottis closer (oblique) - closure of posterior rima glottidis * \*ONLY PURE ADDUCTOR IN LARYNX\**
32
Intrinsic Laryngeal Muscles: **Thyro-arytenoid** - attachement/location? - action(s)?
**LOCATION:** Thyroid angle + crico-thyroid ligament ↔ arytenoid cartilage (antero-lateral surface) **ACTIONS:** **-** sphincter of vestibule + laryngeal inlet - shortening (relaxation) of vocal fold/ligament
33
Intrinsic Laryngeal Muscles: **Vocalis** - attachement/location? - action(s)?
**LOCATION:** arytenoid cartilage (vocal process) ↔ ipsilateral vocal ligament **ACTIONS:** **-** adjustment of tension in vocal fold/ligament: * ▪ relaxation of posterior part of vocal ligament* * ▪ maintaining/increasing tension of anterior part of vocal ligament*
34
Intrinsic Laryngeal Muscles: **Lateral crico-aryteniod** - attachement/location? - action(s)?
**LOCATION:** arch of cricoid cartilage ↔ arytenoid cartilage (muscular process) **ACTIONS:** **-** lateral sliding of arytenoid cartilage on cricoid cartilage (abduction capability) - internal rotation of arytenoid cartilage (by upper fibers of lateral crico-arytenoid m.) - active during both abduction and adduction of vocal fold/ligament [synergist to posterior crico-arytenoid + (thyro-arytenoid + arytenoideus) mm.]
35
Intrinsic Laryngeal Muscles: **Cricothyroid** - attachement/location? - action(s)?
**LOCATION:** arch of cricoid cartilage (antero-lateral surface) ↔ thyroid cartilage (posterior surface) **ACTIONS:** **-** forward and downward rotation of thyroid cartilage - increases tension of the vocal fold/ligament
36
Name 4 functions of the Larynx:
1. **Sphincter** for lower respiratory tract 2. Mechanism for sound production **(phonation)** 3. Changes in **size of laryngeal cavity** depend on dimensions of rima glottidis, vestibule, and laryngeal inlet 4. Muscle actions and **laryngeal mechanics determine functions**
37
What does normal respiration look like? ## Footnote *(in terms of rima glottidis, laryngeal inlet, laryengeal mm., etc.)*
- laryngeal inlet, vestibule, and rima glottidis **are open** - laryngeal muscles are **relaxed** **- narrow slit-shaped** rima glottidis
38
What does forced respiration look like? ## Footnote *(in terms of rima glottidis, laryengeal mm., vocal folds, etc.)*
· posterior crico-arytenoid m. **active** (assistance from lateral crico-arytenoid) → lateral rotation of arytenoid cartilages · **abduction of vocal folds** · **wide** rima glottidis → **increased diameter** of laryngeal airway
39
What does PHONATION look like? ## Footnote *(in terms of rima glottidis, vocal folds, cartilages, laryengeal mm., etc.)*
- **adducted** arytenoid cartilages and vocal folds → **closure** of rima glottidis (active muscles: arytenoideus and lateral crico-arytenoid) - **stridulation of vocal folds** against each other → sound production - **adjustment of vocal fold tension** by thyro-arytenoid, vocalis and cricothyroid mm.
40
What does a WHISPER look like? ## Footnote *(in terms of rima glottidis, vocal folds, cartilages, laryengeal mm., etc.)*
- **adduction of vocal folds** by lateral crico-arytenoid m. - **relaxation** of arytenoideus allows air passage between arytenoid cartilages - modification of air into **toneless speech** by upper parts of airway and oral cavity
41
What does an EFFORT CLOSE look like? ## Footnote *(in terms of rima glottidis, laryengeal mm., etc.)* **when would this occur/be needed?**
- **complete closure** of rima glottidis + lower parts of vestibule → **complete closure** of airway **- related to retention of air in thorax for…** --\> trunk stabilization (e.g., during heavy lifting) --\> increasing intra-abdominal pressure
42
What does the functional precess of SWALLOWING look like?
- **closure** of rima glottidis and vestibule - supero-anterior movement of larynx → **downward movement of epiglottis** (toward arytenoid cartilages) → **narrowing/closure of laryngeal inlet** - supero-anterior movement of larynx → **opening of esophagus** - prevention of food/liquid from entry into airway - movement of **food/liquid through piriform fossa** into esophagus
43
What is the main function of laryngeal INTRINSIC MUSCLES?
opening/closure of rima glottidis
44
What is the main function of laryngeal EXTRINSIC MUSCLES? ## Footnote *(infrahyoid mm. + suprahyoid mm. + stylopharyngeus)*
movement of the entire larynx in the neck
45
Which intrinsic mm. is responsible for **ABduction** of vocal fold?
**Posterior crico-arytenoid **
46
Which intrinsic mm. is responsible for **ADduction** of vocal fold?
**Lateral crico-arytenoid + Arytenoideus **
47
Which intrinsic mm. is responsible for **Adjustment of vocal fold tension** ?
**Thyro-arytenoid + Vocalis + Cricothyroid **
48
SOMATIC MOTOR innervation of the larynx comes from what nerve(s)?
**External laryngeal n.** **Recurrent laryngeal n** (vagus n. --\> superior laryngeal n. --\> internal/external laryngeal nn.)
49
SOMATIC SENSORY innervation of the larynx comes from what nerve(s)?
**Internal laryngeal n.** (through thyrohyoid membrane) → *_Supraglottic larynx_* (= laryngeal cavity down to the level of vocal folds) **Recurrent laryngeal n.** → *_Infraglottic larynx_* (= laryngeal cavity below vocal folds)
50
PARASYMPATHETIC (vasodilation) innervation of the larynx comes from what nerve(s)?
**Internal laryngeal n.** → Supraglottic larynx **Recurrent laryngeal n.** → Infraglottic larynx
51
How do the paths of the **Left & Right Recurrent Laryngeal NN.** differ from each other?
- Left side = loops around **aortic arch** - Right side: loops around **Right subclavian a.** ## Footnote *\*NOTE: Recurrent laryngeal nerve becomes I**nferior laryngeal nerve** once it pierces the _inferior pharyngeal constrictor m._\**
52
Which INTRINSIC laryngeal mm. are innervated by the **Recurrent Laryngeal N.?**
Posterior crico-arytenoid Arytenoideus (transverse + oblique fibers) Thyro-arytenoid Vocalis Lateral crico-arytenoid
53
Which INTRINSIC laryngeal mm. are innervated by the **External Laryngeal N.**?
Cricothyroid
54
What are 2 main blood supplies to the larynx?
**Superior laryngeal a.** ***(Common carotid** a. → External carotid a. → Superior thyroid a. → **Superior laryngeal a.** → (through thyrohyoid membrane along with internal laryngeal n.) **Larynx)*** * *Inferior laryngeal a.** * **(Subclavian a**. → Thyrocervical trunk → Inferior thyroid a. → Inferior laryngeal a. → (ascends in tracheo-esophageal groove along with recurrent/inferior laryngeal n.) **Larynx)***
55
Where do the **superior + inferior laryngeal vv.** drain to? *(hint: not the same place)*
Superior laryngeal v. → Superior thyroid v. → **Internal jugular v.** Inferior laryngeal v. → Inferior thyroid v. → **L. brachiocephalic v.**
56
Trace the lymph drainage paths from the **supraglottic + infraglottic larynx**:
**supraglottic larynx** follows superior laryngeal a. +drains into *deep cervical nodes* at the bifurcation of common carotid artery (C3-C4 intervertebral disc). ** infraglottic larynx** drains into *deep cervical nodes* (typically associated with inferior thyroid a.)
57
**Trachea** 1. location? 2. strucutre? 3. surrounding structures?
1. larynx to thorax; **C6 to sternal angle** (at T4-T5 intervertebral disc) 2. incomplete tracheal **C-shaped cartilages; Trachealis m**. = posterior aspect 3. Posterior surface adj. to esophagus; **CCA + thyroid lobes** are lateral
58
Identify the yellow arrow structures:
59
Identify the yellow arrow structures:

1. Anatomy - BLOCK 4 (6 decks)

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