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Anatomy MD3001 > Larynx > Flashcards

Larynx Flashcards

(97 cards)

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1
Q

What is the larynx between?

A
  • Oropharynx
  • Trachea
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2
Q

What are the functions of the larynx?

A
  • Transport of air
  • Protective sphincter - closes the trachea e.g. if foreign object
  • Phonation - production of sound (with other parts of the body- resonating chambers, tongue, mouth)
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3
Q

What vertebral level is the larynx?

A
  • approx C3-C6
  • Mobile so this can change
  • Slightly higher in infants
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4
Q

Why is the fact that the larynx is higher in infants significant?

A
  • Tip of the epiglottis is in contact with the soft palate
  • Baby can breast feed and breathe at the same time
  • This means they are mandatory nose breathers which means it is uncomfortable if the nose is blocked
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5
Q

What are the laryngeal cartilages?

A
  • Epiglottis
  • Thyroid
  • Cricoid
  • Arytenoid
  • Corniculate
  • Cuneiform
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6
Q

What is the epiglottis attached to?

A
  • Thyroid cartilage by the thyroepiglottic ligament
  • Hyoid by hyoepiglottic ligament
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7
Q

Describe the position of the epiglottis

A
  • Projects upwards and backwards into the pharynx, beind the posterior part of the tongue
  • Because of the tension of the ligaments, it goes back to the breathing position
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8
Q

Describe the parts of the thyroid cartilage

A
  • Left and right laminae that join at the thyroid angle (laryngeal prominence = more prominent in males = Adams apple)
  • Superior horns that attach to the hyoid
  • Inferior horns that articulate with the cricoid
  • Superior thyroid notch
  • Oblique line for muscle attachment
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9
Q

Red arrow

A

Superior thyroid notch

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10
Q

Green arrow

A

Laryngeal prominence

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11
Q

Purple arrow

A

Oblique line

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12
Q

What is the difference in the laryngeal angle in men and women?

A
  • Men = 90 degrees = more prominent
  • Women = 120 degrees
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13
Q

Describe the cricoid cartilage

A
  • Shape of a signet ring with lamina posteriorly
  • Sloping shoulder on the lamina for arytenoid articulation
  • Ridge for attachment of the oesophagus
  • Depressions for attachment of the posterior crico arytenoid muscle
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14
Q

What does the cricoid cartilage articulate with?

A
  • Arytenoids
  • Thyroid
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15
Q

What do the arytenoids articulate with?

A
  • Sloping shoulders of the cricoid lamina
  • Corniculate cartilage superiorly
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16
Q

What are the parts of the arytenoid?

A
  • Vocal process: anteriorly for the attachment of the vocal ligament
  • Muscular process: posteriorly for the attachment of posterior and lateral crico-arytenoid muscles
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17
Q

Red arrow

A

Vocal process

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18
Q

1

A

Depression for the vestibular ligament

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19
Q

2

A

Depression for the attachment of the vocal muscle

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20
Q

Green arrow

A

Muscular process on the arytenoid

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21
Q

Describe the Thyro-hyoid membrane

A
  • Extends between: Upper edges of the thyroid lamina, the superior horns and the body and the greater horns of the hyoid
  • Thickened anteriorly and posteriorly as the median and lateral thyro-hyoid ligaments
  • Hole on either side where it is pierced by the superior laryngeal vessels and superior laryngeal nerve
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22
Q

Describe the fibro-elastic membranes

A
  • Formed from connective tissue under the laryngeal mucous membrane that stretches between laryngeal cartilages
  • Separated by the laryngeal ventricle
  • Superiorly: Quadrangular membrane
  • Inferiorly: Conus elasticus
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23
Q

Red

A

Quadrangular membrane

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24
Q

Green

A

Conus elasticus

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25
Black arrow
Laryngeal ventricle
26
What does the quadrangular membrane extend between?
Lateral aspects of the epiglottis, arytenoid and corniculate cartilage
27
What are the edges of the quadrangular membrane?
* Aryepiglottic fold (free edge) * Vestibular ligamnet
28
Red arrow
Aryepiglottic fold
29
Green arrow
Vestibular ligament
30
Red arrow
aryepiglottic fold
31
Green arrow
Vestibular ligament
32
What is another name for conus elasticus?
Cricovocal membrane
33
What does the conus elasticus blend with anteriorly and why is it significant?
* Median cricothyroid ligament * It is the site of emergency access to the airway- tracheotomy
34
Red arrow
Cricovocal membrane (conus elasticus)
35
Green arrow
Median cricothyroid membrane
36
What is the function of the vocal cords?
They control the laryngeal diameter for: * Speech * Coughing/sneezing (protective reflexes) * Raising intra-abdominal pressure
37
What type of epithelium lines the upper respiratory tract?
Pseudostratified ciliated columnar epithelium
38
What type of epithelium lines the vocal cord?
Stratified squamous epithelium (to withstand the force of vibration
39
Vestibular cord
* False vocal cord * Doesn't vibrate when talking
40
What is the function of the muscles adjacent to and within the vocal cord?
Narrow or widen the opening between them (rims glottis) or alter their tension
41
What are the 3 parts of the laryngeal cavity?
* The vestibule * The laryngeal ventricle * Infraglottic cavity
42
Laryngeal cavity: the vestibule
Between the laryngeal inlet and the vestibular folds
43
Laryngeal cavity: the laryngeal ventricle
Recess between the vestibular and vocal folds • Leads to the saccule which provides lubricating muscles for the vocal folds
44
Laryngeal cavity: Infraglottic cavity
Between the vocal folds and the trachea
45
What is the laryngeal inlet bound by?
Aryepiglottic folds (free edge of the quadrangular membrane
46
What is the rima glottis bound by?
The vocal cords and the vocal processes of the arytenoid
47
Extrinsic laryngeal muscles
* Change the position of the larynx as a whole * Suprahyoid and infrahyoid muscles * Facilitates the closing of the larynx * Extend from the skull neck (more than one place)
48
Intrinsic laryngeal muscles
* Extend between the laryngeal cartilages * Adjust the length/tension of the vocal ligaments (tone of voice) * Open and close the rima glottis * Control the inner dimensions of the vestibule * Facilitate the closing of the laryngeal inlet
49
What do the extrinsic laryngeal muscles extend between?
• The skull to the larynx and the pharynx
50
Which of the extrinsic laryngeal muscles are elevators?
* Stylopharyngeus * Stylohyoid * Salpingopharyngeus * Palatopharyngeus * Mylohyoid * Geniohyoid * Digastric * Thyrohyoid
51
Which of the extrinsic laryngeal muscles are depressors?
* Sternothyroid * Thyrohyoid * Sternohyoid
52
What are the functions of the intrinsic laryngeal muscles?
* Open/ close the inlet (aryepiglottic folds) * Open/close the rima glottis- arytenoid gliding and rotation * Lengthen the vocal folds- rocking at the cricothyroid joints
53
Describe the closure of the laryngeal inlet
• Elevation of the larynx and pharynx by the extrinsic muscles from the skull to the larynx and pharynx - Stylopharyngeus - Stylohyoid - Salpingopharyngeus - Palatopharyngeus * Aryepiglottic muscles act like a 'purse string' * Superior fibres of the thyroarytenoid muscle
54
Red arrow
Stylohyoid
55
Green arrow
Stylopharyngeus
56
Blue arrow
Salpingopharyngeus
57
Purple arrow
Palatopharyngeus
58
Red arrow
Aryepiglottic
59
Opening of the laryngeal inlet
• Descent of the larynx (and pharynx) by elastic recoil (• hyoepiglottic ligament)
60
Opening of vocal folds or rima glottis
* Posterior crico-arytenoid muscle * Attached to the muscular process of the arytenoid
61
red arrow
Posterior crico-arytenoid
62
Closing of the vocal folds or rima glottis
* Inferior fibres of the thyro-arytenoid * Lateral crico-arytenoid * Transverse arytenoid
63
Green arrow
Transverse arytenoid
64
Blue arrow
Thyroarytenoid
65
Red arrow
Lateral Crico arytenoid
66
Lengthening the vocal cords
* Thyroid cartilage rocked back and forwards at the cricothyroid joint (rocking backwards lengthens) * Cricothyroid muscle lengthens the vocal folds or ligaments
67
Altering the tension of the vocal ligaments
* Vocalis muscle (part of the thyro-arytenoid muscle) * Increasing the tension raises the pitch of the voice, decreasing lowers it
68
Describe the folds and rima glottis in quiet respiration
• Rima glottis is triangular
69
Describe the folds and rima glottis in forced inspiration
* Rima is rhomboid * It is widely opened by the posterior crico-arytenoid, externally rotating the arytenoids * Vocal folds are adducted
70
Describe the folds and rima glottis in phonation
* Vocal folds are adducted * Air is forced through the vocal folds causing vibration * Cord length and tension are altered by cricothyroid, thyroarytenoid and vocalis muscles
71
Describe the folds and rima glottis in effort closure
* Vocal folds and vestibular folds are adducted * The airway is closed by the lateral crico arytenoid and transverse arytenoid * abdominal pressure is increased
72
What happens during swallowing?
* Laryngeal elevation * Closure of the laryngeal inlet by the epiglottis * As the larynx descends after swallowing, the epiglottis springs back by the hyoepiglottic ligament
73
Green arrow
Superior laryngeal artery
74
Blue arrow
Inferior laryngeal artery
75
Describe the venous drainage of the larynx
* Superior laryngeal vein -\> Superior thyroid vien -\> Jugular internal vien * Inferior laryngeal vein -\> Inferior thyroid vein -\> brachiocephalic vein
76
What is at risk during a tracheostomy?
The inferior thyroid veins
77
Black arrow
Superior laryngeal vein
78
Green arrow
Inferior laryngeal vein
79
Lymphatic drainage above the vocal cord
Superior deep cervical lymph nodes
80
Lymphatic drainage below the vocal cord
* Prelaryngeal * Pretracheal * Inferior deep cervical * Supraclavicular lymph nodes
81
What is the lymphatic drainage between the vocal cords
There is none
82
Neural supply of the larynx
Superior laryngeal nerve (a branch of the vagus): • Internal branch (internal laryngeal nerve) - Sensation of the larynx down to just above the vocal folds - Accompanied by the superior laryngeal artery • External branch (external laryngeal nerve) - Supplies the cricothyroid muscle Vagus -\> recurrent laryngeal -\> Inferior laryngeal - Accompanied by the inferior laryngeal artery • Recurrent laryngeal - All muscles of the larynx except the cricothyroid - sensation to the vocal cords and the larynx below
83
Potential spaces
* Between muscles of the floor of the mouth * Pre-tracheal space - from the neck to the mediastinum • Retropharyngeal - from the base of the skull to the diaphragm
84
Red arrow
Inferior laryngeal nerve
85
Green arrow
Superior laryngeal
86
Red arrow
Internal branch (internal laryngeal nerve)
87
Blue arrow
External branch (external laryngeal nerve)
88
What supplies the Cricothyroid muscle?
External branch (external laryngeal)
89
What supplies the Muscles of the larynx except the cricothyroid?
Recurrent laryngeal nerve
90
What supplies the sensation of the larynx to just above the vocal cords?
Internal branch (internal laryngeal nerve)
91
What supplies the sensation of the vocal cords?
Recurrent laryngeal
92
Label
93
label
94
What is this muscle?
Tansverse arytenoid
95
What is this muscle?
Oblique arytenoid
96
What is this muscle?
Lateral crico arytenoid
97
What are the green and red arrows pointing to?
* Red = thryoepiglottic * Green = hyoepiglottic

Anatomy MD3001 (13 decks)

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