Larynx And Pharynx Flashcards
(40 cards)
What is the superior border of the larynx?
Epiglottis and the aryepiglottic folds
What is the inferior border of the larynx?
Inferior rim of the cricoid cartilage
What is the lining of the larynx in the newborn?
Columnar ciliated epithelium
What are the true cords lined by?
Nonkeratinized squamous epithelium
Also the seromucinous glands are decreased or absent here
What is the exception of the lamina propria in the vocal cords?
Few, if any lymphatic channels are found
What forms most of the anterior surface of the larynx?
Thyroid cartilage
What is the only complete ring and forms most of the posterior support of the larynx?
Cricoid cartilage
What is different about the epiglottis?
It is elastic cartilage while the others are hyaline cartilage which ossifies with age
What can cause a contact ulcer and where do they occur?
Endotracheal intubation, acid reflux, vocal cord abuse (shouting, coughing)
Occurs posterior portion of one or both sides of the glottis
Presents with hoarseness, coughing, and pain
Where are vocal cord polyps usually located? How do they differ from nodules?
Unilateral, anterior third of the vocal cord and less than 5 mm in size
Nodules are usually bilateral and occur slightly more posterior at the border of the anterior and middle third of the vocal cord
What are some nonneoplastic cysts of the larynx?
Laryngoceles, saccular cysts, ductal cyst
What is a laryngocele?
A cystic dilation of the saccule of morgani, communicate with the larynx, and are air filled
What are saccular cysts?
They also occur at the laryngeal saccule but do not communicate with the larynx and are filled with mucin
What part of the larynx may be affected in sarcoidosis?
Supraglottic larynx
What is a good histologic clue for dysplasia in the larynx?
Dyskeratotic cells
What molecular abnormality is associated with worsening atypia and invasion?
LOH at 3p and 9p, p53 mutations
Over expression of cyclin D1 and EGFR
And others
What should not be seen in verrucous carcinoma?
No infiltrating nests of tumors should be present
What does a foreign body reaction look like in the larynx and what causes it?
Foreign body giant cell reaction that is walled off by fibrous tissue
Caused by Teflon used as a synthetic substance injected into a paralyzed vocal cord
The giant cells contain birefringent clear material present intermixed with chronic inflammation and fibrosis
Other materials such as silicone, gore-Tex and titanium can be used
What can cause granulomas in the larynx?
TB, leprosy, histo, blastomycosis, cocci, candidiasis, rhinoscleroma, sarcoidosis, wegener’s, foreign body reaction, amyloidosis, necrobiosis (rheumatoid nodules), crohn’s disease
What is the characteristic of leprosy in larynx?
Painless and develop supraglottically and progress to the glottis
Appear nodular and ulcerated and can lead to stenosis
Mixture of chronic inflammatory cells and large, foamy macrophages
What does a rheumatoid nodule look like in the larynx?
Necrobiotic collagen nodules with central fibrinoid necrosis surrounded by palisading histiocytes with some lymphocytes and occasional multinucleated giant cells
What does eosinophilic angiocentric fibrosis?
Fibrosis that wraps around blood vessels and has numerous eosinophils
IgG4-related sclerosing disease
What is absent from pseudoepitheliomatous hyperplasia that will keep you from thinking true invasion?
Severe cytologic atypia and dyskeratosis should not be seen
What can you look for in necrotizing sialometaplasia to keep from diagnosing cancer?
Retains a lobular architecture and should have intact myoepithelial layer
May have some cytologic atypia
