Larynx and Thyroid

Question 1

The vagus nerve courses through the _______ in the neck and provides motor innervation to ________ muscles, and sensory innervation to ________ and _____ of the neck

Answer 1

carotid sheath, laryngeal muscles, deep viscera, muscles

Question 2

The larynx is at vertebral levels ________ and is continuous with ______. It opens superoposteriorly at the _______

Answer 2

C3-C6, trachea, laryngeal inlet (aditus)

Question 3

The laryngeal inlet (aditus) is bounded by _________ of mucosa

Answer 3

aryepiglottic folds

Question 4

The thyroid cartilage is ______ cartilage and its anteriormost point is called the _________, while the anterolateral walls are the ________ and the highest and lowest lateral points are called the ___________.

Answer 4

hyaline, laryngeal prominence, laminae, superior and inferior horns

Question 5

The cricoid cartilage is _______ cartilage and sits _______ in relation to the thyroid cartilage.
The anteriormost point is called the _____, and the posteriormost wall is called the ______.

Answer 5

hyaline, lower, arch, lamina

Question 6

The epiglottic cartilage is ______ cartilage and is anchored with ligaments to the _____ and _____ cartilages

Answer 6

elastic, hyoid, thryoid

Question 7

The arytenoid cartilages are _______ cartilage and are ______ shaped. The base articulates with the _____.
The anteriormost point is the ______ process, and the posteriormost point is the ______ process. They are topped with the ______ cartilages

Answer 7

hyaline, pyramid-shaped, cricoid cartilage, vocal process, muscular process, corniculate cartilages

Question 8

The epiglottis folds over the _______ which is within the ________ folds

Answer 8

cuneiform tubercle (cuneiform cartilages), aryepiglottic folds

Question 9

The ________ ligament is located deep to the lateral parts of both the cricoid and thyroid cartilages

Answer 9

lateral cricothyroid ligament

Question 10

The _______ ligament is located deep to both cricoid and thyroid cartilages and just anterior to the arytenoid cartilages

Answer 10

vocal ligament

Question 11

The _______ and the ______ together form the conus elasticus which is an inverted funnel at the base of the larynx

Answer 11

lateral cricothyroid ligament, vocal ligament

Question 12

The vestibular fold lies just superior to the ______ ligament

Answer 12

vocal ligament

Question 13

The ________ is indicative of laryngotracheobronchitis (croup)

Answer 13

Steeple Sign

Question 14

_________ results from the narrowing of subglottic treachea

Answer 14

Steeple sign

Question 15

Laryngeal cavity divisions:
The _______ is the area between the aditus to the vestibular fold.
The ______ is the area between the vestibular and vocal folds.
The _______ cavity is area between the vocal fold and the inferior cricoid cartilage

Answer 15

vestibule, laryngeal ventricle (ventricle of Morgagni), infraglottic cavity

Question 16

The laryngeal ventricle is the home of the ________ which is lined with mucosa and lubricates the vocal cords

Answer 16

saccule of larynx

Question 17

A ________ is an abnormal expansion of the saccule of the larynx

Answer 17

laryngocele

Question 18

larynx except vocal cords formed from ________ which is composed of __________ cells.
The vocal folds are formed from _______ epithelium

Answer 18

respiratory epithelium, ciliated pseudostratified columnar cells, stratified squamous epithelium

Question 19

The identifying features of __________ of the larynx are a lamina propria with prominent mucus glands and lymphatic nodules.

Answer 19

respiratory epithelium

Question 20

The prominent identifying features of the ______ of the larynx are the Reinke’s space in the lamina propria, the vocal ligament, and the vocalis muscle

Answer 20

vocal folds

Question 21

Reinke’s space is composed of _________

Answer 21

dense connective tissue

Question 22

The structure just posterior to the valleculae is the _______.
The structures just adjacent to the vocal folds are the ________.

Answer 22

epiglottis, vestibular fold

Question 23

The _______ is sensitive mucosa responsible for the cough reflex

Answer 23

vestibular fold

Question 24

The structures immediately anterior to the most posterior-superior part of the cricoid cartilage are the _________

Answer 24

aryepiglottic folds

Question 25

The _________ and the _______ form the superior opening to the vestibule. This is called the ______

Answer 25

aryepiglottic folds, epiglottis, aditus

Question 26

The _____ is the space between the vestibular folds. | The ______ is the space between the vocal folds.

Answer 26

rima vestibuli, rima glottidis

Question 27

The ______ is the border between the rima glottidis and the vocal folds. Defines the boundary between the upper and lower larynx

Answer 27

Glottis

Question 28

The boundary between the upper and lower larynx between the rima glottidis and the vocal folds is called the _____

Answer 28

Glottis

Question 29

Blood supply to the larynx is via the superior laryngeal artery which is a branch of the _______ from the ______ and the _____ which is a branch of the ______ from the _______. These arteries anastamose

Answer 29

superior laryngeal artery, superior thyroid artery, carotid artery, inferior laryngeal artery, inferior thyroid artery, thyrocervical trunk

Question 30

The superior larynx is drained via the _______ vein which drains to the _______ vein, then to the ______ vein. The inferior larynx drains via the _____ vein which drains to the ______ vein, then to the _______ vein.

Answer 30

superior laryngeal vein, superior thyroid vein, internal jugular vein inferior laryngeal vein, inferior thyroid vein, brachiocephalic vein

Question 31

The ________ is a tracheostomy bleed concern

Answer 31

inferior laryngeal vein

Question 32

Above the vocal cord level lymph drains to ________ nodes. Below the level of vocal cords lymph drains to _____ or ______ nodes, then to ______ nodes.

Answer 32

superior deep cervical nodes, pre-tracheal nodes, paratracheal nodes, inferior deep cervical nodes

Question 33

Cancer of the larynx results in the following signs/symptoms:

Answer 33

hoarseness, swollen lymph nodes, and earache

Question 34

If cancer develops in the lower larynx what lymph nodes might be a concern?

Answer 34

pre-tracheal or paratracheal nodes

Question 35

Innervation of the larynx is accomplished ultimately through these 2 nerves:

Answer 35

superior laryngeal nerve of vagus, recurrent laryngeal nerve of vagus

Question 36

The sensory nerve of the supraglottic mucosa and the sensory limb of the cough reflex is the _______ which is a branch of the ______ nerve. It pierces the _______ membrane.

Answer 36

internal branch, superior laryngeal nerve, thyrohyoid membrane

Question 37

The motor innervation to the cricothyroid muscle is the _______ and is a branch of the _______ nerve.

Answer 37

external branch, superior laryngeal nerve

Question 38

The innervation to the infraglottic larynx is the _____ nerve of ______.

Answer 38

recurrent laryngeal nerve, vagus (CN X)

Question 39

The motor innervation to every intrinsic muscles of the larynx except the cricothyroid is the _____ nerve.

Answer 39

recurrent laryngeal nerve

Question 40

The ______ nerve courses deep to the inferior pharyngeal constrictor muscle as the inferior laryngeal nerve

Answer 40

recurrent laryngeal nerve (of vagus CN X)

Question 41

A patient presents with hoarseness of voice and a CT scan shows that he has an aneurism of the aorta. What nerve is involved?

Answer 41

recurrent laryngeal nerve

Question 42

The ________ muscles and _______ raise the larynx which aids in high pitch vocal tones

Answer 42

suprahyoid muscles, thyrohyoid

Question 43

The _____ muscles aid in lower pitch vocal tones

Answer 43

infrahyoid muscles

Question 44

The ______ muscle stretches/tenses the vocal ligament and attaches from the anterolateral cricoid cartilage to the inferior margin, as well as to the inferior horn of the thyroid cartilage

Answer 44

cricothyroid

Question 45

The _____ muscle attaches from the lamina of the cricoid cartilage to the muscular process of the arytenoid cartilage

Answer 45

posterior cricoarytenoid muscle

Question 46

The action of the ______ muscle is to abduct the vocal cords for inhalation

Answer 46

posterior cricoarytenoid muscle

Question 47

Asymmetric widening of the vocal ligaments during a deep breath suggests lesion of the _______

Answer 47

recurrent laryngeal nerve

Question 48

The ________ muscle attaches from the superolateral margin of the cricoid cartilage to the muscular process of the arytenoid cartilage

Answer 48

lateral cricoarytenoid muscle

Question 49

The adductors of the vocal ligaments are the _______ muscle, ______ muscle, and the _______ muscle

Answer 49

lateral cricoarytenoid, oblique arytenoid, transverse arytenoid

Question 50

The _____ muscle attaches from the arytenoid cartilage to the other arytenoid cartilage

Answer 50

transverse arytenoid

Question 51

The _____ muscle is an X-shaped vocal ligament adductor that attaches to both arytenoid cartilages

Answer 51

oblique arytenoid

Question 52

The thyroarytenoid muscle has this action: | It’s attachments are the ______ cartilage and the ______ cartilage

Answer 52

relaxes vocal ligaments, internal surface of thyroid cartilage, arytenoid cartilage

Question 53

The _____ muscle relaxes the posterior vocal ligament (tension remains in anterior portion of ligament).

Answer 53

vocalis muscle

Question 54

The _____ muscle attaches to the vocal process of the arytenoid cartilage and to the ipsilateral vocal ligament

Answer 54

vocalis muscle

Question 55

The vocalis muscle is actually the ________

Answer 55

deep fibers of thyroarytenoid

Question 56

The ______ muscle is a continuation of the oblique arytenoid muscles

Answer 56

aryepiglottic muscle

Question 57

The ____ muscle attaches to the arytenoid cartilage and to the mucosa of the aryepiglottic folds

Answer 57

aryepiglottic muscle

Question 58

The _____ muscle decreases the diameter of laryngeal inlet/aditus

Answer 58

aryepiglottic muscle

Question 59

The ______ is deep to the infrahyoid (strap) muscles

Answer 59

thyroid gland

Question 60

The thyroid gland extends through these vertebral levels:

Answer 60

C5-T1

Question 61

The thyroid gland is within this layer of fascia:

Answer 61

within visceral portion of pretracheal fascia

Question 62

The thyroid gland is derived of ______ at the floor of the pharynx and descends to the neck during development along the _______

Answer 62

epithelium, thyroglossal duct

Question 63

The ______ lobe of the thyroid gland is a remnant of the descent of the thyroid gland during development

Answer 63

pyramidal lobe

Question 64

Detached tissues along the thyroglossal duct are referred to as ________

Answer 64

aberrant thyroid tissue

Question 65

A common cause of midline swelling in the anterior neck is a _______

Answer 65

thyroglossal cyst

Question 66

The _____ artery also carries postganglionic sympathetics from the superior cervical ganglion

Answer 66

superior thyroid artery

Question 67

The _____ artery from the ______ carries postganglionic sympathetics from the middle inferior cervical ganglia

Answer 67

inferior thyroid artery, thyrocervical trunk

Question 68

The inferior thyroid artery carries postganglionic sympathetics from the ____________

Answer 68

middle inferior cervical ganglia

Question 69

A surgical concern especially from tracheotomy is the _______

Answer 69

thyroid ima artery (10% of population, from the brachiocephalic trunk)

Question 70

The superior thyroid veins and middle thyroid veins drain to the ______, while the inferior thyroid veins drain to ______

Answer 70

internal jugular vein, brachiocephalic vein(s)

Question 71

The _______ are a surgical concern for bleeding

Answer 71

inferior thyroid veins

Question 72

A cricothyrotomy is done by piercing the _______

Answer 72

medial cricothyroid ligament

Question 73

Surgical concerns for children during a tracheostomy are the ______, ________, ______, and ________.

Answer 73

thymus, left brachiocephalic vein, jugular veinous arch, pleurae in area

Question 74

The parenchymal tissue of the thyroid gland are the ______

Answer 74

follicles

Question 75

The follicles of the thyroid gland are lined with _______ epithelium composed of follicular cells and have a lumen filled with ______

Answer 75

simple cuboidal epithelium, colloid

Question 76

The follicular cells of the thyroid convert _________ to T3 and T4 in response to elevated _____

Answer 76

thyroglobulin, TSH

Question 77

The _____ cells are located between follicles and are paler-staining.

Answer 77

parafollicular (C) cells

Question 78

The ______ cells secrete calcitonin in response to elevated blood Ca2+ which suppresses osteoclasts and antagnizes parathyroid hormone

Answer 78

parafollicular (C) cells

Question 79

Lymph in the thyroid gland drains in this order to these 5 structues:

Answer 79

prelaryngeal nodes & pretracheal nodes & paratracheal nodes —> superior deep cervical nodes OR inferior deep cervical nodes

Question 80

The ______ glands are deep to the visceral portion of pretracheal deep cervical fascia

Answer 80

parathyroid glands

Question 81

There are ___ superior parathyroid glands, and __ inferior parathyroid glands in every person

Answer 81

2, 2

Question 82

______ from the _______ form the thymus and parathyroid glands and cannot form these glands without first migrating to ________

Answer 82

endoderm cells, pharyngeal pouches, neural crest-derived tissue

Question 83

The superior parathyroid glands are derived from endoderm cells from the ______

Answer 83

4th pharyngeal pouch

Question 84

These cells are slightly eosinophilic-staining and secrete parathyroid hormone in response to low blood Ca2+

Answer 84

principle (chief) cells of the thyroid

Question 85

The ______ cells are more eosinophilic than principle cells of the thyroid and accumulate with age, their function isn’t clear

Answer 85

oxyphil cells

Question 86

_____ cells of the thyroid are more packed together than ______ cells

Answer 86

principle (chief) cells, oxyphil cells

Question 87

A goiter may compress the _______

Answer 87

recurrent laryngeal nerves

Question 88

The 3 structures that are concerns for a thyroidectomy are:

Answer 88

thyroid ima artery, inferior thyroid veins, recurrent laryngeal nerves