Larynx and Trachea Flashcards
1
Q
Which will require less movement of vocal cords
A. Sniff
B. Vocal fry
A
A
2
Q
Which of the following has the longest phonatory activity for vocal ligament?
A. “ah” /a/
B. “esss” /s/
C. “arrr” /r/
D. all of the above
A
A
3
Q
You’re friend swallowed and choked with a piece of meat. Where is it easiest to incise using a small blade to provide temporary airway?
A. cricothyroid membrane
B. thyrohyoid membrane
C. trachea
D. chest
A
A
4
Q
In children, the narrowest section of airway is the
A. supraglottis
B. Glottis
C. Subglottis
D. Epiglottis
A
C
5
Q
Lymphatic drainage of the larynx?
A. Upper set, deep cervical
B. Retropharengeal
C. Upper set, parotid
D. Submaxillary
A
A
6
Q
Weakest part of cricoid cartilage?
A. lamina
B. arch, upper
C. arch, middle
D. arch, lower
A
C
7
Q
Motor innervation of cricothyroid
A. Recurrent laryngeal nerve
B. Internal laryngeal nerve, upper branch
C. Internal laryngeal nerve, lower branch
D. External laryngeal nerve
A
D
8
Q
Conus Elasticus
A. Cricothyroid cartillage
B. Thyrohyoid
C. Quadrangular Ligament
D. Vocal Ligament
A
D
9
Q
What innervates the mucous membrane above the vocal folds?
A. Superior laryngeal nerve
B. Inferior laryngeal nerve
C. Internal laryngeal nerve
D. Recurrent laryngeal nerve
A
C
10
Q
Which of the following is true about the Parathyroid gland?
A. Superior parathyroid is usually behind superior poles of thyroid gland
B. Inferior parathyroid is found above the inferior poles of thyroid gland
C. Parathyroid gland is found posteriorly within thyroid sheath but outside capsule
D. SPT is more constant in position, usually at inferior border of thyroid cartilage
E. In thyroid lobectomy, inadvertent injury to Superior and inferior parathyroid would invariably lead to tetany and convulsiveness.
A
C
11
Q
The viscera of the neck can be classified into these three primary functions
A
Endocrine, respiratory, alimentary
12
Q
Largest endocrine gland
A
Thyroid gland
13
Q
Thyroid secretions
A
Thyroid hormone and calcitonin
14
Q
Organs not affected by the thyroid gland
A
Itself, spleen, testes, and uterus
15
Q
Hormone produced by the parathyroid glands
A
Parathormone (PTH)
16
Q
Target organs of the parathyroid glands
A
Skeleton, kidneys, intestine
17
Q
The thyroid gland is deep to which muscles?
A
Sternothyroid and sternohyoid
18
Q
Level of the thyroid gland
A
C5-T1
19
Q
Lobes of the thyroid gland
A
Left and right
20
Q
Which part unites the lobes of the thyroid gland?
A
Isthmus
21
Q
Arteries of the thyroid gland
A
Superior and inferior thyroid arteries
22
Q
Vessels from which the superior and inferior thyroid arteries originate
A
Superior: External cartorid artery
Inferior: Thyrocervical branch of the subclavian artery
23
Q
Level of the isthmus
A
2nd and 3rd tracheal rings
24
Q
The right and left superior and inferior thyroid arteries anastomose extensively to provide potential collateral circulation between the subclavian and internal carotid arteries. T/F
A
F
The collateral circulation is between the subclavian and external carotid arteries.
25
The artery that occasionally supplies the isthmus of the thyroid
Unpaired thyroid ima artery
26
Veins of the thyroid gland
Superior, middle inferior thyroid veins
27
Which vein of the thyroid gland has no corresponding artery?
Middle thyroid vein
28
From where are nerves of the thyroid gland derived?
Superior, middle and inferior cervical (sympathetic) ganglia
29
Sympathetic innervation reach the thyroid gland through
Cardiac and superior and inferior thyroid periarterial plexuses
30
The nerves of the thyroid gland are secretomotor. T/F
F
They are vasomotor. Secretion of the thyroid gland is regulated by the pituitary gland.
31
How many parathyroid glands do people normally have?
Four
32
Which is more constant in position, the superior parathyroid glands or the inferior parathyroid glands?
Superior parathyroid glands
33
Arteries of the parathyroid gland
Branches from inferior thyroid arteries, sometimes also the superior thyroid arteries, thyroid ima artery or laryngeal, tracheal and esophageal arteries
34
Veins of the parathyroid glands
Parathyroid veins
35
The parathyroid veins drain to which vessels?
Thyroid plexus of veins of thyroid gland , and trachea.
36
Lymph vessels from the parathyroid glands drain into which lymph nodes?
Deep cervical lymph nodes and paratracheal lymph nodes
37
Nerves of the parathyroid glands
Thyroid branches of the cervical (sympathetic) ganglia
38
How many cartilages compose the larynx?
9
39
Level of the larynx
C3-C6
40
Most vital function of the larynx
Guards air passages, especially during swallowing
41
Cartilages of the larynx
Paired: arytenoid, corniculate, cuneiform
Unpaired: thyroid, cricoid, epiglottic
42
Largest of the cartilages
Thyroid cartilage
43
Which forms the Adam's apple?
Laryngeal prominence of the thyroid cartilage
44
Superior divergence of the lamina of the thyroid cartilage into a V
Superior thyroid notch
45
The inferior thyroid notch is more conspicuous than the superior thyroid notch. T/F
F
It is less distinct.
46
Superior and inferior projection of the lamina of the thyroid cartilage posteriorly
Superior and inferior horns
47
The superior horn and the superior border of the thyroid cartilage attaches to the hyoid bone through which structure?
Thyrohyoid membrane
48
Parts of the thyrohyoid membrane
Median thyrohyoid ligament, lateral thyrohyoid ligaments
49
Articulation of the inferior horns of the thyroid cartilage with the lateral surfaces of the cricoid cartilage
Cricothyroid joints
50
Main movements at the cricothyroid joints
Rotation and gliding of the thyroid cartilage
51
Ring-like cartilage of the larynx and only complete ring of cartilage to encircle any part of the airway
Cricoid cartilage
52
The posterior part of the cricoid cartilage
Lamina
53
The anterior part of the cricoid cartilage
Arch
54
Attachment of the cricoid cartilage to the thyroid cartilage
Cricothyroid ligament
55
Attachment of the cricoid cartilage to the first tracheal ring
Cricotracheal ligament
56
The paired three-sided pyramidal carilages that articulate with the lateral parts of the superior border of the cricoid cartilage lamina
Arytenoid cartilage
57
Parts of the arytenoid cartilage
Apex (superior), vocal process (anterior), muscular process (lateral projection at base)
58
Articulation of the cricoid cartilage and arytenoid cartilages
Crico-arytenoid joints
59
Movements at the crico-arytenoid joints
Sliding of arytenoid cartilages towards or away from each other, tilting anteriorly and posteriorly of the arytenoid cartilages, and rotation of the arytenoid cartilages
60
Which is medial and which is lateral among the vocal processes and the muscular processes of the arytenoid cartilage?
Medial: vocal processes
Lateral: muscular processes
61
What structure attaches to the vocal process?
Vocal ligaments
62
Where are the vocal ligaments attached?
Anteriorly, the thyroid cartilage lamina
| Posteriorly, the vocal process of the arytenoid cartilage
63
Submucosal skeleton of the vocal folds
Vocal ligaments
64
The opening between the vocal folds
Rima glottidis
65
The vocal ligaments are part of which bigger structure?
Conus elasticus or cricovocal membrane
66
Parts of the cricothyroid ligament
Medial and lateral cricothyroid ligament
67
The epiglottis is inferiorly attached to the thyroid cartilage through which structure?
Thyro-epiglottic ligament
68
Attachment of the epiglottis to the hyoid
Hyo-epiglottic ligament
69
The thin, submucosal sheet of connective tissue that extends between the lateral aspects of the arytenoid and epiglottic cartilages
Quadrangular membrane
70
Which cartilage attaches to the apices of the arytenoid cartilage?
Corniculate cartilage
71
Which cartilage do not directly attach to the other cartilages?
Cuneiform cartilage
72
True of the parathyroids
A. within the fibrous capsule of the thyroid gland
B. blood supply is from the inferior thyroid artery
C. Most people have six parathyroid glands
D. The inferior parathyroid gland is more constant in position than the superior parathyroid
B
73
The vocal folds vibrate and generate sound thru a system of laryngeal muscles innervated by
A. CN 9 and CN 11
B. CN 10 and CN 11
C. CN 9 and CN 12
D. CN 10 only
D
74
This is the cleft separating the vocal folds
A. superior laryngeal aperture
B. rima glottis
C. vestibule
D. ventricle
B
75
The angle of the laryngeal protuberance of males is ___________ that of females.
A. cannot be determined
B. the same as
C. greater than
D. lesser than
C
76
A small eminence in the ventral margin and ventrolateral surface of the arytenoid cartilages
A. arcuate crest
B. oblong pit
C. corniculate
D. fovea triangularis
C
77
The lower end of the epiglottis tapering into a short stalk
A. petiole
B. epiglottic tubercle
C. cornu
D. cartilage triticea
A
78
The most important function of the larynx
A. respiration
B. protection
C. phonation
D. articulation
B
79
In phonation, as air rushes through the open cords, pressure between the folds drops sucking the folds back together. This is known as:
A. elastic property
B. Bernoulli Effect
C. Myoelastic Theory
D. Body Cover Theory
B
80
Phonation is likely to occur if
A. medial surface of vocal cords are soft enough to yield
B. moderate airflow
C. the articulators are working properly
D. the glottis is wide
A
81
What is the main part of the vocal folds?
A. vocal ligament
B. conus elasticus
C. thyroarytenoid muscles
C
82
Cartilage directly above arytenoids
```
A. thyroid cartilage
B. epiglottic cartilage
C. corniculate cartilage
D. cuneiform cartilage
E. AOTA
```
C
83
Movement of the thyroid cartilage towards the cricoid cartilage will result to
A. Vocal cord shortening
B. Vocal cord lengthening
C. Vocal cord abduction
D. Vocal cord adduction
E. NOTA
B
84
A soprano presented with hoarseness. Upon operation she noticed that she cannot sing high notes anymore, although her voice isn't hoarse. Which of the following nerves was affected?
A. internal laryngeal
B. external laryngeal
C. recurrent laryngeal
B
85
Which artery supplies the larynx?
```
A. Common Carotid
B. External Carotid
C. Subclavian
D. B and C
E. A, B and C
```
D
86
What muscle is innervated by both branches of the recurrent laryngeal nerve?
A. Posterior cricoarytenoid
B. Lateral cricoarytenoid
C. Interarytenoids
D. Thyroarytenoid
D
87
The extent of the laryngeal cavity
Laryngeal inlet to inferior border of cricoid cartilage
88
To which cavity does the laryngeal cavity communicate through the laryngeal inlet?
Laryngopharynx
89
What cavity is between the laryngeal inlet and the vestibular folds?`
Laryngeal vestibule
90
What cavity is between the vestibular and vocal folds?
Laryngeal ventricle
91
The blind pocket opening into each ventricle that is lined with mucosal glands
Laryngeal saccule
92
The inferior cavity of the larynx between the vocal folds and the inferior border of the cricoid cartilage
Infraglottic cavity
93
Vocal folds are the same as the vocal cords. T/F
T
94
Each vocal fold is composed of which structures?
Vocal ligament and vocalis muscles
95
Longer vocal folds produce higher vocal pitch. T/F
F
They produce lower pitch.
96
False vocal cords
Vestibular folds
97
Main inspiratory sphincter of the larynx when tightly closed
Vocal folds
98
Complete abduction of the vocal folds form an effective sphincter that prevents entry of air. T/F
F
It is adduction that does that.
99
The vocal aparatus of the larynx
Glottis
100
Shape of the rima glottidis during normal breathing
Narrow and wedge-shaped
101
Shape of the rima glottidis during forced respiration
Wide and trapezoidal
102
The vestibular folds contain the vocal ligaments. T/F
F
They contain the vestibular ligaments. The vocal ligaments are contained in the vocal folds.
103
The space between the vestibular ligaments
Rima vestibuli
104
Shape of rima during phonation
Slit-like
105
Extrinsic laryngeal muscle groups
Infrahyoid, and suprahyoid muscles
106
Extrinsic muscles move the laryngeal components, altering the tension and length of the vocal folds and the size and shape of the rima glottidis. T/F
F
Intrinsic laryngeal muscles did that. Extrinsic laryngeal muscles moved the larynx as a whole
107
Intrinsic muscles of the larynx
```
Lateral and posterior crico-arytenoid
Cricothyroid
Thyro-arytenoid
Transverse and oblique arytenoids
Vocalis
```
108
Action of the lateral crico-arytenoid
Adducts vocal folds
109
Action of transverse and oblique arytenoid muscles
Adducts arytenoid cartilages, closing the posterior rima glottidis
110
To close the rima glottidis, which muscles must act together?
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles
111
Intrinsic muscles of the larynx
```
Lateral and posterior crico-arytenoid
Cricothyroid
Thyro-arytenoid
Transverse and oblique arytenoids
Vocalis
```
112
Action of the lateral crico-arytenoid
Adducts vocal folds
113
Action of transverse and oblique arytenoid muscles
Adducts arytenoid cartilages, closing the posterior rima glottidis
114
To close the rima glottidis, which muscles must act together?
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles
115
Laryngeal muscles for whispering
Lateral crico-arytenoids
116
Action of the posterior crico-arytenoids
Abducts vocal folds
117
Muscles that adduct vocal folds
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles
118
Contraction of which muscles occur as reflexive response to presence of liquid or particles approaching or within the laryngeal vestibule?
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles, ary-epiglottic muscles
119
What happens when lateral crico-artytenoids contract, but the transverse and oblique arytenoid muscles do not?
The arytenoid cartilages remain apart, though the vocal folds close
120
Muscles that attach to the muscular process of the arytenoid cartilage
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles
121
When the posterior crico-arytenoid muscles act, the rima glottidis widens. T/F
T
122
Contraction of which muscles occur as reflexive response to presence of liquid or particles approaching or within the laryngeal vestibule?
Lateral crico-arytenoids, and transverse and oblique arytenoid muscles, ary-epiglottic muscles
123
Principal adductors of the larynx
Lateral crico-arytenoid
124
Action of the thyro-arytenoid muscles
Relaxes vocal ligament
125
Action of cricothyroid muscles
Tenses and stretches vocal ligament
126
Effect of the action of the cricothyroid muscles on the voice
Higher pitch
127
Principal relaxers of the larynx
Thyro-arytenoid muscles
128
Which muscles lower the pitch of the voice?
Thyro-arytenoid muscles
129
The vocalis muscles is medial or lateral the thyro-arytenoid muscles?
Medial
130
Cricothyroid artery is from which vessel?
Superior thyroid artery
131
Arterial supply of the internal surface of the larynx
Laryngeal arteries
132
Arterial supply of the cricothyroid muscle
Cricothyroid artery
133
Cricothyroid artery is from which vessel?
Superior thyroid artery
134
Inferior laryngeal artery supplies which structures?
Mucus membrane, and muscles in the inferior larynx
135
Veins of the larynx
Superior and inferior laryngeal veins
136
Where the veins of the larynx drain
Superior and inferior thyroid veins
137
Where the lymphatic vessels of the larynx superior to the vocal cords drain
Superior deep cervical lymph nodes
138
Where the lymphatic vessels of the pharynx inferior to the vocal cords drain
Inferior deep cervical lymph nodes
139
Which nerve divides onto terminal branches internal laryngeal and external laryngeal nerves?
Superior laryngeal nerve (CN X)
140
Which provides sensory and autonomic innervation to the larynx: internal laryngeal or external laryngeal nerve?
Internal laryngeal
141
Which provides motor innervation to the larynx: internal laryngeal or external laryngeal nerve?
External laryngeal
142
The internal laryngeal nerve pierces which structure with the superior laryngeal artery?
Thyrohyoid membrane
143
The external laryngeal descends posterior to which structure with the superior thyroid artery?
Sternothyroid muscle
144
The internal laryngeal pierces the thyrohyoid membrane along with which structure?
Superior laryngeal artery
145
The external laryngeal descends posterior to which structure together with which structure?
Superior thyroid artery
146
The superior laryngeal nerve arises directly from which nerve?
Inferior vasal ganglion
147
The inferior laryngeal nerve is a continuation of which vagal branch?
Recurrent laryngeal nerve (CN X)
148
Structures supplied by the anterior branch of the inferior laryngeal nerve?
Lateral crico-arytenoid, thyro-arytenoid, vocalis, ary-epiglottic and thyro-eppiglottic muscles
149
Structures supplied by the posterior branch of the inferior laryngeal nerve?
Posterior crico-arytenoid, transverse and oblique arytenoid muscles
150
Cancer of the larynx manifests as ear pain because of
a. Chorda tympani
b. arnold’s nerve
c. Jacobson’s nerver
d. Facial nerve
B
151
Botlinum toxin needs to react on what muscles to reduce contraction
A. bilateral PCA
B. bilateral lateral CA
C. Bilateral thyroaretinoid
D. Bilateral cricothyroid
D
152
The cervical viscera of infants are located more superiorly than in adults because of the infatnts' short neck. T/F
T
153
The duct that connects the foramen cecum to the thyroid gland as the gland descends onto the lower neck
Thyroglossal duct
