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Flashcards in Larynx and Trachea Deck (153):
1

Which will require less movement of vocal cords

A. Sniff
B. Vocal fry

A

2

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

3

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

4

In children, the narrowest section of airway is the

A. supraglottis
B. Glottis
C. Subglottis
D. Epiglottis

C

5

Lymphatic drainage of the larynx?

A. Upper set, deep cervical
B. Retropharengeal
C. Upper set, parotid
D. Submaxillary

A

6

Weakest part of cricoid cartilage?

A. lamina
B. arch, upper
C. arch, middle
D. arch, lower

C

7

Motor innervation of cricothyroid

A. Recurrent laryngeal nerve
B. Internal laryngeal nerve, upper branch
C. Internal laryngeal nerve, lower branch
D. External laryngeal nerve

D

8

Conus Elasticus

A. Cricothyroid cartillage
B. Thyrohyoid
C. Quadrangular Ligament
D. Vocal Ligament

D

9

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

C

10

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.

C

11

The viscera of the neck can be classified into these three primary functions

Endocrine, respiratory, alimentary

12

Largest endocrine gland

Thyroid gland

13

Thyroid secretions

Thyroid hormone and calcitonin

14

Organs not affected by the thyroid gland

Itself, spleen, testes, and uterus

15

Hormone produced by the parathyroid glands

Parathormone (PTH)

16

Target organs of the parathyroid glands

Skeleton, kidneys, intestine

17

The thyroid gland is deep to which muscles?

Sternothyroid and sternohyoid

18

Level of the thyroid gland

C5-T1

19

Lobes of the thyroid gland

Left and right

20

Which part unites the lobes of the thyroid gland?

Isthmus

21

Arteries of the thyroid gland

Superior and inferior thyroid arteries

22

Vessels from which the superior and inferior thyroid arteries originate

Superior: External cartorid artery
Inferior: Thyrocervical branch of the subclavian artery

23

Level of the isthmus

2nd and 3rd tracheal rings

24

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

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