Lecture 31 DA

Question 1

What are the upper and lower boundaries of the larynx?

Answer 1

From the epiglottis to C6, lower border of cricoid cartilage.

Question 2

What makes up the laryngeal skeleton?

Answer 2

Hyoid bone
Thyroid cartilage
Cricoid cartilage

Question 3

Does the laryngeal skeleton have a posterior border?

Answer 3

Only the cricoid cartilage, hyoid and thyroid bone/cartilage are open.

Question 4

What is formed by the laryngeal skeleton posteriorly?

Answer 4

Laryngeal inlet.

Question 5

What is the angle of the thyroid?

Answer 5

Adam’s apple.

Question 6

What is the lamina of the thyroid cartilage?

Answer 6

It has an anterior and posterior lamina.

Question 7

Where are the horns of the thyroid cartilage?

Answer 7

It has four total, two superiorly, two inferiorly.

Question 8

How does the thyroid cartilage articulate with the cricoid cartilage?

Answer 8

Via the inferior horns.

Question 9

Is the cricoid cartilage bridged posteriorly by trachealis?

Answer 9

No, it forms a complete circle.

Question 10

What is the shape of the cricoid cartilage?

Answer 10

Short anterior arch and tall posterior lamina.

Looks like a signet ring.

Question 11

Where are the aratenoid cartilages found, and what shape are they?

Answer 11

Posteriorly on the cricoid cartilage and are pyramid shaped.

Question 12

What are the two processes of the aratenoid cartilage?

Answer 12

Vocal process medially and muscular process laterally.

Question 13

How does aratenoid cartilage mediate phonation?

Answer 13

They can swivel in and out of the cricoid, as well as slide towards and away from each other.

Question 14

What is found between hyoid bone and thyroid cartilage?

Answer 14

Thyrohyoid membrane. Has deficiencies to allow vessels to pass.

Question 15

What is cound between cricoid and thyroid carilages?

Answer 15

Cricothyroid membane (also ligament), is continuous.

Question 16

Where does the epiglottic artilage attach?

Answer 16

To the angle of thyroid posteriorly.

Question 17

Where do vocal ligaments attach?

Answer 17

From arytenoid cartilage to the angle of thyroid posteriorly.

Question 18

Where does the quadratic membrane attach?

Answer 18

From the arytenoid cartilage to the superior border of the epiglottic cartilage. It is complete.

Question 19

What is the vestibular ligament?

Answer 19

Inferior, thickened, free edge of the quadratic membrane.

Question 20

What is the aryepiglottic ligament?

Answer 20

Superior, thickened, free edge of the quadratic membrane.

Question 21

What is the aryepiglottic fold?

Answer 21

Mucosa membrane over the aryepiglottic ligament.

Question 22

What is the vestibular fold?

Answer 22

Mucosa membrane over the vestibular ligament.

Question 23

What is the vocal fold?

Answer 23

Vocal cords. Mucosa membrane over the vocal ligaments.

Question 24

What is the false vocal cord, and what does it do?

Answer 24

Vestibular fold. Doesn’t produce sound in humans. Protects true vocal folds.

Question 25

What is special about the vestibular fold in cats?

Answer 25

They have a very large one which allows them to purr. Meows come from the vocal fold.

Question 26

What reflexes are found in the larynx?

Answer 26

Strong gag and cough reflexes.

Question 27

What happens to the vocal ligaments during phonation?

Answer 27

Adduction.

Question 28

What happens to the vocal ligaments during breathing?

Answer 28

Abduction.

Question 29

What is the rima glottis?

Answer 29

Space between vocal ligaments and directly under it.

Question 30

Where does the cricothyroid muscle attach, and what does it do to the fold when contracting?

Answer 30

Posterior surface of the cricoid to the thyroid. It lengthens the fold.

Question 31

Where does the thyroarytenoid muscle attach, and what does it do to the fold when contracting?

Answer 31

Posterior angle of the thyroid to the arytenoid, along the vocal ligament. Relaxes the fold.

Question 32

Where does the vocalis muscle attach, and what does it do to the fold when contracting?

Answer 32

Runs along the vocal ligament. Relaxes the fold.

Question 33

Where does the lateral cricoarytenoid muscle attach, and what does it do to the fold when contracting?

Answer 33

From arytenoid laterally down to cricoid anteroinferiorly. Adducts the fold.

Question 34

Where does the posterior cricoarytenoid muscle attach, and what does it do to the fold when contracting?

Answer 34

From arytenoid posteriorly down to cricoid medioinferiorly. Abducts the fold.

Question 35

Where do the transverse and oblique cricoarytenoid muscle attach, and what does it do to the fold when contracting?

Answer 35

Between the two arytenoids. Closes rima glottis. Brings the folds together.

Question 36

What nerve innervates the larynx from above and what do its branches innervate?

Answer 36

Superior laryngeal (vagus) Internal laryngeal - sensory to mucosa External laryngeal - cricothyroid muscle

Question 37

What nerve innervates the larynx from above and what do its branches innervate?

Answer 37

``` Recurrent laryngeal (vagus) Inferior laryngeal - all muscles except cricothyroid ```

Question 38

What happens when you damage the recurrent laryngeal nerve?

Answer 38

Hoarse voice and stridor.

Question 39

What is stridor?

Answer 39

The sound of excessive effort needed to talk, as more air is needed to vibrate folds.

Question 40

Where is the thyroid gland found?

Answer 40

Inferior to the thyroid cartilage.

Question 41

What supplies blood to the larynx from above and below?

Answer 41

Superior and inferior laryngeal vessels.

Question 42

Why are blood vessels being directly superficial to the trachea so significant?

Answer 42

If you do an emergency airway tracheotomy, blood can get into the lungs and drown the patient.

Question 43

Where is the best place to do an emergency airway?

Answer 43

Cricothyroid membrane puncture.

Question 44

Where is tracheotomy usually done?

Answer 44

Only in a surgical setting.

Question 45

What is an intubation, what what position should the head and vocal cords be in?

Answer 45

Artificial ventilation. Hyperextend the head. Vocal folds must be relxed to avoid damage.