Pulmonary anatomy Flashcards
(233 cards)
1
Q
What is contained in the thorax?
A
- The heart and lungs in 1 continuous sealed unit
2
Q
How many leaflets does the diaphragm have?
A
2 leaflets
3
Q
Which lung is smaller overall, but taller than the other lung, and why?
A
The left lung because it has a chunk carved out to give a place for the heart to sit in the thorax.
4
Q
Which lung has more volume and is heavier?
A
The right lung
5
Q
The ___ lung has 3 lobes and the ___ lung has 2 lobes.
A
- Right
- Left
6
Q
- What are the lines that seperate the lobes on each lung called?
A
- Fissures
7
Q
- How many fissures does the right lobe have and what are they called?
- How many fissures does the left lobe have and what is it called?
A
- RL = 2 fissures, horizontal and oblique
- LL = 1 fissure, oblique
8
Q
Where do the lungs attach to the bronchi?
A
the hilum
9
Q
How long is the trachea?
A
10-13cm
10
Q
How wide is the trachea?
A
- 2cm
- The width of your thumb is also a good estimate
11
Q
About how much of the top of the trachea is extrathoracic?
A
4cm
12
Q
Where does the vast majority of the trachea sit?
A
in the thorax
13
Q
What is the trachea made up of?
A
annular ligaments that connect each piece of the tracheal cartilage together.
14
Q
Are the tracheal cartilage rings opend or closed?
A
open
15
Q
How many cartilagenous rings are in the trachea?
A
20 on average
16
Q
- What are the subdivisions of the 2 lungs called?
- How many are in each lung?
A
- Bronchopulmonary segments
- The right lung has 10
- the Left lung has 8
17
Q
Which lung has a larger, wider, and shorter (only a few cm long) main stem?
A
- The right lung
18
Q
What are the characteristics of the left lung mainstem?
A
- Narrower
- Much longer at 4-6cm
- It is longer to get out from around where the heart is sitting in the chest
19
Q
- which mainstem is more vertical?
- Which mainstem is more horizontal?
A
- vertical = right
- horizontal = left, again due to the position of the heart
20
Q
- What is the angle of the right mainstem?
- What is the angle of the left mainstem?
- What is the total bifurcation angle at the carina?
A
- Right = 25 degrees
- Left = 45 degrees
- Bifurcation = 70 degrees
21
Q
What is the cartilagenous bifurcation into the right and left mainstem called?
A
the carina
22
Q
Name 2 places you can put an invasive airway
A
- the median cricothyroid ligament
- putting an opening directly into the trachea
23
Q
What is the median cricothyroid ligament?
A
a piece of connective tissue that connects the front of the cricoid cartilage to the front of the thyroid cartilage
24
Q
If you have to intubate with an ETT or put in a trach, what kind of air do you need coming in?
A
- humidified air from the vent since we are bypassing the nose and mouth that normally humidify our inspired air.
25
Does the nose or the mouth help us put moisture into the respiratory system the quickest?
nose
26
True or false:
The position of your head can extend or shorten your trachea
* True
* Extending the head will lengthen and narrow the trachea
* Flexing your head (chin to chest) will make the trachea shorter and wider.
27
Where does the apex of the lung extend past?
Extends past rib 1 and sometimes even up past the clavicle (usually in COPD lungs)
28
Label the structures
29
What is the costodiaphragmatic recess?
It is an area between the visceral and parietal pleura, located on the lateral inferior sides of the lung between the bottom ribs and the diaphragm. This is the one area between both pleura that has a little pocket of air trapped in it.
30
Label the structures
31
* What is the purpose of the linings on the outside of the lungs and the inside of the thorax?
* What are these linings called?
* The purpose is so the lungs can slide around easily in the thorax as we inspire and expire
* They are called pleura
32
What is the visceral pleura?
The connective tissue that is applied to the outside of the lungs. (Viscera means organ)
33
What is the parietal pleura?
The connective tissue that lines the inside of the thorax
34
* What is the space called between the visceral and parietal pleura?
* What does it contain?
* The pleural cavity
* It is a very thin space that contains a thin coating of mucous that helps the lungs slide around.
35
Why is it painful if you get an infection of the visceral or parietal cavities?
Because the pleura become inflamed and cause friction in the pleural space when the lungs are trying to move during inspiration and expiration.
36
Where is the diaphragm anchored?
* L1 on the lumbar spine
* The leaflets of each side of the diaphragm are anchored into the vertebral bodies of the lumbar spine.
37
Label the structures
38
What kind of muscle is the diaphragm made of?
Skeletal muscle
39
* What is the central tendon on the diaphragm made of?
* What is its purpose?
* Connective tissue
* It sits in the middle of the diaphragm and is the platform the heart sits on.
40
What is different about the central tendon than any other tendon in the body?
* This tendon connects muscle to muscle, where every other tendon in the body connects muscle to bone.
41
Why does the heart move up and down in the chest as we inspire and expire?
Because it sits right on top of the diaphragm which also moves up and down.
42
What effect does the weight of the heart have on the diaphragm?
It depresses the left side of the diaphragm more than the right side.
43
What is the caval aperture an opening for?
the inferior vena cava to bring blood back to the heart
44
What is the esophageal aperture an opening for?
the esophagus to makes its way to the stomach
45
What is the aortic aperture an opening for?
the aorta to bring arterial blood to the abdomen
46
Label the structures
47
Label the structures
48
Where do the phrenic nerves run?
Along side the neck stemming from C3, C4, and C5, past the heart, and then connect directly to the right and let leaflets of the diaphragm.
49
* Does the vagus nerve have parasympathetic or sympathetic stimulation?
* What 2 things do the innervate in the chest?
* Parasympathic stimulation
* Innervate the SA and AV node in the heart
50
* How many phrenic nerves do we have?
* Where do the phrenic nerves come from?
* How many do we need to have to stay alive if we are completely healthy?
* 2 phrenic nerves, 1 on each side of the neck.
* C3, C4, C5
* Only need 1 phrenic nerve to stay alive to innervate the diaphragm.
51
* What are the accessory muscles at the top of the thorax called?
* How many of them are there?
* Where are they anchored to?
* Scalene muscles
* 6 total, 3 on each side of the neck.
* The base of the skull/top of the neck and the first 2 ribs
52
What is the purpose of the scalene muscles?
* The provide a platform to either pull the rib cage up or prevent the rib cage from being pulled down when the diaphragm contracts with inspiration.
53
Are the scalene muscles used for forced inspiration or expiration?
forced Inspiration
54
Label the muscle
55
Where are the points of attachment for the sternocleidomastoid muscle?
* The sternum (midline)
* The mastoid process behind the ear.
56
* Does the sternocleidomastoid muscle aid in forced inspiration or expiration?
* How does it do this?
* It aids in forced/deep inspiration.
* It works in the same mechanism as the scalene accessory muscles. Contracting this muscle will prevent the rib cage from being pulled down during inspiration.
57
What is the job of the internal intercostal accessory muscles?
* These aid with forced expiration.
* They compress the thorax and bring it closer to midline.
* They have attachment points on the inside of the rib cage
58
What is the job of the external intercostal accessory muscles?
* These aid with forced inspiration and can sometimes be used with normal quiet breathing.
* Contracting these muscles will pull the rib cage out, expand it, and move it forward.
* The attachment points are in between the ribs on the outer side of the rib cage.
59
What is the job of the abdominal accessory muscles?
* These aid in forced expiration
* The 2 muscle groups used are the rectus abdominus and the oblique abdominals.
* These muscles take all the stuff in your abdominal cavity and push it up against the base of the diaphragm to help push air out of the lungs.
* These muscles create the most force out of all the accessory muscles when forcing an expiration.
60
What is the job of the pec minor accessory muscles?
* These muscle help stabalize the top of the thorax.
* They allow you to inspire deeper than you otherwise would and it makes deep inspiration much easier.
* Pec minor muscles are located deep to the pec major muscles and they connect to the shoulder blades and the top of the rib cage
*
61
Label the structure
62
What are the 3 parts of the pharynx called?
* Nasopharynx
* Oropharynx
* Laryngopharynx
63
What is the nasopharynx?
The upper most portion of the oharynx that contains the opening we have in the nose.
64
What is the oropharynx?
The middle part of the pharynx that contains the oral cavity
65
What is the laryngopharynx?
The lowest part of the pharynx and consists of everything below the oral cavity and in through the larynx
66
Label the structure
67
Label the sucture
68
What happens to the tongue when you paralyze your supine patient in the OR?
The tongue will fall posterior in the back of the airway, because it will be flaccid, and occlude the trachea, which can make for a difficult intubation.
69
Label the structures
70
What are the 3 bony projections in the nasal cavity called?
Inferior, middle, and superior concha
71
What is another name for the concha in the nasal cavity?
turbinates
72
What are 2 major roles of the upper airway?
* **To act as a filter to the lungs. **The upper airways, especially the nose are able to catch and prevent a lot of the junk that we breathe in from making its way to the lungs.
* **To rapidly heat and humidify the inspired air.** The nose brings inspired air upto body temperature almost immediately and it also adds 47mmHg of water vapor to humidify it.
73
What is the purpose of the concha being very porous?
* It gives the nose a place for all the blood vessels to sit in.
* The nose is highly vascularized.
* The nose's job is to heat and humidify inspired air and the main way it does this is by having a very rich supply of blood flow to the area.
74
What would happen if the nose did not heat and humidify inspired air?
* Only the larynx and trachea would get dried out
* The lungs would not get dried out because they already have plenty of moisture in the area.
75
Label the structures
76
* How many sets of concha do we have?
* This gives us a total of how many boney projections?
* 3 sets (superior, middle, and inferior)
* 6 boney projections
77
Why are the concha so curvey?
* Because they are used to generate turbulence as we inspire air through the nose.
* Besides the mucous in the nose, this is another mechanism that helps trap unwanted particles from getting down into the lungs. The curvature only works for larger particles, and not smaller things like smoke.
78
In a healthy adult, we usually inspire ___% through our nose, and ___% through our mouth.
* 50%
* 50%
79
Why does air flow through the nasal passageways increase airway resistance?
Because the nose has narrower passageways than the mouth
80
The superior and middle concha are projections of what facial bone?
The ethmoid bone
81
* The inferior concha are projections of what facial bone?
* What is this set of concha continuous with in the mouth?
* The maxillary bone
* Continuous with the roof of the mouth/hard palate
82
Why are the concha so fragile and easily breakable?
Because they are very thin and porous to accomodate the vasculature of the area. This puts these bones at an increased risk for fracture.
83
What is the most optimal spot for nasal intubation and why?
* The floor of the nose/ inferior concha.
* This area is the sturdiest of all the concha and the floor of the nose is flat, making it easier to guide your tube.
84
What would happen if you broke one of the concha during nasal intubation or NGT insertion?
* You would cause heavy blood loss due to the area being so highly vascularized.
* All of that blood would fall back into the airway.
85
Label the picture
86
Label the structure
87
What is the opening in the skull for the inner ear called?
external acoustic meatus
88
Label the structure
89
What are the 2 purposes of the ethmoid bone being so porous?
* To house a bunch of blood vessels
* To give a route for our smell sensors to be able to pick up scents we have in our nose and relay that info back to the brain.
90
Where is the ethmoid bone positioned in the skull?
At the front of the cranium, midline, at the top of the nasal cavity
91
What is the cribiform plate?
The portion in the ethmpid bone where our smell sensors route through.
It is a passageway for our olfactory neurons get from the brain to the nose
92
Why is the nose such a great place to administer drugs?
Because it is highly vascularized and their are direct neurons that go from the nose to the brain.
93
* What is the upward projection on the ethmoid bone called?
* What does it seperate?
* crista galli
* Seperates the right and left hemispheres and connects to the falx cerebri.
94
Where is our voicebox located?
The larynx
95
What structure represents the top of the upper airway?
* The larynx
96
Where does air move after it has passed through the larynx?
the trachea
97
What is the bifurcation of the trachea called?
The carina
98
What does the trachea branch into after the carina?
The right and left main bronchus
99
What do the right and left main bronchus branch off into?
Smaller and smaller bronchioles, until you get to the terminal bronchioles and then the respiratory bronchioles.
100
What do the respiratory bronchioles turn into?
Alveolar ducts
101
What do the alveolar ducts turn into?
alveoli sacs
102
What is contained in the alveolar sacs?
alveoli
103
How many generations of airways do we have?
* A total of 24 generations that start from 0 and end at 23
104
What generation is the trachea?
0
105
What generations are the 2 mainstem and large bronchi?
1-3
106
What generations are the bronchioles?
4-16, 16 being the terminal bronchioles
107
What generations are the respiratory bronchioles?
17-19
108
What generations are the alveolar ducts?
20-22
109
What generations are the alveolar sacs?
23
110
* What structures are included in the conducting zones?
* What generations does this include?
* Does gas exchange happen here?
* What is this zone used for?
* Trachea, bronchi, and bronchioles.
* Generations 0-16
* No gas exchange happens here
* This zone is a conduit to get fresh air in and allow old air out.
111
What type of structure supports the trachea, bronchi and bronchioles?
Cartilage, to keep larger airways open and patent.
112
* What structures are in the respiratory zones?
* What generations does this include?
* Does gas exchange happen here?
* What is this zone used for?
* alveolar ducts and alveolar sacs
* Generations 20-23
* Yes, gas exchange happens here
* Used for gas exchange betwee nthe alveoli and the pulmonary capillaries.
113
* What structures are in the transitional zone?
* Where is this zone located?
* What generations are included?
* Does gas exchange happen here?
* The respiratory bronchioles
* Between the conducting and respiratory zones
* Generations 17-19
* A small amount od gas exhange happens here because there are a few alveoli on these bronchioles
114
What is the average size of an alveolus?
0.4mm
115
What kind of tissue are the alveoli made up of?
Soft elastic tissue only, no cartilage.
116
What is the functional gas exchange unit in the lung?
Alveoli
117
How many alveoli does a healthy 20 year old have?
500 million
118
Do our lungs have the capability to produce new alveoli?
Yes just at a very slow rate
119
How many capillaries are attached to each alveolus?
1000
120
What is the surface area in the lungs for gas exchange in a young healthy adult?
70 square meters. The size of a tennis court
121
Label the structures
122
Where are goblet cells located an what do they produce?
* Goblet cells are secretory cells that line the upper airways and produce mucous.
* (Can produce a little bit of surfactant bu their main role is to produce mucous in th upepr airways)
123
What is the purpose of cilia on goblet cells?
The mucous produced by the goblet cells and the cilia will beat in a way that will sweep unwanted junk out of the lungs and upper airway
124
* What are clara cells and what do they produce?
* Where are they located?
* What is another name for clara cells?
* These are secretory cells that line the lower/deeper airways that produce surfactant.
* We see these cells as we get further down the respiratory tree and closer to the alveoli.
* Club cells
125
* What are alveolar type I cells
* How much gas exchange surface area do these cover?
* Do these take up more or less real estate than alveolar type II cells?
* These cells are very thin, and they don’t have very much volume which makes it easy for gas exchange.
* These cells make up about 90-95% of the gas exchange surface area.
* These take up more real estate than the type II cells because even though they are very thin, they are very long.
126
* What are alveolar type II cells and what do they do?
* How much gas exchange surface area do these cover?
* How abundant are these cells compared to type I alveolar cells?
* These are secratory cells that are found deeper into the alveoli, and they produce surfactant. These are interspersed between the type I alveolar cells.
* These cells cover about 5-10% of the gas exchange surface area.
* There are 2 times as many type II cells as there are type I cells.
127
How do secretory cells release surfactant?
exocytosis
128
What are the 2 most important cells in the body for producing surfactant?
* Alveolar type II cells
* Clara/club cells
129
What is the major gas exchange cell in the lung?
Alveolar type I cell
130
What is tubular myelin in the alveoli?
* The storage place for surfactant.
* It is a cross-hatched structure with pieces of myelin sitting on top of each other.
* The surfactant proteins and lipids like to hang out in this mesh/netting after they have been produced from and exited the clara and alveolar type II cells.
131
At what point in the respiratory cycle does the surfactant get knocked off the tubular myelin to float up to the air-water interface in the alveoli?
The surfacttant gets knocked off as the lungs/alveoli fill up with air and expand during inspiration.v
132
When does surfactant become an "active" molecule?
* Once it gets knocked off the tubular myelin during inspiration.
* When surfactatn is trapped in the tubular myelin netting it is "inactive"
133
What are Alveolar macrophages?
* The are scavengers in the alveoli that digest the broken down parts of surfactant as the surfactant lipids and proteins fall apart over time.
* The macrophages are part of the surfactant recycling system.
* The parts that re digested are re-uptaken by the surfactant producing cells, and then reused to make new surfactant.
134
What are mast cells?
* Mast cells are a different kind of secretory cell found in the lungs that are inflammation mediators.
* If we suck in a bunch of pollutants, our lungs will react by releasing inflammatory mediators from the mast cells to aid the lungs.
135
What is the most common inflammatory mediator in the lungs that comes from the mast cells?
Histamine
136
What will the release of histamine do in the lungs?
* Irritate the airways and cause the airway smooth muscle to constrict and tighten up to protect the lungs.
* Histamine has dilatory effects in the system but constricts in the airways.
137
Label the structure
138
What is the main sensory nerve of the face?
The trigeminal nerve (cranial nerve V)
139
What are the 3 divisions of the trigeminal nerve (cranial nerve V), and what areas do they cover?
* V1 = opthalmic division. Covers the forehead area
* V2 = Maxillary division. Covers the upper part of the mouth and nose
* V3 = Mandibular division. Covers the mandible
140
Explain how you get a brain freeze from eating something cold.
* The cold temperature gets sensed by the trigeminal nerve V2 (mandibular portion) on the roof of your mouth and sends that info to the brain.
* The brain feels pain, but it gets confused about where it is coming from. The trigeminal nerve is interpreting coldness from the top of the mouth as a headache.
141
What is the fastest way to get rid of a brain freeze?
Press your tongue up against the roof of your mouth to warm the hard palate up
142
What other 2 areas does the trigeminal nerve (cranial nerve V) innervate in the mouth/pharynx?
* oropharynx
* back superior part of the nasopharynx
143
What areas does the glosspharyngeal nerve (cranial nerve IX) innervate in the mouth/pharynx?
* Back inferior part of the nasopharynx
* back superior part of the oropharynx
144
What areas does the vagus nerve (cranial neve X) innervate in the mouth/pharynx?
* Back inferior portion of the oropharynx
*The laryngopharynx
145
* What cranial nerve is this?
* What does it innervate?
* Crainial nerve X
* The vagus nerve
* Innervates the valleculla, epiglottis, larynx, trachea, and the posterior/inferior oropharynx
146
What is the function of the epiglottis?
It is the big piece of cartilage sitting at the back of the tongue that opens and close the airway (larynx) when we need to swallow.
147
* What cranial nerve is this?
* What does it innervate?
* Cranial nerve IX
* Glossopharyngeal nerve
* Innervates the back superior portion of the oropharynx, the back 1/3rd of the tongue, and the tonsils
148
Label which cranial nerve innervates each portion of the tongue, and whether it is somatic sensation or taste sensation.
* Vagus nerve (cranial nerve X), epiglottis, tastse and somatic sensation
* Glosopharyngeal nerve (cranial nerve IX), back 1/3rd of the tongue, taste and somatic sensation.
* Cranial nerve VII via the chorda tyympani, front 2/3rd of the tongue, taste sensation only
* Mandibular nerve/lingual nerve (cranial nerve V-3), front 2/3rd of the tongue, somatic sensation only.
149
What classifies somatic sensation?
* Tickle
* Itch
* touch
* irritant
* pressure
* pain
150
Label the picture
151
What is another name for the hard palate?
Roof of the mouth
152
Where is the soft palate located?
posterior and inferior to the hard palate
153
What piece of anatomy makes people snore?
Having a dangly soft palate
154
What is the projection hanging off the back of the soft palate called?
uvula
155
What tonsils are you able to see in the back of the mouth when someone opens their mouth wide?
The palatine tonsils
156
Label the picture
157
Where are the pharyngeal tonsils located?
* Above and behind the soft palate, essentially in the back of the nasopharynx
158
What happens when your pharyngeal tonsils becomes enlarged?
They push the soft palate forward, get in the way of breathing, and make the airwy more difficult to access.
159
What are the 3 sets of tonsils called?
* Palatine
* Pharyngeal
* Lingual
160
Label the picture
161
Where are the lingual tonsils located?
They hang off the base of the back of the tongue and are situated between the tongue and epiglottis.
162
What is the larynx made up of?
A bunch of pieces of cartilage that are held together by connective tissue.
163
What is the uppermost piece of tissue that makes up the larynx called?
The epiglottis
164
What is the opening between the back of the tongue, the lingual tonsils, and the epiglottis called?
the valleculla
165
What is the importance of the valleculla?
It is where the tip of your mac blade goes when you intubate
166
What are the 2 different ways the epiglottis covers the airway when you swallow?
* The epiglottis can snap down and close like a lid.
* The larynx can move up towards the epiglottis and close that way.
167
What is the large piece of cartilage on the larynx called that is in the shape of a box?
cricoid cartilage
168
The cricoid cartilage makes up the ___ portion of the larynx, and is the only cartilage in the airway that is a ___
* bottom
* complete circle/ ring around the airway
169
From birth til 10 years of age, what is the narrowest part of the airway?
cricoid cartilage
170
From 10 years old through adulthood what is the narrowest part of the airway?
transglottic space (vocal cords)
171
* Where is the transglottic space located?
* What is its purpose?
* between the vocal cords
* It allows air through so we can speak
172
What is the vestibular space?
A space above the vocal cords that acts as a protective entry way to the lower respiratory tract.
173
Where does your ETT pressure cuff sit?
* Below the larynx
* When you inflate the cuff, you should be able to feel it at the top of the sternal notch.
174
* How do you hold cricoid pressure?
* What is the purpose of holding cricoid pressure?
* By taking your fingers and pushing on the front of the cricoid cartilage.
* By putting pressure on the cricoid cartilage, it puts the back part of the cricoid cartilage in a position that closes off the esophagus when tryong to get an airway.
* This can help prevent aspiration from stomach contents
175
What is the downside of using cricoid pressure?
* If the patient is still semi-awake or gets a muscle spasm, it puts alot of pressure in the abdomen, sphincter to the esophagus and the stomach.
* Inthis case the patient could blow out the esophageal sphincter and cause permenant damage.
176
Label the structure
177
How many sets of salivary glands do we have?
* 3
* Sublingual
* submandibular
* parotid
178
What is the purpose of the salivary glands?
To produce and secrete fluid/saliva in the mouth to help get the food processing and break down started
179
Where are the 2 sublingual glands located?
underneath the front of the tongue
180
Where are the 2 submandibular glands located?
towards the back of the mouth and off to the side of the mandible
181
Where are the 2 parotid glands located?
on each side of the face in the cheek area.
182
What is the only free floating bone in the body?
The hyoid bone
183
Where is the hyoid bone located?
It hangs out underneath the tongue and serves as an attachment point for some of the muscles in the floor of the mouth and for some of the pieces of cartilage in the larynx
184
True or false
The larynx can be fractured if a person is choked or hit in the throat.
False
The fact that the larynx is made mostly of cartilage prevents fractures from happening here.
What can be fractured if someone is chopped in the throat isthe hyoid bone.
185
Label the structures
186
What piece of cartilage makes up the bulk of the larynx/ is the largest piece of cartilage in the larynx?
The thyroid cartilage
187
What does the thyroid cartilage serve as an attachment point for?
* It serves as an attachment point for the hyoid bone and everything above it.
* It also serves as an attachment point for the trachea below.
188
* What is the attachment joint between the thyroid cartilage and cricoid cartilage called?
* What is its purpose?
* The cricothyroid joint
* It allows the thyroid cartilage to pivot down/inferior.
189
What is the larynx?
A cartilaginous structure that hangs out/floats in the middle of the neck
190
* Because our tracheal rings are C shaped and not complete rings, what is on the posterior side of the trachea?
* What is it useful for?
* The longitudinal trachealis ligament
* It is useful for helping us swallow things by giving our esophagus room to expand when we are moving large food items through.
* This ligament is also helpful when we cough.
191
What speed do we generate when we cough?
100mph winds
192
Explain how the longitudinal trachealis ligament helps when we cough
* when we cough, this ligament enfolds into the trachea, and divides the trachea into 2 seperate areas.
* In doing this, it is much easier for us to create a very high velocity that will be capable of clearing all the junk out of the airway when we cough.
193
Label the picture
194
What is the cricothyroid joint a projection from on the thyroid cartilage?
It is a projection from the inferior horn
195
* What are the large sides of the thyroid gland called?
* What sits on this surface?
* Lamina
* It is the surface that the thyroid gland is attached to
196
* What are the projections coming off the back superior rear of the thyroid cartilage called?
* What does this connect to?
* Superior horns
* Connects with the hyoid bone underneath the tongue
197
What is another name for the laryngeal prominance?
The adams apple
198
What attaches to the laryngeal prominance?
the vocal cords
199
* Do men or women have a more pronounced laryngeal prominance?
* What does that do to the pitch of their voice?
* Men
* The larger laryngeal prominence stretches the vocal cords and gives men a deeper voice
* A smaller laryngeal prominance, will not stretch the vocal cords, and is what gives women a higher pitched voice.
200
Label the cricoid cartilage
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Where on the cricoid carftilage does the inferior horn (from the thyroid cartilage) attach to?
The more inferior notch called the artiuclar facet for the thyroid cartilage
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Where on the cricoid cartilage does the arytenoid cartilage attach to?
The more superior notch called the articular facet for arytenoid cartilage
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What 2 things does the arytenoid cartilage attach to?
* The cricoid cartilage
* The vocal cords
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What does the articular facet for arytenoid cartilage joint (that is connects to the cricoid cartilage) do?
It allows the arytenoid cartilage to move around so we are able to phonate/speak.
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* What piece of cartilage is this?
* Label the extra piece of pointy cartilage that sits on top.
* Arytenoid cartilage
* Corniculate cartilage
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What shape did Schmidt call the arytenoid cartilages?
Diamond shaped
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What is the corniculate cartilage?
A very small piece of cartilagenous appendage that sits on top of the arytenoid cartilage
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* How many unpaired cartilages are there?
* What are their names?
* 3
* Thyroid cartilage
* cricoid cartilage
* Epiglottis
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* How many paired cartilages are there?
* What are their names?
* 3 sets (6 total)
* Arytenoid cartilage
* Corniculate cartilage
* Cuneform Cartilage
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Label the picture
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* What is the only external laryngeal muscle?
* Where is it?
* The cricothyroid muscle
* It sits on the anterior side of the larynx between the thyroid cartilage and the cricoid cartilage.
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What does contraction of the cricothyroid muscle do?
* Contraction pulls the front of the thyroid cartilage down which tightens the vocal cords.
* The cricothyroid muscle tightens the vocal cords but has no effect on them opening or closing.
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What is the name between the vocal cords called?
Rima glottidis
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Identify the green structures in this picture
* Large C shaped structure is the the thyroid cartilage
* Complete ring structure below the thyroid cartilage is the cricoid cartilage
* The 2 small diamands are the arytenoid cartilage
* The thick red lines in the middle are the vocal cords
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Laryngeal muscle #1:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Cricothyroid muscle
* Location: Only muscle that is fully exterior/outside the larynx. Connects the cricoid cartilage to the thyroid cartilage
* Action: Contraction of this muscle tightens the vocal cords. Tightened muscle = high pitched voice, relaxed muscle = lower pitch voice.
* Effect on rima glottidis: No effect on rima glottidis. Doesn't open or close the cords, just tightens them
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Laryngeal muscle #2:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Vocalis muscle
* Location: runs parallel to the vocal cords on the inside of the larynx
* Action: contraction of this muscle will tighten the vocal cords. This muscle is similar to the cricothyroid muscle, it is just on the inside of the larynx vs the outside.
* Effect on rima glottidis: No effect on rima glottidis. Doesn't open or close the cords, just tighten them.
217
Laryngeal muscle #3:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Thyroarytenoid muscle
* Location: stems from the arytenoid cartilage and attaches to the lateral side of the thyroid cartilage
* Action: This muscle adducts the vocal cords. Adducting = closure because your are adding the cords together.
* Effect on rima glottidis: Movement of this muscle closes the rhima glottidis. When this muscle contracts, and because the arytenoid cartilage is on a swivel, it rotates the left arytenoid clockwise and the right arytenoid counterclockwise. This movement brings the cords in closer together and closes them.
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Laryngeal muscle #4:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Transverse arytenoid muscle
* Location: Stems from the medial side of each arytenoid and attaches the 2 together in the middle.
* Action: This muscle adducts the vocal cords. Adducting = closure because your are adding the cords together.
* Effect on rima glottidis: Movement of this muscle closes the rhima glottidis. When this muscle contracts, and because the arytenoid cartilage is on a swivel, and that swivel is flexible, it pulls both the left and rightv arytenoid cartilages together. This movement brings the cords closer together and closes them.
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Laryngeal muscle #5:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Posterior cricoarytenoid muscle
* Location: Connects the cricoid cartilage to the posterior arytenoid cartilage.
* Action: Abducts the vocal cords to open them. Abducting = opening because we are moving the cords away from each other.
* Effect on rima glottidis: Movement of this muscle opens the rima glottidis. When this muscle contracts, and because the arytenoid cartilage is on a swivel, it rotates the left arytenoid cartilage counterclockwise and the right clockwise. This movement moves the vocal cords further apart and opens them up.
220
Laryngeal muscle #6:
* Name:
* Location:
* Action:
* Effect on rima glottidis:
* Name: Lateral cricoarytenoid muscles
* Location: Connects the cricoid cartilage to the lateral arytenoid cartilage.
* Action: This muscle adducts the vocal cords. Adducting = closure because your are adding the cords together.
* Effect on rima glottidis: Movement of this muscle closes the rhima glottidis. When this muscle contracts, and because the arytenoid cartilage is on a swivel, it rotates the left arytenoid cartilage clockwise and the right counterclockwise. This movement brings the cords in closer together and closes them.
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* What is the only set of laryngeal muscles that abducts (opens) the vocal cords?
* What happens if these don't work properly?
* The posterior cricoarytenoid muscles
* If these aren't working propperly, we will have a really hard time breathing because our vocal cords will want to shut all the time from the actions of the other sets of laryngeal muscles.
222
Identify the muscles
223
Label what each set of vocal cords is doing
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What happens during full abduction of the vocal cords?
If your nervous system is telling your larynx to be as full as possible, it only has 1 muscle set to do that (posterior cricoarytenoid muscle), therefore this set has to be fully activated to get the cords completely abducted.
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What happens during gentle abduction of the vocal cords?
This is what the cords look like when we are just breathing normally. They usually are not fully abducted all the time, just slightly abducted.
226
What happens during stage whisper of the vocal cords?
* If you are whispering, then you have a much smaller opening of the vocal cords for the air to go through. You have just a small opening of the cords on the poswterior side to allow a small amount of air through.
* If you are truly whispering, your vocal cords should not vibrate.
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What happens during phonation of the vocal cords?
* During phonation/speech, the vocal cords are very close together. They do touch and vibrate when you speak.
* The tight closure of the cords when we are talking is what allows us to form different pitches with our voice.
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What do the inferior laryngeal neves innervate?
They innervate and control most of the muscles in our voice box.
229
What happens if just 1 of our laryngeal nerves is dysfunctional or doesn't work anymore?
We can still speak, however, the cords won't get tight enough for our speech to sound completly normal, and our voice will be raspy.
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What happens if both of our inferior laryngeal nerves are dysfunctional or don't work anymore?
We lose all ability to phonate/speak.
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Why are we still able to speak with minimal laryngeal neve function?
because there are more laryngeal muscles that close the cord (which is needed for phonation) than muscles that open the cords.
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