The Larynx

Question 1

The larynx functions as a compound sphincter that closes the airway during swallowing and during _____ (as in coughing, lifting a heavy weight).

Answer 1

Valsalva’s maneuver

Note: don’t forget about phonation

Question 2

What bones lies at vertebral lvl 3?

Answer 2

The hyoid bone

Question 3

Where is the lower border of the larynx?

Answer 3

The cricoid cartilage

Question 4

What structure can be found immediately below the thyroid gland?

Answer 4

The larynx

Question 5

Where are the lesser cornua and greater cornua ?

Answer 5

Lesser: laterally

Greater: posteriorly

Question 6

What ligament runs between the styloid process and the lesser horn of the hyoid?

Answer 6

The stylohyoid ligament

Question 7

Where are the muscles attached on the hyoid?

Answer 7

Along the surface of the greater horn and body of the hyoid

Question 8

The ____ membrane connects the hyoid bone to the thyroid cartilage.

Answer 8

Thyrohyoid

Question 9

What membrane runs from the smooth medial surface of the hyoid bone to attach along
the upper border of the thyroid cartilage.
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Answer 9

The thyrohyoid membrane

Question 10

What pierces the thyrohyoid membrane supero-laterally?

Answer 10

The superior laryngeal artery and nerve

Question 11

Below the thyroid notch is the ____ (Adam’s apple) that, due to growth stimulated by testosterone, is more apparent in men than in women. The result is longer vocal cords that vibrate at a lower frequency.

Answer 11

laryngeal prominence

Question 12

What membrane is below the vocal cords and relatively avascular, allowing it to be incised to provide an emergency airway?

Answer 12

The cricothyroid membrane (called a cricothyrotomy)

Question 13

A pair of ____ cartilages articulate with the upper postero-lateral borders of the cricoid cartilage

Answer 13

arytenoid

Question 14

Each arytenoid cartilages has a base, an apex, an anterior ______,
and a lateral muscular process for muscle attachments.

Answer 14

Vocal process

Question 15

A small detached portion of the apex of the arytenoid cartilage is the?

Answer 15

Corniculate cartilage

Question 16

The base of the arytenoids form a shallow ball and socket ______ articulation with the upper border of the cricoid.

Answer 16

diarthrodial

Note: it’s called the crico-arytenoid joint

Question 17

What movement does the crico-arytenoid joint permit?

Answer 17

Allows the arytenoid cartilages to slide toward or away from one another, to tilt anteriorly and posteriorly, and to rotate

Question 18

What is the crico-arytenoid joint important in?

Answer 18

Tensing, and relaxing the vocal folds

Question 19

At what joints does movement of the larynx occur?

Answer 19

At the cricoarytenoid and cricothyroid joints.

Question 20

Each of the paired vocal ligaments (cords) extends from ?

Answer 20

the vocal process of the arytenoid cartilage to the junction of the thyroid cartilages.

Question 21

Each of the paired vestibular ligaments (cords) courses from the?

Answer 21

anterior surface
of the arytenoid to the base of the epiglottis near the midline and above the vocal
ligament.

Question 22

What does greater tension of the vocal ligament cause?

Answer 22

Higher pitch voice

Question 23

What muscle causes a higher pitched voice (tension on the vocal ligaments)

Answer 23

Cricothyroid muscle

Question 24

What nerve innervates the cricothyroid muscle?

Answer 24

External branch of the superior laryngeal nerve of the vagus

Question 25

What does paralysis of the cricothyroid muscle result in?

Answer 25

A monotone voice because pitch cannot be varied

Question 26

What is the opening to the airway?

Answer 26

The rima glottis

Question 27

What muscle produces actions that oppose those of the cricothyroid muscle?

Answer 27

The thyroarytenoid muscle Note: it has two belies, an internus and externus

Question 28

What muscle inserts anteriorly at the anterior commissure of the thyroid cartilage and postero-laterally on the lateral surface of the arytenoid.

Answer 28

The externus thyroarytenoid

Question 29

What happens when the externus thyroarytenoid contract?

Answer 29

The vocal processes are shortened and there is a slight adduction

Question 30

What muscle arises from the anterior commissure and inserts onto the vocal process of the arytenoid cartilage.

Answer 30

The internus thyroarytenoid

Question 31

What happens during contraction of the internus thyroarytenoid muscle?

Answer 31

The vocal processes are shortened and thickened Note: In isolation, this action serves to lower the resonant frequency (pitch) of the vocal folds.

Question 32

What muscle is known as the vocalis?

Answer 32

The internus thyroarytenoid

Question 33

What muscle serves to lower the resonant frequency (pitch) of the vocal folds?

Answer 33

The internus thyroarytenoid

Question 34

Contraction of the _______ m raises the pitch of the voice, whereas that of the ____ m tends to lower the pitch.

Answer 34

Cricothyroid vocalis (The internus thyroarytenoid)

Question 35

What muscle arises from a broad insertion on the posterior face of the cricoid lamina.

Answer 35

The posterior cricoarytenoid

Question 36

Contraction of the posterior cricoarytenoid displaces the muscular process posteriorly and caudally, while the vocal process moves upward and laterally. What is the result of this?

Answer 36

Abduction of the vocal processes outward (opens the rima glottis) It can also tense the vocal ligament

Question 37

What muscle is the only abductor of the vocal folds and is principally responsible for control of the glottic airway.

Answer 37

The posterior cricoarytenoid

Question 38

What muscle is attached to the anterior part of the muscular process of the arytenoid medially and to the superior border of the cricoid cartilage laterally.

Answer 38

Lateral cricoarytenoid

Question 39

Contraction of the lateral cricoarytenoid muscle results in movement of the muscular process anterolaterally while simultaneously forcing the vocal process downward and medially. What is the result of this?

Answer 39

Adduction and lengthening of the vocal folds

Question 40

What muscle is the most powerful doctor of the vocal folds and important component of the Valsalva procedure?

Answer 40

The lateral cricoarytenoid

Question 41

What is the valsalva procedure?

Answer 41

tightening of the abdominal and thoracic musculature when lifting a heavy object, child birth, defecation, etc.

Question 42

Rapid and forceful contraction of what muscle (laryngospasm) can occur during endoscopic examination of the vocal cords and can be life threatening?

Answer 42

The lateral cricoarytenoid

Question 43

The oblique fibers of the interarytenoids continue to the epiglottis as the _____ muscle that courses along the upper border of the quadrangular membrane

Answer 43

ary-epiglotticus muscle

Question 44

How do the transverse fivers of the interarytenoid muscle rune?

Answer 44

Between the medial surface of the arytenoid cartilages

Question 45

What happens when the interarytenoid muscles contract?

Answer 45

Arytenoid adduction and narrowing of the rima glottis

Question 46

How can the interarytenoid muscle achieve whispering?

Answer 46

By opposing the other muscles so that the vocal cords are slight abducted

Question 47

The anterior surface of the epiglottis is joined to the hyoid by what ligament?

Answer 47

The hyoepiglottic ligament

Question 48

What creates the vestibular fold?

Answer 48

The fibro-elastic quadrangular membrane between the arytenoid cartilages and the epiglottis

Question 49

The superior border of the vestibular fold covers the aryepiglottic ligament and muscle to create a?

Answer 49

Aryepiglottic fold that covers the cuneiform and corniculate cartliages

Question 50

What forms the false vocal cords?

Answer 50

The horizontal part of the vestibular fold

Question 51

The vocal ligament and the vocalis m are covered by a mucosa-lined membrane comprising the _____.

Answer 51

vocal fold Note: It is the vocal fold that vibrates during speech, not the vocal ligament or cord.

Question 52

When can air pass the rima glottis?

Answer 52

When the vocal folds are abducted

Question 53

the vocal fold is the upper border of a larger fold that is called ?

Answer 53

the conus elasticus

Question 54

What points connects the thyroid, cricoid, and arytenoid cartilages to one another?

Answer 54

The conus elasticus

Question 55

What is the conus elasticus composed of?

Answer 55

Mainly yellow elastic tissue

Question 56

What are the borders of the conus elasticus?

Answer 56

Sup: the vocal fold Inferior: upper edge of cricoid Anterior: thyroid cartilage and median cricothyroid ligament (lat portion) that attaches the cricoid and thyroid cartilages

Question 57

What lies between the quadrangular membrane and the small thyroepiglottic muscle?

Answer 57

The saccule of the fusiform laryngeal sinus (ventricle of larynx) Note: it extends superiorly from the anterior end of the sinus

Question 58

Why can there be so many unique voices?

Answer 58

Because the crico-arytenoid joint has 3 degrees of freedom

Question 59

By shortening the cords via the ____ muscle, the pitch is lowered.

Answer 59

Vocalis

Question 60

By tensing the folds via the _____ m, the vibrations are strong and the pitch rises.

Answer 60

cricothyroid

Question 61

______ is produced by the pharynx, oral region and nasal passages and is modified by the tongue, lips, and palatine musculature.

Answer 61

Resonance

Question 62

The opening to the larynx is forcefully closed by the contraction of what adductor muscles ?

Answer 62

the lateral crico-arytenoid, and the transverse and oblique arytenoid muscles.

Question 63

What pulls the larynx toward the epiglottis?

Answer 63

The ary-epiglottic muscle

Question 64

What 3 actions occur during swallowing to protect the larynx? (This is a reflex when god enters the laryngeal vestibule)

Answer 64

A- The opening to the larynx is forcefully closed by the contraction of the adductor muscles - the lateral crico-arytenoid, and the transverse and oblique arytenoid muscles. B The larynx is pulled toward the epiglottis by the paired ary-epiglottic muscles. C. The epiglottis-larrynx partially folds beneath the posterior 1/3 of the tongue.

Question 65

What provides sensory and autonomic innervation above the vocal folds.

Answer 65

The internal laryngeal nerve

Question 66

What accompanies the internal laryngeal nerve?

Answer 66

The super laryngeal artery

Question 67

What branch of the superior laryngeal nerve provides motor sensation to the cricothyroid muscle?

Answer 67

The external laryngeal nerve

Question 68

What nerve travels with the superior thyroid artery and is in danger during thyroid surgery?

Answer 68

The external laryngeal nerve

Question 69

What nerve supplies the muscles of the larynx and sensation below the vocal cords?

Answer 69

The inferior laryngeal nerve ( a branch of the recurrent laryngeal)

Question 70

What nerve is a terminal branch of the recurrent laryngeal nerve that supplies the muscles of the larynx below the vocal cords?

Answer 70

Inferior laryngeal nerve

Question 71

What nerve travels with the inferior laryngeal artery and passes behind the thyroid gland where it is at risk in thyroid surgery?

Answer 71

The inferior laryngeal nerve

Question 72

Where are the lower motor neurons for all the muscles of the larynx, including the stylopharyngeus?

Answer 72

The nucleus ambiguous

Question 73

What 1st order neurons does the superior (jugular) ganglion contain?

Answer 73

Those that mediate sensation (pain and touch)

Question 74

Where do 1st order neurons from superior (jugular) ganglion synapse?

Answer 74

Pain: nucleus of the spinal tract Touch: the pontine nucleus

Question 75

What 1st order neurons does the inferior (nodose) ganglion contain?

Answer 75

Those for non-conscious information

Question 76

Where do the 1st order neurons from the inferior (nodose) ganglion project to?

Answer 76

The solitary nucleus in the brainstem.

Question 77

The nodose ganglion also contains (besides non-conscious) 1st order neurons whose peripheral axons convey ____ from the area of the epiglottis. The central axons of these neurons project to the _____ that is a specialized region of the solitary nucleus.

Answer 77

taste taste center

Question 78

What pathology of the vocal folds is characterized by small growths that are caused by overuse. Results in a raspy voice. Might require surgical removal.

Answer 78

Nodules

Question 79

What pathology of the vocal folds is characterized by benign lesions that can produce a hoarse, breathy voice that tires easily. May require surgery.

Answer 79

Polyps

Question 80

What pathology of the vocal folds is due to inadequate hydration of the vocal folds. A thick mucous prevents the folds from vibrating correctly.

Answer 80

Laryngitis (sicca)