Larynx

Front 1

Overview of the larynx

Back 1

Related posteriorly to C3-C6 vertebrae
Approx 5 cm long in adult male, shorter in females and children
Comprised of 3 unpaired and 3 paired cartilages (total 9)

Front 2

3 internal compartments of larynx

Back 2

1. vestibule
2. ventricle
3. infraglottic cavity

Front 3

vestibule

Back 3

cavity superior to vestibular folds (false vocal cords) up to the level of epiglottis

Front 4

ventricle

Back 4

smallest cavity that extends laterally between vestibular folds and superior to vocal folds

Front 5

infraglottic cavity

Back 5

extends from vocal folds to inferior border of cricoid cartilage`

Front 6

functional anatomy of the laryngeal cartilages

Back 6

structural relationships of 4 (thyroid, cricoid, arytenoids) of 9 change possition and tension of vocal folds to produce variation of pitch
remaining 5 keeps food and foreign bodies out of larynx

Front 7

thyroid cartilage

Back 7

thyroid lamina fused anteriorly to form laryngeal prominence
superior and inferior horns: posterior
inferior pharyngeal constrictor, thyrohyoid and sternohyoid muscles are attached on the lateral side of the laminae

Front 8

cricoid cartilage

Back 8

C6 level
single cartilage located inferiorly to the thyroid cartilage
shaped like a signet ring with thick side on posterior
thyroid cartilage rocks back and forth on top of cricoid cartilage

Front 9

cricothyroid ligaments

Back 9

attach the inferior part of the thyroid cartilage to the cricoid

Front 10

cricothyroid muscle

Back 10

originates fro the anteriolateral aspect of cricoid

Front 11

thyrohyoid membrane

Back 11

attaches the superior horn of each thyroid lamina to the hyoid bone

Front 12

cricothyroid joint

Back 12

attaches the inferior horn of each thyroid lamina to the cricoid cartilage which allows thyroid cartilage to glide and tilt upon cricoid cartelage

Front 13

arytenoid cartelages

Back 13

paired cartilages located on the top of the posterior region of the cricoid cartilage
shaped like 3 sided pyramids

Front 14

muscular process of arytenoid

Back 14

side of aretynoids that attach to the intrinsic laryngeal muscles

Front 15

vocal process of arytenoids

Back 15

side that attaches to the vocal ligaments

Front 16

apex of the arytenoids

Back 16

oriented superiorly
attached to the aryepiglottic fold which helps close the larynx during swallowing

Front 17

Corniculate and cuneiform cartilages

Back 17

paired cartilages located in the posterior region of the aryepiglottic folds
help prevent food and foreign bodies from entering larynx by stabilizing the structural integrity of the aryepiglottic folds when they are closed

Front 18

epiglottic cartilage

Back 18

single thin cartelage shaped like a leaf
inferior part attached to the laryngeal prominence (inside) of the thyroid cartilage via thyoepiglottic ligament
attached to the hyoid bone anteriorly via the hyoepiglottic ligament
helps close the laryngeal leaflet during swallowing

Front 19

Vocal folds

Back 19

True vocal cords - produce sound
refers to the vocal ligaments + cricothyroid ligaments covered by mucous membrane

Front 20

vocal ligament

Back 20

underlies the vocal folds and extends from the inside of the laryngeal prominence to the vocal processes of the arytenoid cartilages

Front 21

cricothyroid ligament

Back 21

extends superiorly from the cricoid cartilage to the vocal ligament (both median and lateral cricothyroid ligaments)

Front 22

conus elasticus

Back 22

vocal ligament + cricothyroid ligament

Front 23

rima glottidis

Back 23

space between the vocal folds

Front 24

glottis

Back 24

refers to the larynx at the level of the vocal folds

Front 25

Vestibular folds

Back 25

false vocal cords - a protective mechanism
-not responsible for sound
-superior to the vocal folds and extend from thyroid to aryenoid cartilages
-formed by the inferior free ridge of quadrangular membrane
-serve as part of the protective mechanism closing the larynx during swallowing

Front 26

Quadrangular membrane

Back 26

inferior free ridge forms the vestibular folds;
extends from the arytenoid to thyroid cartilages
superior edge: forms aryepiglottic fold which engulfs cuneiform and corniculate cartilages

Front 27

rima vestibuli

Back 27

space between vestibular folds

Front 28

areyepiglottic fold

Back 28

top lid of quandrangular membrane extending between epiglottis and arytenoid cartelages
engulfs the cuneiform and corniculate cartilages

Front 29

Space surrounded by quadrangular membrane

Back 29

Vestibule

Front 30

Muscles of the laryngeal leaflet

Back 30

transverse arytenoid muscle
oblique arytenoid muscle
thyroepiglottic muscle

innervation: recurrent laryngeal nerve

actions: contraction of these muscles approximate the aryepiglottic folds and move the arytenoid cartilages toward the epiglottis as it closes
This helps close the laryngeal inlet and keeps foreign bodies outside of the larynx
the thyroepiglottic muscle also changes the size of the laryngeal inlet by assisting the approximation of the epiglottis to the aryepiglottic fold

Front 31

Transverse arytenoid muscle

Back 31

unpaired muscle covering the arytenoid cartilages posteriorly extending from one to another

recurrent laryngeal nerve

action: approximate the aryepiglottic folds
close the laryngeal inlet

Front 32

oblique arytenoid muscle

Back 32

paired muscles located superficially to transverse arytenoids. form x-shape with muscle fibers continuing as the aryepiglottic muscle

recurrent laryngeal nerve

Front 33

thyroepiglottic muscle

Back 33

continuation of the thyroarytenoid muscle beyond the aryepiglottic fold to insert on the epiglottic cartilage

recurrent laryngeal nerve

Front 34

Muscles of the vocal folds

Back 34

Open and closes the rima glottidis

lateral cricoarytenoid muscle
posterior cricoarytenoid muscle
Cricothyroid muscle
Thyroarytenoid muscle
Vocalis muscle

LPCTV

Front 35

lateral cricoarytenoid muscle

Back 35

paired muscle that arises from lateral part of cricoid cartilage and attaches to the muscular processes of the arytenoid cartilages

ADDUCTOR: contraction of this muscle rotates the muscular processes of the arytenoids anteriorly so that their vocal processes and attached vocal ligaments swing medially to CLOSE the rima glottidis

Innervation: recurrent laryngeal nerve

Front 36

posterior cricoarytenoid muscle

Back 36

paired muscle arises from posterior part of cricoid cartilage and attaches to the muscular processes of the arytenoid cartilages

ABDUCTOR: contraction rotates the muscular processes of the aryenoids meially so that their vocal processes and attached vocal ligaments swing laterally to OPEN the rima glottidis

Innervation recuurent laryngeal nerve

Front 37

Bilateral paralysis of the ______ narrows the ______ and leads to suffication

Back 37

posterior cricoarytenoid muscle

rima glottidis

Front 38

cricothyroid muscle

Back 38

paired muscle arises from the anterolateral cricoid cartilage and attaches to inferior horn of thyroid cartilage

Tensor: contraction causes the thyroid cartilage to tilt anteriorly upon the cricoid. This elongates and tightens the vocal ligaments thus raising voice pitch

innervation: external laryngeal nerve (X; branch of the superior laryngeal nerve)

Front 39

Thyroarytenoid muscle

Back 39

Paired muscle arises from thyroid cartilage and inserts into arytenoid cartilages

Relaxor: contraction pulls the arytenoid cartilages anteriorly and slackens the vocal ligaments to lower voice pitch

Innervation: recurrent laryngeal nerve (X)

Front 40

Vocalis muscle

Back 40

Extension of the thyroarytenoid muscle that attaches to the vocal ligament

Small contractions of the vocalis make tiny adjustments to voice pitch and function during whispering

Front 41

Blood supply and sensory innervation to the larynx

Back 41

superior laryngeal artery
inferior laryngeal artery

external (pure motor) and internal laryngeal nerves (pure sensory)

recurrent laryngeal nerve (motor and sensory)

Front 42

Superior laryngeal artery

Back 42

Enters interior of the larynx via thyrohyoid membrane along with internal laryngeal nerve

Front 43

Inferior laryngeal artery

Back 43

Runs with recurrent laryngeal nerve to supply blood to the muscles and membrane of the inferior parts of the larynx

Front 44

Recurrent laryngeal nerve

Back 44

provides motor innervation to all intrinsic laryngeal muscles except cricothyroid and continues as a sensory nerve below the vocal folds

Front 45

External laryngeal nerve

Back 45

PURE MOTOR to cricothyroid

Front 46

Internal laryngeal nerve

Back 46

sensory innervation to the mucous membrane superior to vocal folds

Front 47

Sensory innervation to the mucous membrane of the larynx is from:

Back 47

X

Superior to vocal folds: internal laryngeal nerve
Inferior to vocal folds: recurrent laryngeal nerve

Front 48

Laryngeal spasm

Back 48

mucous membrane of laryngeal aditus very sensitive and contact immediately causes explosive coughing

Front 49

laryngeal obstruction

Back 49

real choking where object lodged in rima glottidis
-need to perform heimlich maneuver or emergency cricothyrotomy (through the median cricothyroid ligament

Front 50

Tracheotomy
Tracheostomy

Back 50

slit incision through trachea
square hole or round
-cut trachea ring 2-3, where isthmus is located
-incision below not advisable due to thyroid ima artery
plexus of inferior thyroid veins
thymus gland in children