06 Larynx and Trachea Anatomy

Question 1

T/F. Embryologically, the supraglottis and glottis are separate entities

Answer 1

True

Question 2

Which branchial arches make the larynx

Answer 2

III, IV, VI

Question 3

How many cartilages make the larynx and what are they

Answer 3

9

• Paired: arytenoid, corniculate, cuneiform
• Unpaired: epiglottis, thyroid, cricoid

Question 4

What blood vessel travels with internal branch of superior laryngeal nerve piercing thyrohyoid membrane?

Answer 4

Superior laryngeal artery

Question 5

What separates the 2 valleculae associated with the tongue and epiglottis?

Answer 5

Median glosso-epiglottic fold

Question 6

What nerve provides sensory innervation to the piriform recess of the larynx?

Answer 6

Internal laryngeal branch of superior laryngeal nerve

Question 7

What is the name of the upper free margin of the conus elasticus?

Answer 7

Vocal ligament

Question 8

What is the name of the lower free margin of the quadrangular membrane

Answer 8

Vestibular fold

Question 9

In an adult, what is the vertebral level of the

• hyoid
• cricoid
• carina

Answer 9

• C3
• C6
• T4

Question 10

What is the membrane b/w the cricoid cartilage and 1st tracheal ring

Answer 10

cricotracheal membrane

Question 11

What part of the thyroid cartilage articulates with the cricoid cartilage

Answer 11

Inferior cornu

Question 12

What muscle adducts the false vocal folds and AE folds

Answer 12

thyroarytenoid muscle

Question 13

What muscles does the anterior branch of the RLN innervate

Answer 13

Lateral cricoarytenoid, thyroarytenoid, vocalis muscles

Question 14

Where does the superior laryngeal artery lie in relation to the superior laryngeal nerve

Answer 14

Artery is inferior to the nerve

Question 15

What are the layers of the VF from superficial to deep

Answer 15

• Squamous epith
• Reinke’s space (superior layer of lamina propria)
• Intermediate and deep layers of lamina propria (vocal ligament)
• Thyroarytenoid muscle

Question 16

What are the 2 types of squamous epithelium lining the TVF

Answer 16

Pseudostratified columna (superiorly and inferiorly) and stratified nonkeratinizing squamous (at the contact points of the TVFs)

Question 17

How does position of larynx differ b/w neonate and adult

Answer 17

Neonate: larynx is C2-C3 with cricoid C3-C4
Adult: larynx is C5 with cricoid at C7

Question 18

What is Broyles’ ligament and its significance

Answer 18

Vocalis muscle tendon that inserts into thyroid cartilage; serves as pathway for tumor extension into the thyroid cartilage

Question 19

What anatomic structures inhibit malignant invasion by laryngeal cancers

Answer 19

Conus elasticus
Quadrangular membrane
Thyrohyoid membrane
Cricothyroid membrane
Internal perichondrium of thyroid lamina

Question 20

Boundaries of Preepiglottic space

Answer 20

Superiorly: hyoepiglottic ligament
Posteriorly: Epiglottic cartilage
Anterioly: thyrohyoid membrane and hyoid bone

Question 21

What anatomic feature of the epiglottis facilitates extension of cancer into the preepiglottic space

Answer 21

fenestrations/dehiscences

Question 22

What vessels are in direct contact with the anterior trachea

Answer 22

brachiocephalic artery and the left brachiocephalic vein

Question 23

What percentage of population has a thyroid ima artery

Answer 23

3-10%

Question 24

Which layers of the TVF are responsible for vibration

Answer 24

epithelium and superficial layer of the lamina propria

Question 25

Average fundamental frequency of

• child
• adult female
• adult male

Answer 25

• 250 Hz
• 200 Hz
• 120 Hz

Question 26

Average dB level of human voice

Answer 26

65-75 dB

Question 27

Maximum range of fundamental freq for human voice

Answer 27

36-1760 Hz

Question 28

Average maximum phonation time for adult male? female?

Answer 28

17-35 sec; 12-26 sec

Question 29

What is the sequence of events during the glottic closure reflex

Answer 29

Closure of TVF then closure of FVF then adduction of AE folds

Question 30

Unlike glottic closure reflex, laryngospasm is mediated solely by stimulation of what nerve

Answer 30

Superior laryngeal nerve