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ENT Week 1 2017/18 > 10: Anatomy 4 - larynx > Flashcards

10: Anatomy 4 - larynx Flashcards

1
Q

What part of the respiratory tract is found above the trachea?

A

Larynx

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2
Q

The larynx is a series of ___ joined by connective tissues and moved by muscles.

A

cartilages

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3
Q

The larynx is found between the ___ and the ___.

A

pharynx

trachea

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4
Q

Which muscles, found in the pretrachial fascia, act as accessory muscles of breathing?

A

Strap muscles

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5
Q

What are the four strap muscles of the neck?

A

Sternothyroid

Sternohyoid

Thyrohyoid

Omohyoid

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6
Q

What part of the pharynx is found posterior to the larynx?

A

Laryngopharynx

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7
Q

What blood vessels are found to either side of the larynx?

A

Common carotid artery

Internal jugular vein

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8
Q

At which vertebral level is the hyoid bone found?

A

C3

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9
Q

At which vertebral level is the thyroid cartilage found?

A

C5

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10
Q

At which vertebral level is the cricoid cartilage found?

A

C6

Same level as cricopharyngeus (START OF THE OESOPHAGUS)

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11
Q

What is the first palpable spinous process?

A

C7

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12
Q

Which directions do the larynx and epiglottis move to prevent aspiration into the respiratory tract?

A

Larynx moves UP

Epiglottis moves DOWN

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13
Q

Which bone are the cartilages of the larynx suspended from?

A

Hyoid bone

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14
Q

Which bone is found at the top of the larynx?

A

Hyoid bone

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15
Q

Which membrane is found between the hyoid bone and the thyroid cartilage?

A

Thyrohyoid membrane

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16
Q

What are three notable parts of the thyroid cartilage?

A

Superior horn

Laryngeal prominence (Adam’s apple)

Inferior horn

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17
Q

What are the four important cartilages of the larynx?

A

Epiglottis

Thyroid cartilage

Arytenoid cartilages (posteriorly)

Cricoid cartilage

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18
Q

What type of cartilage make up the

a) epiglottis
b) thyroid cartilage
c) arytenoid cartilages
d) cricoid cartilage?

A

a) Elastic cartilage

b) c) d) All hyaline cartilage

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19
Q

Which joint connects the

a) thyroid and cricoid cartilages
b) arytenoid and cricoid cartilages?

A

a) Cricothyroid joint

important landmark - where recurrent laryngeal nerve becomes inferior laryngeal nerve

b) Cricoarytenoid joint

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20
Q

What shape is the 1st tracheal ring?

A

C-shaped

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21
Q

Which part of the cricoid cartilage compresses the oesophagus when you press on it?

A

Lamina

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22
Q

What is the inlet of the larynx called?

A

Aditus

to make things even more confusing

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23
Q

What are the two types of vocal fold found in the larynx?

A

False vocal cord

True vocal cord

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24
Q

What must a vocal fold be covered in to be called a vocal cord?

A

Squamous epithelium

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25
Q

What is the origin and insertion of the true vocal cords?

A

Vocal processes of arytenoid cartilages

Thyroid cartilage

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26
Q

What are the two important ligaments of the larynx?

A

Vestibular ligament

Vocal ligament

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27
Q

What is the membrane running between the epiglottis and vestibular ligament?

A

Quadrangular membrane

28
Q

What is the membrane running between the vocal ligament and the cricoid cartilage?

A

Conus elasticus

29
Q

Which membranes join the

a) hyoid bone and thyroid cartilage
b) epiglottis and vestibular ligament
c) vocal ligament and cricoid cartilage?

A

a) Thyrohyoid membrane

b) Quadrangular membrane

c) Conus elasticus

30
Q

What is the space between the true vocal cords called?

A

Rima glottidis

31
Q

What is the space between the epiglottis and tongue called?

A

Vallecula

32
Q

What instrument is placed into the vallecula to view the larynx?

A

Laryngoscope

33
Q

What space is found between the tongue and epiglottis?

A

Vallecula

34
Q

What is the rima glottidis?

A

Space between the true vocal cords

35
Q

The intrinsic muscles of the larynx are all examples of (smooth / skeletal) muscle.

A

skeletal muscle

because using your voice is voluntary

36
Q

What effects do tensing and relaxing the vocal cords have on pitch?

A

Tension = Higher pitch

Relaxation = Lower pitch

37
Q

What effects do abducting and adducting the vocal cords have on volume?

A

Abduction (opening) = Louder

Adduction (closing) = Quieter

38
Q

Which cranial nerve innervates the intrinsic muscles of the larynx?

A

CN X

Vagus nerve

39
Q

Which muscles tense the vocal cords by pulling the thyroid cartilage downwards?

A

Cricothyroid muscles

40
Q

Which muscles pull the thyroid cartilage superiorly to relax the vocal cords?

A

Thyroarytenoid muscles

41
Q

Which muscles pull the vocal cords together to make the voice quieter?

A

Lateral crico-arytenoid muscles

Arytenoid muscles

42
Q

Which muscles pull the vocal cords apart to make the voice louder?

A

Posterior crico-arytenoid muscles

43
Q

Which muscles

a) raise the pitch
b) lower the pitch
c) lower the volume
d) raise the volume

of the voice?

A

a) Cricothyroid muscles

b) Thyroarytenoid muscles

c) Lateral crico-arytenoid muscles

Arytenoid muscles

d) Posterior crico-arytenoid muscles

44
Q

Which intrinsic laryngeal muscles look like a Scotland flag?

A

Arytenoid muscles

(adductors, make the voice quieter - along with posterior crico-arytenoids - by closing the vocal cords)

45
Q

Which muscles

a) OPEN
b) CLOSE
c) TENSE
d) RELAX

the vocal cords?

A

a) Posterior crico-arytenoids

b) Lateral crico-arytenoids, arytenoids

c) Cricothyroids

d) Thyroarytenoids

46
Q

Which muscles OPEN the vocal cords to assist with deep inspiration?

A

Posterior crico-arytenoids

47
Q

Which muscles CLOSE the vocal cords to assist with phonation?

A

Lateral crico-arytenoids

Arytenoids

48
Q

Which lymph nodes do tumours above the rima glottidis drain to?

A

Superior deep cervical nodes

49
Q

Where do tumours above the rima glottidis drain?

What symptom are they associated with?

A

Superior deep cervical nodes

Neck lump

50
Q

Where do tumours on the vocal cords drain?

What symptom are they associated with?

A

Nowhere, usually remain on the cords

Hoarseness

51
Q

Where do tumours below the rima glottidis drain?

What symptom are they associated with?

A

Paratracheal nodes

Hoarseness, airway obstruction

52
Q

Which cranial nerves control

a) levator veli palatini
b) tensor veli palatini?

A

a) CN X

b) CN V3

53
Q

Which cranial nerves control the

a) shape of the tongue
b) shape of the lips?

A

a) CN XII (and X for palatoglossus)

b) CN VII (muscles of facial expression)

54
Q

Given that oral sound and nasal sounds require the soft palate, tongue and lips to move, which cranial nerves are responsible for oral sounds?

A

Levator & tensor veli palatini - CN X, CN V3

Tongue - CN XII, CN X

Lips - CN VII

55
Q

What changes position to change from oral to nasal sounds?

Which muscle controls this?

Which cranial nerve innervates the muscle?

A

Soft palate

Levator veli palatini

CN X

56
Q

Through which neck compartment does CN X travel?

A

Carotid sheathe

along with common carotid artery and internal jugular vein

57
Q

Through which hole in the posterior cranial fossa does CN X pass?

A

Jugular foramen

same as CN IX, X and XI

58
Q

Which nerve supplies pretty much everything to do with the larynx?

A

CN X

Vagus nerve via its many branches

59
Q

Which branches are given off of the vagus nerve as it travels down the neck?

A

Superior laryngeal nerve

Recurrent laryngeal nerve

60
Q

Which branches of the vagus nerve come off the superior laryngeal nerve?

A

Internal laryngeal nerve

External laryngeal nerve

61
Q

Where does the recurrent laryngeal nerve arise on the left and right?

A

Left - hooks under arch of the aorta

Right - hooks under right subclavian artery

62
Q

Which branch of CN X supplies almost everything in the larynx?

What is the exception?

A

Recurrent laryngeal nerve (which turns into inferior laryngeal nerve)

EXCEPTION: cricothyroid muscles (vocal cord tensors) which are supplied by external laryngeal nerve (branch of superior laryngeal nerve)

63
Q

What supplies the cricothyroid muscle?

A

External laryngeal nerve

branch of CN X

64
Q

Which branch of the superior laryngeal nerve supplies the mucosa above the vocal folds?

A

Internal laryngeal nerve

65
Q

Which branch of the recurrent laryngeal nerve supplies the mucosa below the vocal folds?

A

Inferior laryngeal nerves

66
Q

At which joint does the recurrent laryngeal nerve become the inferior laryngeal nerve?

A

Cricothyroid joint

67
Q

What is Galen’s anastomosis?

A

Connection between INTERNAL and INFERIOR laryngeal nerves

Remember internal does mucosa above vocal folds and inferior does mucosa below it, so anastomosis connects the whole thing

ENT Week 1 2017/18 (10 decks)

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