10: Anatomy 4 - larynx Flashcards
What part of the respiratory tract is found above the trachea?
Larynx
The larynx is a series of ___ joined by connective tissues and moved by muscles.
cartilages
The larynx is found between the ___ and the ___.
pharynx
trachea
Which muscles, found in the pretrachial fascia, act as accessory muscles of breathing?
Strap muscles
What are the four strap muscles of the neck?
Sternothyroid
Sternohyoid
Thyrohyoid
Omohyoid
What part of the pharynx is found posterior to the larynx?
Laryngopharynx
What blood vessels are found to either side of the larynx?
Common carotid artery
Internal jugular vein
At which vertebral level is the hyoid bone found?
C3
At which vertebral level is the thyroid cartilage found?
C5
At which vertebral level is the cricoid cartilage found?
C6
Same level as cricopharyngeus (START OF THE OESOPHAGUS)
What is the first palpable spinous process?
C7
Which directions do the larynx and epiglottis move to prevent aspiration into the respiratory tract?
Larynx moves UP
Epiglottis moves DOWN
Which bone are the cartilages of the larynx suspended from?
Hyoid bone
Which bone is found at the top of the larynx?
Hyoid bone
Which membrane is found between the hyoid bone and the thyroid cartilage?
Thyrohyoid membrane
What are three notable parts of the thyroid cartilage?
Superior horn
Laryngeal prominence (Adam’s apple)
Inferior horn
What are the four important cartilages of the larynx?
Epiglottis
Thyroid cartilage
Arytenoid cartilages (posteriorly)
Cricoid cartilage
What type of cartilage make up the
a) epiglottis
b) thyroid cartilage
c) arytenoid cartilages
d) cricoid cartilage?
a) Elastic cartilage
b) c) d) All hyaline cartilage
Which joint connects the
a) thyroid and cricoid cartilages
b) arytenoid and cricoid cartilages?
a) Cricothyroid joint
important landmark - where recurrent laryngeal nerve becomes inferior laryngeal nerve
b) Cricoarytenoid joint
What shape is the 1st tracheal ring?
C-shaped
Which part of the cricoid cartilage compresses the oesophagus when you press on it?
Lamina
What is the inlet of the larynx called?
Aditus
to make things even more confusing
What are the two types of vocal fold found in the larynx?
False vocal cord
True vocal cord
What must a vocal fold be covered in to be called a vocal cord?
Squamous epithelium
What is the origin and insertion of the true vocal cords?
Vocal processes of arytenoid cartilages
Thyroid cartilage
What are the two important ligaments of the larynx?
Vestibular ligament
Vocal ligament
What is the membrane running between the epiglottis and vestibular ligament?
Quadrangular membrane
What is the membrane running between the vocal ligament and the cricoid cartilage?
Conus elasticus
Which membranes join the
a) hyoid bone and thyroid cartilage
b) epiglottis and vestibular ligament
c) vocal ligament and cricoid cartilage?
a) Thyrohyoid membrane
b) Quadrangular membrane
c) Conus elasticus
What is the space between the true vocal cords called?
Rima glottidis
What is the space between the epiglottis and tongue called?
Vallecula
What instrument is placed into the vallecula to view the larynx?
Laryngoscope
What space is found between the tongue and epiglottis?
Vallecula
What is the rima glottidis?
Space between the true vocal cords
The intrinsic muscles of the larynx are all examples of (smooth / skeletal) muscle.
skeletal muscle
because using your voice is voluntary
What effects do tensing and relaxing the vocal cords have on pitch?
Tension = Higher pitch
Relaxation = Lower pitch
What effects do abducting and adducting the vocal cords have on volume?
Abduction (opening) = Louder
Adduction (closing) = Quieter
Which cranial nerve innervates the intrinsic muscles of the larynx?
CN X
Vagus nerve
Which muscles tense the vocal cords by pulling the thyroid cartilage downwards?
Cricothyroid muscles
Which muscles pull the thyroid cartilage superiorly to relax the vocal cords?
Thyroarytenoid muscles
Which muscles pull the vocal cords together to make the voice quieter?
Lateral crico-arytenoid muscles
Arytenoid muscles
Which muscles pull the vocal cords apart to make the voice louder?
Posterior crico-arytenoid muscles
Which muscles
a) raise the pitch
b) lower the pitch
c) lower the volume
d) raise the volume
of the voice?
a) Cricothyroid muscles
b) Thyroarytenoid muscles
c) Lateral crico-arytenoid muscles
Arytenoid muscles
d) Posterior crico-arytenoid muscles
Which intrinsic laryngeal muscles look like a Scotland flag?
Arytenoid muscles
(adductors, make the voice quieter - along with posterior crico-arytenoids - by closing the vocal cords)
Which muscles
a) OPEN
b) CLOSE
c) TENSE
d) RELAX
the vocal cords?
a) Posterior crico-arytenoids
b) Lateral crico-arytenoids, arytenoids
c) Cricothyroids
d) Thyroarytenoids
Which muscles OPEN the vocal cords to assist with deep inspiration?
Posterior crico-arytenoids
Which muscles CLOSE the vocal cords to assist with phonation?
Lateral crico-arytenoids
Arytenoids
Which lymph nodes do tumours above the rima glottidis drain to?
Superior deep cervical nodes
Where do tumours above the rima glottidis drain?
What symptom are they associated with?
Superior deep cervical nodes
Neck lump
Where do tumours on the vocal cords drain?
What symptom are they associated with?
Nowhere, usually remain on the cords
Hoarseness
Where do tumours below the rima glottidis drain?
What symptom are they associated with?
Paratracheal nodes
Hoarseness, airway obstruction
Which cranial nerves control
a) levator veli palatini
b) tensor veli palatini?
a) CN X
b) CN V3
Which cranial nerves control the
a) shape of the tongue
b) shape of the lips?
a) CN XII (and X for palatoglossus)
b) CN VII (muscles of facial expression)
Given that oral sound and nasal sounds require the soft palate, tongue and lips to move, which cranial nerves are responsible for oral sounds?
Levator & tensor veli palatini - CN X, CN V3
Tongue - CN XII, CN X
Lips - CN VII
What changes position to change from oral to nasal sounds?
Which muscle controls this?
Which cranial nerve innervates the muscle?
Soft palate
Levator veli palatini
CN X
Through which neck compartment does CN X travel?
Carotid sheathe
along with common carotid artery and internal jugular vein
Through which hole in the posterior cranial fossa does CN X pass?
Jugular foramen
same as CN IX, X and XI
Which nerve supplies pretty much everything to do with the larynx?
CN X
Vagus nerve via its many branches
Which branches are given off of the vagus nerve as it travels down the neck?
Superior laryngeal nerve
Recurrent laryngeal nerve
Which branches of the vagus nerve come off the superior laryngeal nerve?
Internal laryngeal nerve
External laryngeal nerve
Where does the recurrent laryngeal nerve arise on the left and right?
Left - hooks under arch of the aorta
Right - hooks under right subclavian artery
Which branch of CN X supplies almost everything in the larynx?
What is the exception?
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)
What supplies the cricothyroid muscle?
External laryngeal nerve
branch of CN X
Which branch of the superior laryngeal nerve supplies the mucosa above the vocal folds?
Internal laryngeal nerve
Which branch of the recurrent laryngeal nerve supplies the mucosa below the vocal folds?
Inferior laryngeal nerves
At which joint does the recurrent laryngeal nerve become the inferior laryngeal nerve?
Cricothyroid joint
What is Galen’s anastomosis?
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