10. The larynx Flashcards
describe the location of the larynx
- suspended from hyoid bone
- extends from laryngeal inlet (C3) to lower border of cricoid cartilage (C6) - continues as trachea
- anterior to laryngopharynx
- invested in pre-tracheal fascia
which structures are found anterior and lateral to the larynx
- anterior: infrahyoid muscles
- lateral: lobes of thyroid gland
name the cartilaginous components of the larynx and how they articulate together
- Thyroid cartilage:
- superior horns articulate with hyoid
- inferior horns articulate with cricoid - Cricoid cartilage:
- articulates with inferior horns of thyroid cartilage superiorly
- articulates with paired arytenoids posteriorly - Epiglottis
- stalk is attached to back of anterior aspect of thyroid cartilage - Arytenoid cartilages
- sit on posterior cricoid cartilage
name the ligaments that support the cartilaginous skeleton of the larynx
- thyrohyoid membrane: suspends thyroid cartilage from hyoid bone
- cricothyroid membrane: connects thyroid cartilage to cricoid cartilage
- cricotracheal ligament: connects cricoid cartilage to 1st tracheal ring
- quadrangular membrane: spans between the anterolateral arytenoid cartilage and lateral aspect of epiglottis
which structures do the free upper and lower margins of the quadrangular membranes form
- free upper margin = aryepiglottic fold - 2 folds form margins of oval laryngeal inlet
- free lower fold = vestibular ligament
which structures do the free upper margins of the cricothyroid ligament form
vocal ligament
with what type of membrane is the internal thyroid lined, and which important structures does folds in this membrane create
- Lined with mucous membrane: pseudostratified columnar epithelium containing goblet cells
- Membrane forms 2 sets of mucosal folds:
- vestibular/false vocal folds (contains vestibular ligament)
- true vocal folds/cords (contains vocal ligament)
which type of epithelium lines the vocal cords
stratified squamous epithelium (to withstand abrasion from air)
what is the rima glottides
space between the 2 true vocal cords
into which 3 regions do the mucosal folds divide the larynx
- SUPRAGLOTTIS: epiglottis to vestibular folds
- GLOTTIS: true vocal cords
- INFRAGLOTTIS: below vocal cords to lower border of cricoid cartilage
which structures lie laterally between the true and false vocal folds
Small recess - LARYNGEAL VENTRICLE - that leads laterally and superiorly into SACCULE of larynx.
Contains mucous glands that keep vocal folds moist.
Describe the structures through which an endotracheal tube must pass to secure an airway
Oral cavity… oropharynx… laryngopharynx… through laryngeal inlet into supraglottis… glottis… into infraglottis.
how will Ps with a compromised upper airway present
- stridor
- increased resp. rate
- hypoxia +/- cyanosis
what is often the earliest presenting symptom in carcinomas of the larynx
hoarseness (if lesions involve vocal cords)
can present with voice and/or airway probs
when might carcinomas of the larynx have different prognoses
- if malignancy is small, caught early and involves glottis: favourable prognosis as glottis has very minimal lymphatic drainage
- if malignancy involves supra- or infra-glottis: poorer prognosis as drain to neck nodes and paratracheal nodes respectively
