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Head and Neck > 16) The Larynx > Flashcards

16) The Larynx Flashcards

1
Q

What are the functions of the larynx? (4)

A

Ventilation
Airway protection
Cough
Phonation

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2
Q

Describe the location of the larynx:

A

Between hyoid bone and trachea (C4-C6)

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3
Q

What are the main cartilages making up the larynx?

A

Epiglottis, thyroid, cricoid and arytenoid

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4
Q

Where does the epiglottis attach?

A

Anteriorly to hyoid and inferiorly to thyroid cartilage (thryoepiglottic ligament)

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5
Q

What is the function of the epiglottis?

A

Cover laryngeal inlet to prevent fluids or food entering resp. tract

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6
Q

What is the vallecula and its significance?

A

Depression between tongue base and epiglottis

Important for intubation of trachea

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7
Q

Describe the movements during swallowing to prevent food entering the respiratory tract:

A

Epiglottis pulled down and larynx pulled up and forward

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8
Q

How does epiglottitis present?

A

Sore throat, fever, drooling, sounds on breathing

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9
Q

What is the likely causative organism of epiglottitis?

A

H. influenzae

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10
Q

Describe the structure of the thyroid cartilage:

A

Two laminae meeting in midline to create the laryngeal prominence

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11
Q

How is the thyroid cartilage joined to the other cartilages of the larynx and nearby bone?

A

Joined to hyoid by thyrohyoid membrane

Joined to cricoid by cricothyroid ligament (membrane)

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12
Q

Describe the cricoid cartilage:

A

Complete ring of cartilage, connected to trachea by cricotracheal membrane

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13
Q

Describe the arytenoid cartilages and what attaches to them:

A

Sit on top of cricoid posteriorly and are points of attachment for vocal and vestibular ligaments

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14
Q

What is cricoid pressure?

A

Pressing on cricoid cartilage from front to compress oesophagus and stop regurgitation

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15
Q

What is a cricothryoidotomy?

A

Making an emergency airway through cricothyroid membrane

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16
Q

What forms the false vocal cords?

A

Vestibular fold (ligament)

17
Q

Describe the true vocal cords:

A

Vocal fold with vocal ligament and vocalis muscles forms true vocal cord. Stratified squamous epithelium

18
Q

Where do the vocal cords attach?

A

Anteriorly - thyroid cartilage (fixed)

Posteriorly - arytenoid (mobile)

19
Q

How are the vocal cords moved?

A

Intrinsic muscles of larynx pull arytenoids causing them to pivot on cricoid cartilage and move the cords

20
Q

How would the vocal cords appear during ventilation?

A

Abducted

21
Q

How would the vocal cords appear during phonation?

A

Partially abducted

22
Q

How would the vocal cords appear during swallowing?

A

Adducted

23
Q

What is the only intrinsic muscle of the larynx to be located external to the larynx?

A

Cricothyroid

24
Q

What is the function of cricothyroid?

A

Tense the vocal cords causing higher pitch sounds

25
Q

What is the innervation to cricothyroid?

A

External branch of superior laryngeal nerve (CN X)

26
Q

What muscle causes abduction of the vocal cords?

A

Posterior cricoarytenoid

27
Q

What are some functions of the intrinsic muscles of the larynx?

A

Adduction and abduction
Relaxation and tension of vocal cords
Pulls epiglottis over laryngeal inlet

28
Q

What are the 3 regions of the larynx?

A

Supraglottis - epiglottis to vestibular folds
Glottis - cords plus 1 cm
Subglottis - to lower border of cricoid

29
Q

What does the recurrent laryngeal nerve innervate?

A

Sensory to subglottis and motor to intrinsic muscles of larynx

30
Q

What does the internal branch of the superior laryngeal nerve innervate?

A

Sensory to supraglottis

31
Q

Following thyroid surgery, a woman presents with a deep, hoarse voice. What has occurred?

A

Damage to recurrent laryngeal nerve as inferior thyroid artery runs near nerve

32
Q

What are some causes of recurrent laryngeal nerve palsy?

A 
Thyroid disease
Laryngeal cancer
Thyroidectomy
Apical lung tumour
Aortic aneurysm
33
Q

How does unilateral complete injury of recurrent laryngeal nerve present?

A

Vocal cords in neutral position

Hoarseness and weaker cough

34
Q

How does bilateral injury of recurrent laryngeal nerve present?

A

Difficulty breathing
Stridor
Can’t speak properly

35
Q

What type are the majority of laryngeal cancers?

A

Squamous cell carcinoma

36
Q

What are some risk factors for laryngeal cancer?

A

Smoking and alcohol

Male

37
Q

Why is the prognosis of cancer favourable if only the glottis is affected?

A

Minimal lymphatic drainage for glottis so less likely to spread

38
Q

What are some symptoms of laryngeal cancer?

A 
Hoarseness
Foreign body sensation in throat 
Dysphagia and odynophagia 
Otalgia (referred)
Cough 
Weight loss

Head and Neck (17 decks)

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