5. Tracheobrachial tree & larynx

Question 1

What anatomical feature causes the laryngeal prominence?

Answer 1

• thyroid cartilage surrounding the larynx.

Question 2

At what vertebral level does the laryngeal prominence lie?

Answer 2

• C4, C5.

Question 3

What causes tracheal deviation?

Answer 3

• due to unequal intrathoracic pressure in the chest cavity.

Question 4

At what vertebral level and rib level does the sternal angle of Louis lie?

Answer 4

• T4/T5 and 2nd rib.

Question 5

With regards to the pleura, explain what causes a tension pneumothorax.

Answer 5

• due to the presence of air in the intra-pleural cavity.

Question 6

In the case of a chest injury, wherein the pleural cavity is penetrated on side of the left lung, which side would the trachea deviate towards?

Answer 6

• away from the lesion, therefore towards the right side.

Question 7

From deep to superficial, name the 4 layers surrounding the trachea.

Answer 7

• mucosa.
• submucosa.
• c-shaped ring of hyaline cartilage.
• adventitia.

Question 8

Which artery supplies the thyroid gland?

Answer 8

• inferior thyroid artery.

Question 9

At what vertebral level does the carina lie?

Answer 9

• T4/T5

Question 10

Which bronchus is more susceptible to foreign body inhalation? And why?

Answer 10

• right.

- bc it is wider and more vertical.

Question 11

Which vessels supply the bronchi? And where do they arise from?

Answer 11

• the bronchial branches of the thoracic aorta.

Question 12

Which lymph nodes do the bronchi drain into?

And where do these lymph nodes ultimately drain into?

Answer 12

• the tracheo-bronchial lymph nodes.

- the broncho-mediastinal trunk.

Question 13

Describe the epithelium of the larynx. (2)

Answer 13

• lined with pseudo-stratified ciliated columnar epithelium.
• but not the vocal cords.
• they’re lined with stratified squamous epithelium.

Question 14

At what vertebral level of the larynx found.

Answer 14

• C3 - C6.

Question 15

What structure is the larynx suspended from?

Answer 15

• the hyoid bone.

Question 16

Describe the anatomical relations of the larynx:

1) posteriorly.
2) laterally.
3) anteriorly.

Answer 16

1) oesophagus.
2) lobes of the thyroid gland.
3) infrahyoid muscles.

Question 17

What are the 3 anatomical divisions of the larynx?

And describe their regions.

Answer 17

• supra-glottis - from inferior portion of epiglottis to the vestibular folds (false vocal cord).
• glottis - contains the vocal folds (true and false).
• infra-glottis - from the vocal folds to the trachea.

Question 18

What is the opening between the true vocal cords called?

Answer 18

• rima glottidis.

Question 19

Name the 3 unpaired cartilages surrounding the larynx.

Answer 19

• thyroid cartilage.
• cricoid cartilage.
• epiglottis.

Question 20

Name the 3 paired cartilages surrounding the larynx.

Answer 20

• arytenoid.
• cuneiform.
• corniculate.

Question 21

What is the function of the epiglottis?

What type of cartilage is it made up of?

Answer 21

• closing the larynx during swallowing to prevent food entering the larynx.
• elastic cartilage.

Question 22

Which nerve innervates the cricothyroid muscle for motor innervation?

Answer 22

• external branch of the superior laryngeal nerve.

Question 23

Which nerve provides motor innervation to the intrinsic muscles of the larynx (except the cricothyroid)?

Answer 23

• inferior laryngeal nerve.

Question 24

Which nerve provides sensory innervation to the infraglottis?

Answer 24

• inferior laryngeal nerve.

Question 25

Why is the left recurrent laryngeal nerve more prone to palsy?

Answer 25

• bc the left recurrent laryngeal nerve has a longer course than the right RLN.

Question 26

Describe the differences in anatomical course between the left and right recurrent laryngeal nerves.

Answer 26

• both branch off of their respective vagus nerves.
• right RLN loops under the right subclavian artery.
• left RLN loops under the arch of the aorta.

Question 27

Give three symptoms of unilateral recurrent laryngeal nerve palsy.

Answer 27

• hoarseness.
• bovine cough.
• increased risk of aspiration.

Question 28

Give two symptoms of bilateral recurrent laryngeal nerve palsy.

Answer 28

• no phonation.

- impaired breathing leading to snoring/stridor.