A33 - Larynx Flashcards

1
Q

where is the larynx enclosed?

A

visceral layer of the pre tracheal fascia

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2
Q

what lies anterior to the visceral layer?

A

muscular layer

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3
Q

what is the location of the larynx?

A

Found anterior to the laryngopharynx

Between the carotid sheath structures

Between C4-C6 vertebral levels

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4
Q

what is the borders laryngopharynx?

A

region of the pharynx from the epiglottis to the oesophagus

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5
Q

what is the most important part of the Upper Respiratory Tract?

A

larynx

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6
Q

where does the larynx communicate?

A

oropharynx and nasopharynx above via the oral and nasal cavity and the trachea below

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7
Q

at vertebral level C6 what happens to the larynx?

A

becomes the trachea

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8
Q

at vertebral level C6 what happens to the pharynx?

A

becomes the oesophagus

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9
Q

what does patent mean?

A

keep the respiratory tract open

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10
Q

what is the skeleton of the larynx composed of?

A

cartilages suspended from the hyoid bone

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11
Q

what is the functions of the larynx?

A
  • maintaining patency of URT
  • help prevent entry of foreign bodies into LRT
  • produce sound
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12
Q

how is the thyroid cartilage connected to the hyoid bone?

A

thyrohyoid membrane

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13
Q

how many types of cartilage is there in total in larynx?

A

9 in total

  • 3 pairs (6)
  • 3 individual
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14
Q

what is an important feature of the cricoid cartilage?

A

in a cross section all cartilages are C shaped whereas this is completely enclosed - D shaped

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15
Q

what type of cartilage is the larynx made of? and what is the exception to this rule?

A

hyaline

- epiglottis which is elastic

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16
Q

what is located between the arch of the cricoid cartilage and the thyroid cartilage?

A

cricothyroid membrane

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17
Q

what is the clinical importance for the cricothyroid membrane ?

A

access point for a cricothyroid puncture to gain access to airways

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18
Q

what is the “c –shaped” anterior rings of hyaline cartilage maintain patency?

A

tracheas

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19
Q

what smooth msucle completes the posterior wall of the trachea?

A

trachealis

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20
Q

what are the two horns of the thyroid cartilage?

A

superior and inferior

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21
Q

what is the anterior prominence on the thyroid cartilage?

A

laryngeal prominence

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22
Q

the cricid cartilage becomes broader and thicker at the back to form what?

A

lamina of cricoid

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23
Q

what is the synovial joint between the thyroid and cricoid cartilage?

A

cricothyroid joint

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24
Q

what is the movement of the cricothyroid joint ?

A

nodding movement

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25
Q

what is the way into the larynx?

A

laryngeal inlet

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26
Q

what are the paired cartilages superior to the lamina of the cricoid cartilage?

A

arytenoid cartilages

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27
Q

what is the separate point on the arytenoid cartilage?

A

corniculate cartilages

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28
Q

where do the vocal cords attach?

A

thyroid cartilage

vocal processes of arytenoid cartilages

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29
Q

what are the two vocal processes on the arytenoid cartilage?

A
muscular process (posterior)
vocal process (lateral)
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30
Q

what attaches to the vocal processes?

A

vocal cords

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31
Q

what attaches to the muscular processes?

A

muscles that move the vocal cords

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32
Q

where to the vocal cords attach to the thyroid cartilage?

A

anteriorly to the internal aspect of the thyroid cartilage

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33
Q

what is the thickened elastic tissue between arytenoid and thyroid cartilage?

A

vocal cord/ligament

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34
Q

where are the cuneiform & corniculate cartilages are located?

A

deep to the laryngeal mucosa

35
Q

what is the role of the cuneiform & corniculate cartilages?

A

support the laryngeal inlet but play no part in moving the vocal cords

36
Q

what mucosa lines the larynx?

A

respiratory epithelium

37
Q

what is the mucosa of the vocal cords?

A

stratified squamous epithelium

38
Q

what secretes mucous onto epithelial surfaces?

A

mucous glands

39
Q

what is the mucociliary escalator?

A

cilia beat to sweep the mucous superiorly, towards the pharynx, to be swallowed

40
Q

wha divides internal larynx?

A

vocal cords

41
Q

what are the false vocal folds?

A

superior vestibular folds

42
Q

what are the true vocal cords?

A

inderior vocal folds

43
Q

what is the difference between vocal folds and vocal cords?

A

vocal folds are covered in mucosa vocal cords are not

44
Q

what is the space between the vocal cords?

A

rima glottidis

45
Q

what is the motor and sensory innervation supply of all laryngeal muscles?

A

CN X

46
Q

what branch of CNX supplies superior to vocal fold?

A

internal laryngeal branches of superior laryngeal branch of CN X

47
Q

what branch of CNX supplies inferiro to vocal fold?

A

inferior recurrent laryngeal branches of CN X

48
Q

what is the pathway of the vagus nerve to supply the larynx?

A
  1. the vagus nerve passes through the jugular foramen
  2. the vagus nerve descends through the neck within the carotid sheath
  3. inferior laryngeal nerve (continuation of recurrent laryngeal)
  4. recurrent laryngeal nerve (branches off CN X in the mediastinum
49
Q

where are the extrinsic muscles originate?

A

outwith larynx

50
Q

what is the role larynx?

A

move the whole hyoid

51
Q

what are the extrinsic muscles of the larynx?

A

Suprahyoid muscles

and Infrahyoid muscles

52
Q

what type of muscle are the intrinsic muscles of the larynx?

A

skeletal muscles

53
Q

where do the intrinsic muscles attach?

A

between the cartilages

54
Q

what do the intrinsic muscles of the larynx do?

A

move the cartilages which then move the vocal cords

55
Q

what are the intrinsic muscles of the larynx?

A
  • tensors (of the vocal cords)
  • relaxers(of the vocal cords)
  • adductors (of the vocal cords)
  • abductors (of the vocal cords)
56
Q

what are the intrinsic muscles innervated by?

A

motor branches of CN X

57
Q

what muscles tense the vocal cord?

A

cricothyroid muscles

58
Q

what stretches the vocal cord?

A

‘nodding’ the thyroid cartilage anteriorly at the cricothyroid joints,

59
Q

what muscles relax the vocal cords and pull the he arytenoid cartilages towards the thyroid cartilage?

A

thyro-arytenoid muscles

60
Q

where do the thyro-arytenoid muscles attach?

A

thyroid at front an arytenoid muscles at the back

61
Q

what is the muscles between the thyro-arytenoid and the vocal cord and makes minute variations on the voice

A

vocalis muscle

62
Q

what muscle attaches between the cricoid and arytenoid cartilage?

A

lateral crico-arytenoid muscles

63
Q

what is the action of the lateral crico-arytenoid muscles?

A
  • adduct the vocal cords

- rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline

64
Q

what are the two types of the arytenoid muscles?

A

transverse and oblique arytenoids

65
Q

what is the role of the arytenoid muscles?

A

adduct the vocal cords

assist the lateral cricoarytenoids to gently close the rima glottidis

sphincter function

66
Q

what muscle
- abduct the vocal cords

  • rotate the arytenoid cartilages so that the vocal processes of the cartilages move laterally
  • widens the rima glottidis
A

posterior crico-arytenoid muscles

67
Q

what muscle is involved in the normal resting position of the rima glottidis?

A

laryngeal muscles relaxed

68
Q

what muscle is involved in the forced resprtaion of the rima glottidis?

A

posterior crico-arytenoids contract

69
Q

what muscle is involved in the phonation of the rima glottidis?

A

arytenoids contract

assist lateral crico-arytenoids

70
Q

what muscle is involved in the whispering of the rima glottidis?

A

lateral crico-arytenoids contract

71
Q

how do u produce sound?

A

vibration of the air moving over vocal points

72
Q

what muscles involved in inspiration?

A

diaphragm and/or intercostal muscles

73
Q

what is phonation?

A

producing a sound in the larynx

74
Q

what is articulation?

A

producing a recognisable sound within the oral or nasal cavities

75
Q

what causes oral sound?

A
  • soft palate tenses (CN V3) and elevates (CN X) to close off entrance into nasopharynx
  • directs stream of air through oral cavity
  • sound interrupted by the tongue (CN XII) and the teeth/lips (CN VII) to
  • produce most vowels and consonants in English language
76
Q

what causes nasal sounds?

A
  • soft palate tenses (CN V3) and descends (CN X) to close off entrance into oropharynx
  • directs stream of air through nasal cavities
  • produces one of three sounds: “m”, “n” or “ing”
  • depending on position of tongue (CN XII), teeth and lips (CN VII).
77
Q

how is the vagus nerve tested clinically?

A

listen to patient speak

ask patient to swallow small sip of water

ask patient to cough

78
Q

describe that anatomy of coughing?

A

breathe in using the diaphragm (phrenic nerves)

close the vocal ligaments (CN X)

contract the abdominal wall to build up pressure beneath the closed vocal ligaments

suddenly open the vocal ligaments (CN X)

tense (CN V3) and raise (CN XI) the soft palate to direct the stream of air through the mouth

79
Q

what is the most protective reflex in humans?

A

cough relax

80
Q

what is aspiration?

A

Inhalation of liquid or solid into the lungs

81
Q

what can effect function of the cranial nerve?

A

brainstem stroke

82
Q

what causes brainstem stroke?

A

bleeding from, or blockage of, branches from the vertebral arteries or basilar artery which also supply the cranial nerves attaching to the brainstem

83
Q

a patient with damage to CN X might have?

A

a hoarse voice
abnormal swallow
weak cough

84
Q

what is Cricothyroid puncture?

A

Emergency airway management