Anatomy Flashcards
In males the location of the laryngeal prominence is located at cervical spine level ___
C4
The skeleton of the larynx is formed w/Hyaline Cartilage:
- unpaired cartilages
- paired cartilages
- 3 unpaired cartilages
2. 3 paired cartilages
The 3 Unpaired Cartilages of the Larynx include:
- Thyroid cartilage
- Cricoid cartilage
- Epiglottis
The 3 Paired cartilages of the Larynx include:
- Arytenoids
- Corniculate
- Cuneiform
The arytenoid cartilages sit atop the ___, and consist of 2 processes ___ and ___.
- Cricoid cartilage
2. Vocal process and Muscular process
External Ligaments and Membranes of the Larynx:
- Thyrohyoid Membrane
2. Median Cricothyroid Ligament
The internal laryngeal nerve (and superior laryngeal a/v) pierce the:
Thyrohyoid membrane
Internal Ligaments of the Larynx include:
- True vocal ligament
- False vocal ligament (vestibular ligament, vocal ligament)
- Aryepiglottic ligament
Internal membranes of the Larynx:
- Quadrangular membrane
2. Triangular membrane
The changing space between the vocal ligaments is called the:
Rima Glottidis
The Superior laryngeal nerve arises from the ___.
4th Pharyngeal Arch
The Inferior laryngeal nerve arises from the ___.
6th pharyngeal arch
The Internal Laryngeal Nerve (branch of superior laryngeal n.) is composed of __ and __ fibers, and innervates the __.
- Sensory and Parasympathetic fibers
2. Vestibule
The External Laryngeal Nerve (branch of superior laryngeal n.) is composed of __ fibers, and innervates the ___.
- Purely Motor fibers
2. Cricothyroid muscle
The internal laryngeal nerve goes through the __ membrane and innervates ___.
- Thyrohyoid membrane
2. Mucosa of the thyroid cavity
The Internal laryngeal nerve innervates ___.
Mucosa of the thyroid cavity/vestibule
The 2 Synovial Joints of the Larynx are:
- Cricothyroid joint
2. Cricoarytenoid joint
What is the function of the Cricothyroid Joint?
Thyroid cartilage rocks back and forth anteriorly and posteriorly.
Movement at the Cricothyroid Joint effects the ___ of the vocal ligament.
increases and decreases the Tension in the vocal ligament
What are the 3 movements of the Cricoarytenoid joint?
- Rotation
- Sliding
- Tilting
External rotation of the cricoarytenoid joint__ the rima glottidis.
Opens (rima glottis large)
Internal rotation of the cricoarytenoid joint__ the rima glottidis.
Closes (rima glottis gets small)
Medial sliding of the cricoarytenoid joint produces:
Closing of rima glottidis
Lateral sliding of the cricoarytenoid joint produces
Opening of the rima glottidis
Anterior tilting of the cricoarytenoid joint ___ tension in the vocal folds.
Reduces tension
Posterior tilting of the cricoarytenoid joint ___ tension in the vocal folds.
Increases
Function of the posterior cricoarytenoid muscle
- the ONLY muscle to ABduct the VC
- pulls the muscular process back and laterally rotates the vocal process
Function of the Lateral Cricoarytenoid muscle
- pulls muscular process anteriorly and will rotate medically, closing the vocal cords
“Brother of the posterior cricoarytenoid”
Function of the transverse arytenoid muscle.
- ADducts the vocal cords
- from one arytenoid cartilage to another, fibers run horizontally
Function of the Cricothyroid muscle.
- tenses the vocal cord
- makes the pitch HIGHER
- when contracts, rocks thyroid cartilage continuously
Function of the thyroarytenoid muscle.
- RELAXES the vocal cords
- pitch becomes DEEPER
{pulls thyroid & arytenoid cartilages closer together, thus relaxing the tension in the vocal cords}
The vocalis muscle is apart of which muscle?
Thyroarytenoid muscle
Function of the vocalis muscle
- fine control of vocal cord tension
This muscle is part of the thyroarytenoid and attaches to the vocal ligament
Function of the aryepiglottic muscle
- pulls the epiglottis posteriorly & inferiorly like a trash-can lid, preventing food and water from entering the vestibule
The entrance of the vestibule is called the ___.
Aditus
The eternal laryngeal n. Innervates the __ muscle.
Cricothyroid muscle
The Cricothyroid muscle originates from the ___.
3rd pharyngeal arch
The inferior laryngeal nerve innervates ___ muscles.
All muscles of the larynx, except the Cricothyroid muscle.
The recurrent laryngeal nerve runs __.
Between the esophagus and the trachea
The inferior laryngeal nerve may be injured during a ___ procedure.
Thyroidectomy
What are the layers of the vocal fold (superior -> deep)?
- Squamous epithelium
- BM
- Superficial lamina propria (Reinke’s space)
- Vocal ligament (intermediate and deep lamina propria)
- Vocalis muscle
Primary ADductor of the VFs?
Lateral cricoarytenoid muscles
The vocalis (of the thyroarytenoid muscle) ( shortens/tenses)____ the VF, and the muscularis is an ADductor.
shortens and tenses the VFs
A non-recurrent RLN is more commonly found on the ___ side.
Right.
(only Left w/situs inversus)
The right-sided RLN approaches the larynxa at a ___ angle than does the left-sided nerve
obtuse angle (15-45 degrees)
The RLN is generally ___ to the ITA on the right, and ___ to the ITA on the left.
Anterior to the ITA on the right and Posterior to the ITA on the left.
Killian triangle is located between which musclesc?
Cricopharyngeal muscle and Thyropharyngeus muscles (comprise the Inferior Constrictor)
The thyroid cartilage is derived from the ___ branchial arches?
4th and 6th
The external branch of superior laryngeal nerve innervates the ___ muscle
Cricothyroid muscle
The ___ muscle tilts the larynx, and provides tension and lengthening of the VFs.
Cricothyroid muscle
The cricothyroid muscle tilts the larynx, and provides ___ of the VFs.
Tension and lengthening of the VFs
What is the most common site of upper airway involvement in sarcoidosis?
Epiglottis
The cough reflex is generated by afferent ___ fibers from cough receptors in the esophagus that terminate in the nucleus tractus solitarius of the medulla.
Vagal afferent fibers.
The cough reflex is generated by afferent vagal afferent fibers from cough receptors in the esophagus that terminate in the _____.
Nucleus tractus solitarius of the medulla
The _____ is the space btwn. the free margins of the VF and the anterior/posterior commissures on sagittal view.
Rima glottidis
The _____ muscle is the only intrinsic m of the larynx that receives b/l innervation by the RLN.
Interarytenoid muscle
The Interarytenoid muscle is the only intrinsic m. of the larynx that receives b/l innervation by the ___ nerve.
RLN
The ___ responsible for the development of RRP.
HPV strains 6 and 11
This Flow-volume loop represents ___ pathology.
This is a normal flow volume loop.
* fixed extrathoracic (above the thoracic inlet) and intrathoracic (below the thoracic inlet)
This Flow-volume loop represents ___thoracic obstruction.
Intrathoracic obstruction (below thoracic inlet)
This Flow-volume loop represents ___ lung disease.
Restrictive lung disease
(eg. pleural effusion)
low lung volumes
This Flow-volume loop represents ___ lung disease.
Obstructive lung disease pattern
This Flow-volume loop represents ___thoracic obstruction.
“Variable” Extrathoracic obstruction
Eg. (b/l VC paralysis or tracheomalacia - inspiratory curve is flat due to narrowing and increased glottic resistance. However, expiration forces the VCs apart so expiratory curve is normal)
An example of “Fixed” extrathoracic obstruction = arytenoid fixation or * tracheal stenosis* causing obstruction.
The ___ is the only unpaired laryngeal m., and assists w/ADduction
Transverse arytenoid m.
The ___ m. functions to lengthen the VC and increase pitch.
cricothyroid m.
The ___ m. adducts and internally rotates the arytenoid cartilages, and increase medial compresison.
Lateral cricoarytenoid m.
Types of collagen present in VC tissue?
Type I and III collagen
The main function of the vestibular folds (FVC) IS ___.
**Protection of the airway ** (by providing glandular secretions which provide lubrication and antimicrobial properties)
Lymphatics from the subglottis drain to the lymphatics ___ the vocal fold:
below
deep cervical, recurrent chain, prethyroidal LNs, pre-/para-tracheal LNs
The ___ artery supplies the ___.
Superior laryngeal nerve
The ___ artery to provie blood supply to the intrinsic muscles + laryngeeal mucosa of the inferior larynx.
Inferior laryngeal a.
Posterior glottic stenosis most commonly occurs from ___.
Intubation
Narrowest portion of the pediatric airway?
Subglottis
