Anatomy - Larynx Flashcards
fascial compartment in which the larynx is found
pretracheal
contents of pretracheal fascia
strap muscles thyroid gland trachea and larynx oesophagus and pharynx recurrent laryngeal nerves
which layer of the pretracheal fascia is the larynx in
visceral
function of strap muscles
accessory muscles of breathing
superior border of thyroid cartilage
C4/C5
level of cricoid cartilage
C6
1st palpable vertebrae & marker of inferior extent of neck
C7
marker of superior extent of back
T1
level which larynx becomes trachea and pharynx becomes oesophagus
C6
what bone is the larynx suspended from
hyoid
why is the epiglottis an elastic cartilage
needs to be flexible
v shape in thyroid cartilage
laryngeal prominence (Adam’s apple)
features of cricoid cartilage
narrow front, wide flat back
only cartilage to make a complete ring around the larynx
why is cricothyroid membrane chosen for puncture
avoids damaging vocal cords and is relatively avascular
joint which allows movement between thyroid and cricoid cartilages
capsule of cricothyroid joint - synovial
location of corniculate cartilage
apex of arytenoid cartilages
front process of arytenoid cartilage
vocal process - where cords attach, how they move
back process of arytenoid cartilage
muscular process
what is cricoid pressure and when is it used
pressing on the cricoid cartilage, thus compressing the oesophagus
as you are pressing on an area that is a complete ring, air still gets in, and thus this can be done in ventilation to prevent stomach contents coming up
attachments of vocal folds
thyroid cartilage and vocal processes of arytenoid cartilages
function of cuneiform and corniculate cartilages
support the laryngeal inlet but play no part in vocal cord movement
space between vocal cords
rima glottidis
what is the vallecula
space between posterior surface of tongue and epiglottis
mucosa of larynx
mainly respiratory epithelium
mucosa of vocal cords
stratified squamous epithelium
false vocal cords
vestibular folds - just folds of mucosa
space in between false and true vocal cords
ventricle
laryngeal mucosa sensory innervation
vagus
what are vocal fols
mucosa covering the vocal cords
innervation superior to the vocal fold
superior laryngeal branches of CN X
innervation to vocal fold and inferior
recurrent laryngeal branches of CN X
what is the inferior laryngeal branch of CN X
just a continuation of the recurrent laryngeal branch
what does the recurrent laryngeal nerve loop under on the RHS
subclavian artery
function of intrinsic muscles of larynx
move the cartilages which move the vocal cords
adduct the vocal cords during the cough reflex
function of the cricothyroid muscles
tense the vocal cords
if the vocal cords are tense, what pitch of voice will you have
high
function of thyro-arytenoid muscles
relax the vocal cords
pull the arytenoid cartilages towards the thyroid cartilage
function of lateral crico-arytenoid muscles
adduct the vocal cords
rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline
function of arytenoid muscles
transverse and oblique arytenoids
adduct the vocal cords
assist arytenoid cartilages to fently close the rima glottidis
also have a sphincter function
function of posterior crico-arytenoid muscles
abduct the vocal cords
rotate the arytenoid cartilages so that the vocal processes of the cartilage move laterally
widens the rima glottidis (only muscle that does this)
rima glottidis during normal respiration
larygeal muscles relaxed
rima glottidis during forced respiration
posterior crico-arytenoids contract
rima glottidis during phonation
arytenoids contract
assist lateral crico-arytenoids
rima glottidis during whispering
lateral crico-arytenoids contract
what happens in phonation
expire a stream of air across the vocal cords
length/tension of cords determines pitch
what is articulation
production of a recognisable sound in the oral or nasal cavities
what happens in oral articulation
soft palate tenses (CN V3) and elevates (CN X) to close off entrance to nasopharynx
directs stream of air through oral cavity
sound interrupted by tongue (CN XII) and teeth/lips (CN VII) to produce most vowels and consonants
what happens in nasal articulation
soft palate tenses (CN V3) and descends (CN X) to close off entrance to oropharynx
directs stream of air through nasal cavities
produces one of three sounds - m/n/ing depending on position of tongue (CN XII), teeth and lips (CN VII)
how to clinically test the vagus nerve
ask patient to swallow sip of water - watch larynx move, swallow or cough reflex could be damaged if spluttering
listen to patient speak - hoarseness, intrinsic muscles moving cords normally
ask patient to cough - also requires functioning diaphragm, phrenic nerves, abdo wall etc.