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HNN > Anatomy Of The Larynx > Flashcards

Anatomy Of The Larynx Flashcards

1
Q

Functions of the larynx

A
  • Ventilation
  • Airway protection: prevents flood/fluids entering airways
  • Cough reflex: rapidly expel anything inadvertently entering airways
  • role in sound production (not a primary function)
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2
Q

When does the larynx begin and end?

A
  • begins at laryngeal inlet
  • ends at cricoid cartilage C6
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3
Q

What part of the pharynx is posterior to the larynx?

A

Laryngopharynx

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4
Q

What are the piriform fossae?

A

A small recess on either side of side of laryngeal inlet

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5
Q

Anatomical relationship between the larynx + the hyoid

A

Larynx is suspended from the hyoid bone by the thyrohyoid membrane

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6
Q

What connects the cricoid cartilage to the thyroid cartilage?

A

Cricothyroid membrane

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7
Q

What are the arytenoid cartilages?
Location

A

Sit on the posterior portion of the cricoid cartilage

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8
Q

What is a cricothyroidotomy?
Example of why you may need it

A

Incision made through skin + cricothyroid membrane below the vocal cords to provide airway to patient in an emergency
e.g. severe swelling of vocal cords

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9
Q

What are the margins of the laryngeal inlet

A

2 aryepiglottic folds
Upper edge of epiglottis

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10
Q

What are the aryepiglottic folds?

A
  • Attach epiglottis to arytenoid cartilages
  • (The free upper border of the quadrangular membrane)
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11
Q

What is the false vocal cord formed by?

A

free lower border of the quadrangular membrane

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12
Q

What are the aryepiglottic fold formed from?

A

free upper border of the quadrangular membrane

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13
Q

What forms the true vocal cords?

A

Free upper border of cricothyroid membrane

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14
Q

How is the larynx internally divided?

A
  • Supraglottis: epiglottis up to + including false vocal cords
  • Glottis: false vocal cords to true vocal cords (narrowest part)
  • Infraglottis: below true vocal cord to lower boundary of cricoid C6
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15
Q

What type of epithelium lines the larynx?
What is the exception

A
  • pseudostratified ciliated columnar epithelium (respiratory epithelium)
  • true vocal cords > stratified squamous epithelium
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16
Q

What type of epithelium lines the true vocal cords?

A

Stratified squamous epithelium

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17
Q

What two ways can you view the larynx?

A

Flexible nasendoscopy
Intubation

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18
Q

What must be viewed for laryngoscopic view during intubation?

A
  • Vocal cords must be viewed
  • Placement of endotracheal tube into infraglottic region
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19
Q

Another name for false vocal chords

A

Vestibular fold

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20
Q

Another name for the true vocal chords

A

Vocal folds

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21
Q

What is the rima glottidis?

A

Opening between the true vocal chords

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22
Q

How to orientate yourself when looking at the larynx

A

Point of rima glottidis points forwards (towards epiglottis)

23
Q

Functions of the intrinsic laryngeal muscles

A
  • alter size + shape of laryngeal inlet
  • alter tension in + position of true vocal chords
24
Q

How do the intrinsic laryngeal muscles alter the size + shape of laryngeal inlet?

A

Muscles within aryepiglottic folds contract narrowing inlet + flattens epiglottis

25
Q

How do the intrinsic laryngeal muscles alter the the tension in + position of the true vocal cords?

A

Muscles act on arytenoid cartilages to vary position of true vocal cords

26
Q

Innervation of the intrinsic laryngeal muscles

A

Recurrent laryngeal nerve
(From vagus nerve X)

(Except cricothyroid muscle)

27
Q

What is the recurrent laryngeal nerve a branch of?

A

Vagus nerve X

28
Q

How does the hyoid bone move during swallowing?
What does this do?

A
  • Moved antero-superiorly by suprahyoid muscles
  • Moves position of larynx up + off the pharynx
  • Food/fluid directed into open pharynx
29
Q

What positions can the vocal cords be in?

A

ADducted (closed)
ABducted (open)

30
Q

What position are the vocal cords in when swallowing?

A

Firmly ADducted
(closed)

31
Q

What position are the vocal cords in when breathing?

A

ABducted
(open)

32
Q

What position are the vocal cords in during phonation (talking)?

A
  • ADucted
  • But expired air can be forced through
  • Vocal cords vibrate > sound waves
33
Q

What does the variation of tension of the vocal cords determine?

A

Pitch

34
Q

Tension of true vocal cords in high pitched vs low pitched sounds

A

high pitched: vocal cords taut
low pitched: vocal cords less taut

35
Q

Outline the process of coughing
What is the position of the vocal cords when coughing?

A
  • inspire + fill lungs with air
  • vocal cords ADduct
  • expiratory muscles contract
  • intrathoracic pressure builds
  • vocal cords suddenly ABducts
  • explosive outflow air
36
Q

What muscle changes the tension of the true vocal cords (therefore pitch)?

A

Cricothyroid muscle

37
Q

Action of cricothyroid muscle

A
  • tilts thyroid cartilage forwards of cricoid
  • increases tension in vocal cords
  • higher pitch made
38
Q

Innervation of cricothyroid muscle

A

External branch of superior laryngeal nerve
(Branch of vagus X)

39
Q

Motor and sensory supply of the recurrent laryngeal nerve

A
  • motor: intrinsic laryngeal muscles
  • sensory: infraglottis
40
Q

Supply of the external branch of superior laryngeal nerve

A

Motor innervation to cricothyroid muscle

41
Q

Supply of internal branch of superior laryngeal nerve

A

Sensory innervation to supraglottis + glottis

42
Q

Route of left and right recurrent laryngeal nerve

A
  • left: under arch of aorta
  • right: under right subclavian artery
43
Q

What is the paramedian position?
When does it occur?

A
  • Vocal cords held halfway between full ADduction + full ABduction
  • paralysed vocal cord
44
Q

Symptoms of injury to unilateral recurrent laryngeal nerve

A

Hoarse voice
Weak/ineffective cough

45
Q

Complication of bilateral recurrent laryngeal nerve injury

A
  • Both vocal cords assume paramedian position
  • Narrows rima glottis
  • Significant airway obstruction
46
Q

What is laryngitis?

A

Inflammation of larynx
Often involves vocal cords

47
Q

What is croup?

A
  • common childhood infection
  • causes barking cough + rasping sound when breathing
48
Q

A child presents with a barking/seal like cough, what is the most likely diagnosis?

A

Croup

49
Q

What is epiglottitis?

A

Inflammation of the epiglottis + supraglottis
Significant risk to airway

50
Q

What conditions can affect the larynx?

A
  • laryngitis
  • croup
  • epiglottis
  • laryngeal oedema
  • laryngeal nodule
  • laryngeal cancer
51
Q

Sensory innervation to the larynx

A
  • internal branch of superior laryngeal nerve: supraglottis + glottis
  • recurrent laryngeal nerve: infraglottis
52
Q

What type of cartilage is the epiglottis composed of?

A

Elastic

53
Q

What is the most common cause of epiglottitis?

A

Haemophilus influenzae B

54
Q

What is the valleculae?

A

The space between the posterior tongue + epiglottis

HNN (24 decks)

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