Anatomy of the larynx Flashcards
State the structures in order that lie from nasal cavity to larynx
Nasal cavity Paranasal sinuses Oral cavity Pharynx Larynx
What is contained in the upper airway
Nasal cavity, oral cavity, pharynx (larynx)
Is the larynx anterior or posterior to pharynx
Anterior
What are the anterior borders of the nasal cavities
Nostrils/ cartilaginous septum
What is the posterior border of the nasal cavity
Nasopharynx
What is the inferior border of the nasal cavity
Hard palate
What bones make up the lateral borders of the nasal cavities (7)
Nasal, maxilla, lacrimal, ethmoid, inferior concha bone, palatine, sphenoid
Narwhales Mainly Live (in) England, Ireland, Paris and Spain
What bones make up the superior border of the nasal cavity (4)
Nasal bone, frontal bone, cribiform plate of ethmoid, sphenoid
What are the superior, middle and inferior nasal conchae also known as
Nasal turbinates
What bones make up each of the nasal conchae
Superior and middle are ethmoid
Inferior is its own bone
What do you call the spaces below the conchae
Meatuses
Why does your nose run when you cry
Because the nasolacrimal duct drains into the inferior meatus
What covers the conchae/ meatuses
Ciliated respiratory epithelium
Describe the arterial supply to the nasal sinuses
1) Branches from the external carotid artery via maxillary and facial arteries
2) Branches from the internal carotid artery via the opthalmic artery
Describe venous supply to nasal sinuses
Branches to maxillary and facial veins drain to external jugular vein
Branches to opthalmic vein drain into the cavernous sinus
What is the proper word for nosebleed
Epistaxis
What % of nosebleeds are anterior and what structures are responsible for this
90%
Kisselback plexus
What is Kisselback plexus
Anterior anastomosis of 5 blood vessels
Describe the innervation to nasal sinuses (3)
1) CN1– special sensory (smell)
2) CN V1- opthalmic division of trigeminal- general sensory
3) CN V2- maxillary division of trigeminal. general sensory
What is the eustachian tube
Tube connecting the middle ear to the nasopharynx
What lines the eustachian tube
Ciliated pseudostratified columnar epithelium
What opens the eustachian tube and when
Palantine muscles
Yawning/ swalloing
What are the functions/ uses of opening the eustachian tube
- Equalisation of pressure on either side of the tympanic membrane
- Drains mucus from middle ear
What are paranasal sinuses
Air filled spaces within the facial skeleton, continuus with the nasal cavity
What are the names of the 4 paranasal sinuses
Frontal
Ethnoidal
Sphenoidal
Maxillary
What lines paranasal sinuses
Respiratory epithelium
Whats the semilunar hiatus
Opening of frontal, maxillary and anterior ethoidal sinuses
Whats the ethmoid bulla
Opening of middle ethmoid sinus
What are exudate
The white puss filled spots on tonsils in tonsilitis
What 2 systems is the pharynx part of
Resp
Digestive
What forms the shape of the pharynx
2 sets of 3 muscles;
- 3 outer circular muscles
- 3 inner longitudinal muscles
What nerves supply the pharynx
IX and X
What arteries/ veins supply/ drain pharynx?
Arterial from branches of ECA
Venous drainage to branches if IJV
What are the names of the 3 outer circular muscles that form the pharynx
Inferior, middle and superior constrictor muscles
What are the names of the 3 inner longitudinal muscles that form the pharynx
Stylopharyngeus
Salingophayngeus
Palatopharyngeus
What is the nasopharynx
Part of the pharynx that is the base of the skull to the soft palate.
Behind the nasal cavity
What is the oropharynx
Soft palate to epiglottis
Behind oral cavity
What is the laringopharynx
Epiglottis to ifnerior border of cricoid (behind larynx)
Describe the sensory innervation of each parts of the pharynx
Naso: CNV2
Oro: CN IX
Laringo: CN X
What is the motor innervation of the pharynx
All of the muscles are supplied by CN X, except from the stylopharyngeus which is supplied by CN IX
Between which spinal levels is the larynx found
C3-C6
What makes up the larynx
9 cartilages, connecting ligaments, muscles and vocal cords
What are the functions of the larynx
Phonation
Protection of lower airway
What arteries supply the larynx
Superior laryngeal artery (comes off ECA) and inferior laryngeal artery (comes off thyrocervical trunk)
Name the 3 unpaired cartilage that make up the larynx
Epiglottis
Thryoid
Cricoid
Name the 3 paired cartilages that make up the larynx
Arytenoid
Corniculate
Cuneiform
Which cartilage is mainly responsible for stopping aspiration into trachea
Epiglottis
It closes over laryngeal inlet during swallowing
What ligaments can be seen posteriorly in the larynx
Lateral/ medial thyrohoid ligament
Median cricothyroid ligament
Cricotracheal ligament
2 ‘groups’ of extrinsic muscles to larynx
Suprahyoid
Infrahyoid
Name the suprahyoid muscles
Mylohyoid
Geniohyoid
Stylohyoid
Digastric
Name the infrahyoid muscles
Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid
What intrinsic muscles are involved in phonation
Thyroarytenoid
Posterior and lateral circo-arytenoid
Transverse and oblique arytenoid
Vocalis
What intrinsic muscle is involved in determining pitch of voice
Cricothyroid
What is adams apple
Laryngeal prominence of thyroid cartilage
What is inferior to adams apple
Cricoid cartilage
What is the site of a cricothyroidotomy
Inbetween the crycothyroid ligament
What are the vestibular folds
Mucous membrane encasing vestibular ligaments
Protective function
What is the rima vestibuli
Space between vestibular ligaments
What are the vocal folds
Mucous membrane encasing vocal ligaments
What is the rima glottidis
Space between vocal ligaments
What is the glottis
Vocal apparatus of the larynx including vocal folds, ligaments, rima glottidis
How does larynx appear in normal respiration
Rima glottidis is a narrow wedge shape
How does larynx appear in forced respiration
Abduction of vocal ligaments to create wide, triangular rima glottidis
How does larynx appear during phonation
Adducted arytenoid cartilages and adducted vocal ligaments
Air forced across vocal ligaments produces vibrations
How does larynx appear during whispering
Abducted arytenoid cartilages
Adducted vocal ligaments
What does the superior laryngeal nerve split into
Internal and external laryngeal nerve
What is the action of the recurrent laryngeal nerve
Motor to all intrinsic muscles except cricothyroid
Sensory everywhere below vocal cords
PHONATION
What is the action of the external laryngeal nerve
Motor to cricothyroid muscle
Pitch
What is the action of the internal laryngeal nerve
Sensory innervtion to area above vocal cords
What are the signs/ symptoms/ consequences of damage to recurrent laryngeal nerve
- Paralysis of all muscles except cricothyroid
- Vocal cord unable to abduct/ open
- Hoarseness, stridor, resp distress
What are the signs/ symptoms/ consequences of external laryngeal damage
Paralysis of cricothyroid
- Weak voice with low pitch, reduced range
- Voice tires easily
What is endotracheal intubation
Insertion of plastic tube via mouth, past vocal cords into trachea
