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Anatomy- the Larynx Flashcards

1
Q

what are the functions of the larynx

A 
voice box
sphincter of the respiratory tract:
-regulates airflow 
-protection from aspirated objects 
maintains patency of URT
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2
Q

what is the larynx

A

series of cartilages joined by connective tissue and moved by muscles
found between the pharynx and trachea

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3
Q

what fascia is the larynx in

A

pretrachial fascia

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4
Q

what is in the pretracheal fascia

A 
strap muscles 
thyroid gland 
trachea and larynx 
oesophagus and pharynx 
recurrent laryngeal nerves
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5
Q

what is the function of the strap muscles

A

accessory muscles of breathing - also help in swallowing by positioning the hyoid and larynx

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6
Q

muscles from which pharyngeal arch control the movement of the pharynx

A

6th (vagus)

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7
Q

where is the larynx

A

anterior to laryngopharynx
between carotid sheath structures
between C4-6 level

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8
Q

what level is the crichocartilage at

A

C6

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9
Q

what level is the inferior part of mandible and hyoid bone at

A

C3

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10
Q

where is the laryngopharnx

A

area of pharynx from the epiglottis to the oesophagus

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11
Q

what is the adams apple

A

laryngeal prominence of the thyroid cartilage

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12
Q

what parts of pharynx are used in both breathing and eating

A

oro and laryngopharnx

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13
Q

what reduces the chance of aspiration

A

raising the larynx towards the oesophagus
epiglottis
cough reflex

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14
Q

what aids in the closure of the laryngeal inlet

A

epiglottis moves posteriorly

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15
Q

what bones create the nasal septum

A

ethmoid, vomer, cartilage

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16
Q

is a deviated septum common

A

yes

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17
Q

what is the floor of the nasal cavity

A

palate

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18
Q

what is the roof of the nasal cavity

A

anterior cranial fossa

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19
Q

which wall of nasal cavity has the conchae

A

lateral

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20
Q

what makes up the ‘skeleton’ of the larynx

A

cartilages suspended from the hyoid bone

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21
Q

what articulates with the cricoid cartilage

A

inferior horn of the thyroid cartilage

articulates at cricothyroid joint

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22
Q

which cartilage in larynx is a complete ring

A

only the crichoid- all the rest C shaped

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23
Q

where are the arytenoid cartilages

A

articulate with cricoid cartilage at cricoarytenoid joints

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24
Q

what is ‘cricoid pressure’

A

pressing on the cricoid, the lamina of the cricoid compresses the oesophagus pressing it against C6
closes oesophagus but opens airway
prevents regurgitation/aspiration

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25
what are the three holes of the larynx
laryngeal vestibule laryngeal ventricle infraglottic cavity
26
what are the true vocal chords
true- vocal process of arytenoid cartilage to thyroid cartilage their movement impacts sound
27
what are the vocal chords
free borders of mucosa covered connective tissue in the larynx
28
what are the false vocal chords
arytenoid cartilage to epiglottis
29
what is the conus elasticus
ligament between cricoid and vocal ligament (directs air towards the vocal chords)
30
how many pairs of vocal chords do 1ou have
1 true and 1 false | false are above true vocal chords
31
where is the quadrangular membrane
between vestibular ligament and epiglottis
32
where is a laryngoscope placed
into the vallecula (space between epiglottis and tongue)
33
what is the rima glottidis
space between the true vocal chords
34
what is the aryepiglottic fold
superior border of quadrangular membrane
35
what causes movement of the vocal chords
intrinsic muscles of the larynx all skeletal all innervated by CN X
36
what is the result of vocal chord movement
tension increases pitch relaxation decreases pitch adduction makes voice quieter abduction makes voice louder
37
what are the tensors of the vocal chords and how do they work
cricothyroid muscles tenses the vocal ligament increasing pitch (high voice) 'nods' thyroid cartilage
38
what are the attachments of the cricothyroid muscles
anterolateral cricoid cartilage to inferior horn of thyroid cartilage
39
what are the relaxors of the vocal chords and how do they work
``` thyroarytenoid muscles (a.k.a vocalis muscle) relaxes vocal ligament decreasing pitch (low voice) ```
40
what are the attachments of the thyroarytenoid muscles
posterior thyroid to anterior arytenoid cartilage
41
what are the adductors of the vocal chords
lateral crico-arytenoid muscles arytenoid muscles make voice quieter
42
what are the attachments of the lateral crico-arytenoid muscles
muscular process of the arytenoid to anterior cricoid cartilage
43
how does the lateral cricoarytenoid muscles work
brings vocal ligaments together (uses cricoarytenoid joint at a pivot)
44
how does the arytenoid muscels work
brings vocal ligaments together, closes rima glottidis
45
what are the attachments of the arytenoid muscles
one arytenoid cartilage to another cricoid cartilage (has an oblique and transverse band)
46
what are the abductors of the vocal chords and how do they work
posterior crico-arytenoid muscles abducts vocal chords making voice louder by opening rima glottidis
47
what are the attachments of the posterior crico-arytenoid muscles
posterior cricoid cartilage to the musclular process of arytenoid cartilage uses cricoarytenoid joint as a pivot
48
what shape is the rima glottis in normal resting respiration
open | laryngeal muscles relaxed
49
what shape is the rima glottis in forced respiration
opened wider than resting | posterior crico-arytenoids contract
50
what shape is the rima glottis in phonation
``` adducted arytenoid contract (with help from lateral crico-arytenoid) ```
51
what shape is the rima glottis in whispering
open at cricoarytenoid joints | lateral crico-arytenoids contract)
52
what is supraglottis
upper part of larynx inc epiglottis
53
where do supraglottis tumour spread
drain to superior deep cervical lymph nodes
54
what are the features of glottic tumours
present on cords 95% stay on the cords present woth voice changes/ airway obstruction
55
where do sub glottic tumours spread
paratracheal nodes | present with voice/ airway obstruction
56
describe the expiration needed to speak
controlled expiration contraction of anterolateral abdominal wall and inspiratory intercostal muscles helps build pressure in resp tree inferior to larynx (subglottal pressure)
57
describe phonation
once subglottal pressure threshold is reached then air crosses vocal chords causes vibration (inferior to superior rippling)
58
what is resonance
laryngeal buzz is amplified by the pharynx, oral and nasal cavities (funnel shaped pathway from larynx to mouth)
59
how do you articulate oral sounds
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
60
how do you articulate nasal sounds
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).
61
what is a post laryngectomy
removal of the larynx
62
how can you speak without a larynx
tracheo-oesophageal puncture oesophageal speech (belching) electolarynx
63
what innervates the intrinsic muscles of the larynx
all inferior laryngeal nerve except the cricothyroid which is external laryngeal nerve
64
what is the origin of the inferior laryngeal nerve
vagus (gives off superior laryngeal nerve) gives off left recurrent laryngeal nerve this becomes inferior laryngeal nerve at the level of the cricothyroid joint
65
what is the origin of the external layrngeal nerve
branches off the superior laryngeal nerve (comes from vagus)
66
what supplies the sensory to the mucosa above the vocal chords
internal laryngeal nerve
67
what supplies the mucosa below the folds
inferior laryngeal nerve | mucosa above vocal folds= internal, mucosa below= inferior
68
what is berry's ligament
the suspensory ligament of the thyroid gland
69
nerves from where supply sensory and motor supply to the palate, pharynx and larynx
vagus
70
how do you clinically test the vagus in the pharynx
ask patient to swallow small sip of water watch larynx move up and down splutter may suggest an abnormal swallow and/ or cough
71
how do you clinically test the vagus in the larynx
listen to the patients voice hoarse? intrinsic muscles may not be working well ask patient to cough- normal and powerful?
72
where does the recurrent layrngeal nerve branch of the vagus
mediastinum- loops under arotic arch
73
what foramen does the vagus go through
the jugular foramen
74
how does the vagus descend in the neck
in the carotid sheath

ENT (27 decks)

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