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Eq ACVS Phase 1 > Ch.46 Larynx > Flashcards

Ch.46 Larynx Flashcards

1
Q

Cartilages of the larynx

A
  1. Cricoid
  2. Thyroid
  3. Epiglottic
    1. Arytenoid x2
    1. Corniculate processes x2
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2
Q

what inserts on the muscular process of the corniculate process

A

Cricoarytenoideus Dorsalis CAD

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3
Q

What cartilage are the thyroid, cricoid and arytenoids composed of

A

Hyaline cartilage which can ossify with age and trauma

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4
Q

How does the hyaline cartilage of the cricoid differ from that of the arytenoid

A

Cricoid is stiff 2 - 2.5 megapascal (MPa)
Body of Arytenoid less stiff 0.42 MPa

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5
Q

How does the hyaline cartilage of the larynx differ from articular hyaline

A

Much stiffer with a denser structural arrangement and collagen content
Articular 0.21 MPa
Larynx 0.42 - 2.4 MPa

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6
Q

Which part of the larynx is made from elastic cartilage

A

Apex of the corniculate process
Epiglottis

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7
Q

What holds the epiglottis to the thyroid cartilage

A

Thyroepiglottic ligaments

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8
Q

What are the intrinsic muscles of the larynx

A

PAIRED
1. Cricoarytenoideus Dorsalis
2. Cricoarytenoideus lateralis
3. Cricothyroideus
4. Thyroarytenoideus ventricular and vocalis

UNPAIRED
1. Arytenoideus transversus

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9
Q

Action of CAD

A
  1. Abduct the corniculate processes of the arytenoids
  2. Tense the vocal folds
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10
Q

Action of Arytenoideus transversus

A

Adducts the arytenoids

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11
Q

Action of the Thyroarytenoideus arytenoideus transversus and cricoarytenoideus lateralis

A

Adduct the arytenoids

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12
Q

Action of the cricothyroideus

A

Tense vocal folds during vocalisation

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13
Q

Efferent motor innervation of the intrinsic mm of the larynx

A

Recurrent laryngeal branch of vagus nerve

Except for cricothyroideus which receives efferent motor innervation from the external branch o the cranial laryngeal nerve

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14
Q

Extrinsic laryngeal muscles

A
  1. Sternothyroideus
  2. Thyrohyoid
  3. Thyropharyngeus
  4. Cricopharyngeus
  5. Hyoepiglottic
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15
Q

Depth and capacity of the ventricles

A

2.5cm deep
5 - 6ml capacity
Bounded by medial surface of thyroid cartilage
ventricular and vocalis mm

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16
Q

The mechanoreceptors of the laryngeal mucosa receive afferent neural supply from what

A

Internal branch of the cranial laryngeal nerve a branch of the vagus nerve

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17
Q

What is the source of respiratory reflexes

A

Sensory mechanoreceptors innervated by the cranial laryngeal nerve

18
Q

lymphatic drainage of the larynx

A

Retropharyngeal
Cranial and deep cervical lymph centres

19
Q

Which grading system is recommended and why

A

Havemeyer
Validated with a correlation of histopathologic assessment of the CAD and exercising laryngeal grade

20
Q

Grade II A vs B

A

II - Arytenoid movements are asynchronous and or larynx is asymmetric at times but full abductiopn can be achieved and maintained

A - Transient asymmetry, flutter or delayed movements

B - Assymmetry much of the time, occasions usually after swallowing or nasal occlusion when full symmetrical abduction is achieved a maintained

21
Q

Grades III A,B &C

A

III - Arytenoid movements are asynchronous and or larynx is asymmetric. Full abduction cannot be achieved and maintained.

A - Abduction achieved but not maintained

B - Full abduction never achieved

C - Limited movement. Full abduction never achieved.

22
Q

Grade IV

A

Complete immobility

23
Q

What % of horses with RLN have comorbidities

A

30%

24
Q

What % of horses with RLN will show progression o paralysis over 12 months

A

15%

25
Q

What is responsible for stabilisation of the vocal cord

A

Cricothyroid mm innervated by cranial laryngeal n

and CAD

26
Q

Causes of bilateral laryngeal paralysis

A

Organophosphate toxicity
CNS disease eg EPM
Hepatic dysfunction
Encephalopathy
Lead toxicity
Australian string halt

27
Q

What structures are derived from the fourth branchial arch

A
  1. Lateral wings of the thyroid cartilage
  2. Crico-arytenoid articulation
  3. Cricoid cartilage
  4. Cricothyroideus
  5. Cricopharyngeus
  6. Thyropharyngeus
28
Q

4th branchial arch defect also known as

A

Cricopharyngeal-laryngeal dysplasia

29
Q

What is the reported incidence of 4bad

A

0.02%

30
Q

What is evident on palpation of a horse with 4 bad

A

Deficit of wing of thyroid on one or both sides
Easily palpated gap between cricoid and thyroid cartilages due to absence or atrophy of the cricothyroid muscle

31
Q

What is observed with rostral displacement fo the soft palate

A

Margin of the ostium intrapharyngeum is displaced rostral to the dorsal tips of the corniculate processes of the arytenoid cartilages

32
Q

What can be observed on radiographs of a horse with 4 bad

A

Air in the proximal oesophagus due to dysfunction of the cranial oesophageal sphincter

33
Q

What is found in horses with collapse of the apex of the corniculate process

A

Widening of the transverse arytenoid ligament

34
Q

What % of mucosal disease and granulomas of the arytenoid cartilages progress to granulomas or arytenoid chondropathy

A

10% granulomas
5% chondropathy

35
Q

What % of epiglottic entrapments are ulcerated

A

45%

36
Q

What % of horses with epiglottic entrapment have hypo plastic epiglottis

A

31-36%

37
Q

Structures associated with epiglottic retroversion

A

Hyoepigltticus
Geniohyoid m

38
Q

a. The laryngeal mucosa contains sensory mechanoreceptors for the detection of different stimuli, including transmural pressure changes, airflow, temperature, and laryngeal motion. These mechanoreceptors receive afferent neural supply from the internal branch of the cranial laryngeal nerve, a branch of the vagus nerve

b. The laryngeal mucosa contains sensory mechanoreceptors for the detection of different stimuli, including transmural pressure changes, airflow, temperature, and laryngeal motion. These mechanoreceptors receive efferent neural supply from the internal branch of the cranial laryngeal nerve, a branch of the vagus nerve

c. The laryngeal mucosa contains sensory mechanoreceptors for the detection of different stimuli, including transmural pressure changes, airflow, temperature, and laryngeal motion. These mechanoreceptors receive afferent neural supply from the internal branch of the recurrent laryngeal nerve, a branch of the vagus nerve

d. The laryngeal mucosa contains sensory mechanoreceptors for the detection of different stimuli, including transmural pressure changes, airflow, temperature, and laryngeal motion. These mechanoreceptors receive afferent neural supply from the internal branch of the cranial laryngeal nerve, a branch of the trigeminal nerve

A

a. The laryngeal mucosa contains sensory mechanoreceptors for the detection of different stimuli, including transmural pressure changes, airflow, temperature, and laryngeal motion. These mechanoreceptors receive afferent neural supply from the internal branch of the cranial laryngeal nerve, a branch of the vagus nerve

39
Q

a. The larynx receives arterial blood supply from the cranial laryngeal artery and branches of the ascending pharyngeal arteries.

b. The larynx receives arterial blood supply from the caudal laryngeal artery and branches of the ascending pharyngeal arteries.

c. Venous drainage is provided by the cranial laryngeal and ascending pharyngeal veins, which flow to the external jugular vein via the thyroid vein.

d. None of the above

A

b. The larynx receives arterial blood supply from the caudal laryngeal artery and branches of the ascending pharyngeal arteries.

Venous drainage is provided by the caudal laryngeal and ascending pharyngeal veins, which flow to the external jugular vein via the thyroid vein.

40
Q

a. Recurrent laryngeal neuropathy is a unilateral mononeuropathy affecting the recurrent laryngeal nerves.

b. The muscle paralysis results from progressive loss of large myelinated axons predominantly in the left recurrent laryngeal nerve

c. The muscle paralysis results from progressive loss of small myelinated axons predominantly in the left recurrent laryngeal nerve

d. Pathologically, neurogenic atrophy of the intrinsic laryngeal musculature results in progressive loss abductor arytenoid function whilst the adductors are uneffected.

A

b. The muscle paralysis results from progressive loss of large myelinated axons predominantly in the left recurrent laryngeal nerve

Recurrent laryngeal neuropathy is a bilateral mononeuropathy affecting the recurrent laryngeal nerves.

Pathologically, neurogenic atrophy of the intrinsic laryngeal musculature results in progressive loss of both abductor and adductor arytenoid function

41
Q

The extrinsic muscles of the larynx are

a. thyrohyoideus, hyoepiglotticus, cricopharyngeus, thyropharyngeus, sternothyroideus

b. geniohyoideus, thyrohyoideus, genioglossus, hyoglossus, hyoepiglotticus, styloglossus, sternohyoideus, sternothyroideus

c. geniohyoideus, thyrohyoideus, genioglossus, hyoglossus, hyoepiglotticus, cricopharyngeus, thyropharyngeus

d.thyrohyoideus, hyoepiglotticus, cricopharyngeus,styloglossus, sternohyoideus, sternothyroideus

A

a. thyrohyoideus, hyoepiglotticus, cricopharyngeus, thyropharyngeus, sternothyroideus

Common
thyrohyoideus
hyoepiglotticus
sternothyroideus

Larynx only
cricopharyngeus
thyropharyngeus

Pharynx only
geniohyoideus
genioglossus
hyoglossus
styloglossus
sternohyoideus

Eq ACVS Phase 1 (72 decks)

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