Clinical Anatomy of Larynx

Question 1

Upper Airway

Answer 1

Nose
Mouth
Pharynx
Larynx

Question 2

3 parts of Pharynx

Answer 2

Nasopharynx
Oropharynx
Laryngopharynx

Question 3

Lower Airway

Answer 3

Lungs

Diaphragm

Question 4

Vestibule

Answer 4

Space between teeth and cheeks

Question 5

Hard Palate

Answer 5

Maxilla

Palatine- posterior 1/5th

Question 6

Soft palate

Answer 6

Muscular continuation to oropharynx

Question 7

Oral cavity innervation

Answer 7

Trigeminal Nerve (CN V)

Question 8

Palatine tonsils

Answer 8

Sit laterally to Oropharynx

Question 9

Waldeyer’s Tonsillar ring

Answer 9

Ring of lymphoid tissue around oropharynx

360 degree protection

Question 10

Tonsilitis

Answer 10

Sore throat
Odynophagia- pain on swallowing
Majority viral

Question 11

Quinsy

Answer 11

Severe complication bacterial tonsillitis
Collection forming in peritonsillar space
Deviated uvula
Doesn’t respond to antibiotics

Question 12

Quinsy complications

Answer 12

Surgery to drain pus
Dehydration
difficulty swallowing
Large- close airway

Question 13

Nasal cavity borders

Answer 13

Floor- Hard palate (maxilla + palatine)
Posteriorly- Sphenoid
Roof- Frontal bone + ethmoid

Question 14

Nasal cavity function

Answer 14

Dual olfactory + respiratory organ
Warms + dehumidifies inspired air
Removes + traps pathogens
Drains paranasal sinuses + lacrimal ducts

Question 15

Nasal septum

Answer 15

Septal Cartilage anteriorly
Ethmoid on roof
Vomer below

Question 16

Conchae

Answer 16

Superior- derived from ethmoid
Middle- derived from ethmoid
Inferior

Question 17

Conchae function

Answer 17

Create turbulence in air flow- helps with dehumidifying + warming
Increases SA- more contact with cilia and mucus

Question 18

Olfactory nerve

Answer 18

Passes through cribiform plate

Question 19

Sinuses

Answer 19

4 pairs- frontal, ethmoid, sphenoid, maxillary
Drain into nasal cavity
Maximise SA- greater dehumidification + pathogen capture
Decreases density of skull

Question 20

Frontal sinus drainage

Answer 20

Into Frontonasal duct

–> Semilunar hiatus on lateral wall

Question 21

Ethmoid sinus drainage

Answer 21

Anterior- semilunar hiatus
Middle- ethmoid bulla
Posterior- superior meatus

Question 22

Sphenoid sinus drainage

Answer 22

Roof of nasal cavity

Question 23

Maxillary sinus drainage

Answer 23

Semilunar hiatus

Question 24

Pharynx function

Answer 24

Food propulsion

Airway protection

Question 25

Circular pharyngeal muscles

Answer 25

Used for food production | Superior, middle and inferior constrictor

Question 26

Longitudinal pharyngeal muscles

Answer 26

Protection of airway Change shape of pharynx + hold larynx up Elevate larynx during swallowing

Question 27

Pharyngeal muscles innervation

Answer 27

Vagus | Except for stylopharyngeus- glossopharyngeal

Question 28

Larynx

Answer 28

Phonation | Protection of lower airway

Question 29

Larynx blood supply

Answer 29

Superior laryngeal artery | Inferior laryngeal artery

Question 30

Epiglottis

Answer 30

Yellow elastic cartilage | Flatten down during swallowing posteriorly to close laryngeal inlet

Question 31

Thyroid

Answer 31

Open book shape | Forms laryngeal prominence anteriorly

Question 32

Cricoid

Answer 32

Encapsulates respiratory tract 360 degrees | Thicker posteriorly- narrower anteriorly

Question 33

Arytenoid

Answer 33

Involved in phonation + production of sound | Move vocal folds

Question 34

Sound

Answer 34

Oscillations of the air that form fine, high frequency vibrations that you can hear

Question 35

Vocal folds and vestibular folds

Answer 35

Avascular ligaments Covered in slippery mucous membrane Change shape- produce sound

Question 36

Rima glottidis

Answer 36

Gap between vocal folds | Change in shape causes sound

Question 37

Muscles involved in phonation

Answer 37

Arytenoid Crico-arytenoid Thyro-arytenoid Vocalis

Question 38

Muscles involved in pitch

Answer 38

Cricothyroid

Question 39

Produce sound when...

Answer 39

Rima glottides is narrow

Question 40

Superior laryngeal nerve

Answer 40

Above larynx innervation Becomes internal and external Internal- sensory aspect of larynx External- cricothyroid

Question 41

Recurrent laryngeal

Answer 41

Below larynx Inferior aspect of larynx All intrinsic muscles except cricothyroid --> all that control phonation but not pitch

Question 42

Extrinsic muscles

Answer 42

Suprahyoid | Infrahyoid

Question 43

Recurrent laryngeal palsy

Answer 43

Aphonia Partial- hoarse Stridor- inspiratory barking noises

Question 44

External laryngeal palsy

Answer 44

Weak voice that tires easily Monotonic low pitch Prevent tilting of vocal cords

Question 45

Subclavian Artery branches

Answer 45

Vertebral artery Internal thoracic Thyrocervical

Question 46

External carotid branches

Answer 46

``` Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Maxillary Superficial temporal ```

Question 47

Endotracheal intubation

Answer 47

Gold standard of ventilation Controls airway Plastic tube via mouth, past vocal cords into trachea

Question 48

Endotracheal intubation problems

Answer 48

Must go through vocal cords- problem with Anaesthetised patients Critically unwell Impending airway obstruction

Question 49

Cricothyroidotomy

Answer 49

Feel for cricothyroid ligament Make vertical incision from mid thyroid cartilage to superior aspect of cricoid cartilage Puncture through cricothyroid membrane with horizontal scalpel Insert airway