Clinical Anatomy of the Larynx

Question 1

the larynx is enclosed in which group of fascia in the neck?

Answer 1

the pretracheal fasica

Question 2

what other structures are also enclosed by the pretracheal fascia (excluding larynx)

Answer 2

• the strap muscles
• thyroid gland
• trachea
• oesophagus and pharynx
• recurrent laryngeal nerves

Question 3

what are the 2 layers of the pretracheal fascia?

Answer 3

the visceral layer and the muscular layer

Question 4

where does the thin muscular layer of the pretracheal layer lie in relation to the visceral layer?

Answer 4

the muscular layer lies anterior to the visceral layer

Question 5

functions on the strap muscles?

Answer 5

• move hyoid and larynx

- also act as accessory muscles of breathing as they attach to the sternum

Question 6

in which layer of the pretracheal fascia is the larynx found in?

Answer 6

the visceral layer

Question 7

what vertebral level is the larynx at?

Answer 7

between C4 and C6

Question 8

at what vertebral level is the hyoid bone found?

Answer 8

C3

Question 9

at what vertebral level is the cricoid cartilage found?

Answer 9

about C6

Question 10

what is on the lateral wall of the nasal cavities that makes it ‘featured’?

Answer 10

conchae

Question 11

what is the skeleton of the larynx composed of?

Answer 11

cartilage

Question 12

where are the cartilages that make up the larynx suspended from?

Answer 12

hyoid bone

Question 13

what are the functions of the larynx?

Answer 13

• cartilage maintaining patency of URT
• helps prevent entry of foreign bodies into LRT
• produce sound - vocal cords

Question 14

what type of cartilage makes up the larynx?

Answer 14

all hyaline cartilage apart from the epiglottitis which is elastic

Question 15

what does the laryngeal prominence give rise to?

Answer 15

Adams apple in males

Question 16

what is the only laryngeal cartilage that makes a complete ring around the larynx?

Answer 16

the cricoid cartilage

Question 17

what completes the ring of the C shaped cartilage around the trachea?

Answer 17

trachealis (smooth muscle)

Question 18

what type of joint is the cricothyroid joint and what is its function?

Answer 18

• synovial

- allows ‘nodding’ (A-P) movement between the thryoid and cricoid cartilages

Question 19

where are the arytenoid cartilages?

Answer 19

posterior surface of the larynx just inferior to laryngeal inlet

Question 20

what are the 2 different processes of an arytenoid cartilage?

Answer 20

anterior process- the vocal proces

posterior process- the muscular process

Question 21

what attaches at the anterior process of the arytenoid cartilage?

Answer 21

the vocal cords

Question 22

what attaches to the posterior processes of the arytenoid cartilage?

Answer 22

muscles

Question 23

what part of the cricoid cartilage is the lamina?

Answer 23

the posterior flat surface of the cricoid cartilage

Question 24

why can cricoid pressure be applied when someone is being ventilated?

Answer 24

the lamina of the cricoid cartilage compresses the oesophagus and prevents regurgitation/aspiration

Question 25

what do the vocal cords attach between?

Answer 25

the internal aspect of the thyroid cartilage anteriorly and the vocal processes of arytenoid cartilages posteriorly

Question 26

what is the rima glottidis?

Answer 26

the space between the vocal vords where air moves through

Question 27

what is the space between the tongue and the epiglottis called?

Answer 27

vallecula

Question 28

what lines the vocal cords?

Answer 28

statified squamous epithelium

Question 29

what epithelium lines the inside of the larynx?

Answer 29

respiratory epithelium

Question 30

what is another name for the 'false vocal cords'?

Answer 30

vestibular folds

Question 31

where are the false vocal cords in relation to the true vocal cords?

Answer 31

false vocal cords are superior to the true vocal cords

Question 32

generally, what is the sensory innervation to all of the laryngeal mucosa?

Answer 32

the vagus nerve

Question 33

which branch of the vagus nerve supplies superior to the vocal cords?

Answer 33

superior laryngeal branches of vagus

Question 34

what nerve supplies the vocal cords and inferior?

Answer 34

recurrent laryngeal branches of vagus

Question 35

what branch of vagus is the reccurent laryngeal a continuation of?

Answer 35

inferior laryngeal branch

Question 36

what type of muscles are the intrinsic muscles of the larynx?

Answer 36

all skeletal muscles

Question 37

functions of the intrinsic muscles of the larynx?

Answer 37

``` move the cartilages which moves the vocal cords - tensors -relaxers -adductors -abductors of the vocal cords ```

Question 38

what nerve(s) provide motor innervation to the intrinsic muscles of the larynx?

Answer 38

all supplied by the vagus nerve

Question 39

what do all the intrinsic muscles act to do during the cough reflex?

Answer 39

adduct the vocal cords and close the rima glottitus.

Question 40

what affect do the cricothyroid muscles have on the vocal cords?

Answer 40

tense the vocal cords

Question 41

which muscles are responsible for the 'nodding' of the thyroid cartilage anteriorly at cricothyroid joints?

Answer 41

cricothyroid muscles

Question 42

if the vocal cords are tensed, what pitch does this give?

Answer 42

high pitch

Question 43

function of the thyro-arytenoid muscles?

Answer 43

relax the vocal cords, pull the arytenoid cartilages towards the thyroid cartilage

Question 44

what muscles adduct the vocal cords? and how do they do this?

Answer 44

- lateral crico-arytenoid muscles and the arytenoid muscles | - rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline

Question 45

function of the posterior crico-arytenoid muscles?

Answer 45

abduct the vocal cords

Question 46

how do the posterior crico-arytenoid muscles abduct the vocal cords?

Answer 46

rotate the arytenoid cartilages so that the vocal processes of the cartilages move laterally

Question 47

in normal respiration what state are the laryngeal muscles in?

Answer 47

relaxed

Question 48

during forced respiration what intrinsic laryngeal muscles contract?

Answer 48

posterior crico-arytenoids contract to abduct vocal cords

Question 49

during phonation what muscles contract?

Answer 49

- arytenoids contract | - assist lateral crico-arytenoids

Question 50

what nerve controls the tensing of the soft palate?

Answer 50

CN V3

Question 51

what nerve elevates soft palate?

Answer 51

vagus

Question 52

what sounds can we make through nasal sounds?

Answer 52

- m - n - ing

Question 53

what 3 things can you ask patient to do to test the function og the vagus nerve suppling the palate, pharynx and larynx?

Answer 53

- ask patient to swallow small sip of water - listen to patient speak (are the horse?) - ask patient to cough