Clinical Anatomy of the Larynx Flashcards
What structures are enclosed within the pre tracheal fascia of the neck
Strap muscles thyroid gland trachea and larynx oesophagus and pharynx recurrent laryngeal nerves
Describe the location of the larynx
Anterior to the laryngopharynx
Between C4-C6 vertebral levels
Where is the cricoid cartilage
C6
Where is the superior border of the thyroid cartilage
C4/5
What are the palpable structures i the neck
External occipital protuberance mastoid process transverse processes of cervical vertebrae spinous process of C7 spinous process of T1 clavicle Trachea manubrium of the sternum cricoid cartilage thyroid cartilage hyoid bone mental process of the mandible lower border of the mandible angle of the mandible
What is the main function of the larynx
To maintain the potency of URT
To help prevent entry of foreign bodies into the LRT
What else helps to prevent the entry of foreign bodies into the LRT
vocal cords and cough reflex
produce sound
vocal cords
What type of cartilage is the epiglottis made from
Elastic
What cartilage is the only one to create an entire ring around the larynx
Cricoid
Where is the best place for access for intubation etc. in the larynx
Cricothyroid membrane
What muscle completes the posterior wall of the trachea
Trachealis
What allows us to nod
The capsule of the cricothyroid joint (synovial) - AP movement between the thyroid and cricoid cartilage
What type of muscle covers the cartilage of the trachea
Smooth muscle
Where do your vocal cords attach to
The vocal process of the arytenoid cartilage at the back and the internal aspect of the thyroid cartilage anteriorly
What 5 things does adding pressure to the cricoid cartilage allow
Lamina of the cricoid cartilage compresses the oesophagus
presses it against the C6 vertebral body
Oesophagus is closed but the larynx / airway is open
Prevents regurgitation / aspiration
Allows ventilation
What cartilages are located deep to the laryngeal mucosa
Cuneiform and cornilate cartilages
What does endotracheal intubation involve
Placing a breathing tube inside the trachea through the mouth / nasal cavity oropharynx / nasopharynx laryngeal inlet rima glottidis of the larynx trachea
Why would you not insert an ET tube into a main bronchus
If you did, only 1 lung would inflate and the other would collapse
What is the vallecula
The space between the tongue and the epiglottis
A laryngoscope blade is inserted into here
What is the mucosal lining of inside the larynx mainly made of
Respiratory epithelium
What are exceptions to the respiratory epithelium in the larynx
Vocal cords: Stratified squamous epithelium
Describe how the mucociliary escalator works
The mucous glands secrete mucous onto the epithelial surface
Cilia beat to sweep the mucous (and any foreign bodies stuck in the mucous superiorly, towards the pharynx to be swallowed
What is the nerve of the larynx
Vagus
What divides the larynx
The vocal cords
What is another term for the false vocal cords
Vestibular folds
What is another term for the true vocal cords
Vocal folds
What nerve supplies superior to the vocal cord
Superior laryngeal branch of CN X
What nerve supplies the vocal fold and inferior
Recurrent laryngeal branches of CN X
Describe the path that the vagus nerve takes to the larynx
It passes through the jugular foramen, descends through the neck within the carotid sheath
It then gives off the recruit laryngeal nerve in the mediastinum
What type of muscle are all of the intrinsic muscles of the larynx
Skeletal - they attach between the cartilage and move them
What are the muscles that move the cartilage
Tensors
Relaxers
adductors
abductors
All of the vocal cords
What is the function of the cricothyroid muscles
Tense the vocal cords
Where do the cricothyroid muscles attach
Between the cricoid cartilage and the thyroid cartilage
What happens if you really tense the cricothyroid muscles
You get a very high pitched voice
What is the function of the there-arytenoid muscles
Relax the vocal cords
pull the arytenoid cartilage towards the thyroid cartilage
What is the function of the lateral crico-arytenoid muscles
To adduct the vocal cords
Rotate the arytenoid cartilages so that the vocal processes of the cartilage come together in the midline
What are the 3 sounds that are nasal sounds
m
n
ing
