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c2 > clinical anatomy of the larynx > Flashcards

clinical anatomy of the larynx Flashcards

1
Q

what is the upper airway?

A

from the nasal cavity to the up to the larynx

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2
Q

what is the lower airway?

A

everything beyond the trachea

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3
Q

what are the 3 parts of the pharynx?

A

nasopharynx
oropharynx
laryngopharynx

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4
Q

what is the most superior part of the respiratory tract?

A

nasal cavity

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5
Q

what type of organ is the nasal cavity?

A

dual olfactory and respiratory organ

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6
Q

what are the functions of the nasal cavity?

A
  • Warms and humidifies inspired air
  • Removes and traps pathogens from inspired air
  • Sense of smell
  • Drains paranasal sinuses and lacrimal ducts
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7
Q

where does the nasal cavity extend?

A

nostril to nasopharynx

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8
Q

what are the 3 parts of the nasal cavity?

A
  • vestibule - area around the nostrils to the nasal cavity
  • respiratory region
  • olfactory region - found at the apex of the nasal cavity
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9
Q

what lines the respiratory region of the nasal cavity?

A

ciliated pseudostratified epithelium + goblet cells

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10
Q

what is the function of the respiratory region of the nasal cavity?

A

responsible for trapping pathogens and particulates within inspired air

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11
Q

what is the function of the olfactory region of the nasal cavity?

A

sense of smell

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12
Q

describe the innervation of the nose

A
  • olfactory region is lined by olfactory cells with olfactory receptors
  • olfactor nerves run through cribiform plate to provide special sensory innervation to the nose.
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13
Q

where is the oral cavity found?

A

spans between the oral fissure anteriorly and the opening of the oropharynx posteriorly

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14
Q

what are the 2 major divisions of the oral cavity?

A

vestibule

oral cavity proper

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15
Q

what is the vestibule of the oral cavity?

A

space between the lips/cheeks and the gums/teeth

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16
Q

where is the oral cavity proper? what are its borders?

A

Roof - anterior hard palate and posterior soft palate
Floor
Cheeks (buccinator muscle)

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17
Q

what separates the nasal cavity from the oral cavity?

A

hard palate

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18
Q

what covers the hard palate superiorly and inferiorly?

A

superiorly - pseudostratified columnar epithelium

inferiorly - oral mucosa (stratified squamous epithelium)

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19
Q

what is the soft palate?

A

muscular (not bony) continuation of the hard palate posteriorly

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20
Q

describe the structure of the cheeks

A

made up of the buccinator muscle

lined internally by the oral mucous membrane

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21
Q

what supplies the sensory innervation of the oral cavity?

A

branches of the trigeminal nerve

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22
Q

what are the functions of the oral cavity?

A

digestion
communication
breathing

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23
Q

what is the bony skeleton of the oral cavity made up of?

A

maxilla and mandible - house the upper and lower teeth

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24
Q

what is the pharynx?

A

Muscular tube connecting oral and nasal cavities to the trachea and oesophagus

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25
Q

what controls the shape of the pharynx and the propulsion of food into the oesophagus

A

controlled by 2 sets of pharyngeal muscles - circular and longitudinal

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26
Q

where is the nasopharynx?

A

found between the base of the skull and the soft palate.

continuous with the nasal cavity

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27
Q

what is the function of the nasopharynx?

A

respiratory function performed by conditioning inspired air and propagating it into the larynx

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28
Q

what lines the nasopharynx?

A

ciliated pseudostratified columnar epithelium with goblet cells

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29
Q

where is the oropharynx?

A

located between the soft palate and the superior border of the epiglottis

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30
Q

what structures does the oropharynx contain?

A
  • posterior 1/3 of the tongue
  • lingual tonsils
  • palatine tonsils
  • superior constrictor muscle
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31
Q

where is the laryngopharynx?

A

located between the epiglottis and the inferior border of the circoid cartilage (C6)
continues inferiorly with the oesophagus

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32
Q

how many cartilages is the larynx made of?

A

9

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33
Q

what spinal level is the larynx found at?

A

C3-C6

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34
Q

what does the larynx connect to superiorly and inferiorly?

A

hyoid bone superiorly

trachea inferiorly

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35
Q

what happens to the male larynx after puberty?

A

enlarges with the saggital diameter and nearly doubles

all the cartilages increase in both size and weight

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36
Q

what are the 3 unpaired cartilages of the larynx?

A

epiglottis
thyroid
cricoid

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37
Q

where are the 3 paired cartilages of the larynx?

A

arytenoid
corniculate
cuneiform

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38
Q

what spinal level is the hyoid at?

A

C3

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39
Q

what is the function of the intrinsic laryngeal muscles?

A

act to move the components of the larynx for phonation and breathing

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40
Q

what is the epiglottis?

A

a leaf shaped plate of elastic cartilage which marks the entrance to the larynx
made of yellow cartilage and never calcifies

41
Q

what is the function of the epiglottis?

A

During swallowing, the epiglottis flattens and moves posteriorly to close off the laryngeal inlet and prevent aspiration of food. Closes as a valve and forces food down the lateral food canals

42
Q

what is the thyroid cartilage and where is it found?

A

lies just beneath the hyoid bone

composed of 2 sheets (laminae) which fuse anteriorly to form the laryngeal prominence

43
Q

what does the lateral thyrohyoid ligament connect?

A

connects the superior horns of the thyroid cartilage to the hyoid bone

44
Q

what do the inferior horns of the thyroid cartilage articulate with?

A

cricoid cartilage

45
Q

what is the only complete circle of cartilage in the larynx or trachea?

A

cricoid cartilage

46
Q

what does the cricoid cartilage connect with?

A

superiorly - inferior horns of the thyroid cartilage
posteriorly - 2 arytenoid cartilages by synovial joints
inferiorly - trachea

47
Q

how does the cricoid cartilage attach to the trachea?

A

cricotracheal ligament

48
Q

what are the largest of the paired cartilages?

A

arytenoids

49
Q

what is the vocal process?

A

the anterior point of the aytenoids

50
Q

describe the arrangement of the paired cartilages

A

corniculate cartilages sit atop the arytenoids

cuneiform are above the corniculate located within the ary-epiglottic folds

51
Q

what is the function of the extrinsic ligaments of the larynx?

A

act to attach the components of the larynx to external structures (such as the hyoid and the cricoid cartilage

52
Q

what is the thryohyoid membrane? what structures pass through it?

A

between the thyroid and hyoid bone

pierced laterally by the superior laryngeal vessels and internal laryngeal nerve

53
Q

what forms the vocal folds?

A

cricothyroid ligament with the overlying epithelium

54
Q

where is the quadrangular membrane?

A

act to attach the components of the larynx to external structures (such as the hyoid and the cricoid cartilage).

55
Q

what are the 3 regions of the larynx?

A

vestibule - laryngeal opening to the vestibular folds
ventricle - between the vestibular and vocal folds
infraglottis area - below the vocal folds, continuous with the trachea

56
Q

what covers the vocal and vestibular folds where they connect? why is this important?

A

covered by non-keratinized, stratified squamous epithelium

protects the tissue from the effects of the considerable mechanical stresses that act on the surfaces of the vocal folds

57
Q

what gives the vocal folds shape?

A

vocal ligaments

58
Q

what is the rima glottidis?

A

space between the vocal folds

59
Q

what gives the vestibular fold shape?

A

the quadrangular membrane

60
Q

what are the false cords?

A

free edge above the vocal cords

the vestibular ligament which is the inferior border of the quadrangular membrane

61
Q

what are the functions of the larynx?

A
  • protection of the airway
  • effort closure in coughing, sneezing and abdominal straining
  • phonation
62
Q

what is the rate of flow in a tube proportional to?

A

the radius of the tube to the power of 4

63
Q

what is stridor?

A

high pitched whistling breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree

64
Q

what is stridor a sign of?

A

narrowed or obstructed airway

65
Q

during breathing which way is the epiglottis pointed?

A

upward during breathing

66
Q

how does the larynx deflect food boluses into the oesophagus away from the larynx?

A
  • elevation of the hyoid bone pulls the larynx upwards
  • contraction of the aryepiglotticus muscle causes epiglottis to flatten into a more horizontal position and into contact with arytenoid cartilage
  • closes laryngeal inlet
67
Q

what are the phases of the cough reflex and what happens during them?

A

1) Inspiratory – generates intrathoracic volume
2) Compression – concomitant closure of the vocal cords with contraction of muscles of the chest and abdominal wall causes a rapid rise in intrathoracic and intra-abdominal pressure
3) Expiratory phase – the glottis opens with explosive airflow

68
Q

what is the function of coughing?

A

dislodges mucus, fluids, irritants from the airway

69
Q

what is the function of sneezing?

A

expels mucus from the nasal cavity

70
Q

how does vomiting occur?

A

intra-abdominal pressure and relaxation of oesophageal sphincters allows expulsion of vomitus

71
Q

how does defecating occur?

A

intraabdominal pressure and relaxation of anal sphincters allows expulsion of faeces

72
Q

what do the intrinsic laryngeal muscles control?

A

the shape of the rima glottidis by acting on the arytenoid cartilage to adduct or abduct the vocal cords
the length and tension of the vocal folds to alter pitch

73
Q

what is the function of the lateral cricoarytenoid muscles?

A

major adductors of the vocal folds

narrows the rima glottidis, modulating the tone and volume of speech

74
Q

what are the attachments of the lateral cricoarytenoids?

A

Originates from the arch of the cricoid cartilage, and attaches to the muscularprocess of the arytenoid cartilage.

75
Q

what is the innervation of the lateral cricoarytenoids?

A

inferior laryngeal nerve (branch of the recurrent laryngeal)

76
Q

what is the function of the transverse and oblique arytenoids?

A

adduct the arytenoid cartilages, closing the posterior portion of rima glottidis. This narrows the laryngeal inlet

77
Q

what are the attachments of the transverse and oblique arytenoids?

A

Spans from one arytenoid cartilage to the opposite arytenoid

78
Q

what is the innveration of the transverse and oblique arytenoids?

A

inferior laryngeal nerve

79
Q

how can pitch be altered?

A

by changing the tension of the vocal folds
allows rotation to bring together or approximate the lamina of the thyroid cartilage and the arch of the cricoid cartilage
alters length and tension of the vocal cords

80
Q

what do the thyroarytenoids do?

A

acts to relax the vocal ligament, allowing for a softer voice

81
Q

what are the attachments of the thyroarytenoids?

A

Originates from the inferoposterior aspect of the angle of the thyroid cartilage, and attaches to the anterolateral part of the arytenoid cartilage

82
Q

what is the innervation of the thyroarytenoid muscles?

A

inferior laryngeal nerve

83
Q

what are the branches of the superior laryngeal nerves>

A

internal and external laryngeal nerve

84
Q

what does the internal laryngeal nerve do?

A

sensory innervation to above the vocal cords

85
Q

what does the external laryngeal nerve do?

A

motor to cricothyroid muscle

controls pitch

86
Q

what does the recurrent laryngeal nerve do?

A

Motor to all intrinsic muscles EXCEPT cricothyroid
Sensory innervation to area below vocal cords
PHONATION

87
Q

what does a lesion to the recurrent laryngeal nerve cause?

A

vocal cord paralysis (inability to abduct laterally)

hoarseness (aphonia and stridor)

88
Q

what does a lesion to the external laryngeal nerve cause?

A
  • cricothyroid paralysis preventing higher pitched phonation

- weak voice, low pitch, easily tires, reduced range

89
Q

what is the superior laryngeal artery a branch of?

A

superior thyroid artery

branch of the external carotid artery

90
Q

what does the superior laryngeal artery supply blood to?

A

supplies blood to the muscles, mucous membrane, and glands of the larynx,

91
Q

what is the inferior laryngeal artery a branch of?

A

inferior thyroid artery

derived from the thyrocervical trunk

92
Q

describe the venous drainage of the larynx

A
  • Superior thyroid vein drains above the glottis into the internal jugular
  • Inferior thyroid vein drains below the glottis into the brachiocephalic vein
93
Q

describe the lymphatic drainage of the larynx superior and inferior to the glottis

A

Superior to the glottis: via superior deep cervical lymph nodes
Inferior to the glottis: via inferior deep cervical lymph nodes

94
Q

what is a laryngocoele

A

a herniation of the saccular mucosa

95
Q

what are symptoms of a laryngocoeal?

A

hoarseness, stridor and dysphagia.

96
Q

how does endotracheal intubation occur?

A

they have to carefully thread their tube around the epiglottis and down the cords, avoiding the oesophagus

97
Q

what is the cricoid pressure?

A

cricoid pressure refers to digital pressure against the cricoid cartilage of the larynx, pushing it backwards with the intention of oesophageal compression against the vertebrae and prevention of passive regurgitation of gastric and oesophageal contents

98
Q

why is the cricoid cartilage used to compress the oesophagus?

A

bc its the only complete ring shaped cartilage in the respiratory tract

c2 (37 decks)

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