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Sem 4 > H&N 11: The Larynx > Flashcards

H&N 11: The Larynx Flashcards

1
Q

What are the functions of the larynx?

A

Involved in phonation, ventilation, cough reflex, protection of the lower respiratory tract, swallowing

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2
Q

Which ligament attaches the epiglottis to the thyroid cartilage posteriorly?

A

The thyroepiglottic ligament

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3
Q

How does the epiglottis move during swallowing?

A

Epiglottis is pulled down towards arytenoid cartilages to close off the larynx and prevent aspiration.
Food bolus is directed lateral to the epiglottis into the piriform fossa.

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4
Q

Where do the superior horn and inferior horn of the thyroid cartilage articulate to?

A

Superior horn articulates to hyoid bone

Inferior horn articulates to cricoid cartilage

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5
Q

What shape is the cricoid cartilage?

A

Signet ring shaped (narrow anteriorly and broad posteriorly)

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6
Q

At what spinal level is the inferior border of the larynx?

A

C6

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7
Q

What do the vocal cords attach to?

A

Attach to the inner surface of the thyroid cartilage anteriorly (fixed point), and arytenoids posteriorly (movable)

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8
Q

What muscles move the vocal cords?

A

The intrinsic laryngeal muscles (ABduct and ADduct)

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9
Q

What attaches to the arytenoids?

A

The vocal cords and internal laryngeal muscles

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10
Q

Which membranes are involved in the attachment of the thyroid cartilage superiorly and inferiorly?

A

Thyroid cartilage is attached to hyoid bone superiorly by thyrohyoid membrane
And attached to cricoid cartilage inferiorly by the cricothyroid membrane

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11
Q

What membrane is pierced in a cricothyrotomy?

A

The cricothyroid membrane
Emergency procedure so the patient can breathe if there is an obstruction at/ above the larynx and intubation is unsuccessful

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12
Q

What are the true and false vocal cords?

A

Vocal folds = true vocal cords

Vestibular folds = false vocal cords

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13
Q

How are the vocal cords positioned in respiration, phonation and during swallowing?

A

Respiration: ABducted
Phonation: partially ABducted
Swallowing: ADDucted

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14
Q

What is the innervation of the intrinsic muscles of the larynx?

A

All innervated with the inferior laryngeal nerve (branch of recurrent laryngeal nerve) EXCEPT cricothyroid
(Posterior cricothyroid is the only muscle to ABduct, all the the rest ADduct)

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15
Q

Where is the supraglottis?

A

From the inferior surface of the epiglottis to the false vocal cords

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16
Q

Where is the glottis?

A

The vocal cords and 1cm between them

Actual opening between the vocal cords is the rima glottidis

17
Q

Where is the subglottis?

A

From the lower border of the glottis to the inferior border of the cricoid cartilage

18
Q

What does the superior laryngeal nerve innervate?

A

Internal branch: sensory to the supraglottis

External branch: motor to the cricothyroid

19
Q

What does the recurrent laryngeal nerve innervate?

A

Sensory to the subglottis

Motor to all of the intrinsic muscles of the larynx except the cricothyroid

20
Q

What could cause a recurrent laryngeal nerve palsy?

A 
Apical lung cancer
Aortic aneurysm
Laryngeal cancer
Thyroid disease
Cervical lymphadenopathy 
Diabetes
During thyroid surgery
21
Q

How would a unilateral recurrent laryngeal nerve palsy present differently to a bilateral palsy?

A 
Unilateral = hoarseness of voice
Bilateral = no phonation and breathing impaired
22
Q

What are some symptoms of laryngeal cancer?

A 
Hoarseness of voice
Foreign body sensation in throat
Dysphagia
Odynophagia
Coughing
Weight loss
Otalgia (referred pain from vagus)
23
Q

What increases the risk of laryngeal cancer?

A

Smoking and alcohol

24
Q

Is laryngeal cancer more common in men or women?

A

5 x more common in men

25
Q

How does the prognosis of laryngeal cancer different depending on whether it affects the supraglottis, glottis or subglottis?

A

Supraglottis and glottis = good prognosis

Subglottis = poor prognosis

26
Q

Which muscle of the larynx is innervated by CN IX?

A

Stylopharyngeus

27
Q

The cricothyroid muscle is innervated by which nerve?

A

External laryngeal

External branch of superior laryngeal

28
Q

What is the vasculature of the larynx?

A

Superior laryngeal artery (branch of superior thyroid artery, from ECA)
And inferior laryngeal artery (branch of inferior thyroid artery, from thyrocervical trunk)

29
Q

Which is the only complete ring of cartilage of the larynx?

A

Cricoid

30
Q

What structure does the base of the arytenoid cartilages articulate with?

A

The superior aspect of the cricoid cartilage

31
Q

What is the space between the vocal folds known as?

A

Rima glottidis

32
Q

What is the epithelium of the vocal cords?

A

Non keratinised stratified squamous epithelium

Sem 4 (25 decks)

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